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Z MD 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what is diffuse erythrodermic eczema

A

severe eczema >90% BSA

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2
Q

what are the 3 aspects of bacterial endocarditis that cause cutaneous symptoms and what are they

A

vasculitis - infarcts, Osler’s nodes

emboli - splinter haemorrhages, infarcts, Janeway lesions

coagulopathy - purpura (clubbing)

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3
Q

what is DRESS

A

drug reaction with eosinophilia and systemic involvement causing fever, rash and internal organ involvement

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4
Q

what two common cardio-respiratory conditions have obvious cutaneous signs

A

subacute bacterial endocarditis

sarcoidosis

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5
Q

prodrome of SJS/TEN

A

malaise, fever, headache, myalgia, pharyngitis and eye discomfort 1-3 weeks after drug exposure

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6
Q

what is the medical emergency associated with psoriasis and what does it cause

A

generalised pustular psoriasis - leads to loss of barrier function, thermoregulation and protein loss - risk of pre-renal impairment, high output cardiac failure, sepsis

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7
Q

what is a plaque

A

circumscribed elevated area of skin - broadness is greater than thickness

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8
Q

what is lichenification

A

thickening of areas of skin as a result of chronic rubbing scratching

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9
Q

what is the systemic retinoid that can be given for severe acne and how does it work

A

isotretinoin = roacutane - comedolytic - reduces sebaceous gland activity

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10
Q

what are the early stages of SCC

A

actinic keratosis

SCC in situ (Bowen’s disease)

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11
Q

treatment of post-strep guttate sporiasis

A

phototherapy

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12
Q

what are the subtypes of BCC

A

nodular BCC

superficial BCC

infiltrative BCC

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13
Q

treatment of atopic eczema

A

avoid soap

regular emollient

warm, not hot, showers

topical steroid to inflamed area

mild steroid/non inflammatory for face

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14
Q

how do you confirm diagnosis of scabies

A

scraping of burrow and examination under light microscopy

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15
Q

what is the association between strep and psoriasis

A

can get post-streptococcal guttate psoriasis - occurs 1-2 weeks after Strep URTI - get Sudden generalised onset of small plaque psoriasis

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16
Q

signs of melanoma

A

asymmetry border

irregularity

colour variegation

diameter (>5mm)

evolution

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17
Q

prodrome of DRESS

A

fever, malaise, pharyngitis

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18
Q

what causes perioral/periorifical dermatitis

A

due to misuse of potent topical steroids on face

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19
Q

typical age of onset of psoriasis

A

20s and 50s

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20
Q

what is an open and closed comedone

A

open = blackhead

closed = whitehead

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21
Q

what are lentigines

A

sun-induced pigmented macules (in middle-aged people)

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22
Q

which medications can cause acne

A

lithium

anabolic steroids

topical corticosteroids

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23
Q

subtypes of melanoma

A

superficial spreading melanoma

lentigo maligna

acral lentiginous melanoma

nodular melanoma

desmoplastic

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24
Q

2 major modalities of therapy for stage 4 metastatic melanoma

A

molecular targeted therapy (MAP kinase inhibitors)

immunotherapy

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25
Q

characteristic signs of SCC

A
  • at sun exposed sites (scalp, hands, forearms, neck, ears)
  • scaly nodule which tends to be tender on palpation
  • sometimes with a cutaneous horn
  • skin freely movable over the underlying tissue
  • rapid growth
  • may bleed easily or ulcerate
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26
Q

What is the difference between actinic keratoses and Bowen’s disease

A

AK - dysmorphic cells only in the basal layer of the epidermis Bowen’s - dysmorphic cells are the whole thickness of the epidermis

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27
Q

long term complications of SJS/TEN

A

scarring and strictures

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28
Q

what are the complications of eczema

A

bacterial superinfection

eczema herpeticum (secondary infection with HSV - emergency)

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29
Q

what is the difference in the associations between xanthelasma and eruptive xanthomas

A

xanthelasma - hypercholesterolaemia

eruptive xanthomas - hypertriglyceridaemia (significant risk of pancreatitis)

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30
Q

treatment of impetigo

A

anti-staph antibiotics (flucloxacillin, cephalexin)

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31
Q

characteristic signs of BCC

A
  • pearly nodule with central ulceration
  • telangiectasia across the lesion
  • in sun exposed areas
  • bleeding (in nodular BCC)
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32
Q

what does the rash look like in impetigo

A

rash of blistering and crusting

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33
Q

main cutaneous manifestation of sarcoidosis

A

erythema nodosum over the dorsum of the legs

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34
Q

short term complications of SJS/TEN

A

hypovolaemia

metabolic abnormalities

secondary bacterial infection

DEATH

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35
Q

which type of melanoma has the best prognosis

A

lentigo maligna - slow growing

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36
Q

mainstay treatment of SCC

A

complete surgical excision with clear margins +/- adjuvant chemotherapy in high risk lesions

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37
Q

what are the treatments of psoriasis

A

topical phototherapy

systemic immunosuppression if severe

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38
Q

clinical features of eczema

A

very itchy, erthematous, diffuse rash on the FLEXORS worse in winter and summer

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39
Q

which type of melanoma has the worst prognosis

A

nodular melanoma - does not fulfill the ABDC criteria, rapid growth and early invasion elevated, firm, growing

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40
Q

What type of “nails” are associated with chronic liver disease

A

terry’s nails - white proximal and red distally - thought to be due to hyperalbuminaemia (leuconichia)

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41
Q

what is the difference between primary and secondary erythroderma

A

primary - extends within a few days from the trunk to involve whole skin surface –> scaling

secondary - generalisation of a preceding localised skin disease

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42
Q

what is the difference between a macule, papule and a nodule

A

macule = flat area of altered skin colour, impalpable

papule = elevated palpable lesion 1cm

nodule = elevated papule more than 5mm

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43
Q

what is the difference between palpable and non-palpable purpura

A

non-palpable = coagulopathy

palpable = vasculitis

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44
Q

what causes cradle cap

A

seborrhoeic dermatitis

45
Q

where is the typical reservoir for ringworm infection

A

nails!

46
Q

what does erythema mean

A

redness of skin due to vasodilation

47
Q

what does confluent distribution mean

A

widespread

48
Q

what is the difference between a benign junctional naeus and a benign compound naevus

A

BJN - naevus that appears during childhood where the naevus cells are located at the epidermal side of the dermal-epidermal junction BCN - neaves cells are both in the epidermis and dermis

49
Q

clinical features of scabies

A
  • intensely itchy rash, often starting on hands, interdigital spaces and feet
  • itch its worse at night
  • spares face and head in adults
50
Q

where are the places that psoriasis likes to be

A

scalp

ears

palmar-plantar nails

51
Q

what causees vitiligo

A

autoimmune destruction of melanocytes

52
Q

what is cephalocaudal

A

spread from trunk to limbs

53
Q

what is the fancy word for severe cystic acne

A

acne conglobata

54
Q

which ABs can be given for acne

A

those affective against GNs eg doxycycline or erythomycin

55
Q

what is the difference between a vesicle, bullae and pustule

A

vesicle = a fluid filled blister

bullae = a fluid filled blister that is >5mm

pustule = pus filled blister

56
Q

which skin infections can be caused by staph aureus

A

folliculitis

impetigo

57
Q

what is purpura

A

discolouration of skin or mucous membranes due to bleeding from small vessels - non blanching

58
Q

treatment of scabies

A
  • topical 5% permethrin cream
  • apply cream all over from neck down and leave overnight and wash off in the morning
  • treat clothing with hot wash and tumble dry
  • treat all close contacts
  • index case retreated after one week
59
Q

2 components to rosacea

A

vascular reactivity - redness, flushing

inflammatory rosacea - papules, pustules

Can occur at the same time or in isolation

60
Q

what is sclerosis

A

hardening of the subcutaneous tissue

61
Q

what type of rash is associated with dermatomyositis

A

heliotrope rash (purplish hue that affects the upper eyelid skin) often with some periorbital oedema

62
Q

What does CREST stand for

A

Calcinosis

Raynaud’s

Oesophagea dysmotility

Sclerodactyly

Telangiectasia

63
Q

how do we diagnose melanoma

A

excision biospy –> histology

64
Q

typical rash of psoriasis

A

well demarcated plaques on extensor surfaces, very erythematous, scaly +++ symmetrical silvery scale

65
Q

typical regions of ringworm infection

A

skin nails hair

66
Q

what is the difference between SJS and TEN

A

SJS = involves 30%

TEN - more than 30%

67
Q

what is cellulitis caused by

A

strep (group A)

68
Q

SEs of isotretinoin

A

teratogenic ++

dryness

photosensitivity

?depression

69
Q

How is T staging of melanoma done

A

Breslow thickness (1-4) + ulceration (A or B)

70
Q

what is petechiae

A

pinpoint bleeding into skin or mucosae - does not blanch

71
Q

what is pyoderma gangrenosum and what are they associated with

A

non-infective inflammatory ulceration of the skin

  • CTD
  • malignancy
  • IBD
72
Q

what is the treatment for actinic keratoses

A

cryotherapy

Topical cream

surgical excision for lesions that are resistant to treatment or suspicious for SCC development

73
Q

treatment of HSV1

A

topical or systemic acyclovir or other antiviral

74
Q

treatment of molluscum

A

shower rather than baths restrict sharing of baths and towels topical irritants topical immunostimulants (will go away by themselves)

75
Q

what is the proportion of the different types of skin cancers

A

2/3 BCC

1/3 SCC

2% melanoma

76
Q

what is a wheal

A

area of localised oedema of skin

77
Q

mainstay treatment for BCC

A

nodular or infiltrating - surgical excision with clear margins

superficial - surgical excision/serial curettage/topical imiquimod/photodynamic therapy

78
Q

what is erythroderma

A

description - someone who is red all over (involving more than 90% of skin surface)

79
Q

what are half and half nails

A

white proximal and brown distally

80
Q

what causes livedo reticularis

A

medium vessel vasculopathy

81
Q

treatment of ringworm

A

topical - imidazole

extensive infection/tinea in the nails/tinea on the scalp = oral anti-fungals

82
Q

atopic triad

A

asthma

hayfever

eczema

83
Q

cutaneous manifestation of Addison’s

A

hyperpigmentation in unusual areas - such as mucosa and palms/creases, nails

84
Q

what are the margins of local excision for melanoma

A

melanoma in situ = 0.5cm

less than 1mm = 1cm

between 1-2mm = 1-2cm

more than 2mm = 2cm

85
Q

what is the complication of herpes infection

A

get eczema infection on top = eczema herpeticum - MEDICAL EMERGENCY –> opthalmic herpes –> corneal scarring - blindess

86
Q

where are melanocytes normally located

A

at the epidermal-dermal junction

87
Q

what are the long term complications of rosacea

A

vascular dilatation - redness, telangiectasia

tissue hypertrophy - rhinophyma

88
Q

what is a scale

A

abnormal accumulation of keratin

89
Q

what is telangiectasia

A

dilated blood vessels

90
Q

what causes freckles

A

sun induced increase in melanin (not melanocytes)

91
Q

what is a crust

A

dried exudate from an erosion or ulcer

92
Q

typical rash of ringworm

A

itchy, spreading, gradually enlarging, central clearing rash with scaly edge

93
Q

what is actinic keratoses (sun spots)

A

precursor to SCC - erythematous scaly lesions, not indurated or tender - uneven skin colour

94
Q

what is breslow thickness

A

how deep the melanoma goes down into the skin

95
Q

what are the other causes of erythema nodosum other than sarcoidosis

A

infection

IBD

pregnancy

96
Q

what is the biggest indicator for outcome in melanoma

A

sentinal lymph node positive or negative

97
Q

which mutation is associated with eczema and how does it lead to eczema

A

filaggrin - causes reduced barrier function so irritants easier to penetrate -> inflammation

98
Q

diagnosis of ringworm

A

scraping –> fungal microscopy and culture

99
Q

what is the hallmark of SJS/TEN

A

extensive keratinocyte cell death leading to separation of skin at the dermo-epidermal junction

100
Q

treatment of Bowen’s disease

A

topical cream

surgical excision for suspicious lesions

101
Q

what are the 4 components of acne

A

abnormal keratinization of sebaceous duct

colonization with bacteria

increase in androgen levels –> increased sebum inflammation

102
Q

what is the timing typical of a drug induced erythroderma

A

started the drug 3-4 weeks ago

103
Q

what is a complication of shingles

A

post-herpetic neuralgia

104
Q

what are osler’s nodes and Janeway lesions

A

Osler’s nodes - TENDER erythematous nodules on pads of fingers and toes with a pale centre

Janeway lesions - NON-TENDER haemorrhagic nodules palms and soles

105
Q

BCC, SCC and melanoma arise from

A

BCC - basal cells of the epidermis

SCC - keratinocytes

melanoma - melanocytes

106
Q

treatment of HSV2

A

systemic antiviral treatment may need prophylactic antiviral treatment

107
Q

what is the pururitus screen

A

FBE - anaemia

EUC

LFTs - cholestasis

Iron studies - iron deficiency anaemia

thyroid function tests - hyper/hypothyroidism

CXR - lymphoma

108
Q

what causes seborrhoeic dermatitis

A

inflammatory skin reaction to colonization with skin yeast pityrosporum

109
Q

rosacea management

A
  • avoid triggers
  • vascular laser (for vascular rosacea)
  • topical metronidazole gel, topical azaleic acid, systemic ABs, systemic isotretinoin (inflammatory rosacea)
  • ablative laser or surgery (rhinophyma)

Z MD 2 (15 decks)

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