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Revision Qs > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Common benign markers of photodamage to skin?

A

Wrinkles
Telangiectasias
Lentigines
Mottled pigmentation

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2
Q

3 pre-malignant UV induced skin lesions?

A

Cutaneous horns
Solar/actinic keratosis (firm rough scaly papules)
Bowens disease (red scaly plaque on female leg)

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3
Q

Which skin types are at increased risk of skin cancer?

A

I and II - increased likelihood of burning

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4
Q

What is a macule?

A

Flat discoloured lesion less than half a cm

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5
Q

What is a patch?

A

A flat lesion >5mm e.g. Neurofibromatosis, morphoea

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6
Q

What is a papule?

A

Raised lesion less than half a cm

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7
Q

Example of a condition where papules, vesicles, pustules and nodules are all seen alongside each other (along with commedones)?

A

Acne

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8
Q

What is a plaque?

A

Raised but flattened lesion >5mm e.g. Psoriasis

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9
Q

What are nodules?

A

Raised lesions >5mm inclu most skin cancers

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10
Q

What is a vesicle?

A

Fluid filled papule e.g. Chickenpox, herpes

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11
Q

What is a pustule?

A

An infected vesicle e.g. Acne, chicken pox

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12
Q

What is a bulla/blister?

A

Raised, fluid filled lesion >5mm

Only bullous infection is bullous impetigo

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13
Q

What is a wheal?

A

Classical of urticaria, hives - transient, itchy lesions that look circular

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14
Q

Example of condition that can give you sterile pustules and nail changes?

A

Palmar plantar (pustular) psoriasis

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15
Q

3 nail changes associated with psoriasis?

A

Onykolysis
Subungual hyperkeratosis
Pitting

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16
Q

What is crusting?

A

Dried exudate e.g. From pustules, vesicles, bullae

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17
Q

What is scaling?

A

Keratinisation, typical of psoriasis

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18
Q

What is maceration?

A

Typical of e.g. Athletes foot, fungal infections - fluid destroying surrounding skin

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19
Q

2 things that target lesion is typical of?

A

Single lesion = Lyme disease

Multiple = erythema multiforme (drug reaction)

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20
Q

What is the difference in appearance between ‘classic’ acne and steroid induced acne?

A

Steroid induced acne does not feature commedones, just papules vesicles pustules and nodules

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21
Q

What is erythroderma? 2 common causes?

A

Red, shedding skin typically all over body

Either drug reaction or lymphoma

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22
Q

What is eczema herpeticum?

A

Herpes infection in pre-existing eczema potentially causing sepsis, eye damage

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23
Q

ABCDE of describing malignant melanoma?

A 
Asymmetry
Border (irregular)
Colour (change or multiple different colours)
Diameter (>6-7mm)
Elevation, extra Sx and extra lesions
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24
Q

RFs for BCC?

A 
Acute sunburn as child
Skin types I and II
Sunbed use
Immunosuppression
Old age
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25
Q

Describe a BCC?

A

Pearly papule with raised, rolled edges and importantly telangiectasias typically on the face
Eroded centre, can become rodent ulcer
Slow growing, months-years

26
Q

Management of BCC?

A

Typically Mohs micrography excision

Can use cryotherapy, cautery etc.

27
Q

RFs for SCC?

A 
Chronic, accumulative UV exposure/sunburn incl pUVA Rx for psoriasis
Skin types I, II
Immunosuppression
Old age
Chronic skin damage, ulceration
NER defect (xeroderma pigmentosa)
28
Q

Describe an SCC?

A

Keratinising nodule - rapidly growing, scaly, red mess often painful and firm
Rapidly growing

29
Q

Management of SCCs?

A

Surgical excision with fairly wide margins

30
Q

RFs for malignant melanoma?

A

Prev malignant melanoma
Moley person
Acute sunburn
FH

31
Q

Risk associated with malignant melanoma - how is this quantified histologically? Management?

A

Higher risk of metastasis based on Breslow thickness

Surgical removal, wide margin excision

32
Q

Ddx for malignant melanoma which doesn’t change or evolve rapidly, is less pigmented?

A

Seborrhoeic wart

33
Q

How can skin mets of malignant melanoma present?

A

Bluey-purple lesions ddx angioma

34
Q

What is lentigo maligna?

A

Precancerous, irregular macule on face of elderly person

35
Q

Methods of minimising UV exposure?

A

Avoidance of sun especially between 11-3pm
Avoid sun beds
Clothing - good covering, good type of fabric
Suncreams, high uv factor, good thickness every 2 hours

36
Q

What is eczema?

A

Chronic inflammatory disorder affecting epidermis and dermis, usually with background of atopy

37
Q

Typical progression of eczema through life?

A

Really common in kids esp under 1, starts on face and often gets flexures by 18m
Often completely regresses during teenage years; rare to have new onset in adulthood

38
Q

4 types of triggers for eczema?

A

Irritant e.g. Chemicals, perfumed soaps
Allergic e.g. Pet hairs, dust mites, pollen
Infectious
Environmental incl temp, stress, sweat

39
Q

What is discoid eczema? In whom does it most commonly present?

A

Men aged 60-70, smaller peak in young women
Annular lesions on extensor surfaces (legs, trunk, hands) - not face/scalp
Ddx for psoriasis and taenia

40
Q

What is the difference between allergic contact dermatitis and irritant contact dermatitis?

A

Allergic is hypersensitivity (type 4) background - needs initial sensitisation, subsequent exposure can trigger major reactions
Irritant can happen on first exposure, due to repeated disruption of normal skin barriers

41
Q

Typical presentations of allergic contact dermatitis?

A

Specific locations - e.g. Nickel earrings, watches, tattoos, hair dye, detergents…

42
Q

Typical presentations of irritant contact dermatitis?

A

Chronic wet-dry cycling e.g. People who wash hands a lot

Air conditioning, detergents etc.

43
Q

1st line management of eczema? 3 types of these?

A

Emollients - lotions, creams, and ointments (from watery->thick)

44
Q

Why are emollients and topical steroids best used together for eczema?

A

Emollients improve skin barrier function and this increase effectiveness of steroids

45
Q

Mild topical steroid?

A

Hydrocortisone (Dermol)

46
Q

Moderate strength topical steroid?

A

Eumovate

47
Q

Potent topical steroid?

A

Betnovate

48
Q

Very potent topical steroid?

A

Dermovate

49
Q

Alternative therapies after steroids for use in eczema?

A

Calcineurin inhibitors e.g. Tacrolimus
Occlusive wraps and dressings
Phototherapy
Systemic immunomodulation - methotrexate

50
Q

What is psoriasis?

A

Chronic, typically relapsing remitting autoimmune disorder causing rapid skin turnover and hyperkeratosis-> scaling

51
Q

Most common type of psoriasis?

A

Chronic stable psoriasis - erythematous papular lesions confluencing into plaques with scaling, typically on extensors incl sacrum and scalp

52
Q

What is guttate psoriasis?

A

Loads of small papules, triggered by viral illness often pharyngitis

53
Q

What is palmar plantar psoriasis? 1 differential for it?

A

Pustular psoriasis - sterile pustules affecting hands and feet
Ddx is pompholyx eczema

54
Q

1st line management of psoriasis?

A

Emollients and steroids

55
Q

After emollients and steroids, what 3 things are next line for outpatient psoriasis management?

A

Vit D analogues e.g. Calcitriol
Calcineurin inhibitors e.g. Tacrolimus
Coal tar

56
Q

Inpatient management of psoriasis?

A

Dithranol

57
Q

What is used after topical therapy for psoriasis?

A

pUVA, UVB

Oral immunomodulation e.g. Methotrexate

58
Q

What is a Marjolins ulcer?

A

Skin ulcer with skin cancer (BCC) inside it

59
Q

What is lipodermatosclerosis?

A

Ddx for cellulitis causing inverse champagne bottle legs

60
Q

What is asteatotic eczema?

A

Dry, cracked skin - crazy paving

More typical of elderly/alcoholics

61
Q

What is acrodermatitis enteropathica?

A

Zinc deficiency (autosomal dominant) causing acro and periorifice eczema-like rash, alopecia and diarrhoea

Revision Qs (28 decks)

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