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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
Describe a BCC?
Pearly papule with raised, rolled edges and importantly telangiectasias typically on the face Eroded centre, can become rodent ulcer Slow growing, months-years
26
Management of BCC?
Typically Mohs micrography excision | Can use cryotherapy, cautery etc.
27
RFs for SCC?
``` 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
Describe an SCC?
Keratinising nodule - rapidly growing, scaly, red mess often painful and firm Rapidly growing
29
Management of SCCs?
Surgical excision with fairly wide margins
30
RFs for malignant melanoma?
Prev malignant melanoma Moley person Acute sunburn FH
31
Risk associated with malignant melanoma - how is this quantified histologically? Management?
Higher risk of metastasis based on Breslow thickness | Surgical removal, wide margin excision
32
Ddx for malignant melanoma which doesn't change or evolve rapidly, is less pigmented?
Seborrhoeic wart
33
How can skin mets of malignant melanoma present?
Bluey-purple lesions ddx angioma
34
What is lentigo maligna?
Precancerous, irregular macule on face of elderly person
35
Methods of minimising UV exposure?
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
What is eczema?
Chronic inflammatory disorder affecting epidermis and dermis, usually with background of atopy
37
Typical progression of eczema through life?
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
4 types of triggers for eczema?
Irritant e.g. Chemicals, perfumed soaps Allergic e.g. Pet hairs, dust mites, pollen Infectious Environmental incl temp, stress, sweat
39
What is discoid eczema? In whom does it most commonly present?
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
What is the difference between allergic contact dermatitis and irritant contact dermatitis?
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
Typical presentations of allergic contact dermatitis?
Specific locations - e.g. Nickel earrings, watches, tattoos, hair dye, detergents...
42
Typical presentations of irritant contact dermatitis?
Chronic wet-dry cycling e.g. People who wash hands a lot | Air conditioning, detergents etc.
43
1st line management of eczema? 3 types of these?
Emollients - lotions, creams, and ointments (from watery->thick)
44
Why are emollients and topical steroids best used together for eczema?
Emollients improve skin barrier function and this increase effectiveness of steroids
45
Mild topical steroid?
Hydrocortisone (Dermol)
46
Moderate strength topical steroid?
Eumovate
47
Potent topical steroid?
Betnovate
48
Very potent topical steroid?
Dermovate
49
Alternative therapies after steroids for use in eczema?
Calcineurin inhibitors e.g. Tacrolimus Occlusive wraps and dressings Phototherapy Systemic immunomodulation - methotrexate
50
What is psoriasis?
Chronic, typically relapsing remitting autoimmune disorder causing rapid skin turnover and hyperkeratosis-> scaling
51
Most common type of psoriasis?
Chronic stable psoriasis - erythematous papular lesions confluencing into plaques with scaling, typically on extensors incl sacrum and scalp
52
What is guttate psoriasis?
Loads of small papules, triggered by viral illness often pharyngitis
53
What is palmar plantar psoriasis? 1 differential for it?
Pustular psoriasis - sterile pustules affecting hands and feet Ddx is pompholyx eczema
54
1st line management of psoriasis?
Emollients and steroids
55
After emollients and steroids, what 3 things are next line for outpatient psoriasis management?
Vit D analogues e.g. Calcitriol Calcineurin inhibitors e.g. Tacrolimus Coal tar
56
Inpatient management of psoriasis?
Dithranol
57
What is used after topical therapy for psoriasis?
pUVA, UVB | Oral immunomodulation e.g. Methotrexate
58
What is a Marjolins ulcer?
Skin ulcer with skin cancer (BCC) inside it
59
What is lipodermatosclerosis?
Ddx for cellulitis causing inverse champagne bottle legs
60
What is asteatotic eczema?
Dry, cracked skin - crazy paving | More typical of elderly/alcoholics
61
What is acrodermatitis enteropathica?
Zinc deficiency (autosomal dominant) causing acro and periorifice eczema-like rash, alopecia and diarrhoea

Revision Qs (28 decks)

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