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Julia PCP2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

When might you see lichenified skin?

A

As a result of chronic itching of eczema

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2
Q

What is the ABCDE for taking a history of a skin lesion?

A 
A - asymmetry
B - border irregularity
C - colour variation
D - diameter 
E - evolution over time
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3
Q

What is a macule?

A

A flat area of altered skin colour (impalpable)

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4
Q

What is a papule?

A

An elevated, palpable skin lesion

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5
Q

What is a nodule?

A

An elevated, palpable skin lesions >5mm

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6
Q

What is a vesicle?

A

A fluid-filled blister

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7
Q

Palpable purpura are characteristic of what group of conditions?

A

Vasculitides

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8
Q

How does tinea corporis typically present?

A

Scaly, annular lesions on the body that are itchy & have an area of central clearing

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9
Q

What is the management of tinea?

A
  • Topical agent, eg/ imidazole or terbinafine creams
  • Oral griseofulvin for extensive infections
  • Tinea of the scalp needs prolonged treatment with oral antifungals
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10
Q

What are some specific treatments of molluscum contagiosum?

A
  • Topical irritants - eg/ salicylic acid
  • Topical immunostimulants
  • Destructive methods
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11
Q

Which pathogen usually causes folliculitis?

A

Staph. aureus

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12
Q

Which pathogen usually causes impetigo?

A

Staph. aureus

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13
Q

What is the treatment of impetigo?

A

Anti-staph antibiotics: flucloxacillin or cephalexin

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14
Q

Which organism commonly causes cellulitis?

A

Grp A Streptococcus

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15
Q

What are 3 features of eczema on history?

A
  • Itchy rash
  • Located in flexures
  • Worse in winter
  • Pt may also have asthma & hayfever
  • Family Hx of eczema
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16
Q

What are some of the triggers of eczema?

A
  • Stress & anxiety
  • Irritants (soap)
  • Allergy
  • Heat
  • Infection
  • Genetic predisposition (Filaggrin mutation)
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17
Q

What does discoid eczema look like?

A

Annular disc-like patches of eczema (mimics psoriasis & tinea)

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18
Q

What is asteatotic eczema?

A

Eczema that is worst on the front of the legs of elderly patients, and flares up in winter

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19
Q

What is pompholyx?

A

Vesicular hand & foot eczema

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20
Q

What is the treatment of diffuse erythrodermic eczema?

A

Intense topicals & systemic immunosuppression

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21
Q

What is eczema herpeticum & how is it treated?

A

Secondary infection of eczematous skin with HSV virus. Tx: systemic antiviral treatment + opthalmology assessment if eye involvement

22
Q

What are the lifestyle modifications for atopic eczema?

A
  • Avoid soap
  • Regular emollient
  • Warm, not hot showers
23
Q

What are specific eczema treatments?

A
  • Topical steroids
  • Non-steroid anti-inflammatory creams (eg/ pimecrolimus)
  • Treat suspected infections with antibiotics
  • Phototherapy with UVB
  • Systemic immunosuppression
24
Q

What are 3 features of eczema on examination?

A
  • Erythematous, ill-defined scaly patches
  • Rash in flexural areas
  • Lichenified skin in chronic eczema
25
Q

What are 3 features of psoriasis on history?

A
  • Mostly on extensor surfaces
  • Symmetrical involvement
  • Well-demarcated plaques
  • Some itch
  • Gradually worsening
  • Better with UV exposure
26
Q

What are 3 features of psoriasis on examination?

A
  • On extensor surfaces
  • Well demarcated plaques
  • Silvery-white scale
  • Very erythematous/salmon pink
  • Scalp involvement
27
Q

How does flexural & genital psoriasis differ from typical psoriasis?

A

Flexural & genital psoriasis is less scaly, and has a ‘glazed’ appearance (often confused with tinea)

28
Q

What is post-streptococcal guttate psoriasis?

A

Occurs 1-2 weeks after Strep infection - sudden onset of small plaque psoriasis

29
Q

What are the treatment options for psoriasis?

A
  • Topical - steroids, tars, calcipotriol, dithranol, emollients
  • Phototherapy - narrowband UVB treatment
  • Systemic - oral acitretin, methotrexate, cyclosporin A, biologic agents
30
Q

What are the 4 components of acne?

A
  1. Abnormal keratinization of sebaceous duct
  2. Colonization with bacteria
  3. Increase in androgen levels leading to increased sebum production
  4. Inflammation
31
Q

What are the topical treatments for acne?

A

Keratolytics, comedolytics, anti-bacterials

32
Q

What are some systemic treatments for acne?

A

Antibiotics (doxycycline, minocycline), anti-androgenic OCP (females), systemic retionoids (isotretinoin)

33
Q

How long is the treatment course of systemic isotretinoin for acne?

A

6-12 months (specialist use only)

34
Q

What are some of the adverse effects of systemic isotretinoin?

A

Teratogenic, dryness, photosensitivity, controversial association with depression

35
Q

What are some triggers of vascular rosacea?

A

Sunlight, alcohol, hot foods, spicy foods, emotion, heat, topical steroids

36
Q

What are some clinical features of rabies?

A
  • Spares face & head in adults
  • Intensely itchy rash, starting on hands & feet
  • Itch is worse at night
  • Spreads to genital areas, generalised body rash
  • Incubation period 4-6 weeks
37
Q

What are the general management considerations for scabies?

A
  • Treat all close contacts
  • Treat index case at diagnosis & again at 1 week
  • Post-scabetic itch can take weeks to settle
38
Q

What is the topical treatment of scabies?

A

-5% permethrin cream from neck down

39
Q

Which is the most commonly diagnosed skin cancer?

A

BCC (67%)

40
Q

What are the 2 precursor lesions to SCC?

A
  • Solar (actinic) keratosis

- Bowen’s disease (SCC in situ)

41
Q

What is the typical description of an SCC?

A

Erythematous, hyperkeratotic papule or nodule that may bleed or ulcerate & may be tender

42
Q

What is the typical description of a BCC?

A

Pearly nodules often containing prominent, dilated subepidermal blood vessels (telangiectasias), may bleed

43
Q

Which non-pigmentous skin cancer is more likely to metastasize?

A

SCC

44
Q

How are solar keratoses described?

A

Erythematous, scaly lesions commonly found on the dorsum of hands

45
Q

What is the treatment of solar keratoses?

A

Options include:

  • Cryotherapy
  • Topical
  • Surgical excision
46
Q

What are some features of Bowen’s disease?

A
  • Full thickness epidermal dysplasia, with no invasion
  • Commonly seen in lower limbs
  • Risk of malignant transformation to SCC is 3-5%
  • Often asymptomatic, but can be itchy, painful or may bleed
47
Q

What is a benign junctional naevus?

A

A naevus located at the epidermal side of the dermo-epidermal junction

48
Q

What is a benign compound naevus?

A

A naevus located in the epidermis & the dermis

49
Q

What is a benign intradermal naevus?

A

An intradermal naevus - usually pale in colour

50
Q

What are some features of a benign mole?

A
  • Small
  • Evenly coloured
  • Regular edges
  • Symmetrical
  • Does not change with time
51
Q

Name 4 risk factors for melanoma.

A
  • Multiple dysplastic naevi (>5)
  • Past history of melanoma
  • Family Hx
  • History of blistering sunburn
  • Type 1 skin
  • Freckling
  • Red hair
  • Immunosuppression
52
Q

What are some features of melanoma?

A
  • Itch
  • Increasing size
  • Irregular border
  • Colour variation
  • Inflammation
  • Crusting or bleeding

Julia PCP2 (21 decks)

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