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Dermatology Flashcards

1
Q

Most important Prognostic factor with malignant melanoma

A

Depth Breslow depth under 1mm 95% 5yr survival Down to above 4mm is 50%

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2
Q

Scoring criteria for malignant melanoma

A

Glasgow scale 3or above to refer Major - change in size, shape, colour Minor - inflam / crusting / bleeding / sensory change / diam over 7mm

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3
Q

Multiple Small crusty lesion on top of head Old crusty man head

A

Actinic keratosis… Pre malig (SCC) prevent future risk,.. Fluoro cream (can give hydrocortisone too to settle inflam)

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4
Q

Diagnosis

A

Actinic Keratosis

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5
Q

diagnosis

A

SCC

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6
Q

diagnosis

A

BCC (pearly, flesh-coloured papule with telangiectasia)

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7
Q

diagnosis and causes

A
  • Stevens-Johnson syndrome severe form of erythema multiforme associated with mucosal involvement and systemic symptoms
  • rash is typically maculopapular with target lesions being characteristic. May develop into vesicles or bullae

Causes

  • idiopathic
  • bacteria: Mycoplasma, Streptococcus
  • viruses: herpes simplex virus, Orf
  • drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill
  • connective tissue disease e.g. SLE
  • sarcoidosis
  • malignancy
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8
Q

diagnosis, features, and causes

A

erythema multiform

Features

  • target lesions
  • initially seen on the back of the hands / feet before spreading to the torso
  • upper limbs are more commonly affected than the lower limbs
  • pruritus is occasionally seen and is usually mild

Usually HSV

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9
Q

child with conjuctivitis and maculopapular rash behind ears, progresses to this blotchy body rash.

Diagnosis, and what four bad complications?

A

measles

can have koplik spots on mouth too

Complications

  • encephalitis: typically occurs 1-2 weeks following the onset of the illness)
  • febrile convulsions
  • giant cell pneumonia
  • keratoconjunctivitis, corneal ulceration
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10
Q

Diagnosis

A

Erythema infectiosum (also known as fifth disease or ‘slapped-cheek syndrome’)

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11
Q

diagnosis description and associated conditions (5 categories)

A

Erythema nodosum

Overview

  • inflammation of subcutaneous fat
  • typically causes tender, erythematous, nodular lesions
  • usualyl resolves with no scars in 6 weeks

Associated with…

  • infection: streptococci, TB, brucellosis
  • systemic disease: sarcoidosis, inflammatory bowel disease, Behcet’s
  • malignancy/lymphoma
  • drugs: penicillins, sulphonamides, combined oral contraceptive pill
  • pregnancy
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12
Q

Most common skin cancer

A

BCC.

  • 3 out of 10 Caucasians develop BCC
  • 80% found on the head and neck
  • rarely metastasise or kill
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13
Q

Description and Diagnosis

A

Paget’s disease of the nipple

  • Itchy red scaly or crusted nipple, from intraductal breast cancer (mass in 50%)
  • associated with an underlying mass lesion and 90% of such patients will have an invasive carcinoma
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14
Q

Paget’s disease of nipple vs eczema…

A

Paget’s has well demarcated edge

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15
Q

Drugs that can precipitate psoriasis

A
  • beta blockers
  • lithium
  • antimalarials (chloroquine and hydroxychloroquine)
  • NSAIDs
  • ACEi
  • infliximab
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16
Q

diagnose

A

Keratoacanthoma

  • benign epithelial tumour
  • more frequent in middle age
  • Need to exclude SCC
17
Q

What is this condition associated with

A

Erythema Nodosum

  • infection: streptococci, TB, brucellosis
  • systemic disease: sarcoidosis, inflammatory bowel disease, Behcet’s
  • malignancy/lymphoma
  • drugs: penicillins, sulphonamides, combined oral contraceptive pill
  • pregnancy
18
Q

A 4-year-old boy develops multiple tear-drop papules on his trunk and limbs. He is otherwise well. A diagnosis of guttate psoriasis is suspected. What is the most appropriate management?

A
  • Usually self limiting (6 weeks or so)

So

  • Reassurance + topical treatment if lesions are symptomatic
19
Q

Top differential

A

Pityriasis rosea (could be guttate psoriasis… both self-limiting. Guttate preceded by strep sore throat 2-4 weeks)

On image:

  • herald patch (usually on trunk)
  • followed by erythematous, oval, scaly patches which follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a ‘fir-tree’ appearance
20
Q

Two types of contact dermatitis

A
  • irritant contact dermatitis: common - non-allergic reaction due to weak acids or alkalis (e.g. detergents). Often seen on the hands. Erythema is typical, crusting and vesicles are rare
  • allergic contact dermatitis: type IV hypersensitivity reaction. Uncommon - often seen on the head following hair dyes. Presents as an acute weeping eczema which predominately affects the margins of the hairline rather than the hairy scalp itself. Topical treatment with a potent steroid is indicated
21
Q

What is this rash?

A

Erythema Multiforme

Associated with

  • viruses: herpes simplex virus (the most common cause)
  • idiopathic
  • bacteria: Mycoplasma, Streptococcus
  • drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
  • connective tissue disease e.g. SLE
  • sarcoidosis
  • malignancy
22
Q

Management

A

Seborrhoeic keratoses

  • variation in colour
  • stuck on appearance
  • Reassure

options for removal include curettage, cryosurgery and shave biopsy

23
Q

Appropriate test following anaphylaxis to investigate the cause of the reaction?

A
  • Radioallergosorbent test (RAST)
  • (tests IgE

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