DERMATOLOGY Flashcards
1
Q
what kind of skin disease is acne?
a) infective
b) inflammatory
c) degenerative
A
b) inflammatory
2
Q
what percentage of teenagers suffer from acne?
a) 5%
b) 20%
c) 50%
d) 85%
A
d) 85%
3
Q
acne is characterised by excess ____ production and _____ of the hair follicle causing _____.
A
sebum
hyperkeritinisation
blockage
4
Q
what bacteria often colonises the skin of a patient with acne?
A
propionibacterium acnes
5
Q
what part of the face is normally affected in a teenager or young adult with acne?
A
T zone
6
Q
what part of the face is normally affected in a late onset acne?
A
chin and jaw
7
Q
name both types of commedones than can be present on the face of a patient with acne
A
whiteheads
blackheads
8
Q
which of these isn’t a classical sign of acne?
a) pustules
b) papules
c) hemangioma
d) nodules
e) cysts
A
c) hemangioma
9
Q
give a complication of acne
A
scarring
10
Q
aside from hormones, name 3 risk factors for acne
A
smoking
diet
psychological
11
Q
how is acne severity scored?
A
leeds acne grading system
numerical with pictures
12
Q
name 3 types of topical cream that can be given for acne
A
benzoyl peroxide
retinoids
antibiotics
13
Q
how does benzoyl peroxidase work?
A
antibacterial
comedolytic
14
Q
give a side effect of benzoyl peroxidase
A
skin bleaching/irritation
15
Q
give an example of a retinoid topical cream
A
adapalene
tretinoin
16
Q
how do retinoid topical creams work?
A
vitamin A precursors
regulate epithelial growth
17
Q
give a side effect of retinoids
A
irritation
photosensitivity
18
Q
give an example of an antibiotic topical combination cream that could be prescribed
A
erythromycin and zinc
clindamycin and benzoyl peroxide
19
Q
give an example of anti-androgen oral therapy for acne
A
COCP
20
Q
give an example of an oral antibiotic which may be prescribed for acne
A
erythromycin
trimethroprim
21
Q
when should systemic/oral retinoids be used?
A
severe cases only
22
Q
why shouldn’t oral retinoids be used in pregnancy?
A
90% risk of birth defects
23
Q
give a side effect of oral retinoids
A
depression or suicide links??
24
Q
how can steroids be administered in acne?
A
intra-lesion injections
oral steroids
25
what type of condition is eczema?
a) inflammatory
b) infective
c) haemorrhagic
a) inflammatory
26
in which age group is eczema most common
young children
27
give 4 risk factors for eczema
season of year
stress
infection
allergy
28
what type of eczema would these symptoms indicate?
| weeping, crusting, blistering, redness, papule, swelling, scaling
acute
29
what type of eczema is characterised by greater pigmentation and scale and less exudate and vesicles?
chronic
30
where is visual dermatitis present in eczema?
flexures
31
name 2 tests that could be used to diagnose eczema
patch test
| antibody testing
32
name the most mild form of treatment for eczema
emollient cream
33
why should steroids be used with caution in eczema?
rebound when treatment stopped
| can have side effects
34
give 3 examples of immunosuppressants that can be used to treat eczema
tacrolimus
ciclosporin
methotrexate
azathioprine
35
give 3 advantages of using wet wraps for eczema
skin cooling
reduces itch
promotes steroid absorption
36
give a treatment therapy for eczema
phototherapy
37
give an example of 2 organisms that can cause infection of broken skin in eczema
s aureus
molluscum contagiosa
eczema herpeticum
38
do eczema lesions classically have sharp or hard-to-distinguish margins?
hard to distinguish
39
what are the two types of exogenous eczema?
allergic
| irritant
40
what type of eczema makes up more than 80% of all cases of contact dermatitis?
irritant exogenous eczema
41
what is irritant eczema mediated by?
type 4 hypersensitivity reaction
42
what type of eczema is characterised by irreparable cell damage due to an irritant, with lesions limited to the area of contact?
irritant
43
what are the 5 types of endogenous eczema?
```
atopic
seborrhoea
discoid
stasis/varicose
pompholyx
```
44
what two diseases is atopic eczema coupled with?
asthma
| hayfever
45
where does atopic asthma classically start on the body?
face
46
what antibody mediates atopic eczema hypersensitivity reaction?
IgE
47
IgE hypersensitivity eczema causes:
a) decreased ability of skin to hold water
b) increased sensitivity of skin to sunlight
c) pruritus causing skin lesions
a) decreased ability of skin to hold water
48
what percentage of atopic eczema clears in early teens?
a) 5-10%
b) 20-30%
c) 60-70%
d) 85-90%
c) 60-70%
49
give 4 examples of where seborrheic eczema normally occurs
scalp, ears, eyebrows, nose, axilla, groin, pubis (areas rick in sebaceous glands)
50
what is the name of seborrheic eczema in babies?
cradle cap
51
who does seborrheic eczema normally affect?
a) infant males
b) infant females
c) adult males
d) adult females
c) adult males
52
what type of eczema is characterised by greasy yellow scales, lichenification, and exaggerated follicular orifices?
seborrheic eczema
53
name 2 special senses conditions associated with seborrheic eczema
otitis externa
| chronic blepharitis
54
how would you describe a discoid eczema lesion?
coin shaped
| well demarcated
55
which part of the body does discoid eczema normally affect?
limbs
56
which of these features would you NOT see on a discoid eczema lesion?
a) vesicles
b) crust
c) clots
c) clots
57
where does varicose eczema normally affect the body?
over varicose veins (lower legs)
58
what type of eczema is characterised by lichenification, oedema, purport, pigmentation and ulcers?
varicose
59
attacks of pompholyx are
a) recurrent, long-lasting
b) recurrent, acute
c) single, long-lasting
d) single, acute
b) recurrent, acute
60
where are pompholyx eczema lesions normally found?
palms and soles of feet
61
what is treatment for pompholyx eczema?
self-resolves in 2-3 weeks
62
name the 3 unclassified forms of eczema
asteatotic
lichen simplex
juvenile plantar dermatosis
63
who does asteatotic eczema normally affect?
elderly
64
what eczema is characterised by 'crazy paving' and red fissures?
asteatotic
65
which form of eczema can be caused by overwashing, low humidity, central heating, diuretics and hypothyroidism?
asteatotic
66
what is lichen simplex caused by?
skin damage due to repeated scratching
67
name 4 of the areas commonly affected by lichen simplex
```
nape of neck
lower legs
scalp
upper thigh
pubis
forearm
```
68
what is juvenile plantar dermatosis caused by?
sweat gland blockage due to impermeable modern socks
69
where does juvenile plantar dermatosis affect?
weight bearing areas of skin
70
what do juvenile plantar dermatosis lesions look like?
shiny and dry
| painful fissures
71
give 2 organisms that commonly cause cellulitis
staph aureus
| group a strep
72
describe the broders of a cellulitic region
ill defined
73
which areas of flesh are swollen in cellulitis?
subcutaneous fat and dermis
74
illness of what type can also present with a cellulitis rash?
systemic
75
what bacterial skin infection is associated with diabetes, athletes foot, venous eczema and other skin lesions?
cellulitis
76
what antibiotic group is commonly prescribed for cellulitis and how is it adminstered?
IV beta lactam penicillins
77
give 2 dermatological complications of cellulitis
abscess
| necrotising fasciitis
78
what is Ludwig's angina?
complication of cellulitis - cellulitis in sublmandibular space due to dental infections
79
is erysipelas an acute or chronic infection?
acute
80
what part of the flesh does erysipelas affect
superficial skin layers
81
describe a classic erysipelatic rash
raised with erythema and well defined edges
82
what is erysipelas most commonly caused by?
strep pyogenes exotoxin
83
which of these group does NOT have an increased risk of erysipelas?
a) elderly
b) children
c) immuno-suppressed
d) poor dental hygiene
e) diabetes
d) poor dental hygiene
84
suggest 2 antibiotics that could be given oral or IV to treat erysipelas
penicillin
clindamicin
erythromycin
85
what treatment would you recommend to a patient with risk of re-infection of erysipelas?
prophylactic antibiotics
86
give 3 complications of erysipelas
necrotising fasciitis
sepsis
bone infection
87
what are the 2 main causative organisms for impetigo?
staph aureus
| strep pyogenes
88
describe the spread of impetigo
highly contagious
| direct contact
89
what is the classical description for an impetigo lesion?
a) purple & pus
b) golden lumps
c) purple crusts
d) golden crusts
d) golden crusts
90
what is ecthyma?
painful, deep ulcers
91
what are the two parallel treatments for impetigo?
antiseptic wash
| oral penicillin/macrolide
92
give 3 organisms that can cause folliculitis
s aureus
strep pyogenes
pseudomonas aerug.
93
where does folliculitus normally affect?
hairy areas
94
folliculitis can commonly occur following what activity?
shaving
95
folliculitis is treated in the same way as what other bacterial skin infection?
impetigo
96
what is intertrigo?
inflammation of a body fold
97
describe 3 symptoms of intertrigo
```
raw
red
itchy
painful
oozing
```
98
where does intertrigo most normally affect?
warm moist skin folds (chaffing)
99
these risk factors are most likely to predispose to what bacterial skin infection?
overweight, diabetes, immobile, incontinant
intertrigo
100
how is intertrigo treated?
remove moisture from area, antiperspirants etc
101
what genus of fungi causes tinea infections?
dermatophytosis
102
give 2 examples of dermatophytosis fungi
trichophyton
epidermophyton
microsporum
103
what is a common name for tinea pedis?
athletes foot
104
which 2 parts of the foot does athletes foot affect?
plantar
| interdigital
105
how is athletes foot spread?
contact e.g. swimming pools, locker rooms
106
give a complication of athlete's foot
ontchomycosis - spread to nails
107
what is tinea manuum?
infection of hand
108
which of tinea pedis and tinea manuum is more aggressive?
tinea manuum
109
which of these is not a symptom of tinea manuum
a) itching
b) burning
c) crackling
d) open bleeding
e) scaling
d) open bleeding
110
how is tinea manuum transmitted?
sexually
111
what is tinea unguium?
onychomycosis - nail fungal infection
112
does tinea unguium more commonly affect finger or toe nails?
toes
113
what are the first and second most common tinea infections?
pedis
| unguium
114
what is tinea cruris?
groin infection
115
in which gender is tinea cruris most common in?
males
116
what is tinea corporis?
fungal infection of body
117
where does tinea corporis most commonly affect?
arms
legs
glabrous skin
118
what is tinea capitis?
fungal scalp infection
119
name an additional symptom of tinea capitis
patches of hair loss
120
who does tinea capitis normally affect?
a) infants
b) pre-pubescent children
c) middle-aged
d) elderly
b) pre-pubescent children
121
what is tinea faciei?
facial fungal skin infection
122
what is tinea nigra?
dark painless patches on bottom of feet and hands
123
what are the 2 most common forms of candida?
oral
| vaginal
124
name 4 rarer types of candida
```
oesophageal
angular stomatitis
antibiotic-triggered
perianal
systemic
onychomycosis
```
125
what kind of genital discharge might you expect with candida?
cottage-cheese
126
what is the most common candida organism that causes infection?
candida albicans
127
what is dual treatment for candida infection?
chlorahexidine mouth wash
| topical antifungals e.g. clotrimazole
128
where does pityriasis versicolor normally affect on the body?
trunk and extremities
129
how does the skin eruption classical of pityriasis versicolor change in summer and winter?
hypopigmentation in sun
| reddish-brown in winter
130
what fungal skin condition is caused by malasseria globosa fungus?
pityriasis versicolor
131
suggest a drug that you could use to treat pityriasis versicolor
grisoflivine
| ketoconazole
132
in what type of climate is pityriasis versicolor more common?
warm, humid
133
which age group does pityriasis most commonly affect?
a) infants
b) adolescents
c) middle aged
d) elderly
b) adolescents
134
give 3 examples of antifungal creams and how long they should be given
```
terbinafine
clotrimazole
trimovate
ketoconazole
four week course
```
135
what skin infestation is caused by pediculus humanus capitis?
headlice
136
how do headlice survive?
parasites, feed on human blood
137
what disease do headlice cause?
pediculosis capitis
138
how are headlice spread?
direct contact
139
who do headlice most commonly infest?
school children
140
give 2 treatment options for headlice
combing
shaving
topical ointments
141
what type of skin disease is scabies?
mite infestation
142
what organism causes scabies?
sarcoptes scabiei
143
how is scabies spread?
direct skin contact
144
when is the itch of scabies worse?
night time
145
what skin infestation has a pimple like rash?
scabies
146
what form of scabies has scaled lesions?
norwegian crusted scabies
147
what infestation is characterised by papules, nodules and burrows?
scabies
148
how is scabies transmitted?
skin to skin contact for more than 10 mins
149
how is scabies treated? (3 thing)
topical cream all over body
disinfect household items
prophylaxis of household contacts
150
malathion, ivermectin, dimeticone and permethrin are examples of treatment for what kind of skin disease?
infestation
151
what is the difference between mosquito and midge bites?
midge last several days
| mosquito several hours
152
what is the difference between a mosquito bite and a biting fly (tabanidae) bite?
mosquito = low welt
| biting fly = painful welt
153
which areas of skin are most commonly affected by mosquito, midge, flea, bed bug and biting fly bites?
exposed skin and appendages
154
how do bed bug bites differ from midge and mosquito bites?
bed bug bites can look like a rash and can last weeks
155
can you feel a bed bug bite?
no
156
where do lice commonly bite?
pubic area
| scalp
157
where do larval and adult ticks normally bite?
covered skin and skin creases
158
can you feel a lice or tick bite?
no
159
why can adult ticks be dangerous?
can transmit diseases
160
which gender is lichen planus more common in?
females
161
what type of skin disease is lichen planus?
a) infective
b) inflammatory
c) infestation
d) haemorrhagic
b) inflammatory
162
what is the cause of lichen planus?
unknown maybe immune
163
shiny, itchy, purple plaques with a polygonal shape and flat topped are characteristic of what inflammatory skin disease?
lichen planus
164
what is wickham's striae?
| where are they normally present?
white lines in lichen planus papules
| mainly in oral mucosa
165
which 4 areas does lichen planus normally affect?
wrist
ankle
mucus membranes
scalp
166
lichenplanopilaris and scarring alopecia are examples of what inflammatory skin disease
lichen planus of scalp
167
which of these does NOT describe a possible presentation of lichen planus lesions
a) annular
b) linear
c) bullous
d) infective
e) ulcerated
f) pigmented
d) infective
168
which skin layers are thickened in lichen planus?
stratum corneum
| stratum granulosum
169
which skin layer is degenerated in lichen planus, and what appearance does this have?
stratum basale - saw tooth appearance
170
give 2 examples of potent topical steroids which could be given to treat lichen planus
elocon
betnovate
dermovate
171
when would you consider referring lichen planus to a dermatologist?
if evidence of neoplastic change
172
what type of skin disease is psoriasis?
a) infective
b) inflammatory
c) infestation
d) haemorrhagic
b) inflammatory
173
what age group most commonly gets psoriasis?
a) infants
b) young adults
c) middle aged
d) elderly
b) young adults
174
psoriasis is a _____ disease triggered by _____ factors
genetic
| environmental
175
how is psoriasis mediated (gene mutations in this factor)
MHC
176
what part of joints does psoriasis affect?
extensors
177
give 2 environmental risk factors for psoriasis
seasonal change
| stress
178
give 3 lifestyle risk factors for psoriasis
alcohol
smoking
obesity
179
give 3 drug risk factors for psoriasis
NSAIDs
beta blockers
fast withdrawal of topical corticosteroids
180
give 3 treatment options for psoriasis
steroid creams
photo-therapy
immuno-suppressants
181
what 2 immuno-suppressants are commonly used to treat psoriasis?
cyclosporin
| methotrexate
182
what type of psoriasis makes up 90% of all cases?
plaque
183
how would you describe a plaque psoriatic lesion?
red patches with white scales
184
how would you describe guttate psoriasis?
drop shaped lesion
185
what is the main trigger for guttate psoriasis?
strep infection
| strep pharyngitis
186
what is inverse psoriasis?
red patches in skin folds e.g. nappy area
187
what is inverse psoriasis in the nappy area often confused with?
napkin dermatitis
188
what is pustular dermatitis?
pus filled lesions
189
what is a severe for of pustular psoriasis that occurs in pregnancy?
impetigo herpetiformis
190
what is erythrodermic psoriasis and what causes it?
widespread rash, complication of other forms of psoriasis
191
what nail changes might you see in erythrodermic psoriasis?
pitting
| oncholysis
192
how can erythrodermic psoriasis be fatal?
extreme inflammation and exfoliation disrupt thermoregulation and barrier function
193
what inflammatory skin condition is characterised by abnormal, excessive, rapid epidermal growth and proliferation
psoriasis
194
what is Koebner phenomenon?
skin injury can trigger psoriatic changes on skin
195
give a bone complication of psoriasis that affects 30% of patients with psoriasis
psoriatic arthritis
196
what is dactylitis?
finger and toes psoriatic arthritis
197
can psoriasis be pre-malignant?
yes
198
name a GI condition that psoriasis sufferers are more likely to get
Crohn's
199
give an example of a co-morbidity that would cause psoriasis to be more extreme/severe
HIV
200
what type of skin disease is rosacea?
a) infective
b) inflammatory
c) infestation
d) haemorrhagic
b) inflammatory
201
in what gender is rosacea most common?
females
202
what age group is most commonly affected by rosacea?
middle aged
203
where do rosacea lesions most commonly appear on the body?
sun exposed sites such as face and chest
204
what inflammatory skin condition is characterised by papules, pustules, telangiectasia, flushing and erythema?
rosacea
205
name 2 ENT symptoms of rosacea
rhinophyma (large, red, bulbous nose)
| blepharitis
206
what might you feel upon inspection of the neck of a patient with rosacea?
lymphadenopathy
207
what causes rosacea?
inflammatory response to sun damage
208
give an example of a topical treatment for rosacea
azelaic acid
| metronidazole gel
209
give an example of a systemic drug which you could give for rosacea
doxycycline
| lymecyclin
210
name a physical treatment for rosacea
laser
211
what type of skin disease is urticaria?
a) infective
b) inflammatory
c) infestation
d) haemorrhagic
b) inflammatory
212
what percentage of people will experience urticaria at some point in their life?
a) 5%
b) 15%
c) 25%
d) 35%
b) 15%
213
give 3 physical/environmental causes of urticaria
pressure
temperature
water
214
give 3 other causes of urticaria
idiopathic
medication reaction
vasculitis
hereditary
215
when would you suspect a hereditary cause for urticaria?
recurrent attacks
216
what inflammatory skin condition is described as transient pruritic swellings?
urticaria
217
wheals, hives and nettle rash are ways to describe which inflammatory skin condition?
urticaria
218
urticaria can cause swelling of which 3 areas apart from skin?
face
mouth
airway
219
urticaria is a medical emergency when it presents with what?
angioedema
220
what is the difference between acute and chronic urticaria?
acute
221
what causes oedema in urticaria?
leakage of capillaries in dermis
222
what two intrinsic substances trigger urticaria?
histamine
| cytokines
223
what is acute treatment for urticaria?
adrenaline (epipen)
224
give 2 drug treatments for urticaria
antihistamines
| oral steroids
225
what virus causes chicken pox and herpes zoster (shingles)?
varicella zoster virus
226
what happens to the immune system of a patient following infection with VZV?
initial immune reaction and infection
| lifelong immunity
227
does the VZV virus get eradicated from the body following infection?
remains dormant in dorsal ganglion
228
what viral skin infection is characterised by small itchy blisters which scab alongside systemic fever, fatigue, headaches and muscle aches?
chicken pox/ shingles
229
when is a person with chicken pox infectious?
1-2 days before the rash appears until the lesion crusts over
230
what is a tzanck smear used to diagnose?
chicken pox and shingles vesicular fluid
231
why should aspirin not be given with chicken pox?
can lead to reye's syndrome
232
what is reye's syndrome?
swelling of liver and brain in children recovering from viral infection
233
suggest a drug used to treat shingles in adults
acyclovir
234
is there a vaccine available for chicken pox?
yes
235
where does a VZV rash lie in shingles?
follows nerve distribution
236
what is postherpetic neuralgia
complication of reactivation of VZV
237
what is ramsay hunt syndrome?
VZV reactivation in facial nerve ganglion
238
what VZV complication is characterised by facial paralysis, ear pain, taste loss and rash?
Ramsay Hunt
239
what is the name of VZV infection in a baby?
fetal varicella syndrome
240
when in pregnancy is VZV most dangerous for the mother?
third trimester
241
what strain of herpes simplex causes oral herpes?
HSV 1
242
what strain of herpes simplex causes genital herpes?
HSV 2
243
which of these does NOT describe herpes simplex
a) cycles between active and remission
b) first infection more severe
c) affects 40% adults
d) decreases in frequency and severity over time
c) affects 40% adults
244
what is hepatic whitlow?
herpes infection of fingers
245
what is Bell's Palsy?
HSV reactivation causing facial paralysis
246
what antiviral treatment is recommended for herpes simplex?
aciclovir
247
what fungal disease are people with HIV more inclined to?
thrush
248
what disease (exacerbated by HIV) is characterised by purple/dark lesions of the skin and mucus membranes?
Kaposi's sarcoma
249
what HIV related disease is characterised by white lesions on the bottom/side of tongue that can be flat or furry?
oral hairy leukoplakia
250
what virus causes oral hairy leukoplakia?
EBV
251
how is oral hairy leukoplakia treated?
acyclovir
252
give an example of a viral disease that can become chronic and progressive with HIV, that is normally self limiting
molluscum contageosum
253
how is HIV-exacarbeted molluscum contageosum treated?
imiquimod
254
name a dermatological condition that is more severe in HIV and only improves as HIV improves
seborrheic dermatitis
255
what vegetable do viral warts often look like?
a) tomato
b) cauliflower
c) carrot
d) potato
b) cauliflower
256
what is the major causative organism of viral warts?
human papilloma virus
257
what part of the skin does HPV infect?
squamous epithelium
258
what is the latin name for a common wart?
verruca vulgaris
259
where are verruca vulgaris?
hands
260
what is verruca plana? where do they lie?
flat wart
| face, hands, neck, wrists, knees
261
what is a filiform/digitate wart and where do they lie?
thread/finger like
| eyelids and lips
262
what is a condyloma acuminatum or a verruca acuminata?
genital wart
263
what is a periungal wart?
cauliflower cluster around nails
264
what is verruca planteris?
plantar wart
265
what are mosaic wart?
tight clusters of plantar warts
266
HPV warts type 2 and 4 are ____ warts.
Type 14 and 16 are _____ warts.
Type 1 are ____ warts
Type 6 and 11 are _____
common
dysplasic
plantar
genital
267
which of these layers of is not thickened in a viral wart?
a) corneum
b) spinosum
c) granulosum
d) basale
d) basale
268
what is the name of the HPV vaccine for girls?
gardasil
269
give 2 examples of topical treatments that you might give for viral warts
salicylic acid
| imiquimod
270
what other therapy could you give for viral warts?
cryotherapy
271
what virus causes molluscum contageosum?
pox
272
what colour are the papules characteristic of molluscum contageosum?
pearly white
273
describe the shape of molluscum contageosum papules
smooth
| umbilicate centre
274
what group of the population are most at risk of molluscum contageosum (spread by close contact)
school children
275
what is the name of a T1 drug eruption?
anaphylactic
276
give 2 examples of T1 drug eruptions
anaphylaxis
angioedema
urticaria
277
what is the name of a T2 drug eruption?
cytotoxic
278
give an example of a cytotoxic reaction
thrombocytopenia
| toxic epidermal necrolysis
279
what is the name of a T3 drug eruption?
immune complex
280
give an example of a T3 immune reaction
serum sickness
| vasculitis
281
what is the name of a T4 drug eruption?
cell mediated
282
give an example of a cell mediated drug eruption
```
maculopapular rash (morbilliform rash)
toxic epidermal necrolysis
```
283
what is AGEP?
acute generalised exanthematous pustulosis
284
which two places on the body do the erythema and pustules of AGEP mainly affect?
face
| flexures
285
what is DRESS?
drug reaction with eosinophilia and systemic symptoms
286
describe the rash present in DRESS
widespread
maculopapular
pustular
287
which drug reaction is characterised by a rash AND lymphadenopathy, hepatitis, pericarditis, nephritis, pneumonitis?
DRESS
288
which drug reaction is most commonly caused by
a) antibiotics, antifungals
b) anti epileptics, sulphonamides, allopurinol
a) AGEP
| b) DRESS or EM minor
289
erythroderma is a _____ skin infection with _____, ____ ____ and _______
widespread
pruritus
hair loss
hyperkeratosis
290
give 3 causes of erythroderma
```
drugs
dermatitis
psoriasis
immunobullous disorders
cancer
HIV
```
291
give 3 complications of erythroderma
deranged thermoregulation
fluid/electrolyte imbalance
hypoalbuminaemia
secondary infection
292
what type of reaction is erythema multiform minor?
T4 hypersensitivity
293
aside from skin, where does erythema multiform minor commonly affect?
mucus membranes
294
suggest 3 causes for EM minor
herpes
vaccines
drugs
295
what causes 50% of cases for EM minor?
idiopathic
296
name 3 related skin diseases characterised by widespread blisters and targetoid lesion with epidermal detachment and crusting
EM major
steven johnson
toxic epidermal necrolysis
297
what happens to the skin in SJS/TEM/EMmajor?
necrosis
298
what is the major cause of EMmajor/SJS/TEM?
drugs
299
what immune complexes have been linked to development of EMmajor/SJS/TEM?
HLA/MHC
300
the complications of EMmajor/SJS/TEM are similar to that of what major trauma?
severe burns
301
what dermatological condition is characterised by hyper pigmentation and thickening of skin with a velvety texture?
acanthosis nigricans
302
where in the body does acanthosis nigricans most commonly affect?
body folds
303
give 4 causes of acanthosis nigricans
```
increased insulin
obesity
drugs (steroids, COCP)
increased growth factor
cancer
```
304
what is the name of a necrotising skin condition associated with diabetes and rheumatoid arthritis?
necrobiosis lipiodica
305
what is the first presentation of necrobiosis lipiodica?
bruised lesion on skins with erythema
306
what causes necrobiosis lipiodica lesions to develop into open sores and ulcers?
local trauma
307
which of these is not true of necrobiosis lipiodica?
a) inflammatory
b) necrotic
c) granulomatous
d) can affect underlying fat
b) necrotic
308
in which gender is granuloma annulare more common in?
women
309
in what shape are the red bumps of granuloma annulare arranged in?
circle
310
give 3 examples of common sites of granuloma annulare
hands
feet
knuckles
back of legs
311
what is granuloma annulare caused by?
t cell clustering below skin
312
what drug type is most common for treating granuloma annulare?
steroids
313
what part of the flesh is affected by erythema nodosum?
inflammation of fat
314
how does erythema nodosum present?
painful nodules on shins
315
in what age group is erythema nodusum most common?
a) infants
b) teenagers
c) middle aged
d) elderly
b) teenagers
316
what systemic symptoms can exist with erythema nodosum?
flu like
317
what is the name for the syndrome comprising acute sarcoidosis, erythema nodosum, fever and joint symptoms?
a) Hashimoto's
b) Dressler's
c) Steven-Johnson
d) Lofgren's
d) Lofgren's
318
what causes 30-50% of all cases of erythema nodosum?
idiopathic
319
give 3 other causes of erythema nodosum
```
infection
autoimmune
cancer
pregnancy
drugs
```
320
what is treatment for erythema nodosum?
self limiting
321
what is the main cause of recurrent attacks of erythema nodosum in children?
streptococcal infection
322
what is the effect of pyoderma gangrenosum on tissue?
necrolysis
323
where do pyoderma gangrenosum ulcers normally arise?
legs
324
what is pathergy pyoderma gangrenosum?
new ulcers at site of trauma
325
what is PAPA syndrome?
pyogenic sterile arthritis, pyoderma gangrenosum, acne
326
give 3 drug types used to treat pyoderma gangrenosum
steroids
immunosuppressants
antibiotics (aminoglycoside)
327
what is the rash characteristic of systemic lupus erythematous? give 2 of its features
butterfly
| malar, discoid
328
how do patients with SLE react to light?
photophobia
329
what type of antibody cause SLE?
antinuclear
330
give 4 complications/systemic symptoms of SLE
```
renal disorder
neurological disorders
blood disorders
immune disorders
arthritis
vasculitis
Raynaud's
alopecia
```
331
from what variant of lupus do 98% of patients go on to develop SLE?
acute cutaneous lupus
332
from what variant of lupus do 5-30% of patients go on to develop SLE?
chronic lupus
333
how is SLE treated?
immunosuppressants
334
give a cardiovascular complication of SLE
accelerated atherosclerosis
335
what kind of disease is scleroderma?
autoimmune
336
what causes hardening of the skin in scleroderma?
increased collagen synthesis
337
what peripheral temperature regulation disease is associated with scleroderma?
Raynaud's
338
name 3 visible hand signs present in scleroderma
sclerodactyly
claw hand
telangectasia
339
name a systemic complication of scleroderma
oesophageal dysfunction
340
can scleroderma be multi systemic?
yes
341
what is treatment for scleroderma?
none present
342
what is lichen sclerosus characterised by?
white patches on skin
343
give a general complication of lichen sclerosus
scarring
344
why can lichen sclerosus lead to loss of genital function?
shrinking and thinning of genital area - pain, itching, loss
345
lichen sclerosus can affect the ___ and the ____ on women and the _____ on men
vulvu, anus (women)
| foreskin (men)
346
lichen sclerosis leads to ___keratosis, dermal _____ and epidermal _____
hyperkeratosis
dermal sclerosis
epidermal atrophy
347
give 3 risk factors for development of lichen sclerosus
autoimmune
family history
infection
post-menopause
348
what bacteria can cause lichen sclerosus?
borrelia
349
give 2 viruses that can cause lichen sclerosus
HPV
hep C
lyme's disease
350
what drug group is often given as treatment for lichen sclerosus?
steroids
351
what condition is characterised by chronic inflammation, erythema and scarring on the face, ears and scalp with scaling and crust
discoid lupus erythematosus
352
what are the 3 types of discoid lupus erythematous?
localised
generalised
childhood
353
what is morphoea a localised version of?
scleroderma
354
what 3 symptoms of scleroderma does morphoea lack?
raynaud's
sclerodactyly
tenangectasia
nail fold changes
355
give an example of a topical steroid which could be given to treat morphoea
imiquimod
356
if morphoea is very deep/stubborn, what might treatment be?
IV steroids and methotrexate
357
what type of autoimmune disease is dermatomyositis?
neuromuscular
358
dermatomyositis is inflammation of what?
muscles and skin
359
where else in the body does dermatomyositis affect?
can have systemic symptoms
360
what causes damage of microscopic vessels in dermatomyositis?
complement mediated
361
dermatomyositis is characterised by muscle _____, tissue _____ and lymphatic _____.
muscle atrophy
tissue ischaemia
lymphatic infiltration
362
which gender does dermatomyositis normally affect?
women
363
how does dermatomyositis present on the skin of the body and face?
body - shawl, red rash on back and upper neck
| face - lilac rash on upper eyelids
364
what other diseases is vitiligo linked to?
autoimmune
365
is vitiligo acute or chronic?
chronic
366
what occurs to the skin in vitiligo?
portions lose pigment
367
how does non-segmental vitiligo present?
symmetrical patches
368
what is focal non segmental vitiligo? who does it affect?
scattered macules
| children
369
what is is acrofacial non segmental vitiligo?
fingers and orifices
370
what is mucosal non segmental vitiligo?
mucosal membranes
371
how is vitiligo treated?
steroids
phototherapy
cacineurin inhibitors
372
what causes destruction of blood vessels in vasculitis?
inflammation
373
what are the two types of vasculitis?
systemic
| cutaneous (microvessels)
374
give 2 skin signs that might present with vasculitis?
purpura
| livedo reticularis
375
give 4 systemic symptoms of vasculitis
myalgia
arthralgia
fever
malaise
376
give 2 other body system effects of vasculitis
systemic
| nervous system
377
give 4 causes of vasculitis
autoimmune e.g. RA
cancer
infection
chemicals/drugs e.g. cocaine
378
give 3 possible treatments for vasculitis
corticosteroids
immunosuppressants
antimicrobials
379
what type of disease is immunobullous pemphigus?
autoimmune
380
what effect does pemphigus have on the skin and mucus membranes?
blistering
381
what is acantholyis and when does it occur?
un-glueing effect of epidermis
| occurs in pemphigus
382
what occurs to pemphigus blisters?
slough into sores
383
how can pemphigus be fatal?
overwhelming infection in sores
384
what is pemphigus vulgarise and what condition is it associated with?
starts in mouth
| associated with myasthenia gravis
385
what is folliaceus pemphigus and where does it mainly affect? how severe is it?
crusty sores on scalp like eczema
| least severe form
386
what is intraepidermal pemphigus and how is it mediated?
intraepidermal blisters
| IgA mediated
387
what is paraneoplastic pemphigus a complication of?
cancer in airways
388
how is pemphigus treated?
oral steroids
389
what antibodies mediate pemphigoid disease?
desmoglein autoantibodies
390
what type of disease is pemphigoid disease?
autoimmune
391
which part of the flesh does pemphigoid disease affect?
connective tissue
392
what type of hypersensitivity reaction is pemphigoid?
type 2
393
what two antibodies could mediate pemphigoid?
IgG
| IgA (more difficult to treat)
394
what characteristic do pemphigus and pemphigoid NOT share?
a) blistering
b) autoimmune
c) acantholysis
d) can form sores
c) pemphigoid NEVER has acantholysis
395
which is more common? pemphigus or pemphigoid?
pemphigoid
396
give a cause of pemphigoid urticarial bullae on inner thighs, arms and trunk
drugs
| furosemide, captopril, antibiotics
397
dermatitis herpetiformis is characterised by what?
chronic blistering rash with herpes-like appearance
398
does herpes cause dermatitis herpetiformis?
no
399
which surfaces of the body are normally affected by dermatitis herpatiformis?
extensors
400
what GI disease can often accompany dermatitis herpatiformis? why?
coeliac disease
| can cause jejunal villous atrophy
401
in which skin layer does dermatitis herpatiformis start?
dermis
402
what antibody mediates dermatitis herpetiformis?
IgA
403
what lifestyle change can dramatically improve dermatitis herpetiformis?
gluten-free diet
404
what is juvenile spring eruption?
rash on helices of ears when exposed to sunlight
405
what causes benign summer light eruption?
sunbathing
406
what type of hypersensitivity reaction causes benign summer light eruption?
type 4 hypersensitivity triggered by UV rays
407
porphyrias are characterised by an accumulation of what?
porphyrins (precursors of heme, p450 etc)
408
what types of porphyria is caused by exposure to sunlight?
cutaneous
| vesiulo-erosive
409
what is chronic actinic dermatitis and what causes it?
skin inflammation from Uv light
410
where does chronic actinide dermatitis normally erupt?
upper chest
hands
face
411
what is cutaneous lupus erythematous?
transient butterfly rash after sun exposure
