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Y3 CORE CONDITIONS > DERMATOLOGY > Flashcards

DERMATOLOGY Flashcards

1
Q

what kind of skin disease is acne?

a) infective
b) inflammatory
c) degenerative

A

b) inflammatory

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2
Q

what percentage of teenagers suffer from acne?

a) 5%
b) 20%
c) 50%
d) 85%

A

d) 85%

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3
Q

acne is characterised by excess ____ production and _____ of the hair follicle causing _____.

A

sebum
hyperkeritinisation
blockage

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4
Q

what bacteria often colonises the skin of a patient with acne?

A

propionibacterium acnes

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5
Q

what part of the face is normally affected in a teenager or young adult with acne?

A

T zone

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6
Q

what part of the face is normally affected in a late onset acne?

A

chin and jaw

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7
Q

name both types of commedones than can be present on the face of a patient with acne

A

whiteheads

blackheads

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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

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9
Q

give a complication of acne

A

scarring

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10
Q

aside from hormones, name 3 risk factors for acne

A

smoking
diet
psychological

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11
Q

how is acne severity scored?

A

leeds acne grading system

numerical with pictures

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12
Q

name 3 types of topical cream that can be given for acne

A

benzoyl peroxide
retinoids
antibiotics

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13
Q

how does benzoyl peroxidase work?

A

antibacterial

comedolytic

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14
Q

give a side effect of benzoyl peroxidase

A

skin bleaching/irritation

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15
Q

give an example of a retinoid topical cream

A

adapalene

tretinoin

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16
Q

how do retinoid topical creams work?

A

vitamin A precursors

regulate epithelial growth

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17
Q

give a side effect of retinoids

A

irritation

photosensitivity

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18
Q

give an example of an antibiotic topical combination cream that could be prescribed

A

erythromycin and zinc

clindamycin and benzoyl peroxide

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19
Q

give an example of anti-androgen oral therapy for acne

A

COCP

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20
Q

give an example of an oral antibiotic which may be prescribed for acne

A

erythromycin

trimethroprim

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21
Q

when should systemic/oral retinoids be used?

A

severe cases only

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22
Q

why shouldn’t oral retinoids be used in pregnancy?

A

90% risk of birth defects

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23
Q

give a side effect of oral retinoids

A

depression or suicide links??

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24
Q

how can steroids be administered in acne?

A

intra-lesion injections

oral steroids

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25
Q

what type of condition is eczema?

a) inflammatory
b) infective
c) haemorrhagic

A

a) inflammatory

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26
Q

in which age group is eczema most common

A

young children

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27
Q

give 4 risk factors for eczema

A

season of year
stress
infection
allergy

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28
Q

what type of eczema would these symptoms indicate?

weeping, crusting, blistering, redness, papule, swelling, scaling

A

acute

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29
Q

what type of eczema is characterised by greater pigmentation and scale and less exudate and vesicles?

A

chronic

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30
Q

where is visual dermatitis present in eczema?

A

flexures

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31
Q

name 2 tests that could be used to diagnose eczema

A

patch test

antibody testing

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32
Q

name the most mild form of treatment for eczema

A

emollient cream

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33
Q

why should steroids be used with caution in eczema?

A

rebound when treatment stopped

can have side effects

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34
Q

give 3 examples of immunosuppressants that can be used to treat eczema

A

tacrolimus
ciclosporin
methotrexate
azathioprine

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35
Q

give 3 advantages of using wet wraps for eczema

A

skin cooling
reduces itch
promotes steroid absorption

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36
Q

give a treatment therapy for eczema

A

phototherapy

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37
Q

give an example of 2 organisms that can cause infection of broken skin in eczema

A

s aureus
molluscum contagiosa
eczema herpeticum

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38
Q

do eczema lesions classically have sharp or hard-to-distinguish margins?

A

hard to distinguish

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39
Q

what are the two types of exogenous eczema?

A

allergic

irritant

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40
Q

what type of eczema makes up more than 80% of all cases of contact dermatitis?

A

irritant exogenous eczema

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41
Q

what is irritant eczema mediated by?

A

type 4 hypersensitivity reaction

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42
Q

what type of eczema is characterised by irreparable cell damage due to an irritant, with lesions limited to the area of contact?

A

irritant

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43
Q

what are the 5 types of endogenous eczema?

A 
atopic
seborrhoea
discoid
stasis/varicose
pompholyx
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44
Q

what two diseases is atopic eczema coupled with?

A

asthma

hayfever

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45
Q

where does atopic asthma classically start on the body?

A

face

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46
Q

what antibody mediates atopic eczema hypersensitivity reaction?

A

IgE

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47
Q

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

a) decreased ability of skin to hold water

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48
Q

what percentage of atopic eczema clears in early teens?

a) 5-10%
b) 20-30%
c) 60-70%
d) 85-90%

A

c) 60-70%

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49
Q

give 4 examples of where seborrheic eczema normally occurs

A

scalp, ears, eyebrows, nose, axilla, groin, pubis (areas rick in sebaceous glands)

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50
Q

what is the name of seborrheic eczema in babies?

A

cradle cap

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51
Q

who does seborrheic eczema normally affect?

a) infant males
b) infant females
c) adult males
d) adult females

A

c) adult males

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52
Q

what type of eczema is characterised by greasy yellow scales, lichenification, and exaggerated follicular orifices?

A

seborrheic eczema

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53
Q

name 2 special senses conditions associated with seborrheic eczema

A

otitis externa

chronic blepharitis

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54
Q

how would you describe a discoid eczema lesion?

A

coin shaped

well demarcated

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55
Q

which part of the body does discoid eczema normally affect?

A

limbs

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56
Q

which of these features would you NOT see on a discoid eczema lesion?

a) vesicles
b) crust
c) clots

A

c) clots

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57
Q

where does varicose eczema normally affect the body?

A

over varicose veins (lower legs)

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58
Q

what type of eczema is characterised by lichenification, oedema, purport, pigmentation and ulcers?

A

varicose

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59
Q

attacks of pompholyx are

a) recurrent, long-lasting
b) recurrent, acute
c) single, long-lasting
d) single, acute

A

b) recurrent, acute

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60
Q

where are pompholyx eczema lesions normally found?

A

palms and soles of feet

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61
Q

what is treatment for pompholyx eczema?

A

self-resolves in 2-3 weeks

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62
Q

name the 3 unclassified forms of eczema

A

asteatotic
lichen simplex
juvenile plantar dermatosis

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63
Q

who does asteatotic eczema normally affect?

A

elderly

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64
Q

what eczema is characterised by ‘crazy paving’ and red fissures?

A

asteatotic

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65
Q

which form of eczema can be caused by overwashing, low humidity, central heating, diuretics and hypothyroidism?

A

asteatotic

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66
Q

what is lichen simplex caused by?

A

skin damage due to repeated scratching

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67
Q

name 4 of the areas commonly affected by lichen simplex

A 
nape of neck
lower legs
scalp
upper thigh
pubis
forearm
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68
Q

what is juvenile plantar dermatosis caused by?

A

sweat gland blockage due to impermeable modern socks

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69
Q

where does juvenile plantar dermatosis affect?

A

weight bearing areas of skin

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70
Q

what do juvenile plantar dermatosis lesions look like?

A

shiny and dry

painful fissures

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71
Q

give 2 organisms that commonly cause cellulitis

A

staph aureus

group a strep

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72
Q

describe the broders of a cellulitic region

A

ill defined

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73
Q

which areas of flesh are swollen in cellulitis?

A

subcutaneous fat and dermis

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74
Q

illness of what type can also present with a cellulitis rash?

A

systemic

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75
Q

what bacterial skin infection is associated with diabetes, athletes foot, venous eczema and other skin lesions?

A

cellulitis

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76
Q

what antibiotic group is commonly prescribed for cellulitis and how is it adminstered?

A

IV beta lactam penicillins

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77
Q

give 2 dermatological complications of cellulitis

A

abscess

necrotising fasciitis

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78
Q

what is Ludwig’s angina?

A

complication of cellulitis - cellulitis in sublmandibular space due to dental infections

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79
Q

is erysipelas an acute or chronic infection?

A

acute

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80
Q

what part of the flesh does erysipelas affect

A

superficial skin layers

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81
Q

describe a classic erysipelatic rash

A

raised with erythema and well defined edges

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82
Q

what is erysipelas most commonly caused by?

A

strep pyogenes exotoxin

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83
Q

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

A

d) poor dental hygiene

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84
Q

suggest 2 antibiotics that could be given oral or IV to treat erysipelas

A

penicillin
clindamicin
erythromycin

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85
Q

what treatment would you recommend to a patient with risk of re-infection of erysipelas?

A

prophylactic antibiotics

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86
Q

give 3 complications of erysipelas

A

necrotising fasciitis
sepsis
bone infection

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87
Q

what are the 2 main causative organisms for impetigo?

A

staph aureus

strep pyogenes

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88
Q

describe the spread of impetigo

A

highly contagious

direct contact

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89
Q

what is the classical description for an impetigo lesion?

a) purple & pus
b) golden lumps
c) purple crusts
d) golden crusts

A

d) golden crusts

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90
Q

what is ecthyma?

A

painful, deep ulcers

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91
Q

what are the two parallel treatments for impetigo?

A

antiseptic wash

oral penicillin/macrolide

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92
Q

give 3 organisms that can cause folliculitis

A

s aureus
strep pyogenes
pseudomonas aerug.

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93
Q

where does folliculitus normally affect?

A

hairy areas

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94
Q

folliculitis can commonly occur following what activity?

A

shaving

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95
Q

folliculitis is treated in the same way as what other bacterial skin infection?

A

impetigo

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96
Q

what is intertrigo?

A

inflammation of a body fold

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97
Q

describe 3 symptoms of intertrigo

A 
raw
red
itchy
painful
oozing
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98
Q

where does intertrigo most normally affect?

A

warm moist skin folds (chaffing)

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99
Q

these risk factors are most likely to predispose to what bacterial skin infection?
overweight, diabetes, immobile, incontinant

A

intertrigo

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100
Q

how is intertrigo treated?

A

remove moisture from area, antiperspirants etc

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101
Q

what genus of fungi causes tinea infections?

A

dermatophytosis

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102
Q

give 2 examples of dermatophytosis fungi

A

trichophyton
epidermophyton
microsporum

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103
Q

what is a common name for tinea pedis?

A

athletes foot

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104
Q

which 2 parts of the foot does athletes foot affect?

A

plantar

interdigital

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105
Q

how is athletes foot spread?

A

contact e.g. swimming pools, locker rooms

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106
Q

give a complication of athlete’s foot

A

ontchomycosis - spread to nails

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107
Q

what is tinea manuum?

A

infection of hand

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108
Q

which of tinea pedis and tinea manuum is more aggressive?

A

tinea manuum

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109
Q

which of these is not a symptom of tinea manuum

a) itching
b) burning
c) crackling
d) open bleeding
e) scaling

A

d) open bleeding

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110
Q

how is tinea manuum transmitted?

A

sexually

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111
Q

what is tinea unguium?

A

onychomycosis - nail fungal infection

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112
Q

does tinea unguium more commonly affect finger or toe nails?

A

toes

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113
Q

what are the first and second most common tinea infections?

A

pedis

unguium

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114
Q

what is tinea cruris?

A

groin infection

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115
Q

in which gender is tinea cruris most common in?

A

males

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116
Q

what is tinea corporis?

A

fungal infection of body

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117
Q

where does tinea corporis most commonly affect?

A

arms
legs
glabrous skin

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118
Q

what is tinea capitis?

A

fungal scalp infection

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119
Q

name an additional symptom of tinea capitis

A

patches of hair loss

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120
Q

who does tinea capitis normally affect?

a) infants
b) pre-pubescent children
c) middle-aged
d) elderly

A

b) pre-pubescent children

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121
Q

what is tinea faciei?

A

facial fungal skin infection

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122
Q

what is tinea nigra?

A

dark painless patches on bottom of feet and hands

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123
Q

what are the 2 most common forms of candida?

A

oral

vaginal

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124
Q

name 4 rarer types of candida

A 
oesophageal
angular stomatitis
antibiotic-triggered
perianal
systemic
onychomycosis
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125
Q

what kind of genital discharge might you expect with candida?

A

cottage-cheese

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126
Q

what is the most common candida organism that causes infection?

A

candida albicans

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127
Q

what is dual treatment for candida infection?

A

chlorahexidine mouth wash

topical antifungals e.g. clotrimazole

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128
Q

where does pityriasis versicolor normally affect on the body?

A

trunk and extremities

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129
Q

how does the skin eruption classical of pityriasis versicolor change in summer and winter?

A

hypopigmentation in sun

reddish-brown in winter

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130
Q

what fungal skin condition is caused by malasseria globosa fungus?

A

pityriasis versicolor

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131
Q

suggest a drug that you could use to treat pityriasis versicolor

A

grisoflivine

ketoconazole

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132
Q

in what type of climate is pityriasis versicolor more common?

A

warm, humid

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133
Q

which age group does pityriasis most commonly affect?

a) infants
b) adolescents
c) middle aged
d) elderly

A

b) adolescents

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134
Q

give 3 examples of antifungal creams and how long they should be given

A 
terbinafine
clotrimazole
trimovate
ketoconazole
four week course
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135
Q

what skin infestation is caused by pediculus humanus capitis?

A

headlice

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136
Q

how do headlice survive?

A

parasites, feed on human blood

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137
Q

what disease do headlice cause?

A

pediculosis capitis

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138
Q

how are headlice spread?

A

direct contact

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139
Q

who do headlice most commonly infest?

A

school children

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140
Q

give 2 treatment options for headlice

A

combing
shaving
topical ointments

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141
Q

what type of skin disease is scabies?

A

mite infestation

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142
Q

what organism causes scabies?

A

sarcoptes scabiei

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143
Q

how is scabies spread?

A

direct skin contact

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144
Q

when is the itch of scabies worse?

A

night time

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145
Q

what skin infestation has a pimple like rash?

A

scabies

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146
Q

what form of scabies has scaled lesions?

A

norwegian crusted scabies

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147
Q

what infestation is characterised by papules, nodules and burrows?

A

scabies

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148
Q

how is scabies transmitted?

A

skin to skin contact for more than 10 mins

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149
Q

how is scabies treated? (3 thing)

A

topical cream all over body
disinfect household items
prophylaxis of household contacts

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150
Q

malathion, ivermectin, dimeticone and permethrin are examples of treatment for what kind of skin disease?

A

infestation

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151
Q

what is the difference between mosquito and midge bites?

A

midge last several days

mosquito several hours

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152
Q

what is the difference between a mosquito bite and a biting fly (tabanidae) bite?

A

mosquito = low welt

biting fly = painful welt

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153
Q

which areas of skin are most commonly affected by mosquito, midge, flea, bed bug and biting fly bites?

A

exposed skin and appendages

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154
Q

how do bed bug bites differ from midge and mosquito bites?

A

bed bug bites can look like a rash and can last weeks

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155
Q

can you feel a bed bug bite?

A

no

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156
Q

where do lice commonly bite?

A

pubic area

scalp

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157
Q

where do larval and adult ticks normally bite?

A

covered skin and skin creases

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158
Q

can you feel a lice or tick bite?

A

no

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159
Q

why can adult ticks be dangerous?

A

can transmit diseases

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160
Q

which gender is lichen planus more common in?

A

females

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161
Q

what type of skin disease is lichen planus?

a) infective
b) inflammatory
c) infestation
d) haemorrhagic

A

b) inflammatory

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162
Q

what is the cause of lichen planus?

A

unknown maybe immune

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163
Q

shiny, itchy, purple plaques with a polygonal shape and flat topped are characteristic of what inflammatory skin disease?

A

lichen planus

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164
Q

what is wickham’s striae?

where are they normally present?

A

white lines in lichen planus papules

mainly in oral mucosa

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165
Q

which 4 areas does lichen planus normally affect?

A

wrist
ankle
mucus membranes
scalp

166
Q

lichenplanopilaris and scarring alopecia are examples of what inflammatory skin disease

A

lichen planus of scalp

167
Q

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

A

d) infective

168
Q

which skin layers are thickened in lichen planus?

A

stratum corneum

stratum granulosum

169
Q

which skin layer is degenerated in lichen planus, and what appearance does this have?

A

stratum basale - saw tooth appearance

170
Q

give 2 examples of potent topical steroids which could be given to treat lichen planus

A

elocon
betnovate
dermovate

171
Q

when would you consider referring lichen planus to a dermatologist?

A

if evidence of neoplastic change

172
Q

what type of skin disease is psoriasis?

a) infective
b) inflammatory
c) infestation
d) haemorrhagic

A

b) inflammatory

173
Q

what age group most commonly gets psoriasis?

a) infants
b) young adults
c) middle aged
d) elderly

A

b) young adults

174
Q

psoriasis is a _____ disease triggered by _____ factors

A

genetic

environmental

175
Q

how is psoriasis mediated (gene mutations in this factor)

A

MHC

176
Q

what part of joints does psoriasis affect?

A

extensors

177
Q

give 2 environmental risk factors for psoriasis

A

seasonal change

stress

178
Q

give 3 lifestyle risk factors for psoriasis

A

alcohol
smoking
obesity

179
Q

give 3 drug risk factors for psoriasis

A

NSAIDs
beta blockers
fast withdrawal of topical corticosteroids

180
Q

give 3 treatment options for psoriasis

A

steroid creams
photo-therapy
immuno-suppressants

181
Q

what 2 immuno-suppressants are commonly used to treat psoriasis?

A

cyclosporin

methotrexate

182
Q

what type of psoriasis makes up 90% of all cases?

A

plaque

183
Q

how would you describe a plaque psoriatic lesion?

A

red patches with white scales

184
Q

how would you describe guttate psoriasis?

A

drop shaped lesion

185
Q

what is the main trigger for guttate psoriasis?

A

strep infection

strep pharyngitis

186
Q

what is inverse psoriasis?

A

red patches in skin folds e.g. nappy area

187
Q

what is inverse psoriasis in the nappy area often confused with?

A

napkin dermatitis

188
Q

what is pustular dermatitis?

A

pus filled lesions

189
Q

what is a severe for of pustular psoriasis that occurs in pregnancy?

A

impetigo herpetiformis

190
Q

what is erythrodermic psoriasis and what causes it?

A

widespread rash, complication of other forms of psoriasis

191
Q

what nail changes might you see in erythrodermic psoriasis?

A

pitting

oncholysis

192
Q

how can erythrodermic psoriasis be fatal?

A

extreme inflammation and exfoliation disrupt thermoregulation and barrier function

193
Q

what inflammatory skin condition is characterised by abnormal, excessive, rapid epidermal growth and proliferation

A

psoriasis

194
Q

what is Koebner phenomenon?

A

skin injury can trigger psoriatic changes on skin

195
Q

give a bone complication of psoriasis that affects 30% of patients with psoriasis

A

psoriatic arthritis

196
Q

what is dactylitis?

A

finger and toes psoriatic arthritis

197
Q

can psoriasis be pre-malignant?

A

yes

198
Q

name a GI condition that psoriasis sufferers are more likely to get

A

Crohn’s

199
Q

give an example of a co-morbidity that would cause psoriasis to be more extreme/severe

A

HIV

200
Q

what type of skin disease is rosacea?

a) infective
b) inflammatory
c) infestation
d) haemorrhagic

A

b) inflammatory

201
Q

in what gender is rosacea most common?

A

females

202
Q

what age group is most commonly affected by rosacea?

A

middle aged

203
Q

where do rosacea lesions most commonly appear on the body?

A

sun exposed sites such as face and chest

204
Q

what inflammatory skin condition is characterised by papules, pustules, telangiectasia, flushing and erythema?

A

rosacea

205
Q

name 2 ENT symptoms of rosacea

A

rhinophyma (large, red, bulbous nose)

blepharitis

206
Q

what might you feel upon inspection of the neck of a patient with rosacea?

A

lymphadenopathy

207
Q

what causes rosacea?

A

inflammatory response to sun damage

208
Q

give an example of a topical treatment for rosacea

A

azelaic acid

metronidazole gel

209
Q

give an example of a systemic drug which you could give for rosacea

A

doxycycline

lymecyclin

210
Q

name a physical treatment for rosacea

A

laser

211
Q

what type of skin disease is urticaria?

a) infective
b) inflammatory
c) infestation
d) haemorrhagic

A

b) inflammatory

212
Q

what percentage of people will experience urticaria at some point in their life?

a) 5%
b) 15%
c) 25%
d) 35%

A

b) 15%

213
Q

give 3 physical/environmental causes of urticaria

A

pressure
temperature
water

214
Q

give 3 other causes of urticaria

A

idiopathic
medication reaction
vasculitis
hereditary

215
Q

when would you suspect a hereditary cause for urticaria?

A

recurrent attacks

216
Q

what inflammatory skin condition is described as transient pruritic swellings?

A

urticaria

217
Q

wheals, hives and nettle rash are ways to describe which inflammatory skin condition?

A

urticaria

218
Q

urticaria can cause swelling of which 3 areas apart from skin?

A

face
mouth
airway

219
Q

urticaria is a medical emergency when it presents with what?

A

angioedema

220
Q

what is the difference between acute and chronic urticaria?

A

acute

221
Q

what causes oedema in urticaria?

A

leakage of capillaries in dermis

222
Q

what two intrinsic substances trigger urticaria?

A

histamine

cytokines

223
Q

what is acute treatment for urticaria?

A

adrenaline (epipen)

224
Q

give 2 drug treatments for urticaria

A

antihistamines

oral steroids

225
Q

what virus causes chicken pox and herpes zoster (shingles)?

A

varicella zoster virus

226
Q

what happens to the immune system of a patient following infection with VZV?

A

initial immune reaction and infection

lifelong immunity

227
Q

does the VZV virus get eradicated from the body following infection?

A

remains dormant in dorsal ganglion

228
Q

what viral skin infection is characterised by small itchy blisters which scab alongside systemic fever, fatigue, headaches and muscle aches?

A

chicken pox/ shingles

229
Q

when is a person with chicken pox infectious?

A

1-2 days before the rash appears until the lesion crusts over

230
Q

what is a tzanck smear used to diagnose?

A

chicken pox and shingles vesicular fluid

231
Q

why should aspirin not be given with chicken pox?

A

can lead to reye’s syndrome

232
Q

what is reye’s syndrome?

A

swelling of liver and brain in children recovering from viral infection

233
Q

suggest a drug used to treat shingles in adults

A

acyclovir

234
Q

is there a vaccine available for chicken pox?

A

yes

235
Q

where does a VZV rash lie in shingles?

A

follows nerve distribution

236
Q

what is postherpetic neuralgia

A

complication of reactivation of VZV

237
Q

what is ramsay hunt syndrome?

A

VZV reactivation in facial nerve ganglion

238
Q

what VZV complication is characterised by facial paralysis, ear pain, taste loss and rash?

A

Ramsay Hunt

239
Q

what is the name of VZV infection in a baby?

A

fetal varicella syndrome

240
Q

when in pregnancy is VZV most dangerous for the mother?

A

third trimester

241
Q

what strain of herpes simplex causes oral herpes?

A

HSV 1

242
Q

what strain of herpes simplex causes genital herpes?

A

HSV 2

243
Q

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

A

c) affects 40% adults

244
Q

what is hepatic whitlow?

A

herpes infection of fingers

245
Q

what is Bell’s Palsy?

A

HSV reactivation causing facial paralysis

246
Q

what antiviral treatment is recommended for herpes simplex?

A

aciclovir

247
Q

what fungal disease are people with HIV more inclined to?

A

thrush

248
Q

what disease (exacerbated by HIV) is characterised by purple/dark lesions of the skin and mucus membranes?

A

Kaposi’s sarcoma

249
Q

what HIV related disease is characterised by white lesions on the bottom/side of tongue that can be flat or furry?

A

oral hairy leukoplakia

250
Q

what virus causes oral hairy leukoplakia?

A

EBV

251
Q

how is oral hairy leukoplakia treated?

A

acyclovir

252
Q

give an example of a viral disease that can become chronic and progressive with HIV, that is normally self limiting

A

molluscum contageosum

253
Q

how is HIV-exacarbeted molluscum contageosum treated?

A

imiquimod

254
Q

name a dermatological condition that is more severe in HIV and only improves as HIV improves

A

seborrheic dermatitis

255
Q

what vegetable do viral warts often look like?

a) tomato
b) cauliflower
c) carrot
d) potato

A

b) cauliflower

256
Q

what is the major causative organism of viral warts?

A

human papilloma virus

257
Q

what part of the skin does HPV infect?

A

squamous epithelium

258
Q

what is the latin name for a common wart?

A

verruca vulgaris

259
Q

where are verruca vulgaris?

A

hands

260
Q

what is verruca plana? where do they lie?

A

flat wart

face, hands, neck, wrists, knees

261
Q

what is a filiform/digitate wart and where do they lie?

A

thread/finger like

eyelids and lips

262
Q

what is a condyloma acuminatum or a verruca acuminata?

A

genital wart

263
Q

what is a periungal wart?

A

cauliflower cluster around nails

264
Q

what is verruca planteris?

A

plantar wart

265
Q

what are mosaic wart?

A

tight clusters of plantar warts

266
Q

HPV warts type 2 and 4 are ____ warts.
Type 14 and 16 are _____ warts.
Type 1 are ____ warts
Type 6 and 11 are _____

A

common
dysplasic
plantar
genital

267
Q

which of these layers of is not thickened in a viral wart?

a) corneum
b) spinosum
c) granulosum
d) basale

A

d) basale

268
Q

what is the name of the HPV vaccine for girls?

A

gardasil

269
Q

give 2 examples of topical treatments that you might give for viral warts

A

salicylic acid

imiquimod

270
Q

what other therapy could you give for viral warts?

A

cryotherapy

271
Q

what virus causes molluscum contageosum?

A

pox

272
Q

what colour are the papules characteristic of molluscum contageosum?

A

pearly white

273
Q

describe the shape of molluscum contageosum papules

A

smooth

umbilicate centre

274
Q

what group of the population are most at risk of molluscum contageosum (spread by close contact)

A

school children

275
Q

what is the name of a T1 drug eruption?

A

anaphylactic

276
Q

give 2 examples of T1 drug eruptions

A

anaphylaxis
angioedema
urticaria

277
Q

what is the name of a T2 drug eruption?

A

cytotoxic

278
Q

give an example of a cytotoxic reaction

A

thrombocytopenia

toxic epidermal necrolysis

279
Q

what is the name of a T3 drug eruption?

A

immune complex

280
Q

give an example of a T3 immune reaction

A

serum sickness

vasculitis

281
Q

what is the name of a T4 drug eruption?

A

cell mediated

282
Q

give an example of a cell mediated drug eruption

A 
maculopapular rash (morbilliform rash)
toxic epidermal necrolysis
283
Q

what is AGEP?

A

acute generalised exanthematous pustulosis

284
Q

which two places on the body do the erythema and pustules of AGEP mainly affect?

A

face

flexures

285
Q

what is DRESS?

A

drug reaction with eosinophilia and systemic symptoms

286
Q

describe the rash present in DRESS

A

widespread
maculopapular
pustular

287
Q

which drug reaction is characterised by a rash AND lymphadenopathy, hepatitis, pericarditis, nephritis, pneumonitis?

A

DRESS

288
Q

which drug reaction is most commonly caused by

a) antibiotics, antifungals
b) anti epileptics, sulphonamides, allopurinol

A

a) AGEP

b) DRESS or EM minor

289
Q

erythroderma is a _____ skin infection with _____, ____ ____ and _______

A

widespread
pruritus
hair loss
hyperkeratosis

290
Q

give 3 causes of erythroderma

A 
drugs
dermatitis
psoriasis
immunobullous disorders
cancer
HIV
291
Q

give 3 complications of erythroderma

A

deranged thermoregulation
fluid/electrolyte imbalance
hypoalbuminaemia
secondary infection

292
Q

what type of reaction is erythema multiform minor?

A

T4 hypersensitivity

293
Q

aside from skin, where does erythema multiform minor commonly affect?

A

mucus membranes

294
Q

suggest 3 causes for EM minor

A

herpes
vaccines
drugs

295
Q

what causes 50% of cases for EM minor?

A

idiopathic

296
Q

name 3 related skin diseases characterised by widespread blisters and targetoid lesion with epidermal detachment and crusting

A

EM major
steven johnson
toxic epidermal necrolysis

297
Q

what happens to the skin in SJS/TEM/EMmajor?

A

necrosis

298
Q

what is the major cause of EMmajor/SJS/TEM?

A

drugs

299
Q

what immune complexes have been linked to development of EMmajor/SJS/TEM?

A

HLA/MHC

300
Q

the complications of EMmajor/SJS/TEM are similar to that of what major trauma?

A

severe burns

301
Q

what dermatological condition is characterised by hyper pigmentation and thickening of skin with a velvety texture?

A

acanthosis nigricans

302
Q

where in the body does acanthosis nigricans most commonly affect?

A

body folds

303
Q

give 4 causes of acanthosis nigricans

A 
increased insulin
obesity
drugs (steroids, COCP)
increased growth factor
cancer
304
Q

what is the name of a necrotising skin condition associated with diabetes and rheumatoid arthritis?

A

necrobiosis lipiodica

305
Q

what is the first presentation of necrobiosis lipiodica?

A

bruised lesion on skins with erythema

306
Q

what causes necrobiosis lipiodica lesions to develop into open sores and ulcers?

A

local trauma

307
Q

which of these is not true of necrobiosis lipiodica?

a) inflammatory
b) necrotic
c) granulomatous
d) can affect underlying fat

A

b) necrotic

308
Q

in which gender is granuloma annulare more common in?

A

women

309
Q

in what shape are the red bumps of granuloma annulare arranged in?

A

circle

310
Q

give 3 examples of common sites of granuloma annulare

A

hands
feet
knuckles
back of legs

311
Q

what is granuloma annulare caused by?

A

t cell clustering below skin

312
Q

what drug type is most common for treating granuloma annulare?

A

steroids

313
Q

what part of the flesh is affected by erythema nodosum?

A

inflammation of fat

314
Q

how does erythema nodosum present?

A

painful nodules on shins

315
Q

in what age group is erythema nodusum most common?

a) infants
b) teenagers
c) middle aged
d) elderly

A

b) teenagers

316
Q

what systemic symptoms can exist with erythema nodosum?

A

flu like

317
Q

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

A

d) Lofgren’s

318
Q

what causes 30-50% of all cases of erythema nodosum?

A

idiopathic

319
Q

give 3 other causes of erythema nodosum

A 
infection
autoimmune
cancer
pregnancy
drugs
320
Q

what is treatment for erythema nodosum?

A

self limiting

321
Q

what is the main cause of recurrent attacks of erythema nodosum in children?

A

streptococcal infection

322
Q

what is the effect of pyoderma gangrenosum on tissue?

A

necrolysis

323
Q

where do pyoderma gangrenosum ulcers normally arise?

A

legs

324
Q

what is pathergy pyoderma gangrenosum?

A

new ulcers at site of trauma

325
Q

what is PAPA syndrome?

A

pyogenic sterile arthritis, pyoderma gangrenosum, acne

326
Q

give 3 drug types used to treat pyoderma gangrenosum

A

steroids
immunosuppressants
antibiotics (aminoglycoside)

327
Q

what is the rash characteristic of systemic lupus erythematous? give 2 of its features

A

butterfly

malar, discoid

328
Q

how do patients with SLE react to light?

A

photophobia

329
Q

what type of antibody cause SLE?

A

antinuclear

330
Q

give 4 complications/systemic symptoms of SLE

A 
renal disorder
neurological disorders
blood disorders
immune disorders
arthritis
vasculitis
Raynaud's
alopecia
331
Q

from what variant of lupus do 98% of patients go on to develop SLE?

A

acute cutaneous lupus

332
Q

from what variant of lupus do 5-30% of patients go on to develop SLE?

A

chronic lupus

333
Q

how is SLE treated?

A

immunosuppressants

334
Q

give a cardiovascular complication of SLE

A

accelerated atherosclerosis

335
Q

what kind of disease is scleroderma?

A

autoimmune

336
Q

what causes hardening of the skin in scleroderma?

A

increased collagen synthesis

337
Q

what peripheral temperature regulation disease is associated with scleroderma?

A

Raynaud’s

338
Q

name 3 visible hand signs present in scleroderma

A

sclerodactyly
claw hand
telangectasia

339
Q

name a systemic complication of scleroderma

A

oesophageal dysfunction

340
Q

can scleroderma be multi systemic?

A

yes

341
Q

what is treatment for scleroderma?

A

none present

342
Q

what is lichen sclerosus characterised by?

A

white patches on skin

343
Q

give a general complication of lichen sclerosus

A

scarring

344
Q

why can lichen sclerosus lead to loss of genital function?

A

shrinking and thinning of genital area - pain, itching, loss

345
Q

lichen sclerosus can affect the ___ and the ____ on women and the _____ on men

A

vulvu, anus (women)

foreskin (men)

346
Q

lichen sclerosis leads to ___keratosis, dermal _____ and epidermal _____

A

hyperkeratosis
dermal sclerosis
epidermal atrophy

347
Q

give 3 risk factors for development of lichen sclerosus

A

autoimmune
family history
infection
post-menopause

348
Q

what bacteria can cause lichen sclerosus?

A

borrelia

349
Q

give 2 viruses that can cause lichen sclerosus

A

HPV
hep C
lyme’s disease

350
Q

what drug group is often given as treatment for lichen sclerosus?

A

steroids

351
Q

what condition is characterised by chronic inflammation, erythema and scarring on the face, ears and scalp with scaling and crust

A

discoid lupus erythematosus

352
Q

what are the 3 types of discoid lupus erythematous?

A

localised
generalised
childhood

353
Q

what is morphoea a localised version of?

A

scleroderma

354
Q

what 3 symptoms of scleroderma does morphoea lack?

A

raynaud’s
sclerodactyly
tenangectasia
nail fold changes

355
Q

give an example of a topical steroid which could be given to treat morphoea

A

imiquimod

356
Q

if morphoea is very deep/stubborn, what might treatment be?

A

IV steroids and methotrexate

357
Q

what type of autoimmune disease is dermatomyositis?

A

neuromuscular

358
Q

dermatomyositis is inflammation of what?

A

muscles and skin

359
Q

where else in the body does dermatomyositis affect?

A

can have systemic symptoms

360
Q

what causes damage of microscopic vessels in dermatomyositis?

A

complement mediated

361
Q

dermatomyositis is characterised by muscle _____, tissue _____ and lymphatic _____.

A

muscle atrophy
tissue ischaemia
lymphatic infiltration

362
Q

which gender does dermatomyositis normally affect?

A

women

363
Q

how does dermatomyositis present on the skin of the body and face?

A

body - shawl, red rash on back and upper neck

face - lilac rash on upper eyelids

364
Q

what other diseases is vitiligo linked to?

A

autoimmune

365
Q

is vitiligo acute or chronic?

A

chronic

366
Q

what occurs to the skin in vitiligo?

A

portions lose pigment

367
Q

how does non-segmental vitiligo present?

A

symmetrical patches

368
Q

what is focal non segmental vitiligo? who does it affect?

A

scattered macules

children

369
Q

what is is acrofacial non segmental vitiligo?

A

fingers and orifices

370
Q

what is mucosal non segmental vitiligo?

A

mucosal membranes

371
Q

how is vitiligo treated?

A

steroids
phototherapy
cacineurin inhibitors

372
Q

what causes destruction of blood vessels in vasculitis?

A

inflammation

373
Q

what are the two types of vasculitis?

A

systemic

cutaneous (microvessels)

374
Q

give 2 skin signs that might present with vasculitis?

A

purpura

livedo reticularis

375
Q

give 4 systemic symptoms of vasculitis

A

myalgia
arthralgia
fever
malaise

376
Q

give 2 other body system effects of vasculitis

A

systemic

nervous system

377
Q

give 4 causes of vasculitis

A

autoimmune e.g. RA
cancer
infection
chemicals/drugs e.g. cocaine

378
Q

give 3 possible treatments for vasculitis

A

corticosteroids
immunosuppressants
antimicrobials

379
Q

what type of disease is immunobullous pemphigus?

A

autoimmune

380
Q

what effect does pemphigus have on the skin and mucus membranes?

A

blistering

381
Q

what is acantholyis and when does it occur?

A

un-glueing effect of epidermis

occurs in pemphigus

382
Q

what occurs to pemphigus blisters?

A

slough into sores

383
Q

how can pemphigus be fatal?

A

overwhelming infection in sores

384
Q

what is pemphigus vulgarise and what condition is it associated with?

A

starts in mouth

associated with myasthenia gravis

385
Q

what is folliaceus pemphigus and where does it mainly affect? how severe is it?

A

crusty sores on scalp like eczema

least severe form

386
Q

what is intraepidermal pemphigus and how is it mediated?

A

intraepidermal blisters

IgA mediated

387
Q

what is paraneoplastic pemphigus a complication of?

A

cancer in airways

388
Q

how is pemphigus treated?

A

oral steroids

389
Q

what antibodies mediate pemphigoid disease?

A

desmoglein autoantibodies

390
Q

what type of disease is pemphigoid disease?

A

autoimmune

391
Q

which part of the flesh does pemphigoid disease affect?

A

connective tissue

392
Q

what type of hypersensitivity reaction is pemphigoid?

A

type 2

393
Q

what two antibodies could mediate pemphigoid?

A

IgG

IgA (more difficult to treat)

394
Q

what characteristic do pemphigus and pemphigoid NOT share?

a) blistering
b) autoimmune
c) acantholysis
d) can form sores

A

c) pemphigoid NEVER has acantholysis

395
Q

which is more common? pemphigus or pemphigoid?

A

pemphigoid

396
Q

give a cause of pemphigoid urticarial bullae on inner thighs, arms and trunk

A

drugs

furosemide, captopril, antibiotics

397
Q

dermatitis herpetiformis is characterised by what?

A

chronic blistering rash with herpes-like appearance

398
Q

does herpes cause dermatitis herpetiformis?

A

no

399
Q

which surfaces of the body are normally affected by dermatitis herpatiformis?

A

extensors

400
Q

what GI disease can often accompany dermatitis herpatiformis? why?

A

coeliac disease

can cause jejunal villous atrophy

401
Q

in which skin layer does dermatitis herpatiformis start?

A

dermis

402
Q

what antibody mediates dermatitis herpetiformis?

A

IgA

403
Q

what lifestyle change can dramatically improve dermatitis herpetiformis?

A

gluten-free diet

404
Q

what is juvenile spring eruption?

A

rash on helices of ears when exposed to sunlight

405
Q

what causes benign summer light eruption?

A

sunbathing

406
Q

what type of hypersensitivity reaction causes benign summer light eruption?

A

type 4 hypersensitivity triggered by UV rays

407
Q

porphyrias are characterised by an accumulation of what?

A

porphyrins (precursors of heme, p450 etc)

408
Q

what types of porphyria is caused by exposure to sunlight?

A

cutaneous

vesiulo-erosive

409
Q

what is chronic actinic dermatitis and what causes it?

A

skin inflammation from Uv light

410
Q

where does chronic actinide dermatitis normally erupt?

A

upper chest
hands
face

411
Q

what is cutaneous lupus erythematous?

A

transient butterfly rash after sun exposure

Y3 CORE CONDITIONS (15 decks)

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