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General Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What makes acne worse

A 
POP
hormone changes around menstruation
Thick, greasy make-up
Picking / squeezing spots
Heavy sweating
Humidity
Tight clothes
Diet high in milk and sugar
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2
Q

Skin care advice for acne

A

Don’t wash more than normal
Mild soap, lukewarm water
Antiseptic washes
Fragrance free, water based moisturiser

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3
Q

Topical tx for acne

A

Azelaic acid
Salicylic acid
Benzoyl peroxide - antibacterial, anti-inflammatory, unlocks pores
Retinoids - unblock pores, anti-inflammatory
Topical antibiotics

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4
Q

Tablets for acne

A

Any systemic tx may take months to show effect.

  • Antibiotics - tetracyclines (doxycycline, tetracycline, oxytetracycline) erythromycin, trimethoprim
  • COCP esp Dianette
  • Isotretinoin - specialist advice
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5
Q

Tx for scarring by acne

A

Laser resurfacing
Chemical peels
Microdermabrasion
Subcison - for depressed scars

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6
Q

Complications of acne

A 
Anxiety 
Depression
Low self esteem 
Social isolation 
Scarring
Post-inflammatory hyper-pigmentation
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7
Q

What is acne excoriee

A

Excessive scratching / picking at normal skin / skin with minor abnormalities –> irritation, inflammation and scarring.
Picking continues until material is pulled from the skin

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8
Q

What is dermatitis herpetiformis

A

Autoimmune blistering condition - associated with coeliac

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9
Q

Presentation of dermatitis herpetiformis

A

Intense itch
Bullous rash - papules/blisters upto 1cm
Extensor surfaces - esp scalp, buttocks, elbows, knees

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10
Q

Tx of dermatitis herpetiformis

A

Dapsone (anti-leprotic)

Gluten free diet

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11
Q

What is pompholyx?

A

Type of eczema - itchy blisters on hands and feet

Followed by inflamed dry skin

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12
Q

Causes of pompholyx

A 
Metals such as nickel or cobalt
Antibiotic - neomycin
Certain chemicals - e.g perfume
Fungal infection of skin
Emotional stress
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13
Q

Tx of pompholyx

A 
Compresses / soaks
Emollients
Steroids
Antibiotics
Antifungal 
If severe / persistent --> dermatologist - PUVA, methotrexate, azathioprine, dapsone, tacrolimus
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14
Q

Prognosis of pompholyx

A

May clear up in 3-4 weeks + not return.
Or may be more persistent.
Some people have recurring short bouts.

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15
Q

What is seborrhoeic dermatitis

A

Skin inflammation, most common on the greasy areas of the skin - where most sebum is produced.
I.e scalp, forehead, sides of nose.
–> dry skin, red flaky patches

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16
Q

Tx of seborrhoeic dermatitis

A

Antifungal / antiyeast cream + shampoo - ketoconazole
Anti dandruff shampoo - zinc or coal tar based
Scale softener
Mild steroid cream
Pimecrolimus / tacrolimus cream
Anti fungal tablets
Phototherapy

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17
Q

Risk factors for compromised wound healing

A

DM
Peripheral vascular disease
Bleeding diathesis
Hx of keloid formation / scar hypertrophy

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18
Q

What is lichen planus?

A 
Chronic mucocutaneous dermatosis
White striae
Plaques
Erosions in mouth
Skin papules
Scalp involvement leads to alopecia
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19
Q

Features of seborrhoeic keratosis

A 
Pigmented
Benign tumour of basal keratinocytes 
Occur on face and trunk of elderly people
Dark 
rough
Greasy
Stuck on appearance
Well-defined edge
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20
Q

What is dercum’s disease

A

Multiple painful lipomas
Most common in obese, middle aged F
+/- headaches, amenorrhoea, reduced sweating

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21
Q

Features of a lipoma

A

Soft, mobile lesions
Composed of fatty tissue
Painless

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22
Q

What is a deep capillary naevus also known as

A

Port-wine stain

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23
Q

Features of a deep capillary naevus

A

Congenital
Malformation of capillaries in deep and superficial dermis
Most commonly - unilateral on the face
+/- seizures, learning difficulties, eye abnormalities

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24
Q

What is sturge-weber syndrome

A 
Collection of symptoms:
deep capillary naevus (port wine stain)
Fits
Developmental problems
Glaucoma
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25
Q

What is a superficial capillary naevus also known as

A

Salmon patch

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26
Q

Features of a superficial capillary naevus

A 
Small
Flat 
Pink patch 
Poorly defined border 
Common on forehead and nape of neck
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27
Q

Features of a ganglion cyst

A 
Benign
Terse
Cystic swelling
Back of wrist
Painless
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28
Q

What is a cavernous haemangioma also known as

A

Strawberry naevus

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29
Q

Features of a cavernous haemangioma

A 
Appears in 1st few months
Bright red lesion on face or trunk
Rapidly growing
Can ulcerate and bleed
Eventually regresses and disappears
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30
Q

Appearance and cause of acanthosis nigricans

A

Black, velvety overgrowth in axillae/neck/groin

Associated with diabetes, Cushing’s syndrome, acromegaly, PCOS, Lymphoma, adenocarcinoma of GIT

31
Q

Appearance and cause of Paget’s disease of the nipple

A

Scaly, dry rash on nipple

Caused by breast cancer

32
Q

Appearance and cause of tylosis

A

Hyperkeratosis of palms and soles

Due to oesophageal cancer

33
Q

Appearance and cause of dematomyositis

A

Purple heliotrope rash on eyelids
Scaly pink rash on knuckles

Autoimmune condition related to polymyositis
Or
Caused by lung or breast cancer

34
Q

Appearance of diabetic dermopathy

A

Depressed pigmented scars on the shin

Associated with diabetic microangiopathy

35
Q

Appearance of pretibial myxoedema

A

Raised erythematous plaques over the shins and dorsum of feet.
In hyperthyroidism

36
Q

Dermatological manifestations of hyperthyroidism

A

Pretibial myxoedema
Alopeica
Palmar erythema
Hyperhidrosis

37
Q

Appearance and cause of erythema an igne

A

Brown lacy rash on skin
Due to exposure to heat for long periods
E.g. Hot water bottles, sitting against radiators

Common in hypothyroid patients who are cold

38
Q

Dermatological manifestations of hypothyroidism

A 
Alopecia
Dry coarse hair
Puffy skin
Peri orbital oedema
Xanthoma
Malar flush
39
Q

Appearance and cause of xanthelasma

A

Yellow plaques around eyelid

Hyperlipidaemia

40
Q

Appearance and cause of granuloma annulare

A

Small red-purple papules arranged in a ring
On back of hands or feet
Often due to DM

41
Q

Appearance of a neurofibroma

A

Firm and rubbery

Single or multiple

42
Q

Features of cellulitis

A 
Erythema
Swelling
Local pain
Blistering 
Pyrexial patient
43
Q

What is a pyogenic granuloma

A

An acquired haemangioma
Commonly at the site of a thorn prick

Bright red nodule.
Bleeds easily
Enlarges rapidly over 2-3 weeks

44
Q

Appearance of kaposi’s sarcoma

A

Plaque / nodules in skin and mucous membrane

Bruise like appearance

45
Q

Features of a sebaceous cyst

A

Arise from hair follicle
Common on scalp, face, ears, back, upper arms
Contain keratin

Painless 
Mobile
Central punctum
Fixed to overlying skin
Not tethered to underlying subcutaneous tissue
46
Q

Commonest cause of necrotising fasciitis

A

Group A streptococcus (e.g. Strep pyogenes)

47
Q

Appearance of necrotising fasciitis

A

Erythema
Swelling
Necrotic tissue
Systemically unwell + fever

48
Q

Appearance of impetigo

A

Thin walled blisters
Itch
Bleed
Golden crust

49
Q

What causes livedo reticularis

A 
Can be normal - response to cold
Vasculitis 
Anti phospholipid syndrome
Polycythaemia rubra Vera
Cholesterol emboli
50
Q

What is the most common form of skin cancer

A

Basal cell carcinoma

51
Q

Risk factors for basal cell carcinoma

A 
UV light exposure
X-ray exposure
Chronic scar
Genetic predisposition
Male
52
Q

Presentation of basal cell carcinoma

A

Small, skin coloured papules
Telangiectasia
Pearly edge
Central necrosis

53
Q

What is a rodent ulcer

A

Basal cell carcinoma

54
Q

What is acrodermatitis enteropathica

Features

A

Rare inherited disorder of zinc malabsorption
Perianal and oral red scaly, pusular rash
Failure to thrive
Diarrhoea
Poor wound healing

55
Q

Skin conditions associated with HIV

A 
Leukoplakia 
Oral candidiasis 
Severe herpes episodes 
Kaposi's sarcoma 
Molluscum contagiosum
56
Q

What 2 skin conditions can develop along side Reiter’s syndrome

A
  • keratoderma blenorrhagicum

- circinate balanitis

57
Q

Appearance of keratoderma blenorrhagicum

A 
Pustular 
Crusty
Yellow-brown 
Papular lesion
On soles of feet 
Indistinguishable from pustular psoriasis
58
Q

What is erythema nodosum

A

Presumed hypersensitivity reaction.

Dermatological manifestation of infectious, or other, disease

59
Q

Appearance of erythema nodosum

A

Start as red, tender nodules. Poorly defined border - 2 to 6 cms.
Become tense, hard and painful.
May become fluctuant.
DO NOT suppurate or ulcerate.

60
Q

What are lisch nodules and when do they occur

A

Fibromas on the iris

Occurs in neurofibromatosis

61
Q

Difference between nodule and papule

A

Both raised
Nodule > 5mm
Papule <5mm

62
Q

How many cafe au lait spots are significant

A

More than 5

63
Q

What is a macule

A

Flat , non-palpable, colour change

<1cm

64
Q

What is a papule

A

Raised, palpable, circumscribed lesion,

< 1cm

65
Q

What is a plaque

A 
palpable, circumscribed, 
relatively flat topped lesion, 
greater in surface area than in thickness, 
> 1 cm, 
can be smooth or irregular and scaly
66
Q

What is a nodule

A

palpable, circrumscribed lesion,

larger than a papule - > 1cm and < 2 cm

67
Q

What is a vesicle

A

clear fluid –filled lesion,

<0.5 cm = smaller than a bulla

68
Q

What is a bulla

A

clear fluid-filled lesion,

>0.5cm = larger than a vesicle

69
Q

What is a pustule

A

turbid fluid-filled lesion,

filled with inflammatory cells

70
Q

What is lichenification

A

accentuated skin markings due to thickening of the epidermis

71
Q

Conditions associated with pyoderma gangrenosum

A 
Crohn's
UC
Rheumatoid arthritis 
Beçhets 
Active Hepatitis 
Primary biliary cirrhosis 
Myelo proliferative disorders (leukaemia, myeloma, lymphoma)
72
Q

Appearance of pyoderma gangrenosum

A 
solitary nodules / deep-seated pustules
rupture - form an ulcer. 
Ulcer border has a deep purple / dusky colour 
usually undermined edge. 
 bright erythematous / violaceous halo. 
Necrosis is a common feature.

extremely painful

73
Q

Most common organisms in cellulitis

A

Strep pyogenes
Staph aureus
(In infants - blood borne group B strep)

General Medicine (25 decks)

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