Dermatology Flashcards
what is the most common malignant skin tumour?
basal cell carcinoma
how would you treat a baby with eczema?
emollient
very careful w/ topical steroids if severe [can stunt growth]
what causes scabies? and what lesion is characteristic
mite under skin
linear track lesion
what is an unusual feature that characterises an urticaria rash?
rapidly changing/moves round body
treatment for urticaria?
oral antihistamine [non-sedating, then sedating if needed]
management of and treatment for urticaria with angio-oedema involving mouth/throat?
secure airway
IM adrenaline & IV hydrocortisone
topical treatment for mild acne
benzoyl peroxide azelaic acid topical antibiotics keratolytics retinoids vit B3 derivative nicotinamide
oral treatment for moderate-severe inflammatory acne?
oral antibiotics [3-4 MONTHS]
hormonal treatment [co-cyprindiol] in women
3rd line treatment of acne if topical agents and antibiotics fail?
oral retinoid [isotretinoin]
contraindication for oral retinoids for acne?
teratogenic!
1st line/mild management of eczema
avoid known irritants
emollients
TOPICAL CORTICOSTEROIDS [hydrocortisone]
topical calcineurin inhibitors
treatment of moderate/severe eczema when topical therapies unsuccessful?
sedative antihistamines
UV treatment
oral prednisolone/ azathioprine/ ciclosporin
treatment for bacterial superinfection in eczema
antibiotics
topical treatment for psoriasis?
emollients vitamin D3 analogues coal tar tazarotene [vit A antagonist/retinoid] corticosteroids dithranol
systemic treatment for psoriasis
oral retinoic acid derivatives methotrexate ciclosporin biological agents [TNF-a blockers] phototherapy
contraindication for retinoic acid derivatives in psoriasis?
teratogenic
what recurrent infection may be common in adults with eczema?
staphylococcus aureus
side effects of corticosteroids for atopic dermatitis [eczema]
skin atrophy suppression of skin barrier homestasis telangiectasia striae [stretch marks] acne hypopigmentation hypertrichosis
side effects of calcineurin inhibitors for eczema?
burning/stinging
theoretical cancer risk
downsides of UV therapy for eczema
cancer risk
increased photoaging of skin
how does azathioprine work?
blocks DNA synthesis & therefore cell proliferation
what is myelotoxicity?
bone marrow suppression
why is close follow-up required when using ciclosporin for eczema?
narrow therapeutic window
renal impairment
what type of drug is ciclosporin?
calcineurin inhibitor
immunosuppressive
seborrhoeic dermatitis is associated with proliferation of which commensal yeast colonization?
malassezia
what is seborrhoea?
oily skin
common uninflamed form of seborrhoeic dermatitis?
dandruff
treatment of scalp seborrhoeic dermatitis
anti-fungal treatment
keratolytic
treatment of seborrhoeic dermatitis on flexures, trunk and face
anti-fungal
steroid [for itch]
how do topical vitamin D analogues work?
inhibit cell proliferation
stimulate keratinocyte differentiation
reason to not use dithranol for psoriasis?
stains bath, skin, clothes etc
what type of drug is methotrexate?
DMARD
immunosuppressive [anti-proliferative, anti-inflamm]
methotrexate inhibits metabolism of which nutrient/vitamin?
folic acid
guttate psoriasis is classically triggered by what bacterial infections?
streptococcal
[upper resp tract]
retinoids are derivatives of which vitamin?
A
the anti-proliferative action of retinoids reduces which feature of psoriasis?
hyperkeratosis
when would you consider biologics in psoriasis?
unresponsive to standard therapies
intolerance/contraindication to standard therapies
severity meets NICE criteria for biologic
how do TNF-alpha antagonists work?
bind to TNK-a, blocking receptor mediated events [inflamm]
4 key factors associated w/ acne
- seborrhoea
- comedo formation [black/white heads]
- colonisation
- inflammation
what is rosacea?
chronic inflammatory facial dermatosis
flushing, erythema, papules, pustules
treatment of rosacea
topical antibiotic [metronidazole]
topical azelaic acid
2 main clinical features of urticaria
wheals [hives]
angio-oedema
examples of pigmented skin lesions
mole [melanocytic naevus]
seborrhoeic wart
freckle [lentigo, ephelis]
basal cell carcinoma
risk factors for melanoma
UV exposure high density freckles red hair >100 moles >5 atypical moles family history
early signs of melanoma
enlargement
colour change [usually darkening]
ABCDE of melanoma
Asymmetry Border irregularity Colour variability Diameter >5mm elevation irregularity
4 types of melanoma
superficial spreading
nodular
lentigo maligna [face]
acral lentiginous [palms/soles]
differential diagnosis of melanoma
benign pigmented naevus seborrhoeic wart freckle pigmented BCC pyogenic granuloma
Tx of melanoma
surgical excision
B-RAF inhibitors [vemurafenib]
immunotherapy - PD-1 inhibitors [nivolumab]
mortality rate for melanoma
20%
what is toxic epidermal necrolysis
life threatening drug reaction causing widespread blistering and skin peeling
which types of drugs can cause toxic epidermal necrolysis
Abx
anti-epileptics
NSAIDs
(+ others)
what other types of conditions may a vitiligo Pt have
autoimmune e.g. pernicious anaemia, hypothyroid
what type of dermatological condition typically causes annular lesions?
fungi e.g. ringworm
local S.E.s of topical corticosteroids
skin thinning > atrophy/ stretch marks bruising tearing of the skin telangiectasia worsening of condition: acne/roseacea allergy
what are retinoids, what effect do they have + what diseases are they useful in treating?
components of vitamin A
reduce hyperkeratosis [skin thickening/epithelial overgrowth]
for acne, psoriasis, keratoderma
