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Stage 3: FOCP > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What to ask in history of rash - HPC

A
  • Relieving/exacerbating factors
  • Associated symptoms: itch, pain, burning
  • Systemic complaints
  • How long: duration, persistent intermittent
  • Treatments tried to date
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2
Q

Relevant PMH for history of rash

A
  • Diabetes
  • Thyroid
  • Atopic disorders – eczema, asthma, hayfever
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3
Q

What drugs are associated with psoriasis (cardiac, neuro)

A

beta blockers, lithium

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4
Q

Relevant family hx for history of rash

A
  • Atopic disorders

* Skin cancers

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5
Q

What to ask in history of lesion - HPC

A
  • Onset: Initial appearance + evolution, Duration
  • Character: Pain, itch, discharge, bleeding
  • Skin type (Fitzpatrick)
  • UV exposure – sunbeds, occupation, travel
  • History of skin cancer
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6
Q

ABCDE of describing a pigmented lesion

A
  • Asymmetry
  • Border: smooth edge vs craggy
  • Colours: how many
  • Diameter
  • Elevation and evolution
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7
Q

What is a flat discoloured lesion <5mm called

A

Macule

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8
Q

What is a flat discoloured lesion >5mm called

A

Patch

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9
Q

What is a solid elevation <5mm called

A

Papule

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10
Q

What is a solid elevation >5mm called

A

Nodule

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11
Q

What is a clear fluid-filled lesion <5mm called

A

Vesicle

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12
Q

What is a clear fluid-filled lesion >5mm called

A

Bullous (blister)

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13
Q

What is a pus-filled lesion <5mm called

A

Pustule

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14
Q

What is a scaly raised lesion >5mm called

A

Plaque

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15
Q

What autoimmune condition is pyoderma gangrenosum associated with

A

IBD: Crohn’s and Ulcerating Colitis

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16
Q

Describe the Koebner phenomenon.

In which type of pt does it occur most often

A
  • Appearance of linear skin lesions exacerbated by trauma eg scratching, surgery
  • Happens most often in people with psoriasis
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17
Q

Name a dermatological emergency

A

Erythroderma

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18
Q

What skin condition causes target lesions

A

Erythema multiforme

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19
Q

Commonest cause of erythemia multiforme

A

Viral infection

second most common cause is allergy

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20
Q

Which layer of skin does UVA damage

A

Epidermis

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21
Q

Which layer of skin does UVB damage

A

Dermis

22
Q

Which layer of skin does infrared damage

A

Deep dermis and subcutaneous tissue

23
Q

What are cherry angiomas

  • in which age group are they more common
  • do they require urgent referral
A

Benign blood vessel lesion

Common in elderly

Benign, harmless

24
Q

What are 3 pre-malignant versions of SCC

A
  1. Actinic keratosis
  2. Bowen’s disease
  3. Cutaneous horn
25
Q

What is the pre-malignant version of melanoma

A

Lentigo maligna

26
Q

What is the pre-malignant version of BCC

A

BCC does NOT have a pre-cancer version

27
Q

List the skin cancers from the highest grade to lowest

A
  1. Melanoma
  2. SCC
  3. BCC
28
Q

Main features of BCC

A
  • Slow growing
  • Pearly translucency with dilated blood vessels running over (telengectasia)
  • Rolled-edge
  • Ulcerated
29
Q

Main features of SCC

A
  • Faster growing
  • Either raised bump or red, scaly skin patch
  • May have crusty edges or blood
  • tends to occur on sun-exposed areas
30
Q

Common sites of melanoma

  • for men
  • for women
A

Men: back
Women: legs

31
Q

What are common sites for acral lentiginous melanoma

A
  • under nail
  • palms
  • soles
32
Q

4 types of exogenous eczema

A
  • irritant
  • allergic
  • photodermatitis
  • dust mite allergy
33
Q

What autoimmune condition is associated with erythema nodosum

A

IBD (both Crohn’s and UC)

34
Q

What other 3 findings might one find in someone who has cutaneous vasculitis

(think of other systems associated with microvascular problems)

A
  1. Eye: Roth’s spots
  2. Kidney: Microscopic haematuria
  3. Spleen: Splenomegaly
35
Q

Difference between irritant and allergic eczema

  • timing
  • exposure
A

Irritant: immediate inflammatory reaction, no prior exposure required

Allergic: slow reaction, usually after prolonged exposure

36
Q

Difference between type 1 and 4 allergy

  • cells involved
  • how to test
  • timing
  • result of exposure to allergen
A

Type 4:

  • T lymphocyte response
  • Patch test
  • Immediate reaction
  • Can cause anaphylaxis

Type 1:

  • IgE response to soluble antigen
  • Blood test
  • Delayed reaction
  • Causes allergic contact dermatitis
37
Q

Is allergic eczema type 1 or 4 allergy

A

type 4

38
Q

Is dust mite allergy type 1 or 4 allergy

A

type 1

39
Q

8 Types of endogenous chronic eczema

A
  1. atopic dermatitis
  2. seborrheic dermatitis
  3. discoid eczema
  4. pompholyx
  5. varicose eczema
  6. asteatotic eczema
  7. lichen simplex chronicus
  8. eczema herpeticum
40
Q

Where does eczema tend to present in children

A

face, flexors

41
Q

Where does eczema tend to present in adults

A

chest, lower back

42
Q

Risk factors for eczema

A
  • genetics
  • environment
  • endogenous (associated with atopy)
43
Q

What is pompholyx

A

Small stingy blisters on hands and feet which burst and dry up, become vesicles

44
Q

What is asteatotic eczema

A

Eczema with a fish scale/ mosaic type pattern

45
Q

Where does lichen simplex chronicus tend to occur

A

inner ankle
inner elbow
nape of neck

46
Q

What causes eczema herpeticum

What is a serious risk of this condition

A

HSV colonisation on top of eczema

Risk of corneal ulceration

47
Q

How to differentiate eczema vs psoriasis

  • borders
  • itchiness
  • appearance
  • where it occurs
A

Borders: diffuse (eczema) vs well-defined (psoriasis)

Itchiness: Eczema more itchy

Appearance: can see scratch marks (eczema) vs white silvery skin (psoriasis)

Where: flexor surface (eczema) vs extensor surface (psoriasis)

48
Q

Conditions associated with psoriasis

A
  • psoriatic arthritis
  • IBD
  • uveitis
  • Coeliac’s
  • metabolic syndrome
49
Q

What are the 6 components of metabolic syndrome

A
  1. obesity
  2. hypertension
  3. high cholesterol
  4. gout
  5. CVD
  6. T2DM
50
Q

pathology of psoriasis:

keratinocytes

A
  • keratinocytes normally take 28 days to migrate to skin surface (enough time to lose stickiness)
  • take 4 days in psoriasis
  • keratinocytes still sticky, stick together as plaques
51
Q

What type of psoriasis appears after acute infection eg strep throat

A

Guttate

52
Q

Describe Fitzpatrick skin types 1-6

A

TYPE 1: Highly sensitive, always burns, never tans.

TYPE 2: Very sun sensitive, burns easily, tans minimally.

TYPE 3: Sun sensitive skin, sometimes burns, slowly tans to light brown.

TYPE 4: Minimally sun sensitive, burns minimally, always tans to moderate brown.

TYPE 5: Sun insensitive skin, rarely burns, tans well.

TYPE 6: Sun insensitive, never burns, deeply pigmented.

Stage 3: FOCP (47 decks)

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