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Phase 2 - General Practice > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What words do you use to describe different small lesions?

A 
< 5mm
Papule - raised lump, solid
Macule - flat lesion, non-palpable
Vesicle - fluid filled (e.g a cyst, pustule)
Scaled - horny epithelium
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2
Q

What words do you use to describe different large lesions?

A 
>5mm
Patch - flat
Bulla
Nodule - raised
Plaque - raised and larger
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3
Q

What are some secondary characteristics of skin lesions?

A 
Scales
Atrophy
Lichenification
Crusts - dried exudate
Pigmentation
Ulcers
Fissures 
Telectangasia 
Induration
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4
Q

What are some location descriptors?

A 
Continuous
Discontinuous
Dermatomal
Symmetrical
Flexor/Extensors
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5
Q

What is eczema?

Where is it? (Ages)

A

An atopic chronic, relapsing condition of the skin.
It is itchy, erythematous patches
With dry and scaly skin
Can have nail pitting

Common in people with asthma and hayfever, young children (can grow out of it)
Flexor surfaces commonly
In babies - facial and extensors (nappy sparing)

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6
Q

What is psoriasis?
Who is affected?
Describe…
Other?

A

A chronic inflammatory skin condition
Affects men and women equally.
Get it on extensor surfaces, in folds of skin (under the breasts)
Tends to be symmetrical, red erythematous patches of differing sizes, has silver scales overlying (can look like fungal infection except for scales)

Can be associated with joint pain
Kobner phenomenon - get it in sites of damage

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7
Q

What is scabies?

A

An infestation of the skin by small mites
They burrow under the surface in areas like the wrist
Get multiple itchy papules

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8
Q

How do you treat eczema?

A 
No scratching, avoid perfumed things, soap alternatives
Cover (avoid damaging)
Emollients
Topical Immunomodulators (Tacrolimus)
Steroids
Then oral
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9
Q

How do you treat psoriasis?

A 
Wash and dry thoroughly
Large amounts of emollient
Vitamin D therapy
Topical Steroid Cream (if extensive can do oral)
Tar treatment and Calcineurin Inhibitors
(Joints - DMARDs)
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10
Q

What is shingles?

A

Shingles is Herpes Zoster infection in the nerve roots of different dermatomes
Can present first with pain in area (e.g Back Pain)
Seen in middle aged people, presents after small infection

It is asymmetrical (don’t cross the midline), dermatomal, erthyematous papules.

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11
Q

How do you treat scabies?

A

Need to clean EVERYTHING (wash all clothes etc)
Treat with a topical cream
Prophylaxis to people in contact with them

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12
Q

How do you treat shingles?

A

Aciclovir for 7 days (800mg 4x daily) if over 50 or other reason to need treating
Advice needed if immunocompromised or have eye involvement

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13
Q

What is acne rosacea?
Appearance?

Who affects?

Triggers?

A

Unknown pathology, chronic, relapsing inflammation
Erthematous rash with pustules, telectangasia, lymphoedema
Can get Rhinopympia

More common in fair skinned, middle aged
Appears on the face
Can have a trigger - stress, heat, infection, spice, steroids

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14
Q

How do you treat acne rosacea?

A

Avoid Triggers unless relapsing - metronidazole

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15
Q

What is Erythema Nodosum?
When do you see it?
How do you treat it?

A

Tender, erythematous Nodules commonly seen on the shins and extensor surfaces
20% people have a fever with it

Seen in infections, IBD, strep infections, TB, the COCP, malignancy, idiopathic

Goes in 8 weeks or so, give analgesia and compression can help

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16
Q

What is Lichen Planus?

A

Itchy, red, polygonal flat with papules
On flexor surfaces, soles and palms, mucous membranes and genitals
Symmetrical

Also get Kobner phenomenon

17
Q

How do you treat Lichen Planus?

A

Emollients

Moderate topical steroids

18
Q

What is Seborrhic Keratosis?
Who gets them?
Treatment?

A

Keratinised, pigmented (melanin) Nodules, can have cracks in them, well demarcated

Seen commonly in older males
On sun exposed surfaces
Benign

Can remove them if patient wishes

19
Q

What is Vitiligo?

Treatment?

A

Autoimmune depigmentation of the skin due to destruction of melanocytes
Symmetrical
More common in Afro-Caribbean populations

Protect from sun, steroids can help repigment if early in onset

20
Q

What is Urticaria?

A

A widespread inflammatory condition due to a hypersensitivity reaction.
Can be due to any allergy, seen in anaphylaxis
Due to presence of mast cells and histamine in the dermis

Has a central Wheal (white dot) and outer Flare (red)

Can be acute and chronic

21
Q

What are the types of wart?

How do you treat warts?

A

Planar - flat topped wart

Common - soles of feet and on hands in children

22
Q

What are some common fungal skin infections?

A

Tinea :
Dermatophyes in dead keratin “ring worm”
Affects many areas of body

Intertrigo:
Yeast infection in folds, bright red

Pityriasis Versicolar:
Flaky fungus of body becomes mycelial form causes infection and rash
Flaky, brown patches on chest and back
Long time and can reoccur

They all like humid environments

23
Q

What are some common Viral skin infections?

A

Herpes Zoster (Shingles)
Varicella Zoster (Chicken Pox)
Warts (HPV2)
Herpes Simplex - oral and genital warts

24
Q

Types of Skin Cancer?

A

Malignant Melanoma
Basal Cell Carcinoma
Squamous Cell Carcinoma

25
Q

What is Malignant Melanoma?
Causes and Risks?

How bad is it?
Appearance?
Treatment?

A

Pigmented lesions, flat, cancerous growth of melanocytes, damaged moles can become MM
ABDCE

UV Light, pale skin risk, FHx, birth marks

Metastasises easily

26
Q

Malignant Melanoma
Investigation
Treatment?

A

Full thickness excisional biopsy with 2mm margin
Staging tends to be on thickness

Low Stage: Excise with margin up to 2cm depending on stage
Stage 3: Mets to lymph node? remove
Stage 4: Radio/Chemotherapy
or palliative

27
Q

What is SCC?
How bad is it?
Appearance?

Staging?
Treatment?

A

Hyperkeratonic, crusting, ulcers, “horny” growth
Tend to be on sun exposed areas
Older people, fair skin, FHx, previous skin cancer, smoking

Can metastasise, fast growing, poor differentiation

1/5th of skin cancers
TNM staging
URGENT REFERRAL
Radiotherapy and removal

28
Q

What is BCC?
How bad is it?
Appearance?
Who gets them?

Investigations?
Treatment?

A

Cancer from Basal layer of epidermis
Raised border “rolled edge”, indurated white centre “pearl like”
Telectangasia
Only local spread

Old, sun exposed, face

Investigate with Biopsy, Histology and then…

Excise with 4mm margin or cryotherapy for superficial ones

29
Q

What is Erythema Multiform?

A

Target Lesions on hands and feet
Seen in any immune modulating disease (rheum, infections, pregnancy)

Treat the underlying cause and reassure

30
Q

What are the red flags for skin cancers

A 
Asymmetry
Borders - irregular
Colour - abnormal
Diameter > 6mm
Evolving
31
Q

What are the red flags for skin cancers?

When do you refer?

What are some minor changes you would worry about in a mole

A 
Asymmetry
Borders - irregular
Colour - abnormal
Diameter > 6mm
Evolving

Refer if more than 3 of these present in a “mole”

Minor changes - weeping, inflammation, itching

32
Q

What are some complications of Lichen Planus?

A

Nail Pitting or Grooves
Scarring Alopecia
Malignancy

33
Q

What are some complications of Eczema?

A

Secondary Infection (Bacterial or Viral and treat as such) - crusty and weeping (B) and sore

Lichenification

34
Q

What are the 4 types of Malignant Melanoma?

A

Acral Lentiginous (acro_ areas)
Lentigo (slow growing)
Nodular (can become red, raised, quick to grow)
Superficial Spread

(going up in likelihood)

35
Q

How do you treat fungal infections?

A

Topical azoles:
Nizoral/Selenium shampoo
Or cream

Oral if extensive

36
Q

How do you treat bacterial infections?

A

Fluclox 4x day
Rest, elevate, analgesia

Refer if systemically unwell or complications

37
Q

What is Pityriasis Rosea?

How do you treat?

A

Uwell
“Herald patch” - red, scales
then
widespread rash later

Goes on its own in 3 months
If itchy - emollient, steroid, anti-histamine

Phase 2 - General Practice (5 decks)

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