Dermatology Flashcards
What is the most common skin cancer in uk
BCC
Risk factors for BCC
M > F
UV exposure
Skin Type 1
Immunesuppresion
Typical appearance of BCC
Pearly rolled edge
Ulcerated centre
Telangiectesia
Do they commonly metastasise
No, but if they do its bad
Does SCC metastasise
Yes - locally invasive
RF for SCC
UV exposure
Pre-malignancy conditions
Genetic predisposition
Presentation SCC
Kerastotic (scaly, crusty)
Ill-defined
Dignosis
Biopsy
+- CT
Tx
Surgical excision
Prognosis good unless mets
Maliganant melanoma tumour of what cell
epidermal melanocytes
3rd most common cancer in M & W
RF
Multiple melanocytic naevi
> 5 atypical naevi
Presentation
A asymmetrical B boarder irregularity C colour irregularity D > 6mm E evolution - change, bleed
4 subtypes
Superficial spreading
lentigo maligna
nodular
acral lentiginous
Scoring system
Looks a thickness
Tx
Surgical excision
+- CT (chemo + radio)
Eczema prevalence in < 12 years
20%
Exacerbated by
Stress
Allergens
Presentation
itchy
flexor
erythematous patches
4 types
Nummular dermatitis -related to injury
seborrhoea dermatitis - skin folds
irritant contact - relation to products
allergic contact dermatitis - nickle
Tx eczema
Avoid triggers
emollients - 3-4 a day keep skin moist and create barrier
Steroids if inflamamed
Steroid ladder
Mild :hydrocortison
Moderate: emovate
Potent
V potent
Cause of psoriasis
Overgrowth of keratinocytes
triggers psoriasis
stress
trauma infection
presentation psoriasis
well demarcated
extensor surface
symmetrical
Auspitz sign - scratch causes capillary bleeding
nail changes (50%) - pitting, leukonychia, onchlysis
associated conditions psoriasis
Psoriatic arthropathy
uveitis
IBD
metabolic syndrome
Tx psoriasis
Topcical Tx - emollients
Systemic agents - oral steroids or immunosuppressants (MTX) → dermatology
Phototherapy
Acne causes
Hormonal
↑ sebum production
bacterial colonisation
related to stress
Presentations
Non-inflam = open and close comedones Inflam = papules and pustules nodule and cyst
→ face, chest upper back
Tx
Mild
- topical agents - retinoids
- COCP
Moderate
- antibiotics - tetracycline
- anti-androgen therapy
severe
- referral to term
- isotretinoin (dries skin, teratogenic, monitor LFT)
Rosacea - who common in
30-60 years
W>M
Cause unknown
Rosacea presentation
Flushing telangiectasia central face ocular rosacea - gritty in eye avoid topical steroids - Topical antibiotics - metronidazole
Common bacterial infection
Appearance +
Cellulitis
Erysipelas - more superficial
→ red, warm, tender
→ mark skin
→ antibiotics oral or IV
Impetigo
honey crusted lesion
very contagious - washing hands, wash bed lined
topical antibiotics - fucidin can consider oral
Staphlycocoal scalded skin syndrom
Staphly coagulase negative - severe infection, very painful → admit
Warts causes + incubation
HPV
Spread - auto inoculation, direct to skin to skin
12 months
Presentation
Keratinous surface
verruca
Tx
Cryoptherapy
Varicella zoster infection
chicken pox
no Tx unless immnuocromised (aciclovir - risk encephalitis)
Herpes zoster painful rash
Shingles Can have pain before dermatomal rash Tx acyclovir if early in presentation Clears 3-4 weeks Comps: post hepatic pain
Fungal - dermatophyte (ringword)
named based on location it infects
Tx candidiasis
clotrimazole cream
Tx pityriasis versicolour
Discolouration of skin
Common in young in summer months
Scapies CF
Itch worse at night might see burrows
Topical permethrin 5% cream, Malathion 0.5% liquid
Tx close contacts
Blistering pemphigus
Rare automiine
Middle aged
effects epidermis
presents:
Blisters and erosions → rupture
skin and mucus membranes
Tx
Steroids
Immunosuppressant
Pemphigoid
Deeper in skin - hemidesmosomes
Present Tense, fluid filled blister itch trunk and limbs Less likely to burst
TX
Wound dressing
local or systemic Tx
Emergency
Erythema multiform
Acutre inflammatory condition
May be ppt HSV
Target lesions, rarely mucosal
Usually self-resolving
Ensure no drug or infection causing it
Steven johnson syndrome/toxic epidermal necrolysis
Rare - potential fatal
Usually 2 to medications
100 x more common in HIV
Presentation
Nikolsky sign - rub skin and blisters off
complications
dehydration
infection
gi ulceration
shock
SJS <10% BSA
TEN >30% BSA
SCROTEN used to predict mortality
Dermatomyotitis
50-70 years
Rash - proximal myopathy
heliotrop rash - over eyelids and butterfly
gottron papules - knuckles finger - non tender
steroids and immunosuppressents
Systemic sclerosis
CREST Calcinosis Raynauds Oesphalgeal dysmobility Telangestastia
Diffuse or systemic
Erythema nodosum
Diffuse hypersensitivity
present: tender, common shins
Ass:
TB, malignancy, gastric malignancy, sarcoidid, IBD
Acanthosis nigerians
Cushing's PCOS Insulin resistance Malignancy Drug induced (steroids)
Lichen Planus
10
purple, flat topped macules
forearms and wrists
Look in mouth
Koebner phenomeno - what is and what associated with
Scratch and leave mark
psoriasis lichen planus, vitiligo
Actinic keratosis associated
SCC
Molluscum contagiosum
Pearly, with umbilicate centre
Guttate psoriasis - Hx
Recent sore throat → diffuse rash
Rhinophyma what is it, who more common in which condition is it associated with?
Rosacea - most common in men
British association of dermatologist app
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