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Year 2 MBChB > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is vitiligo?

A

Autoimmune condition resulting in the loss of melanocytes, and depigmentation of the skin

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2
Q

What conditions are associated with vitiligo?

A

T1DM
Alopecia
Addisons
Anaemia

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3
Q

What are the features of vitiligo?

A

Well demarcated plaques of depigmented skin

Peripheries most affected

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4
Q

What is the management of vitiligo?

A

Sun block
Make up
Cannot be reversed

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5
Q

What is impetigo?

A

Superficial bacterial skin infection

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6
Q

What is impetigo usually caused by?

A

Staph aureus

Strep pyogenes

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7
Q

What are the features of impetigo?

A

Golden crusted skin lesions, usually around mouth

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8
Q

What is the management of impetigo?

A

Localised: topical fusidic acid/retapamulin
Extensive: oral flucloxacillin

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9
Q

What is acne rosacea?

A

Chronic skin disease of unknown aetiology

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10
Q

What is the presentation of acne rosacea?

A

Flushing
Rhinophyma
Telangiectasia
Persistent erythema + pustules

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11
Q

What is the management of acne rosacea?

A

Topical metronidazole
Oxytetracycline
Laser therapy for telangiectasia

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12
Q

What is acne vulgaris

A

Condition characterised by obstruction of pilosebaceous follicles with keratin plugs

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13
Q

What are the features of mild acne vulgaris?

A

Open and closed comedones

Sparse inflammatory lesions

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14
Q

What are the features of moderate acne vagaries?

A

Widespread non-inflamm lesions and numerous papules and pustules

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15
Q

What are the features of severe acne vulgaris?

A

Extensive inflamm lesions

may include nodules, pitting, and scarring

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16
Q

What is the management of acne vulgaris?

A

Topical retinoids
Topical abx + retinoids
oral oxytetracycline
Oral isotretinoin

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17
Q

What organism mainly causes fungal nail infections?

A

Trichophyton rubrum

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18
Q

What are the features of fungal nail infections?

A

Unsightly nails; thickened, rough, opaque

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19
Q

What investigations are done in fungal nail infections?

A

Nail clippings/scrapings

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20
Q

What is the management of a fungal nail infection caused by dermatophytes?

A

Oral terbinafine/itraconazole for 3-6m

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21
Q

What is the management of a fungal nail infection caused by candida?

A

Topical antifungals

Oral itraconazole for 12 weeks

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22
Q

What is dermatitis herpetiformis?

A

Autoimmune blistering skin disorder

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23
Q

What disease is dermatitis herpetiformis associated with?

A

Coeliac disease

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24
Q

What is dermatitis herpetiformis caused by?

A

IgA deposition in the dermis

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25
Q

What are the features of dermatitis herpetiformis?

A

Itchy vesicular skin lesions on extensor surfaces

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26
Q

How is dermatitis herpetiformis investigated?

A

Skinn biopsy - direct immunofluorescence

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27
Q

What is the management of dermatitis herpetiformis?

A

Gluten free diet

Dapsone

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28
Q

What may guttate psoriasis be preceded by?

A

Strep infection - 2-4 weeks

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29
Q

What are the features of guttate psoriasis?

A

Tear drop papules on trunk and limbs

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30
Q

What is the management of guttate psoriasis?

A

Resolves 2-3m
Emollients + steroid creams
UVB phototherapy

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31
Q

What is erythema nodosum?

A

Symmetrical erythematous tender nodules

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32
Q

What is pretibial myxoedema seen in?

A

Graves disease

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33
Q

What is pretibial myxoedema?

A

Shiny orange peel skin

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34
Q

What is pyoderma gangrenosym?

A

Small red papule that developed into deep red necrotic ulcer with volaceous border

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35
Q

What are some causes of shin lesions?

A

Strep infection
Sarcoid
IBD

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36
Q

What is necrobiosis lipoidica diabeticorum?

A

Shiny, painless yellow/red skin in diabetics

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37
Q

What is alopecia areata?

A

Autoimmune condition leading to localised well demarcated patches of hair loss

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38
Q

What is cellulitis?

A

Infection of subcut tissues

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39
Q

What organism commonly causes cellulitis?

A

Strep pyogenes

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40
Q

What is the presentation of cellulitis?

A

Erythematous skin
Oedema
Pain
Reduced mobility

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41
Q

What does erythematous tracking mean?

A

Spread to lymph

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42
Q

What is the management of cellulitis?

A

Benzyl penicillin
Flucloxacillin
Paracetamol
Demarcation to assess spread

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43
Q

What is the presentation of henoch-schonlein purpura?

A

Erythematous and purpuric papules on buttocks and lower limbs (extensor surfaces)
Polyarthritis

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44
Q

What is the management of henoch-schonlein purpura?

A

Analgesia for arthralgia

Self-limiting

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45
Q

What is a keratoacanthoma?

A

Benign epithelial tumour

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46
Q

What is the presentation of keratoacanthoma?

A

Solitary nodule with central keratin (may be horny)

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47
Q

What is the management of a keratoacanthoma?

A

Refer under 2 week rule
Complete excision
Sun protection advice

48
Q

What are some drug causes of urticaria?

A

Aspirin
Penicillins
NSAIDs
Opiates

49
Q

What is the presentation of lichen planus?

A

Itchy papular rash most common on palms and soles
White lace pattern
Polygonal
Oral involvement in 50%

50
Q

What is porphyria cutanea tarda caused by?

A

Defect in uroporphyrinogen decarboxylase
Alcohol
Hep C

51
Q

How does porphyria cutanea tarda present?

A 
Photosensitive rash - face and dorsum of hands 
Blistering 
Skin fragility 
Excessive hair growth 
Hyperpigmentation
52
Q

How is porphyria cutanea tarda investigate?

A

Pink fluorescence of urine under Woods lamp

53
Q

How is porphyria cutanea tarda managed?

A

Chloroquinine

Venesection

54
Q

What gene is most important in eczema?

A

Filaggrin

55
Q

What are chronic changes in atopic eczema?

A

Excoriation
Lichenification
Secondary infection

56
Q

What type of hypersensitivity reaction of contact allergic dermatitis?

A

Type IV (T lymphocytes)

57
Q

What is bullous pemphigoid?

A

Autoimmune condition

Antibodies against hemidesmosal proteins leading to sub epidermal blistering

58
Q

How does bullous pemphigoid present?

A

Itchy, tense blisters around flexures
Heal without scarring
Mouth usually spared

59
Q

How is bullous pemphigoid investigated?

A

Immunofluorescence: IgG & C3 at DEJ

60
Q

What is the management of bullous pemphigoid?

A

Corticosteroids PO
Topical corticosteroids
Immunoscupression
Abx

61
Q

What is the commonest cause of erythema multiforme?

A

HSV

62
Q

What is the major form of erythema multiforme?

A

SJS - mucosal involvement

63
Q

How does erythema multiforme present?

A

Target lesions
upper limbs affected more than lower
mild pruritus

64
Q

What is the management of erythema multiforme?

A

Withdraw drug
Treat infection
Analgesia
Local skin care

65
Q

How does pemphigus vulgaris present?

A

Flaccid blisters
Pain
Do scar
Oral cavity affected

66
Q

How is pemphigus managed?

A

Steroids

Immunosupression

67
Q

What T cells are key in psoriasis?

A

TH2 & TH17

68
Q

What are some skin signs of diabetes?

A

Ulcers, xanthomata, necrobiosis lipoidica, acanthuses nigricans

69
Q

What is erysipelas usually caused by?

A

Strep

70
Q

What are thyroid hormones actions in the skin?

A

Promotes fibroblasts, regulates epidermal differentiation, skin perfusion + hair

71
Q

What are the skin features in SLE?

A

Butterfly rash, photosensitivity

72
Q

What is the morphology of erythema multiforme?

A

Target lesions

73
Q

What is SJS?

A

Variant of erythema multiforme with blistering and marked mucosal involvement

74
Q

What skin disorders are associated with HIV?

A

Kaposki’s sarcoma, seborrhoea eczema, infections

75
Q

What are the features of a BCC?

A

Raised, pearly edge, telangiectasia, central ulceration

76
Q

What are the surgical treatments for a BCC?

A

Standard excision, Mohs surgery

77
Q

What are the non-surgical treatments for a BCC?

A

Imiquimod, PDT, cryotherapy

78
Q

What are SSC pre-cursors?

A

AK and Bowen’s

79
Q

What is Bowen’s disease?

A

Intra-epidermal SCC

80
Q

What is AK?

A

Hyperkeratotic areas on sun-exposed sites

81
Q

What is the most common skin cancer post-transplant?

A

SCC

82
Q

Which type of malignant melanoma occurs on palms/soles mainly?

A

Acral lentiginous

83
Q

What are the phases of melanomas?

A

Radial growth –> vertical growth

84
Q

Which phase of melanoma growth can metastasise?

A

Vertical growth phase

85
Q

Which type of growth do nodular melanomas exhibit?

A

Vertical growth from the outset

86
Q

What is Breslow thickness?

A

Measures from the granular layer of epidermis to the deepest tumour cell

87
Q

What is Breslow thickness used for?

A

Determining prognosis

88
Q

What is urticaria?

A

A transient eruption of erythematous and oedematous swellings of the dermis, usually associated with itching

89
Q

What is angio-oedema?

A

Transient swellings in the pepper dermal, subcut and submucosal tissues

90
Q

What do antihistamines do?

A

Reversible competitive inhibitors of histamine binding to histamine receptors

91
Q

What drug is given in anaphylaxis and how much?

A

IM adrenaline 1mL of 1:1000

92
Q

Which nerve fibres transmit itch?

A

Unmyelinated C fibres

93
Q

What is the major gene locus in psoriasis?

A

6p21.3 (PSORS 1)

94
Q

Which HLA antigen causes a 10-fold increased risk of psoriasis?

A

HLA-Cw6

95
Q

What is the pathogenesis of psoriasis?

A

Hyperproliferation of epidermal cells - faster epidermal turnover time

96
Q

What is the normal epidermal turnover time?

A

25 days

97
Q

What are histological features of psoriasis?

A

Parakeratotic stratum corneum, absence of granular layer, expanded prickle cell layer

98
Q

What is Auspitz’ sign?

A

Removing scale reveals pinpoint bleeding

99
Q

What are the features of chronic plaque psoriasis?

A

erythematous scaly plaques on extensor surfaces (silvery scale)

100
Q

What is Koebner phenomenon?

A

Psoriasis develops in sites of trauma (scratching, burns)

101
Q

Who does guttate psoriasis affect?

A

Young patients (15-25 years)

102
Q

What are the features of guttate psoriasis?

A

Raindrop psoriatic lesions on the trunk 7-10 days after strep throat

103
Q

What is the management of guttate psoriasis?

A

Nil, emollients, topical tar, phototherapy

104
Q

What is the management of scalp psoriasis?

A

Olive oil, tar shampoos, coconut oil

105
Q

What are the blood changes in pustular psoriasis?

A

Hypoalbuniaemia, hypocalcaemia and leucocytosis

106
Q

What are psoriatic nail changes?

A

nail pitting, oncholysis, ‘oil drop’ lesions

107
Q

What is the treatment of psoriasis (increasing in severity)?

A

Topical (emollients, tar, vit D analogues, topical steroids), phototherapy, oral treatments

108
Q

What does coal tar do in psoriasis?

A

Reduces DNA synthesis and epidermal proliferation

109
Q

What should you never use on generalised psoriasis?

A

Potent topical steroids

110
Q

Why should you never use potent topical steroids on generalised psoriasis?

A

Risk of rebound flare up

111
Q

What is furunculosis?

A

Acute deep infection of the hair follicles

112
Q

What is staphylococcal scalded skin syndrome?

A

Epidermolytic exotoxin produced by staph causes splitting between desmosomes in granular layer

113
Q

What is the management of bacterial skin infections?

A

Swab, fusidic acid, oral abx if extensive

114
Q

What is the management of SSSS/facial erysipelas?

A

IV antibiotics

115
Q

What is the management of viral warts?

A

Salicylic acid (at least three months therapy), cryotherapy

116
Q

How are fungal infections investigated?

A

Skin scrapings, Woods lamp, biopsy with PAS stain

117
Q

What is the management of fungal infections?

A

Topical antifungals, oral if tinea ungium or capitis

Year 2 MBChB (8 decks)

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