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3b > dermatology > Flashcards

dermatology Flashcards

1
Q

What is erythema nodosum & which diseases is it associated with

A

Blue/red painful lesions on shins, associated with sarcoid, strep infection and sulphonamides

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2
Q

What is erythema multiforme & what causes it

A

Symmetrical target lesions on palms soles and limbs. Caused by infections (HSV, mycoplasma) and drugs (SNAPP - sulphonamides, NSAIDs, allopurinol, penicillin, phenytoin)

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3
Q

What is Stevens Johnson syndrome?

A

More severe form of EM with mucosal involvement

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4
Q

What is Toxic Epidermal Necrolysis and how do you treat it?

A

Extreme form of SJS usually from a drug reaction, extensive mucosal ulceration and epidermal loss. Increased risk in HIV, treat with dexamethasone and IVIG

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5
Q

What is dermatitis herpetiformis and how do you treat it?

A

Itchy vesicles on extensor surfaces, associated with coeliac disease. IgA deposition. treat with dapsone.

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6
Q

What is pyoderma gangrenosum?

A

Wide, deep ulceration on legs associated with IBD, RA, wegeners. Treat with high dose steroids.

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7
Q

What is livedo reticularis?

A

Persistent red/blue mottled lesions that don’t blanch, usually on legs, triggered by cold. Associated with vasculitis, antiphospholipid syndrome

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8
Q

5 features of malignant melanoma

A

Asymmetry, Border irregular, Multiple colours, Diameter >6mm, Evolving/elevated

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9
Q

5 risk factors for malignant melanoma

A

Family history, fair skin, lots of moles, sun exposure, increasing age, immunosupression

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10
Q

5 classifications of malignant melanoma?

A

Superficial spreading, lentigo melanoma maligna, acral lentiginous, nodular melanoma, amelanotic

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11
Q

2 staging criteria for malignant melanoma?

A

Breslows depth and Clarks staging

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12
Q

Treatment of malignant melanoma

A

Depending on staging - excision, +/- lymphadenectomy +/- chemotherapy

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13
Q

What does SCC look like?

A

Ulcerated lesion with hard raised everted edges, on sun exposed areas. can bleed, itch and be painful.

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14
Q

7 risk factors for SCC

A

Sun exposure, smoking, fair skin, moles, outdoor occupation, pre malignant lesions, skin trauma, asbestos, arsenic

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15
Q

What are actinic keratotoses?

A

Pre malignant, irregular, crusty warty lesions. Treat with 5-fluouracil/diclofenac/imiquimod

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16
Q

What is the evolution of SCC?

A

Actinic keratoses -> Bowens -> SCC

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17
Q

Treatment of SCC?

A

Topical 5 fluouracil or salicylic acid, cryotherapy, excision

18
Q

2 risk factors for BCC

A

Fair skin and sun exposure

19
Q

What does BCC look like?

A

Typically a pearly nodule with a red, raised, rolled edge, telangiectasia,

20
Q

Treatment of BCC?

A

Topical 5-fluouracil or salicylic acid, cryotherapy, excision

21
Q

What are seborrhoeic keratoses?

A

Crusty, pigmented, wart like benign lesions

22
Q

8 risk factors for cellulitis

A

Diabetes, skin breaks, insect bites, chronic venous insufficiency, IVDU, immunosuppression, varicose veins, lymphedema, age, fungal infections, obesity

23
Q

2 common bacterial causes of cellulitis

A

Group a beta haemolytic strep - pyogenes and staph aureus

24
Q

Presentation of cellulitis

A

Typically unilateral leg, erythema (rubor) warmth (calor) pain (dolor) swelling (tumor) - quick spreading.

25
Q

Treatment of cellulitis?

A

General - analgesia, raise legs, ?tetanus booster
Admit if systemically unwell, unstable comorbidities, sepsis, immunocompromised etc etc. Fluclox/erythromycin oral in 1ry care, IV in hospital

26
Q

6 acute and 2 chronic complications of cellulitis

A

Acute - nec fasc, osteomyelitis, abscess, sepsis, meningitis, post strep glomerulonephritis.
Chronic - persistent ulceration, lymphedema

27
Q

Pathology of psoriasis

A

Chronic inflammatory skin condition. Hyperproliferation of keratinocytes and T cell driven inflammatory infiltration of dermis and epidermis

28
Q

5 histopathological findings in psoriasis

A

Parakeratosis, acanthosis, T cells in upper dermis, lengthened retes ridges, absent granular layer, munro microabscesses, capillary loop dilatation

29
Q

Presentation of psoriasis

A

Well circumscribed erythematous plaques with silver scaling. Kobner phenomenon. Extensor surfaces, scalp. Arthropathy. Nail changes.

30
Q

4 nail changes in psoriasis

A

Beaus lines, pitting, onycholysis, subungual hyperkeratosis

31
Q

4 other types of psoriasis

A

Guttate - follows strep infection
Palmo-planar pustular
Flexural
Erythrodermic - emergency - rx with methotrexate

32
Q

Management of psoriasis

A 
Emollients
Vit D analogues
Topical corticosteroids
Salicylic acid
Coal tar
Dithranol
Retinoids
UVB
33
Q

Epidemiology of psoriasis

A

Peaks in 20s and 50s

34
Q

5 pillars of acne

A 
Basal keratinocyte proliferation in pilosebaceous follicles
Increased sebum production
Propionibacterium acnes colonisation
Inflammation
Comedones blocking secretions
35
Q

Treatment pathway of acne

A

Mild - topical benzoyl peroxide, azelaic acid, topical clindamycin
Moderate - topical benzoyl peroxide and retinoids, doxycycline/minocycline
Severe - isotretinoin

36
Q

What is bullous pemphigoid?

A

Autoimmune subepidermal blistering due to IgG autoantibodies BP1 and BP2

37
Q

How does bullous pemphigoid present?

A

Acute or insidious onset, thick tense blisters on flexural surfaces, self limiting

38
Q

Treatment for bullous pemphigoid

A

Steroids & immunosuppresants, topical if localised systemic if severe

39
Q

What is pemphigus vulgaris?

A

Autoimmune epidermal blistering due to IgG autoantibodies - keratinocyte surfaces (desmoglien)

40
Q

How does pemphigus vulgaris present?

A

Age 40-60, mucosal, oral lesions, flaccid blisters. Nikolsky sign - slight rubbing exfoliates outer layer of skin

41
Q

Causes of erythema nodosum

A

Idiopathic, Drugs, OCP, Sarcoid, UC/crohns/behcets, Microbiology - EBV/strep/mycoplasma

42
Q

Presentation of lichen planus

A

Planus - Purple Pruritic Papular Polygonal rash on flexure surfaces, Wickhams striae on surface - white lace like

3b (4 decks)

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