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Danny's Phase 2A Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

ACNE

What is it and when is the normal onset?

A

Inflammation of pilosebaceous units

adolescence to early adulthood

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2
Q

ACNE

Features of Acne?

A

1) Increased sebum production by sebaceous glands
2) Colonisation of pilosebaceous glands by Propionibacterium acnes
3) Follicular epidermal hyperproliferation + blockage of pilosebaceous ducts

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3
Q

ACNE

Why is it more common during puberty?

A
  • Androgen and progesterone production increases so sebum production increases
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4
Q

ACNE

Types of Acne?

A
  • Open comedones- blackheads- keratin

- Closed comedones- Whiteheads- sebum, keratin and deeper in ducts

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5
Q

ACNE

What may closed comedones cause?

A

Inflammatory papules , nodules &cysts

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6
Q

ACNE

First Line treatment?

A

Keratolytics (benzyl peroxide)- thins skin, clears pores, decreases bacteria
Topical Retinoids- (iso/tretinoin), topical erythromycin

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7
Q

ACNE

Second Line treatment?

A

low does Abx ( Doxycycline/ erythromycin)

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8
Q

ACNE

Third line treatment?

A
  • Po retinoids (isotretinoin )

vitamin A analogues that affect cell growth and differentiation

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9
Q

ECZEMA

Aetiology?

A
  • Abnormal epithelial barrier function

- Allows antigens/irritants to penetrate skin & reach immune cells

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10
Q

ECZEMA

Which cell(s) drive the acute phase?

A

Th-2 CD4 Lymphocytes

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11
Q 
ECZEMA
Which cell(s) drive the chronic phase?
A

Th0/Th1 CD4 lymphocytes

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12
Q

ECZEMA

Exacerbating factors?

A
  • animal hair
  • strong detergents
  • dietary allergens
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13
Q

ECZEMA

Where is it normally found and what does it look like?

A
  • usually found in flexures

- Itchy, erythematous, scaly patches

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14
Q

ECZEMA

Management?

A

1) Emollient creams (hydrate)

2) Steroid creams e.g hydrocortisone/ betamethasone

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15
Q

CONTACT DERMATITIS

Cause?

A
  • CLeaning products
  • Chemical irritants
  • Type IV hypersensitivity
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16
Q

CONTACT DERMATITIS

Features?

A
  • Unusual rash, clear cut borders/ odd shaped areas of erythema/ scaling
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17
Q

CONTACT DERMATITIS

Treat?

A

1) Remove cause
2) Steroids
3) Antipruritic agents `

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18
Q

PSORIASIS

Cause and triggers?

A
  • polygenic- 9 loci identified

1) Group A strep infection
2) UV light
3) Lithium
4) Alcohol
5) Stress

All T- lymphocyte driven

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19
Q

PSORIASIS

What is plaque psoriasis?

A

found in kids/ adults

  • Eruption of small circular plaques, on trunk, 2 weeks after strep infection (sore throat)
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20
Q

PSORIASIS

What is Erythrodermic psoriasis?

A

severe and life threatening

  • widespread intense inflammation of the skin- fever, malaise, circulating problems
21
Q

PSORIASIS

What may be seen if someone has psoriasis?

A

1) pitting/ onycholysis / yellow- brown nails

2) Psoriatic arthritis in 20% of patients

22
Q

PSORIASIS

Management? (1st and 2nd)

A

1st - emollient creams (hydrate)
2nd- Topical Agents - Vit D3 analogues (calcipotriol)
- Coal tar
- Retinoids (Tazorotene)
- Corticosteroids
- Salicylic acid

23
Q

PSORIASIS

3rd and 4th line treatment?

A

3rd- UV radiation - risk of skin cancer/ ageing

4th- Systematic therapy if all else fails and also erythrodermic psoriasis requires systematic therapy

  • Oral retinoids
  • Immunosuppression (methotrexate, azathioprine)
  • Biological Agents (infliximab)
24
Q

SKIN CANCER

What is the most serious case of skin cancer?

A

MALIGNANT MELANOMA

Metastases early and hard to treat after this

25
Q

SKIN CANCER

Criteria of malignant melanoma?

A 
Asymmetry of mole
Border irregularity 
Colour variation
Diameter >6mm
Evolution
26
Q

SKIN CANCER

List the Glasgow 7 point Criteria

A

MAJOR
- Change in size
shape
colour

MINOR

  • diameter >6mm
  • inflammation/bleeding
  • mild itch/ altered sensation
27
Q

SKIN CANCER

Name 4 types of melanoma?

A

Superficial Spreading Melanoma
Nodular Melanoma
Lentigo Malignant Melanoma
Acral Lentiginous Melanoma

28
Q

SKIN CANCER

What is Superficial Spreading Melanoma (70% of melanomas)

A

Large, flat, irregular pigmented lesion that grows out before deep

29
Q

SKIN CANCER

What is Nodular Melanoma? (15% of all melanomas)

A
  • rapidly growing pigmented nodule that bleeds/ ulcerates
30
Q

SKIN CANCER

What is Lentigo Malignant Melanoma?

A
  • Patch of ‘lentigo melanoma’- slow growing lesion on face of elderly
31
Q

SKIN CANCER

WHat is Acral Lentiginous Melanoma?

A

Pigmented lesions on palm, sole or under nail

32
Q

SKIN CANCER

Treat?

A
  • excision

- mets treated with chemo

33
Q

What is Basal Cell Carcinoma?

A
  • most common malignant skin tumour
  • occurs later in life on sun exposed skin
  • shiny nodule which may ulcerate
34
Q

Treatment of basal cell carcinoma and squamous cell carcinoma?

A
  • excision

- radiotherapy to treat mets/ recurrence

35
Q

What is Squamous Cell Carcinoma?

A
  • more dangerous than BCC as it can metastasise

- ulcerated lesion with hard, raised edges at sun exposed sites

36
Q

SKIN ULCERS

What are they?

A

Abnormal breaks in epithelial surface

37
Q

SKIN ULCERS

Different classes?

A
  • Venous (70%)
  • Mixed A+V (15% )
  • Arterial (2%)
  • neuropathic, diabetic, traumatic, infective, lymphoedema
38
Q

SKIN ULCERS

Where is a common site for a venous skin ulcer and how does it occur?

A

1) Incompetence of valves in lower legs
2) Blood pooling and varicose veins
3) They aren’t drained fast enough- dies and sloughed off leaving ulcer, commonly just above medial malleolus

39
Q

SKIN ULCERS

Cause of Arterial Skin Ulcer?

A
  • Atheroma
  • More painful and shallow
  • NEVER use compression bandaging
40
Q

SKIN ULCERS

Management?

A

1) prevent smoking, adequate nutrition, good nursing care

2) Compression bandaging if ABPI okay
don’t cut off blood supply! this is a cause

41
Q

CELLULITIS

What is it

A
  • spreading infection involving deep subcutaneous layer
42
Q

CELLULITIS

Causes

A

Group A strep / s pyogens/ s aureus

43
Q

CELLULITIS

Lower limb risks?

A
  • lymphoedema
  • ulcer
  • trauma
  • athletes foot
44
Q

CELLULITIS

Features

A
  • Erythema, poorly marked margins, warmth, swell, tender, maybe a fever
45
Q

CELLULITIS

Ix?

A
  • FBC
  • Cultures
  • swab at rash/ point of entry
46
Q

CELLULITIS

Treatment?

A
  • Phenoxymethylpenicillin/ Flucloxacillin (erythromycin if allergic)
47
Q

NECROTIZING FASCIITIS

What is it?

A

Rapid deep fascia infection = necrosis of subcutaneous tissue

48
Q

NECROTIZING FASCIITIS

Features?

A
  • pain
  • erythema
  • systemic toxicity
49
Q

NECROTIZING FASCIITIS

Treat?

A

-benzylpenicillin and surgical debridement

Danny's Phase 2A Medicine (15 decks)

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