Dermatology Flashcards
Itchy tender blisters around flexures with no mucosal involvement
Bullous pemphigoid
With mucosal is pemphigus vulgaris
Skin biopsy of itchy tense blisters with no mucosal involvement
IgG and C3 at dermoepidermal junction (bullous pemphigoid is autoimmune) give corticosteroids
What is positive Nikolsky’s sign?
the appearance of epidermis separating with mild lateral pressure in toxic epidermal necrolysis
features of toxic epidermal necrolysis
Nikolsky’s sign positive (separating epidermis with mild lateral pressure)
Extensive scalded-like rash
Systemically unwell
Intensely itchy vesicular rash on back of elbows
Dermatitis herpetiformis. IgA deposits, anti gliadin antibody, associated with coeliac
Skin patch Vs skin prick
Patch is useful for contact dermatitis
Prick is for food allergies and pollen
RAST is IgE amount that reacts to known allergens.. food allergies and pollen too
Which antibiotics are most associated with development of Stephen Johnson’s syndrome
Cotrimoxazole , penicillins
Teardrop lessons following a sore throat
Guttate psoriasis
Treatment for guttate psoriasis
Self resolve in 2-3 months but can use UVB therapy and tonsillectomy if recurrent
Features of leprosy
Hypopigmented skin with reduced sensation
diagnosis for erythematous lesions on shins with orange peel texture
pretibial myxoedema (see n in graves)
Pan systolic murmur, V waves in JVP, (tricuspid incompetence) in young patient diagnosis
Ebsteins abnormality -congenital heart defect with low insertion of tricuspid valve
INR target for aortic and mitral mechanical valves
3 and 3.5
How long does erythema nodosum usually last
6 weeks, no scarring
Old burn or scar… Patient presents with painless ulcerated lesion.. what is it?
SCC in 80% of cases. And is more dangerous -likely to metastasise
Treatment for alopecia areata
50% resolve within a year, 80-90% eventually.
Can give topical corticosteroids
A 55-year-old man presents with multiple erythematous target lesions two days after starting a new medication. What drug?
Erythema multiforme… Caused by viruses (HSV), mycoplasma/strep,
Penicillin, sulphonamides, carbamazepine, nsaids, contraceptive pill
Sarcoid
small blisters on the palms and soles
pruritic, sometimes burning sensation
Diagnosis
Pompholyx… Type of eczema often triggered by hot climates.
Cold compress, emollients, topical steroids… But quite resistant to treatment
Treatment for keloid scar
triamcinolone (topical steroids) if early
What hypersensitivity is allergic contact dermatitis
Type IV (delayed…) T cell mediated
What condition is associated with plucked chicken skin —
Small, yellow papules of 1-5 mm in diameter in a reticular pattern and coalescing at places into plaques
Pseudoxanthoma elasticum
Also get angoid streaks
Treatment for Norwegian scabies
Ivermectin, isolate
Management of venous ulcer
Compression bandages
Most common skin lesion in TB
Lupus vulgaris… Usually on face, erythematous flat plaque which gradually becomes elevated and may ulcerate later
Patient develops oval erythematous plaque then generalised pruritic rash. Diagnosis and what virus is linked to it?
Pityriasis rosacea
Herpes hominis virus 7 (HHV-7) is thought to play a role in the aetiology
Patient with herpes… What sign indicates ocular involvement is likely?
Vesicles on the tip of the nose, or vesicles on the side of the nose…Hutchinson’s sign which is strongly predictive for ocular involvement…
pinpoint petechial ‘blueberry muffin’ skin lesions
congenital cytomegalovirus
erythematous oval lesions on his back and upper arms which have a slight scale just inside the edge. They vary in size from 1 to 5 cm in diameter. What is the most likely diagnosis?
Pityriasis rosea
Guttate is usually smaller and scale isn’t just round the edge
Diagnosis… Initially smooth dome papule then becomes crater or volcano
Keratoacanthoma
Benign epithelial tumour… But refer for excision as might be SSC
Small erythematous patch with Wood grain appearance. Smoking history
Erythema gyratum repens… Paraneoplastic eruption commonly seen w lung cancer
What is infection that causes pityriasis versicolour? typically hypopigmentation
Malassezia, so treat with anti fungal ketoconazole shampoo or oral itraconazole
Flaccid oral blisters, acantholysis on biopsy
Pemphigus vulgaris
Bullous pemphigoid is more common is the elderly, and blisters are tense, with no Acantholysis
Management for impetigo
hydrogen peroxide 1% cream is first line of systemically well and few chances of complications
Followed by fusidic cream
Can give Oral fluclox if extensive disease
Diagnosis of monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter this is accompanied by pruritic painful blisters…
Eczema herpeticum
life threatening -treat with IV aciclovir
Fungal cause of tinea capitus -scalp ring worm
Trichophyton tonsurans
Asymp flat slightly scarlet pink or brown symmetrical rash around groin or axillae
Erythrasma
Overgrowth of diphtheroid Corynebacterium minutissimum
Coral red florescence on Wood’s light
Topical miconazole
Pregnant lady develops large, flat, symmetrical, brown-pigmented patch across her cheeks, forehead, nose and upper lip.
Melasma. Benign and relatively common.
perioral dermatitis: red, crusted lesions
Alopecia
What deficiency?
Zinc
May also have geophagia - ingesting clay/soil
Red spots with blue/white centre in mouth
Koplik spots in measles
Symmetrical, brown, velvety plaques on neck/axilla/groin…..what is acanthosis nigracans associated with?
It’s caused by insulin resistance… All things that are associated with weight gain…hypothy, DM, PCOS, COCP, obesity, prader willi, acromegaly, ……and gastric cancer
photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands
Porphyria cutanea tarda
inherited defect in uroporphyrinogen decarboxylase or caused by hepatocyte damage e.g. alcohol, hepatitis C, oestrogen.
Erythroderma
90% or more of the skin is affected
pigmented lesions on lips, oral mucosa, face, palms and soles, diarrhoea
Peutz-Jeghers syndrome
Necrobiosis lipoidica management
Skin condition in diabetes
Topical corticosteroids
Rash assx with Mycoplasma pneumoniae
Erythema multiforme or nodosum
