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Neuro And Special Senses > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the hallmark of acute eczema?

A

Vesicles

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2
Q

Describe the symptoms of chronic eczema

A

Itchy
Poorly defined
Pink or red

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3
Q

What is lichenification?

A

Thickening of the skin with increased skin markings due to persistent scratching

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4
Q

What is the cause of atopic eczema?

A

Defective protein filaggrin

Therefore corneocytes are deformed and natural moisturising factors reduced

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5
Q

Which immune cells predominate in atopic eczema?

A

Th 2 lymphocytes

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6
Q

What percentage of children clear eczema by puberty?

A

90

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7
Q

Describe the treatment of eczema

A 
Emollients frequently 
Soap substitute - avoid fragranced products 
Topical steroids 
Immunomodulators for steroid sparing 
Sedating antihistamine to help sleep
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8
Q

Why do ointments work better than creams?

A

The grease in ointment forms an occlusive barrier preventing evaporation of water and delivers the steroid more effectively

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9
Q

Give examples of topical immunomodulators

A

Tacrolimus ointment - Protopic

Pimecrolimus cream

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10
Q

Name the types of eczema

A

Atopic
Discoid
Allergic contact

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11
Q

Give some drugs that will dry up exudate

A

Potassium permanganate

Aluminium acetate

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12
Q

Dermatitis herpetiformis is associated with which condition?

A

Gluten enteropathy

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13
Q

What findings are characteristic of scabies?

A

Itching worse at night
Other people itching too
Excoriated papules on trunk and limbs
Burrows found in between fingers or toes etc

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14
Q

What is the treatment for scabies?

A

5% permethrin cream
For patient and all their contacts
Wash all clothes and bedding on high after using cream

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15
Q

What is bullous pemphigoid?

A

An autoimmune condition that begins as a non-specific itchy rash and then weeks to months later bullae appear on the skin. Often localised to one part of the body for a while then spreads.

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16
Q

How do you treat bullous pemphigoid?

A

Potent topical steroid or oral dependent on extent of disease
Long term prednisolone often required
Steroid sparing agent eg. Azathioprine

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17
Q

Which microbe causes molluscum contagiosum?

A

Pox virus

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18
Q

Describe the lesions of molluscum contagiosum

A

Small 1-5mm white or pink umbilicated papules

Found anywhere on the skin

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19
Q

What is the management of vitiligo?

A

Avoid the sun and use protection
Systemic steroids can prevent rapid spread
Cosmetics/fake tan
Repigmentation can be attempted with topical steroid or tacrolimus

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20
Q

What are the 4 patterns of melanoma?

A

Lentigo maligna
Superficial spreading
Nodular
Acral lentiginous

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21
Q

Describe lentigo maligna melanoma

A

Large 1-3cm brown patch on sun exposed skin

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22
Q

Describe superficial spreading melanoma

A

Flat and brown, enlarging diameter
Variation in pigment
Eventually start growing downwards

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23
Q

Describe nodular melanoma

A

No radial growth

Grows only vertically

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24
Q

Describe acral lentiginous melanoma

A

Melanoma that occurs on the palms, soles or under the nails

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25
Q

Name the A-E used for pigmented lesions

A 
Asymmetry
Border
Colour
Diameter
Evolution
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26
Q

What are the risk factors for melanoma?

A 
Fair hair/red hair
Burn in the sun - type 1 skin
Badly sunburnt more than once
Large number of moles >50
Past or family hx melanoma
Atypical mole syndromes
Giant congenital melanocytic naevus
Use of tanning beds
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27
Q

What factors affect prognosis in melanoma?

A

Breslow’s thickness
Ulceration
Involvement of regional lymph nodes
Metastasis

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28
Q

What is Breslow’s thickness?

A

The depth in mm from the top of the granular layer to the deepest point of invasion

29
Q

What is Kaposi’s sarcoma?

A

Malignant growth of blood vessels caused by human herpes virus 8

30
Q

Describe the lesions in Kaposi’s sarcoma

A

Begin as small red/purple/brown macules or papules that grow into nodules and plaques

31
Q

What is a cherry angioma?

A

Small 1-4mm bright red or purple papule on the trunk or proximal limbs
Benign

32
Q

What are common warts?

A

Infection of the epidermis with one of the many human papilloma viruses

33
Q

Describe seborrhoeic keratosis

A

Flat but warty surface
Stuck on appearance
Black or white
Gradually become more prominent and deepen in colour

34
Q

What is a cutaneous horn?

A

A keratotic outgrowth from the skin. At its base will be solar keratosis, Bowen’s disease or SCC

35
Q

Describe solar keratosis

A

Rough, scaly papules on chronically sun exposed skin

36
Q

What are the 3 main types of BCC?

A

Nodular
Superficial
Infiltrating

37
Q

Describe a nodular BCC

A

Small, pearly papule with obvious telangiectasia
Gradually increase in size and may form rolled edge
Centre may ulcerated and form a crust

38
Q

Describe a superficial BCC

A

Growth is along the base of the epidermis
Presents as scaly plaque
Can become quite large

39
Q

Describe an infiltrating BCC

A

Fine strands of tumour cell infiltrate the dermis

Can look like a scar on presentation

40
Q

What factors influence prognosis of SCC?

A 
Size of lesion
Depth
Poor differentiation
Immunsuppression
Perineural invasion
Recurrent
41
Q

Describe acanthosis nigricans

A

Skin or flexures in dry and thickness, dark brown and has a papillomatous velvety surface

42
Q

Which malignancies are associated with acanthosis nigricans?

A

Lung
Stomach
Ovary

43
Q

Cellulitis tends to be caused by what bacteria?

A

Group A, C or G beta haemolytic strep

44
Q

Necrotising fasciitis is usually caused by which bacteria?

A

Group A beta haemolytic strep

45
Q

How do you treat venous ulcers?

A

Clean and debride
Apply emollient and dressing
Compression bandaging

46
Q

What are the commonest sites of venous ulcers?

A

Lower third of legs over medial or lateral malleolus

47
Q

What are the features of venous ulcer?

A

Large
Superficial
Painless

48
Q

What are the features of arterial ulcers?

A

Painful
Punched out
Deep

49
Q

Where do arterial ulcers occur?

A

Tips of toes, dorsum of foot, heel and front of shin

50
Q

How do you treat an arterial ulcer?

A

Refer to vascular surgeon
Debride and cover with dressing
Analgesia
Do not give tight bandages

51
Q

What are the features of a neuropathic ulcer?

A

Deep
Painless
Often covered with thick callous

52
Q

What is the treatment for neuropathic ulcers?

A

Remove callous to see extent
Take swabs and treat any infection
Bed rest/below knee cast to take pressure off

53
Q

Describe pyoderma gangrenosum

A

Rapidly growing ulcer with an overhanging edge and a yellow honeycomb base

54
Q

Which conditions are associated with pyoderma gangrenosum?

A

UC
Crohn’s
RA
Myeloma

55
Q

Which bacteria cause impetigo?

A

Staph aureus

Group A beta haemolytic strep

56
Q

How does impetigo look?

A

Starts as vesicles

Rapidly break down into honey coloured crust

57
Q

What is the management of impetigo?

A

Avoid sharing towels etc
Topical Abx eg. Fucidin
Use arachis or olive oil to soften and remove crust
If caused by Group A strep then need PO penicillin V because of glomrulonephritis risk

58
Q

What is eczema herpeticum?

A

Atopic eczema with a secondary herpes simplex infection

59
Q

What is the hallmark of acne?

A

Comedones

60
Q

What colour are open and closed comedones?

A

Open - black

Closed - white

61
Q

What is the management of acne?

A 
Topical retinoids to unplug follicles
Duac (benzoyl peroxide and Clindamycin) for inflammatory lesions
Topical abx eg. Erythromycin 
Systemic abx eg. Lymecycline
Anti-androgens in females 
Oral isotretinoin
62
Q

Describe rosacea

A

Rash that looks like acne on a red background
Tends to be older patients
No comedones present

63
Q

Give some complications of rosacea

A 
Blepharitis
Conjunctivitis 
Keratitis
Chronic lymphoedema of the face
Rhinophyma
64
Q

What is the treatment of rosacea?

A

Antibiotics eg. Lymecycline

Topical metronidazole cream

65
Q

Which virus causes shingles?

A

Varicella zoster

66
Q

At what age does psoriasis commonly begin?

A

15-25 year olds

67
Q

Describe psoriasis lesions

A

Erythematous, clearly defined borders
Silvery scale
Symmetrical

68
Q

What are the treatment options of psoriasis?

A 
Emollients
Vitamin D3 analogues 
Topical steroids 
Topical retinoids
Coal tar
Phototherapy 
Methotrexate
Biologics

Neuro And Special Senses (5 decks)

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