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My Final Year 4 Revision > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

What is the leading cause for dry skin?

A

Towels

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2
Q

What get wet while it drys?

A

Towels

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3
Q

What has a dry sense of humour?

A

Me… and towels

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4
Q

What conditions are included in “atopy”?

A

Eczema Rhinitis Asthma

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5
Q

Describe an Acne lesion?

A

Steroids

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6
Q

Describe a Macule lesion?

A

Flat <10mm

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7
Q

Describe a Patch lesion?

A

Flat >10mm

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8
Q

Describe a Plaque lesion?

A

Elevated or depressed >10mm

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9
Q

Describe a Papule lesion?

A

Elevated or depressed < 10mm

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10
Q

Describe a Nodule lesion?

A

Firm Extending into the dermis

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11
Q

Describe a Vesicle lesion?

A

Elevated Fluid filled <10mm

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12
Q

Describe a Pustules lesion?

A

Elevated Puss filled >10mm

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13
Q

Describe a Bulla lesions?

A

Elevated Clear fluid blister <10mm

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14
Q

Describe a targatoid lesion?

A

Coin shaped with central duskiness

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15
Q

Describe a Reticulate lesion?

A

Lesions in a net like pattern

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16
Q

Describe a Lichenfied lesion?

A

Increased thickening of the skin

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17
Q

Describe a Excoriated lesion?

A

Partial or complete loss of epidermis

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18
Q

What symptom are typical of Eczema?

A

Itchy dry lesion in a flexor distribution and on cheeks in children. Onset <2 years with other feature of atopy

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19
Q

What Endogenous types of Eczema are there?

A

Atopic Varicose Seborrhoeic

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20
Q

What exogenous types of eczema are there?

A

Photodermatitis Contact irritant eczema Contact allergic eczema

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21
Q

How is Eczema with a infection treated?

A

Topical treatment of Fucidin H cream BD

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22
Q

What is Eczema herpeticum?

A

Worsening Eczema caused by herpes simplex virus

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23
Q

What is the 1st line treatments for eczema?

A

Topicals- emollients, creams etc.

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24
Q

What is the 2nd line treatment for eczema?

A

steroids Calcineurin inhibitors

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25
Q

What are Calcineurin inhibitors?

A

Suppress T cel responce, are often use to avoid SE of long term steroids

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26
Q

What is the last line of therapy for eczema?

A

Systemic steroids or immunosuppresion.

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27
Q

Is phototherapy effective in eczema?

A

Yes, used for severe or resistant eczema

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28
Q

What questions should be asked about a rash?

A
  • Duration - Temporal pattern - Distribution - Associated symptoms - Exacerbation and relieving factors
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29
Q

What is erythrodermic eczema?

A

Covering more than 90% of the body

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30
Q

What can cause erythrodermic eczema?

A

Withdraw of steroid 2nd to infection Psychological stress Contact dermatitis

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31
Q

What is the most common type of psoriasis?

A

Chronic plaque psoriasis

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32
Q

What psoriasis occurs after strep. throat?

A

Guttate psoriases, can progress CPP

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33
Q

What can trigger psoriasis?

A

Infection Stress Durgs - alcohol, abx

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34
Q

Is there a genetic component to psoriasis?

A

Yes T 1 - <40yo 75% of patens T2 - 1st time 55-60, 25% of patient

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35
Q

What factors are involved in the pathophysiology of psoriasis?

A
  • Epidermal hyperplasia - Angiogenesis - T cell infiltration - TNF-a
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36
Q

What is the Auspitz sign?

A

Removal of scales reveals pin prick bleeding points under the skin

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37
Q

What is the likely diagnosis?

A

Eczema herpeticum

  • rapid progression
  • Paingul
  • Eroded punched out lesion
  • vesicles
  • fever
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38
Q

What type of lesion is…

A

Macule

  • flat
  • < 10 mm
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39
Q

What type of lesion is…

A

Plaque (psoriasis)

  • >10mm
40
Q

What type of lesion is…

A

Vesicle (herpes –> genital warts)

  • fluid
  • < 10mm
41
Q

What type of lesion is…

A

Bulla

  • > 10mm
  • Fluid filled
42
Q

What type of lesion is…

A

Macule

  • flat
  • <10mm

This is petechiae - bleeding from small blood vessels

43
Q

What type of Eczema is this?

A

Seborrhoeic dermatitis

44
Q

What is the typical dystribution of Chronic plaque psoriasis?

A
  • Scalp
  • Genitalia and nasal cleft
  • Extensor surfaces on knees and elbows
45
Q

What is the diagnosis of this…

A

Guttate Psoriasis

  • Small ping plaques
  • more commonnin younger patients
  • progresses to CCP
46
Q

What can precede psoriatic skin lesions?

A

Psoriatic Arthropathy precede Psoriasis in around 50% of paitients

47
Q

What type od psoraisis might this be?

A

Erythrodermic psoraisis

No clearly defined plaques

Covers > 90% of body

Hypotension –> IV fluids

48
Q

What type of psoriasis can be trigger by cessation of steroid therapy?

A

Generalised Pustular Psoraisis

Medical emergency

49
Q

When suspecting Psoriasis, what other conditions maybe in the diferential diagnosis?

A

Lichen Planus

Atopic Eczema

Suborrhoeic dematitis

50
Q

What is lichen planus?

A

Plaques of hyperkeratotic, hyperpigmentsed, flat and rough

Chronic inflammatory condition

Self resolved however topical steroids and emolient to treat.

51
Q

What is suborrhoeic dermatitis?

A

Inflammation of the subeceous glands

Treated with antifungals and steroids

52
Q

What medication can trigger psoriasis

A

B-blockers

NSAIDS

Lithium

53
Q

What stigmata of psoriasis may be present on the nails?

A

Onycholysis

Oil spots

Pitting oedema

54
Q

What is the main disease to diffentiate from Acne Vulgaris?

A

Rosecea - has facial flushing, more localised, no comadones

Treatment with topical steroids and abx

55
Q

What is the APSEA?

A

Acne psochological and social affects of acne score

56
Q

What is Isotrtinoin and when is it used for Acne vulgaris?

A

A oral retinoid (vit A). Used after 3 months of PO abx and topical retinoid fails to treat acne vulgaris.

57
Q

What SE are there to isotetrinoin?

A

Teratrogenic - Fertile female have to be pregnanc tested every 4/12

Low mood

58
Q

What sytemic therapies are there fore eczema and psoriasis?

A

Methotrexate

Aziothioprine (eczema), Acitretin (psoriasis)

Cyclosporin

59
Q

What monitoring is inluded with methotrexate?

A

3/12 LFT and FBC (panycytopenia)

Folate supplimentation

60
Q

What monitoring is needed with cyclosporin?

A

HTN

Renal finction

Hypertrichosis - abnormal hair growth

61
Q

When perscibing topical steroids what dose should be used?

A

FTU - finger tip unit/

In dosage box write: “As per finger tip unit”

62
Q

What is this and what disease might it indicate?

A

Acantosis nigricans

Most commonly: gastric cancer

Also: DM, Cushings and PCOS

63
Q

What is this skin lesion?

Erythematous papules which are painful no central clearing

A

Erythema nodosum

Can be due to:

Post-strep infection

IBD

TB
Viral

Sarcoid

OCP

NSIADS

64
Q

What is this skin lesion

A
65
Q

Describe tinea corporis, and what causes them?

A

Ring worm raised lesion which is centrally spared.

Caused by dermatifit - a fungus which grows under the skin

66
Q

What is the most common skin cancers?

A

1st Basal cell carincoma

2n Squamous cell carcinoma

67
Q

What scale is used to classify skin colour?

A

Fitzpatrick skin types

68
Q

What precancerous skin lesion are there?

A

Bowens disease

Actin keratosis

69
Q

What are these lesions called?

A

Actinic keratosis

Precancerous and a chance to develope into SCC. Due to UV exposer

70
Q

What are these lesions called?

A

Bowens disease

Squamous sell carcinoma in situ

71
Q

What is this lesion?

A

Basal cell carcinoma

Pearly, rolled edge +/- talengecia

72
Q

How is bowens disease treated?

A

Surgery

Cryotherapy

Topical chemotherapy

72
Q

treatment of infected eczema

A

fucidin h cream. antibiotics with mild potency to treat secondary infection and eczema

73
Q

What is the treatment for a suspected melanoma?

A

Excision

73
Q

eczema- grouped vesicles, rapidly worsening painful, eroded punched out lesions, fever

A

eczema herpeticum

74
Q

What prognostic tool can be used from histology of a melanoma?

A

Breslow thickness, the depth of the melaoma in the epidermis

74
Q

complications of eczema herpeticum

A

encephalitis, pneumonitis, hepatitis

75
Q

Prurigo

A

intense itchy papules and nodules

75
Q

first eczema treatment

A

bath additives, emollients, creams, ointments

76
Q
A
76
Q

psoriatic nail changes

A

erythema, pitting, hyperkeratosis, ocholysis

77
Q

itchy rash, purple/red bumps. shiny patches

A

lichen planus

78
Q

small pink plaques on trunk after infection

A

guttate psoriasis

79
Q

psoriasis over 90% of body. skin is red, hot and painful, pt is unwell

A

erythrodermic psoriasis

80
Q

treatment of psoriasis

A

emollient, soap substitute, vit d analogue

81
Q

severe psoriasis treatment

A

phototherapy, non bios eg methotreate

82
Q

hirsutism. obesity, acne, menstrual irregularities

A

PCOS

83
Q

treatment of acne

A

topical retinoidstopical antibioticsphototherapyoral abxretinoids

84
Q

indictions for isotretinoin

A

moderate acne unresponsive to other therapy, severe acne, scarring, psychological impact,

85
Q

risk factors for BCC

A

chronic sun exposure, fitzpatrick skin tye 1 and 2, chemicals, immunosuppression, gorlins syndrome

86
Q

risk factors for SCC

A

chronic sun exposure, fitzpatrick skin tye 1 and 2, chemicals, immunosuppression, cigarettes, chronic ulcers, xeroderma pigmentosum

87
Q

premalignant lesions

A

actinitic/solar keratoses, bowens disease

88
Q

ABCDE of melanoma

A

asymmetry ,border irregularity, colour variation, diameter, evolution

89
Q

itching without rash

A

pruritis

90
Q

widespread rash

A

neurological psychogenic, thyroid disease, pancreas problems, adrenal problems, GI (cholestasis), inflam ,infection, malignancy (hodgkins lymphoma, AML, CML, ALL, CLL)

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