Dermatology Flashcards
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What is the leading cause for dry skin?
Towels
What get wet while it drys?
Towels
What has a dry sense of humour?
Me… and towels
What conditions are included in “atopy”?
Eczema Rhinitis Asthma
Describe an Acne lesion?
Steroids
Describe a Macule lesion?
Flat <10mm
Describe a Patch lesion?
Flat >10mm
Describe a Plaque lesion?
Elevated or depressed >10mm
Describe a Papule lesion?
Elevated or depressed < 10mm
Describe a Nodule lesion?
Firm Extending into the dermis
Describe a Vesicle lesion?
Elevated Fluid filled <10mm
Describe a Pustules lesion?
Elevated Puss filled >10mm
Describe a Bulla lesions?
Elevated Clear fluid blister <10mm
Describe a targatoid lesion?
Coin shaped with central duskiness
Describe a Reticulate lesion?
Lesions in a net like pattern
Describe a Lichenfied lesion?
Increased thickening of the skin
Describe a Excoriated lesion?
Partial or complete loss of epidermis
What symptom are typical of Eczema?
Itchy dry lesion in a flexor distribution and on cheeks in children. Onset <2 years with other feature of atopy
What Endogenous types of Eczema are there?
Atopic Varicose Seborrhoeic
What exogenous types of eczema are there?
Photodermatitis Contact irritant eczema Contact allergic eczema
How is Eczema with a infection treated?
Topical treatment of Fucidin H cream BD
What is Eczema herpeticum?
Worsening Eczema caused by herpes simplex virus
What is the 1st line treatments for eczema?
Topicals- emollients, creams etc.
What is the 2nd line treatment for eczema?
steroids Calcineurin inhibitors
What are Calcineurin inhibitors?
Suppress T cel responce, are often use to avoid SE of long term steroids
What is the last line of therapy for eczema?
Systemic steroids or immunosuppresion.
Is phototherapy effective in eczema?
Yes, used for severe or resistant eczema
What questions should be asked about a rash?
- Duration - Temporal pattern - Distribution - Associated symptoms - Exacerbation and relieving factors
What is erythrodermic eczema?
Covering more than 90% of the body
What can cause erythrodermic eczema?
Withdraw of steroid 2nd to infection Psychological stress Contact dermatitis
What is the most common type of psoriasis?
Chronic plaque psoriasis
What psoriasis occurs after strep. throat?
Guttate psoriases, can progress CPP
What can trigger psoriasis?
Infection Stress Durgs - alcohol, abx
Is there a genetic component to psoriasis?
Yes T 1 - <40yo 75% of patens T2 - 1st time 55-60, 25% of patient
What factors are involved in the pathophysiology of psoriasis?
- Epidermal hyperplasia - Angiogenesis - T cell infiltration - TNF-a
What is the Auspitz sign?
Removal of scales reveals pin prick bleeding points under the skin
What is the likely diagnosis?

Eczema herpeticum
- rapid progression
- Paingul
- Eroded punched out lesion
- vesicles
- fever
What type of lesion is…

Macule
- flat
- < 10 mm
What type of lesion is…

Plaque (psoriasis)
- >10mm
What type of lesion is…

Vesicle (herpes –> genital warts)
- fluid
- < 10mm
What type of lesion is…

Bulla
- > 10mm
- Fluid filled
What type of lesion is…

Macule
- flat
- <10mm
This is petechiae - bleeding from small blood vessels
What type of Eczema is this?

Seborrhoeic dermatitis
What is the typical dystribution of Chronic plaque psoriasis?
- Scalp
- Genitalia and nasal cleft
- Extensor surfaces on knees and elbows

What is the diagnosis of this…

Guttate Psoriasis
- Small ping plaques
- more commonnin younger patients
- progresses to CCP
What can precede psoriatic skin lesions?
Psoriatic Arthropathy precede Psoriasis in around 50% of paitients

What type od psoraisis might this be?

Erythrodermic psoraisis
No clearly defined plaques
Covers > 90% of body
Hypotension –> IV fluids
What type of psoriasis can be trigger by cessation of steroid therapy?
Generalised Pustular Psoraisis
Medical emergency
When suspecting Psoriasis, what other conditions maybe in the diferential diagnosis?
Lichen Planus
Atopic Eczema
Suborrhoeic dematitis
What is lichen planus?
Plaques of hyperkeratotic, hyperpigmentsed, flat and rough
Chronic inflammatory condition
Self resolved however topical steroids and emolient to treat.

What is suborrhoeic dermatitis?
Inflammation of the subeceous glands
Treated with antifungals and steroids

What medication can trigger psoriasis
B-blockers
NSAIDS
Lithium
What stigmata of psoriasis may be present on the nails?
Onycholysis
Oil spots
Pitting oedema
What is the main disease to diffentiate from Acne Vulgaris?
Rosecea - has facial flushing, more localised, no comadones
Treatment with topical steroids and abx

What is the APSEA?
Acne psochological and social affects of acne score
What is Isotrtinoin and when is it used for Acne vulgaris?
A oral retinoid (vit A). Used after 3 months of PO abx and topical retinoid fails to treat acne vulgaris.
What SE are there to isotetrinoin?
Teratrogenic - Fertile female have to be pregnanc tested every 4/12
Low mood
What sytemic therapies are there fore eczema and psoriasis?
Methotrexate
Aziothioprine (eczema), Acitretin (psoriasis)
Cyclosporin
What monitoring is inluded with methotrexate?
3/12 LFT and FBC (panycytopenia)
Folate supplimentation
What monitoring is needed with cyclosporin?
HTN
Renal finction
Hypertrichosis - abnormal hair growth
When perscibing topical steroids what dose should be used?
FTU - finger tip unit/
In dosage box write: “As per finger tip unit”
What is this and what disease might it indicate?

Acantosis nigricans
Most commonly: gastric cancer
Also: DM, Cushings and PCOS
What is this skin lesion?
Erythematous papules which are painful no central clearing

Erythema nodosum
Can be due to:
Post-strep infection
IBD
TB
Viral
Sarcoid
OCP
NSIADS
What is this skin lesion
Describe tinea corporis, and what causes them?
Ring worm raised lesion which is centrally spared.
Caused by dermatifit - a fungus which grows under the skin

What is the most common skin cancers?
1st Basal cell carincoma
2n Squamous cell carcinoma
What scale is used to classify skin colour?
Fitzpatrick skin types
What precancerous skin lesion are there?
Bowens disease
Actin keratosis
What are these lesions called?
Actinic keratosis
Precancerous and a chance to develope into SCC. Due to UV exposer
What are these lesions called?

Bowens disease
Squamous sell carcinoma in situ
What is this lesion?

Basal cell carcinoma
Pearly, rolled edge +/- talengecia
How is bowens disease treated?
Surgery
Cryotherapy
Topical chemotherapy
treatment of infected eczema
fucidin h cream. antibiotics with mild potency to treat secondary infection and eczema
What is the treatment for a suspected melanoma?
Excision
eczema- grouped vesicles, rapidly worsening painful, eroded punched out lesions, fever
eczema herpeticum
What prognostic tool can be used from histology of a melanoma?
Breslow thickness, the depth of the melaoma in the epidermis
complications of eczema herpeticum
encephalitis, pneumonitis, hepatitis
Prurigo
intense itchy papules and nodules
first eczema treatment
bath additives, emollients, creams, ointments
psoriatic nail changes
erythema, pitting, hyperkeratosis, ocholysis
itchy rash, purple/red bumps. shiny patches
lichen planus
small pink plaques on trunk after infection
guttate psoriasis
psoriasis over 90% of body. skin is red, hot and painful, pt is unwell
erythrodermic psoriasis
treatment of psoriasis
emollient, soap substitute, vit d analogue
severe psoriasis treatment
phototherapy, non bios eg methotreate
hirsutism. obesity, acne, menstrual irregularities
PCOS
treatment of acne
topical retinoidstopical antibioticsphototherapyoral abxretinoids
indictions for isotretinoin
moderate acne unresponsive to other therapy, severe acne, scarring, psychological impact,
risk factors for BCC
chronic sun exposure, fitzpatrick skin tye 1 and 2, chemicals, immunosuppression, gorlins syndrome
risk factors for SCC
chronic sun exposure, fitzpatrick skin tye 1 and 2, chemicals, immunosuppression, cigarettes, chronic ulcers, xeroderma pigmentosum
premalignant lesions
actinitic/solar keratoses, bowens disease
ABCDE of melanoma
asymmetry ,border irregularity, colour variation, diameter, evolution
itching without rash
pruritis
widespread rash
neurological psychogenic, thyroid disease, pancreas problems, adrenal problems, GI (cholestasis), inflam ,infection, malignancy (hodgkins lymphoma, AML, CML, ALL, CLL)