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MBBS / MBChB finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What makes acne worse

A 
POP
hormone changes around menstruation
Thick, greasy make-up
Picking / squeezing spots
Heavy sweating
Humidity
Tight clothes
Diet high in milk and sugar
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2
Q

Skin care advice for acne

A

Don’t wash more than normal
Mild soap, lukewarm water
Antiseptic washes
Fragrance free, water based moisturiser

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3
Q

Topical tx for acne

A

Azelaic acid
Salicylic acid
Benzoyl peroxide - antibacterial, anti-inflammatory, unlocks pores
Retinoids - unblock pores, anti-inflammatory
Topical antibiotics

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4
Q

Tablets for acne

A

Any systemic tx may take months to show effect.

  • Antibiotics - tetracyclines (doxycycline, tetracycline, oxytetracycline) erythromycin, trimethoprim
  • COCP esp Dianette
  • Isotretinoin - specialist advice
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5
Q

Tx for scarring by acne

A

Laser resurfacing
Chemical peels
Microdermabrasion
Subcison - for depressed scars

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6
Q

Complications of acne

A 
Anxiety 
Depression
Low self esteem 
Social isolation 
Scarring
Post-inflammatory hyper-pigmentation
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7
Q

What is acne excoriee

A

Excessive scratching / picking at normal skin / skin with minor abnormalities –> irritation, inflammation and scarring.
Picking continues until material is pulled from the skin

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8
Q

What is dermatitis herpetiformis

A

Autoimmune blistering condition - associated with coeliac

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9
Q

Presentation of dermatitis herpetiformis

A

Intense itch
Bullous rash - papules/blisters upto 1cm
Extensor surfaces - esp scalp, buttocks, elbows, knees

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10
Q

Tx of dermatitis herpetiformis

A

Dapsone (anti-leprotic)

Gluten free diet

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11
Q

What is pompholyx?

A

Type of eczema - itchy blisters on hands and feet

Followed by inflamed dry skin

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12
Q

Causes of pompholyx

A 
Metals such as nickel or cobalt
Antibiotic - neomycin
Certain chemicals - e.g perfume
Fungal infection of skin
Emotional stress
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13
Q

Tx of pompholyx

A 
Compresses / soaks
Emollients
Steroids
Antibiotics
Antifungal 
If severe / persistent --> dermatologist - PUVA, methotrexate, azathioprine, dapsone, tacrolimus
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14
Q

Prognosis of pompholyx

A

May clear up in 3-4 weeks + not return.
Or may be more persistent.
Some people have recurring short bouts.

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15
Q

What is seborrhoeic dermatitis

A

Skin inflammation, most common on the greasy areas of the skin - where most sebum is produced.
I.e scalp, forehead, sides of nose.
–> dry skin, red flaky patches

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16
Q

Tx of seborrhoeic dermatitis

A

Antifungal / antiyeast cream + shampoo - ketoconazole
Anti dandruff shampoo - zinc or coal tar based
Scale softener
Mild steroid cream
Pimecrolimus / tacrolimus cream
Anti fungal tablets
Phototherapy

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17
Q

Risk factors for compromised wound healing

A

DM
Peripheral vascular disease
Bleeding diathesis
Hx of keloid formation / scar hypertrophy

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18
Q

What is lichen planus?

A 
Chronic mucocutaneous dermatosis
White striae
Plaques
Erosions in mouth
Skin papules
Scalp involvement leads to alopecia
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19
Q

Features of seborrhoeic keratosis

A 
Pigmented
Benign tumour of basal keratinocytes 
Occur on face and trunk of elderly people
Dark 
rough
Greasy
Stuck on appearance
Well-defined edge
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20
Q

What is dercum’s disease

A

Multiple painful lipomas
Most common in obese, middle aged F
+/- headaches, amenorrhoea, reduced sweating

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21
Q

Features of a lipoma

A

Soft, mobile lesions
Composed of fatty tissue
Painless

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22
Q

What is a deep capillary naevus also known as

A

Port-wine stain

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23
Q

Features of a deep capillary naevus

A

Congenital
Malformation of capillaries in deep and superficial dermis
Most commonly - unilateral on the face
+/- seizures, learning difficulties, eye abnormalities

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24
Q

What is sturge-weber syndrome

A 
Collection of symptoms:
deep capillary naevus (port wine stain)
Fits
Developmental problems
Glaucoma
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25
What is a superficial capillary naevus also known as
Salmon patch
26
Features of a superficial capillary naevus
``` Small Flat Pink patch Poorly defined border Common on forehead and nape of neck ```
27
Features of a ganglion cyst
``` Benign Terse Cystic swelling Back of wrist Painless ```
28
What is a cavernous haemangioma also known as
Strawberry naevus
29
Features of a cavernous haemangioma
``` Appears in 1st few months Bright red lesion on face or trunk Rapidly growing Can ulcerate and bleed Eventually regresses and disappears ```
30
Appearance and cause of acanthosis nigricans
Black, velvety overgrowth in axillae/neck/groin Associated with diabetes, Cushing's syndrome, acromegaly, PCOS, Lymphoma, adenocarcinoma of GIT
31
Appearance and cause of Paget's disease of the nipple
Scaly, dry rash on nipple | Caused by breast cancer
32
Appearance and cause of tylosis
Hyperkeratosis of palms and soles | Due to oesophageal cancer
33
Appearance and cause of dematomyositis
Purple heliotrope rash on eyelids Scaly pink rash on knuckles Autoimmune condition related to polymyositis Or Caused by lung or breast cancer
34
Appearance of diabetic dermopathy
Depressed pigmented scars on the shin | Associated with diabetic microangiopathy
35
Appearance of pretibial myxoedema
Raised erythematous plaques over the shins and dorsum of feet. In hyperthyroidism
36
Dermatological manifestations of hyperthyroidism
Pretibial myxoedema Alopeica Palmar erythema Hyperhidrosis
37
Appearance and cause of erythema an igne
Brown lacy rash on skin Due to exposure to heat for long periods E.g. Hot water bottles, sitting against radiators Common in hypothyroid patients who are cold
38
Dermatological manifestations of hypothyroidism
``` Alopecia Dry coarse hair Puffy skin Peri orbital oedema Xanthoma Malar flush ```
39
Appearance and cause of xanthelasma
Yellow plaques around eyelid | Hyperlipidaemia
40
Appearance and cause of granuloma annulare
Small red-purple papules arranged in a ring On back of hands or feet Often due to DM
41
Appearance of a neurofibroma
Firm and rubbery | Single or multiple
42
Features of cellulitis
``` Erythema Swelling Local pain Blistering Pyrexial patient ```
43
What is a pyogenic granuloma
An acquired haemangioma Commonly at the site of a thorn prick Bright red nodule. Bleeds easily Enlarges rapidly over 2-3 weeks
44
Appearance of kaposi's sarcoma
Plaque / nodules in skin and mucous membrane | Bruise like appearance
45
Features of a sebaceous cyst
Arise from hair follicle Common on scalp, face, ears, back, upper arms Contain keratin ``` Painless Mobile Central punctum Fixed to overlying skin Not tethered to underlying subcutaneous tissue ```
46
Commonest cause of necrotising fasciitis
Group A streptococcus (e.g. Strep pyogenes)
47
Appearance of necrotising fasciitis
Erythema Swelling Necrotic tissue Systemically unwell + fever
48
Appearance of impetigo
Thin walled blisters Itch Bleed Golden crust
49
What causes livedo reticularis
``` Can be normal - response to cold Vasculitis Anti phospholipid syndrome Polycythaemia rubra Vera Cholesterol emboli ```
50
What is the most common form of skin cancer
Basal cell carcinoma
51
Risk factors for basal cell carcinoma
``` UV light exposure X-ray exposure Chronic scar Genetic predisposition Male ```
52
Presentation of basal cell carcinoma
Small, skin coloured papules Telangiectasia Pearly edge Central necrosis
53
What is a rodent ulcer
Basal cell carcinoma
54
What is acrodermatitis enteropathica | Features
Rare inherited disorder of zinc malabsorption Perianal and oral red scaly, pusular rash Failure to thrive Diarrhoea Poor wound healing
55
Skin conditions associated with HIV
``` Leukoplakia Oral candidiasis Severe herpes episodes Kaposi's sarcoma Molluscum contagiosum ```
56
What 2 skin conditions can develop along side Reiter's syndrome
- keratoderma blenorrhagicum | - circinate balanitis
57
Appearance of keratoderma blenorrhagicum
``` Pustular Crusty Yellow-brown Papular lesion On soles of feet Indistinguishable from pustular psoriasis ```
58
What is erythema nodosum
Presumed hypersensitivity reaction. | Dermatological manifestation of infectious, or other, disease
59
Appearance of erythema nodosum
Start as red, tender nodules. Poorly defined border - 2 to 6 cms. Become tense, hard and painful. May become fluctuant. DO NOT suppurate or ulcerate.
60
What are lisch nodules and when do they occur
Fibromas on the iris | Occurs in neurofibromatosis
61
Difference between nodule and papule
Both raised Nodule > 5mm Papule <5mm
62
How many cafe au lait spots are significant
More than 5
63
What is a macule
Flat , non-palpable, colour change | <1cm
64
What is a papule
Raised, palpable, circumscribed lesion, | < 1cm
65
What is a plaque
``` palpable, circumscribed, relatively flat topped lesion, greater in surface area than in thickness, > 1 cm, can be smooth or irregular and scaly ```
66
What is a nodule
palpable, circrumscribed lesion, | larger than a papule - > 1cm and < 2 cm
67
What is a vesicle
clear fluid –filled lesion, | <0.5 cm = smaller than a bulla
68
What is a bulla
clear fluid-filled lesion, | >0.5cm = larger than a vesicle
69
What is a pustule
turbid fluid-filled lesion, | filled with inflammatory cells
70
What is lichenification
accentuated skin markings due to thickening of the epidermis
71
Conditions associated with pyoderma gangrenosum
``` Crohn's UC Rheumatoid arthritis Beçhets Active Hepatitis Primary biliary cirrhosis Myelo proliferative disorders (leukaemia, myeloma, lymphoma) ```
72
Appearance of pyoderma gangrenosum
``` solitary nodules / deep-seated pustules rupture - form an ulcer. Ulcer border has a deep purple / dusky colour usually undermined edge. bright erythematous / violaceous halo. Necrosis is a common feature. ``` extremely painful
73
Most common organisms in cellulitis
Strep pyogenes Staph aureus (In infants - blood borne group B strep)

MBBS / MBChB finals (25 decks)

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