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EOY4 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are some differential diagnoses of an itchy rash in a child?

A 
Scabies
Atopic dermatitis 
Seberrhoeic dermatitis
Chickenpox
Urticaria
Fungal infections
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2
Q

How is scabies managed?

A

Scabicidal cream permethrin applied all over the body
All household members treated
Launder all clothing and bedding
Antihistamines for the itching

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3
Q

Fifth disease is caused by what?

A

Parvovirus B19

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4
Q

What is the concern regarding contracting rubella during pregnancy?

A

Congenital Rubella syndrome (triad of deafness, blindness and congenital heart disease)

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5
Q

Koplik spots are pathognomonic for what?

A

Measles (white spots on buccal mucosa)

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6
Q

Which virus presents in children with a sudden high fever lasting a few days, and a rash that appears 1-2 days after the fever has settled?

A

Roseola aka sixth disease

Caused by human herpes virus 6

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7
Q

As well as a purpuric rash, Henoch-Schonlein Purpura has a classic triad of which 3 symptoms?

A

Arthralgia
Abdominal symptoms
Haematuria

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8
Q

What is the likely diagnosis for an erythematous, raised lesion developing in the first few weeks of life?

A

Strawberry naevus aka capillary hemangioma

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9
Q

What are strawberry naevus?

A

Haemangioma which occurs during infancy, usually on the face or scalp
Present within first few weeks of life and increase in size until about 6-9 months old when they regress over a few years

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10
Q

Molluscum contagisoum is due to what?

A

Molluscum contagiosum virus, a member of the Poxvirus family

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11
Q

What management plan would you give for a patient with molluscum contagiosum?

A

Reassure that it is self limiting

Avoid sharing towels and clothes etc as it is contagious

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12
Q

Rose pink macules in a Christmas tree distribution on the trunk is characteristic of what rash?

A

Pityriasis rosea

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13
Q

A 12 year old child presents with itchy tear drop scaly papules on her trunk. She had a streptococcal throat infection 3/52 ago. What is the most likely cause of her rash?

A

Guttate psoriasis

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14
Q

What condition is an indication for high dose aspirin in children?

A

Kawasaki disease

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15
Q

Koplick spots are pathognomonic for which infection?

A

Measles

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16
Q

What causes Scarlet fever?

A

Group A beta haemolytic strep, commonly Strep pyogenes

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17
Q

How is scarlet fever managed?

A

Penicillin V 10 days

As it is the only childhood maculopapular rash caused by bacteria

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18
Q

How does Scarlet fever typically present?

A

Strawberry tongue
Sandpaper rash
Red, flushed cheeks

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19
Q

What is the management of Kawasaki disease?

A

IV immunoglobulin
High dose aspirin, then taper to a lower dose
ECHO (due to risk of coronary artery aneurysm)

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20
Q

What are some complications of Scarlet fever?

A

Post strep glomerulonephritis
Rheumatic fever
Reactive arthritis

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21
Q

What will blood tests show in Kawasaki disease?

A

Low WCC
Raised ESR
Raised CRP
Raised platelets (hence why aspirin is given as tx to be anti platelet)

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22
Q

What is the cause of slapped cheek syndrome?

A

Parvovirus B19

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23
Q

Which viral exanthemas presents with a red rash on the cheeks follow by an itchy maculopapular lace like rash on the trunk and limbs?

A

Fifth disease/ slapped cheek syndrome

24
Q

Wickham’s striae are seen in which condition?

A

Lichen planus, especially oral

25
Q

Which topical steroids are suitable for use on delicate areas of skin?

A

Hydrocortisone (least potent)

Eumovate

26
Q

Which is the most potent topical steroid?

A

Dermovate

27
Q

What causes acne?

A 
Increased androgens (during puberty) stimulate sebaceous gland hyperplasia and increased serum production
Infection of sebaceous gland by Propionibacterium Acnes 
Inflammation leads to comedones, pustules
28
Q

What topical therapies would you use to manage acne?

A

Topical benzoyl peroxide
Topical retinoids
Topical Abx

29
Q

What manage would you give to acne that is persistent despite trying all of the topical therapies?

A

Oral Abx
Oral COCP if female and contraception required
Oral isotretinoin

30
Q

What topical treatments can help rosacea?

A

Emollient soap substitutes
Topical ivermectin first line
Or topical metronidazole
Avoid steroids as this can worsen

31
Q

What antibiotic can help acne rosacea?

A 
Topical metronidazole 
Oral tetracycline (erythromycin if pregnant)
32
Q

Can steroids be used in rosacea?

A

No

They can induce rosacea and worsen it

33
Q

What are common causative organisms of cellulitis?

A

Staphylococcus aureus

Strep pyogenes

34
Q

What organism commonly causes erysipelas?

A

Strep pyogenes

35
Q

How can cellulitis and erysipelas be distinguished between on visual inspection?

A

Erysipelas has sharp borders with raised edges

Cellulitis has a more ill-defined edge

36
Q

Which antibiotic is used to treat erysipelas?

A

Penicillin V

37
Q

Which antibiotic is used to treat cellulitis?

A

Fluxocacillin

38
Q

What would you use to treat impetigo?

A

Topical fusidic acid Abx if few lesions

Oral flucloxacillin if extensive

39
Q

Topical fusidic acid is the 1st line treatment for what?

A

Impetigo

40
Q

What are some risk factors for squamous cell carcinoma?

A

Solar keratoses, Bowen’s Disease, albinism, immunosuppression
Chronic UV exposure, type 1 and 2 skin
Male, increasing age

41
Q

Where does melanoma commonly metastasise to?

A 
BBLLL
Brain
Bone
Liver
Lungs 
Lymph
42
Q

How does lichen planus present?

A

Itchy rash
Typically on palms and soles, genitals and flexor surfaces of arms
6 P’s: planar, polygonal, purple, pruritis, papules or plaques
Sometimes covered with “white lace pattern” = Wickham’s striae

43
Q

What is Wickham’s striae?

A

Lichen planus covered in a white lace pattern

Common if oral involvement

44
Q

Where does lichen planus commonly occur?

A

Palms and soles
Genitals
Flexors of arms
Oral (Wickham’s striae)

45
Q

What is the main treatment for lichen planus?

A

Topical steroids

46
Q

What are some drugs known to induce Steven Johnson’s/ TEN?

A 
Penicillin
Phenytoin
Allopurinol 
NSAIDs
Carbamazepine
47
Q

What is the difference between Stevens Johnson syndrome and toxic epidermal necrolysis?

A

SJS involves <10% of total skin surface

TEN involves >30% of total skin surface

48
Q

What is Nikolsky’s sign?

A

Seen in SJS/ TEN

Epidermal layer of skin easily sloughs off when pressure is applied

49
Q

What drugs can exacerbate psoriasis?

A

Beta blockers
NSAIDs
ACE
Also trauma and alcohol

50
Q

Pityriasis rosea rash will typically take how long to resolve?

A

6-12 weeks, self limiting

51
Q

A young adult presenting with a red patch following a URTI and a few days later lots of red scaly patches is typically of what?

A

Pityriasis rosea

Self limitng

52
Q

What drug is recommended prophylaxis for cluster headache?

A

Verapamil

Acutely 100% O2 and SC Triptan

53
Q

Which type of melanoma is seen more in dark skinned individuals?

A

Acral lentiginous melanoma

54
Q

Which disease is associated with dermatitis herpetiformis?

A

Coeliac disease

Due to IgA deposits, very itchy

55
Q

What causes impetigo?

A

Usually staph aureus or strep pyogenes

56
Q

What does Breslow thickness measure?

A

Invasion of melanoma

EOY4 (15 decks)

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