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Specialties > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the pathology for eczema?

A

Defect in filaggrin gene, allows transepidermal water loss and penetration of irritants.

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2
Q

How does eczema present?

A

Itchy, dry, scaly erythematous patches on flexor surfaces (face and extensor surfaces in infants)
Papular and vesicular

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3
Q

What is the complication of continuously scratching eczema?

A

Lichenification

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4
Q

What are the management options of eczema?

A 
Emollients
Topical steroids eg hydrocortisone
Topical immunomodulators eg tacrolimus
Non-sedating antihistamine eg cetirizine
Oral Prednisolone
Antiobiotics/antivirals if infected
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5
Q

What is the pathology for psoriasis?

A

Hyperproliferation of keratinocytes and inflammatory cell infiltration

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6
Q

How does psoriasis most commonly present in adolescence?

A

Sudden onset guttate psoriasis following streptococcal infection

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7
Q

What is Auspitz sign?

A

Gentle removal of psoriatic scale resulting in capillary bleeding

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8
Q

Different types of psoriasis?

A 
Guttate
Chronic plaque (most common)
Seborrhoeic
Flexural
Pustular
Erythrodermic
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9
Q

How does psoriasis present?

A

Well-demarcated erythematous scale patches on extensor surfaces and scalp
Burning, itching, painful

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10
Q

Features of psoriasis other than plaques?

A

Nail changes eg pitting, onycholysis

Psoriatic arthropathy

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11
Q

Types of topical treatments for psoriasis?

A 
Vitamin D analogues
Corticosteroids
Coal tar preparations
Dithranol
Retinoids
Keratolytics
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12
Q

3 functions of the skin

A

Regulation - temperature and fluid balance
Sensation
Protection - first defensive barrier to infection

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13
Q

4 stages of wound healing process

A

Haemostasis
Inflammatory
Proliferative
Remodelling

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14
Q

5 layers of epidermis

A 
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale
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15
Q

3 zones of burn in Jackson’s model

A

Coagulation zone
Zone of stasis
Zone of hyperaemia

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16
Q

What is lichee planus?

A

T cell mediated autoimmune disorder in which inflammatory cells attack an unknown protein within the skin and mucosal keratinocytes

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17
Q

Which virus is lichen planus associated with?

A

Hepatitis B + C

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18
Q

Where does lichen planus usually affect?

A

Flexor surfaces typically wrists and ankles

Sites of trauma

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19
Q

What does lichen planus look like?

A

Violaceous, polygonal papules which join together to form plaques
(5 P’s: purple, pruritic, poly-angular, planar, papules)
Overlying white scales

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20
Q

What are the white scales in lichen planus called?

A

Wickham’s striae

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21
Q

How is lichen planus treated?

A

High potency topical steroids

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22
Q

What systemic treatments are there for lichen planus?

A

Corticosteroids
Ciclosporin
Retinoids

23
Q

Which cells are responsible for histamine release in urticaria?

A

Mast cells and circulating basophils

24
Q

Risk factors for scabies

A 
Overcrowding
Refugee camps
Hospitals
Prisons
Poverty
Immunosupressed/immunodeficient patients
25
Q

How long after infestation of mite does itch present with scabies?

A

4-6 weeks

26
Q

Sign of scabies

A

Burrows in tracks

27
Q

Treatment of scabies

A

Topical insecticide eg ivermectin (repeat after 8-10 days)

28
Q

Complication of scabies

A

Secondary staph infection

29
Q

Categories for systemic causes of itch

A 
Cholestasis
Endocrine
Haematological
Chronic renal failure
Miscellanous
30
Q

What are the cholestatic causes of itch?

A

PBC
Extrahepatic obstruction eg gallstones, sclerosing cholangitis
Obstetric cholestasis
Drugs eg opiates, COCP

31
Q

Name 4 endocrine causes of itch

A

Thyrotoxicosis
Hyperparathyroidism
Myxoedema
Diabetes

32
Q

Name 4 haematological causes of itch

A

Hodgkin’s lymphoma
Iron deficiency
Polycythaemia
Multiple myeloma

33
Q

Name a non-haematological malignant cause of itch

A

Bronchial carcinoma

34
Q

What is erythema nodosum?

A

Inflammation of fat cells under the skin. Hypersensitivity response to a variety of causes eg Group A beta haemolytic strep, primary tuberculosis, , IBD, chlamydia, leprosy.
Red tender nodules that last a few weeks and should resolve within a month.

35
Q

What is koebner phenomenon and which conditions can it be seen in?

A

Appearance of new skin lesions in areas of cutaneous injury, usually caused by scratching in otherwise healthy skin.
Occurs mostly in psoriasis, vitiligo and lichen planus.

36
Q 
Order the following topical steroids according to potency:
Betnovate
Dermovate
Eumovate
Hydrocortisone 1%
A

Mild potency: Hydrocortisone 1%
Moderate potency: Eumovate
Potent: Betnovate
Very Potent: Dermovate

37
Q

What is angular cheilitis and what condition is it associated with?

A

A contact irritant dermatitis due to dribbling of saliva, with secondary proliferation of bacteria or candida. Associated with crohn’s disease.

38
Q

What is the definition of cellulitis and what organism is it commonly caused by?

A

spreading of inflammation in subcutaneous tissue, most commonly caused by streptococcus pyogenes.

39
Q

What is a complication of lichen sclerosis

A

Oral squamous cell carcinoma

40
Q

What is dermatitis herpetiformis?

A

Autoimmune blistering skin condition associated with coeliac disease

41
Q

Who is most likely to be affected by dermatitis herpetiformis?

A

White people
Males
20s and 30s

42
Q

How does dermatitis herpetiformis present?

A

Itchy bullies rash on extensor surfaces eg buttocks, scalp, knees and elbows

43
Q

What investigations would you do for herpetiformis?

A

Skin biopsy - IgA deposition
Anti tissue transglutaminase antibodies
IgA endomysial antibodies

44
Q

What is seen on immunofluorescence assay in lichen planus?

A

IgM deposition

45
Q

What does histology show for lichen planus?

A

Saw tooth pattern of epidermal hyperplasia

Lymphocytic infiltration

46
Q

What is actinic keratosis?

A

Thickened scaly skin due to long term sun exposure, UV induced.

47
Q

How is actinic keratosis treated?

A

5-fluorouracil

48
Q

Complication of actinic keratosis

A

SCC

49
Q

How is head lice treated?

A

Dimeticone 4% gel

50
Q

What is gingival hyperplasia and what does it indicate?

A

Gum overgrowth - can be caused by CCB

51
Q

What is telogen effluvium?

A

Diffuse hair loss triggered by stress, bereavement, childbirth. Resolves spontaneously within 100 days

52
Q

What is erythrodermic psoriasis?

A

Dermatological emergency
Hypotension, tachycardia, borderline pyrexia
Requires hospital admission

53
Q

What skin condition is associated with DM?

A

Necrobiosis lipoidica diabeticorum

54
Q

Difference in appearance of lichen planus and lichen sclerosus?

A

Lichen planus - Purple, polygonal, papular, pruritic

Lichen sclerosus - white polygonal papules, forms plaques, itch, dyspareunia, perianal fissures

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