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Finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What skin condition can steroids lead to

A

Acne

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2
Q

What skin condition can immunosuppression lead to

A

Skin cancer

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3
Q

What is tinea corporis

A

Ringworm - a fungal skin infection

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4
Q

What does tinea corporis look like

A

An oval ring of scaly red patches that form a ring around an area of central sparing

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5
Q

Which number T helper cell is involved in a) Eczema b) Psoriasis

A

Eczema - Th2

Psoriasis - Th1

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6
Q

What structure can you use when describing skin lesions

A 
Distribution 
Type of lesion
Shape
Edge
Colour
Secondary features
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7
Q

Ways you can describe the distribution of skin lesion/rash

A 
Central/distal
Symmetrical/asymmetrical
Flexor, extensor, truncal, palmar, plantar
Localised/generalised
Dermatomal
Follicular
Photosensitive/exposed
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8
Q

Ways you can describe the type of skin lesion

A 
Macule
Papule
Vesicle
Pustule
Patch
Plaque
Nodule
Bullae
Erosion
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9
Q

What is a macule defined as

A

A flat lesion <0.5cm

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10
Q

What is the size limit for papules, vesicles, pustules

A

<0.5cm

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11
Q

What is a patch defined as

A

A flat lesion >0.5cm

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12
Q

What is a plaque defined as

A

A flat lesion >1cm and palpable

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13
Q

What would you call a raised lesion >0.5cm

A

Nodule

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14
Q

What would you call a raised lesion >0.5cm and filled with fluid

A

Bullae

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15
Q

Ways you can describe the shape of a skin lesion

A 
Circular
Linear
Annular (ring, target)
Irregular
Reticulated (like a net)
Discoid
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16
Q

Ways you can describe the edge of a skin lesion

A

Well demarcated
Ill defined
Raised/flat
Confluent

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17
Q

Ways you can describe the colour of a skin lesion

A

Erythematous
Pigmented/hypopigmented
Purpuric/violaceous
Black/brown/tan

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18
Q

Some of the secondary features that may be associated with a skin lesion/rash

A 
Crust
Scale
Keratosis
Lichenification
Erosion
Excoriation
Fissure
Ulceration
Desquamation (peeling)
Exudate
Verrucous/warty
Dry
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19
Q

What are the two main types of exogenous eczema

A

Irritant/allergic contact

Photosensitive/photoallergic

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20
Q

What are the 7 types of endogenous eczema

A 
Atopic
Seborrhoeic
Asteatotic
Discoid
Pityriasis alba
Pompholyx
Varicose
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21
Q

Classic description of the rash of atopic eczema

A

Papules and vesicles with an erythematous base over the flexor surfaces

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22
Q

Classic description of the rash associated with seborrhoeic dermatitis/eczema

A

Greasy/scaly erythematous rash around the nose/ears/scalp

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23
Q

Classic description of asteatotic eczema/dermatitis

A

Cracked dry skin on lower limbs

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24
Q

Classic description of pityriasis alba

A

Pink scaly patches that later leave hypopigmented areas of skin

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25
Q

Classic description of pompholyx eczema/dermatitis

A

Itchy blisters/vesicles on lateral aspects of fingers and toes. It’s an acute presentation of eczema

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26
Q

What is lichenification

A

Increased skin markings - seen in chronic eczema

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27
Q

Classic description of wheals

A

Transient, circumscribed, elevated papules or plaques with erythematous borders and pale centres

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28
Q

Features of infected eczema

A 
Weeping
Pustules
Crust
Not improving with normal treatment
Rapidly worsening
Fever
Malaise
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29
Q

Complications of untreated eczema herpeticum

A

Hepatitis
Encephalitis
Pneumonitis

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30
Q

Features of eczema herpeticum

A

Rapidly worsening painful areas of clustered blisters. Punched out uniform erosions (circular, depressed, ulcerated), may become confluent areas of erosion with crusting
Systemic fever, lethargy, distress

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31
Q

Which virus causes eczema herpeticum

A

Herpes simplex 1

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32
Q

A combined steroid + antibiotic cream used for localised skin infections

A

Fucidin

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33
Q

What class of topical treatments reduce T cell response

A

Topical calcineurin inhibitors e.g. Tacrolimus

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34
Q

Underlying pathological process that causes psoriasis

A

Epithelial turnover is accelerated - 3-4 days rather than weeks. Also inflammatory and autoimmune aspects.

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35
Q

What are the differences between type 1 and type 2 psoriasis

A

Type 1;
75%
Presents <40 years old
HLA-CW6 gene associated

Type 2;
25%
Presents age 55-60
No gene association

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36
Q

A child who has one parent with psoriasis has what chance of having it themselves

A

1 in 4

37
Q

Which type of psoriasis often happens after a strep throat infection

A

Guttate psorasis

38
Q

What is erythrodermic psoriasis

A

A psoriasis flare than covers 90% of the body surface, become hypotensive and need admission

39
Q

What is generalised pustular psoriasis

A

A flare of psoriasis with red/hot/painful pustules that develop within plaques. Usually as a result of steroid withdrawal. Needs emergency admission.

40
Q

How does alcohol affect psoriasis

A

Makes it worse/less responsive to treatment

41
Q

Medications that can trigger psoriasis

A 
Antimalarials
NSAIDs
Non-selective beta blockers
Lithium
Terbinafine (oral anti-fungal)
42
Q

Nail changes associated with psoriasis

A

Pitting
Onycholysis
Periungal erythema
Subungal hyperkeratosis

43
Q

What is Auspitz’s sign

A

The appearance of punctate bleeding spots when psoriasis scales are scraped off

44
Q

Criteria for referral of psoriasis to dermatology

A 
Erythroderma
>20% body area involved (extensive)
Severe disabling psorasis
Failure to respond to topical treatments
Unstable/rapidly extending psoriasis
45
Q

What score/tool is used as an objective measure of psoriasis severity

A

PASI - Psoriasis area severity index

46
Q

What score/questionnaire is used to subjectively measure the severity of skin diseases

A

DLQI - Dermatology life quality index

47
Q

What score is used to screen for psoriatic arthritis

A

PEST score

48
Q

How do light therapies work for psoriasis

A

Slow keratinocyte growth

49
Q

Underlying patho of acne vulgaris

A

Blockage and inflammation of the pilosebaceous unit
Keratinisation and plugging of the follicle leads to build up of sebum from the sebaceous gland which causes inflammation

50
Q

Which bacteria plays a role in acne

A

Propionbacterium acnes

51
Q

Which hormones plays a role in acne

A

Androgens

52
Q

What do you call the non-inflammatory lesions seen in acne

A

Comedones - open (black heads) or closed (white heads)

53
Q

What do you call the inflammatory lesions seen in acne

A

Papules
Pustules
Nodules

54
Q

What scale is used to assess the psychosocial effects of acne

A

APSEA scale

55
Q

What scoring system is used to assess the clinical severity of acne

A

Leeds scoring system

56
Q

Indications for oral retinoids (Isotretinoin) in acne

A 
Moderate and not responding to treatment or relapsing
Severe acne
Scarring
Unusual form of it
Psychological impact
57
Q

Topical retinoids are particularly good at treating which aspect of acne?

A

Comedones

58
Q

In general, how long to acne treatments take to work

A

8 weeks - 3 months. So follow up usually 8-12 weeks after each treatment initiation

59
Q

What is acne fulminans/acne maligna

A

A a rare skin disorder presenting as an acute, painful, ulcerating, and hemorrhagic clinical form of acne. It may or may not be associated with systemic symptoms such as fever and polyarthritis. Acne fulminans also may cause bone lesions and laboratory abnormalities.

60
Q

What is acne conglobata

A

A highly inflammatory disease presenting with comedones, nodules, abscesses, and draining sinus tracts.

61
Q

Is basal cell or squamous cell carcinoma more common

A

BCC

62
Q

Risk factors for BCC and SCC

A

Chronic UV exposure
Fitzpatrick skin type 1 + 2
Immunosuppression
Previous SCC

63
Q

Which syndrome is strongly associated with developing basal cell carcinomas

A

Gorlin syndrome (naevoid basal cell carcinoma syndrome)

64
Q

Risk factors for SCC specifically

A

Smoking
Chronic ulcers
Xeroderma pigmentosum

65
Q

What is the name of the system used to describe skin types

A

Fitzpatrick

66
Q

Describe Fitzpatrick skin type I

A

Always burns, never tans
Pale white skin
Ginger/blonde hair
Blue/hazel eyes

67
Q

Describe Fitzpatrick skin type II

A

Usually burns, tans poorly
Fair skin
Blue eyes

68
Q

Describe Fitzpatrick skin type III

A

Burn turns into tan

Darker white skin

69
Q

Describe Fitzpatrick skin type IV

A

Tans easily, burns minimally

Light brown skin

70
Q

Describe Fitzpatrick skin type V

A

Tans dark brown, rarely burns

Brown skin

71
Q

Describe Fitzpatrick skin type VI

A

Always tans dark, never burns

Dark brown/black skin

72
Q

Typical description of SCC

A

Fast growing, hardened nodular lesion with crusted/hyperkeratotic surface. May ulcerate and may be painful

73
Q

Typical description of BCC

A

Slow growing, pearly translucent nodule with telangiectasia

74
Q

What is Bowen’s disease

A

Squamous cell carcinoma in situ

75
Q

High risk features of primary SCC that would need MDT discussion

A

Location - ear, lip, eyelid, nose, scale
Size - >20mm wide, >4mm deep, invading below dermis
Immunosuppression
Recurrent

76
Q

Advice regarding sun protection for patients with skin cancer history

A

UVA+UVB protection, SPF 30+, star rating 3/4 (UVA protection), apply 30 mins before then every 2hrs, don’t rub it in just apply a film, wear a hat and appropriate clothing, stay in shade 11am-3pm

77
Q

Treatment options for BCC

A 
Leaving them (if elderly)
Imiquimod cream
Photodynamic therapy
Radiotherapy
Surgical excision
78
Q

Describe a junctional naevus

A

Brown + Flat

Melanocytes are are the dermo-epidermal junction

79
Q

Technical name for a mole

A

Melanocytic naevus

80
Q

Describe an intradermal naevus

A

Skin coloured + Raised

Melanocytes are in the dermis

81
Q

Describe an intermediate naevus

A

Centre is raised and skin coloured but edge is flat and brown

82
Q

Describe a compound naevus

A

Brown + Raised

Melanocytes in the dermo-epidermal junction and dermis

83
Q

What are the 3 main types of skin cancer

A

BCC
SCC
Melanoma

84
Q

Is assessing for skin cancer mets what do you examine for

A

Lymphadenopathy

Hepatosplenomegaly

85
Q

What scale is used to stage/assess prognosis of melanomas

A

Breslow thickness scale

86
Q

How long does pruritus need to be present for to class as chronic

A

> 6 weeks

87
Q

What is pruritus

A

Itch without rash

88
Q

What is prurigo

A

Intensely itchy papules and nodules

89
Q

Non-dermatological causes of widespread itch

A 
Post-herpetic neuropathy
OCD, anxiety
Hyperthyroidism
DM
CKD causing hyperparathyroidism and uraemia
Cholestasis
Hodgkins leukaemia
Dermatomyositis
Scleroderma
Medication

Finals (32 decks)

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