Dermatology Flashcards

1
Q

What is eczema?

A

Itchy, dry inflammatory skin disease

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2
Q

What is the commonest type of eczema, particular in children?

A

Atopic eczema

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3
Q

What is atopy?

A

Overactive immune response to environmental stimuli

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4
Q

What is an atopic march?

A

Tendency to have:
Eczema
Asthma
Hayfever

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5
Q

What is the distribution of atopic eczema in infancy?

A

Face/neck (cheeks)

Can spread more generally

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6
Q

What is the distribution of atopic eczema in older children?

A

Flexural pattern

antecubital fosse, popliteal fosse, wrists, hands, ankles

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7
Q

Where is the abnormality in atopic eczema?

A

Filaggrin expression

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8
Q

What do filaggrin proteins do?

A

Bind the keratin filaments together, also play role in natural moisturising factor

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9
Q

Due to the loss of skin barrier function in atopic eczema, what happens?

A

Loss of water
Irritants may penetrate
Allergens may penetrate

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10
Q

What can childhood eczema flares be associated with?

A
Infection/viral illness
Environment: central heating/cold air
Pets
Teething
Stress
Sometimes no flare
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11
Q

Where does seborrheoic dermatitis normally effect?

A

Scalp and face

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12
Q

Which age group does seborrheoic dermatitis usually affect?

A

<3mo

Usually resolved by 12mo

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13
Q

What is seborrheoic dermatitis associated with?

A

Proliferation of various species of the skin commensal Malassezia in its yeast form

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14
Q

Which fungi is seborrheoic dermatitis associated with?

A

Malassezia

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15
Q

What is an associated sign of seborrheoic dermatitis in infants?

A

Cradle cap

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16
Q

What is the treatment for seborrheoic dermatitis?

A

Emollients, anti fungal creams/shampoos, mild topical steroids

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17
Q

What is the pattern discoid eczema?

A

Scattered annular/circular patches of itchy eczema

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18
Q

What can discoid eczema present as part of?

A

Atopic eczema

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19
Q

Where does pomphylx eczema present?

A

Hand and foot

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20
Q

What is pomphylz eczema characterised by?

A

Vesicles and intensely itchy

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21
Q

What is exogenous eczema?

A

Allergic eczema - sensitised to allergen

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22
Q

What type of hypersensitivity is associated with exogenous eczema?

A

Type IV hypersensitivity

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23
Q

What is irritant eczema associated with?

A

Repeated contact:
water/soaps
Irritant foods: citrus, tomatoes, chemical irritants

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24
Q

What type of reaction is an immediate reaction to food?

A

Type 1 reaction

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25
Q

What happens during an immediate reaction to food?

A

Lip swelling
Facial redness/itching
Anaphylactoid symptoms

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26
Q

What type of reaction is a late reaction to food?

A

Type IV hypersensitivity

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27
Q

What happens during a late reaction to food?

A

Worsening of eczema 24/48hrs after ingestion
GI problems
Failure to thrive
Severe eczema unresponsive to treatment
Severe generalised itching - even when skin clear

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28
Q

What are the tests to do for an immediate reaction to food?

A

Blood test for specific IgE antibodies

Skin prick testing

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29
Q

What are the commonest food allergies?

A

Milk, soy, peanuts, eggs

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30
Q

What are common airbourne allergens?

A

House dute mites, pet dander, pollens

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31
Q

What are the tests for late reaction to food?

A

No test
Dietary restrictions/eliminations 6-8wks
Eliminate one food at a time

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32
Q

What is the treatment for eczema?

A
Emollients
Topical steroids
Calcineurin inhibitors
UVB light therapy
Immunosuppressive medication
33
Q

What can happen with prolonged use of topical steroids?

A

Skin thinning

34
Q

What is a mild topical steroid?

A

Hydrocortisone

35
Q

What is a moderate topical steroid?

A

Eumovate

36
Q

What is a potent topical steroid?

A

Betnovate

37
Q

What is a very potent topical steroid?

A

Dermovate

38
Q

How to use steroids for eczema?

A

Once daily 1-2wks

39
Q

What is the unit for using topical steroids?

A

Finger tip unit

40
Q

What is impetigo?

A

Common acute superficial bacteria skin infection

41
Q

What are the features of impetigo?

A

Pustules

Honey-coloured crusted erosions

42
Q

What is the causative bacteria of impetigo?

A

Staph aureus

43
Q

What are the treatments for impetigo?

A
Topical antibacterial (fucidin)
Oral antibiotic (flucloxacillin)
44
Q

What does molluscum contagiosum look like?

A

Pearly papules, umbilicated centre

45
Q

How long can molluscum contagiosum take to clear?

A

24 months

Is self-limiting

46
Q

What is the incubation time for molluscum contagiosum?

A

2wk-6mo

47
Q

What treatment can be used for molluscum contagiosum?

A

5% potassium hydroxide

48
Q

What are viral warts?

A

Non-cancerous growths of the skin caused by infection with HPV

49
Q

What are treatments for viral warts?

A

Topical - salicylic acid and paring

Cryotherapy

50
Q

What are viral exanthems?

A

Viral exanthem is an eruptive skin rash that is often related to a viral infection

51
Q

What are common symptoms with viral exanthems?

A

Fever, malaise, headache

52
Q

What are examples of viral exanthems?

A
Chicken pox
Measles
Rubella
Roseola
Erythema infectiosum
53
Q

What virus causes chickenpox?

A

Varicella-zoster virus

54
Q

Who is susceptible to chickenpox at all times?

A

Immunocompromised

55
Q

What does chickenpox present like?

A

Red papules
Progressing to vesicles often start on the trunk
Itchy
Associated viral symptoms

56
Q

What is the incubation period for chicken pox?

A

10-21 days

57
Q

When is chickenpox contagious?

A

1-2 days before rash appears and until lesions have crusted

58
Q

What is the common name for parvovirus?

A

Slapped cheek

59
Q

What is the incubation for parvovirus?

A

7-10days

60
Q

What are the symptoms of parvovirus?

A

Viral symptoms
Erythematous rash cheeks
Lace-like network rash (trunk and limbs)

61
Q

What does parvovirus target?

A

Red cells in bone marrow

62
Q

What is a rare complication of parvovirus?

A

Aplastic crisis

63
Q

What virus causes hand, foot and mouth?

A

Enterovirus

Usually Coxsackie virus A16

64
Q

What are the signs/symptoms of hand, foot and mouth?

A

Blisters on hands, feet and in mouth

Viral symptoms

65
Q

What is the treatment for hand, foot and mouth?

A

Self-limiting

Supportive

66
Q

What does eczema coxsackium appear like?

A

Flared sites picks out areas of eczema

Associated viral symptoms

67
Q

What does eczema herpeticum appear like?

A

Unwell child
Monomorphic punched out lesions
Hx eczema

68
Q

What is the treatment for eczema herpeticum?

A

Aciclovir

69
Q

What are the signs/symptoms of orofacial granulomatosis?

A

Lip swelling and fissuring

Oral mucosal lesions

70
Q

Which disease is susceptible to orofacial granulomatosis?

A

Crohn’s disease

71
Q

What investigations for orofacial granulomatosis if GI symptoms?

A

Faecal calprotectin

72
Q

What are clinical features of erythema nodosum?

A

Painful, erythematous subcutaneous nodules

Over shins

73
Q

What are causes of erythema nodosum?

A
Infection
IBD
Sarcoidosis
Drugs
Mycobacterial infections
Idiopathic
74
Q

What is a rare disease linked to coeliac disease?

A

Dermatitis herpetiformis

75
Q

How does dermatitis herpetiformis present?

A

Itchy blisters in clusters
Often symmetry
Scalp, shoulders, buttocks, elbows, knees

76
Q

What are some causes of urticaria?

A
Viral infection
Bacterial infection
Food/drug allergy
NSAIDs, opiates
Vaccinations
77
Q

What is urticaria?

A

Wheals/hives

78
Q

What are treatment options for urticaria?

A

Antihistamines

Medication withdrawal