Dermatology Flashcards
What is a macule?
An inpalpable circumscribed area of altered colour but normal texture.
What is a patch?
Same as a macule but larger than 0.5cm diameter.
What is a papule?
Small paplpable circumscribed area of altered colour but normal texture.
What is a plaque?
An area of palpable alteration greater than 0.5cm diameter.
What is a nodule?
A large circumscribed swelling within the surface of the skin.
What is a vesicle or bulla?
An accumulation of fluid within the skin.
What is an ulcer?
Loss of substance due to skin necrosis.
What is eczema?
Eczema is an inflamatory skin condition characterised by dry pruritic skin with a chronic relapsing course.
Eczema diagnostic factors
- Presence of risk factors
- Pruritis
- Xerosis
- Sites of skin involvement - flexor regions, face, hands and feet
Atopic eczema risk factors
- age <5 years
- family history of eczema
- allergic rhinitis
- asthma
Atopic eczema investigations
- Clinical diagnosis
- Allergy testing
- IgE levels
- Skin biopsy
Treatment of chronic or relapsing excema (not refractory)
- 1st line emoillients
- symptoms not controlled by emollients alone
- continuous use of low to mid potency topical corticosteroids
Treatment of refractory chronic eczema
- Resistant to topical corticosteroids
- emollients
- continuous use of high potency topical steroids
- Resistent to high potency topical corticosteroids
- emollients
- UV light therapy or topical coal tar
- Resistant to UV light therapy and topical therapy
- emollients
- systemic immunosuppressive agents
What is psoriasis?
Psoriasis is a chronic inflammatory skin disease characterised by erythematous, circumscribed scaly papules, and plaques. It can cause itching, irritation, burning and stinging.
Diagnostic factors for psoriasis
- Skin lesions
- Family history
- Skin discomfort
Risk factors for psoriasis
- Genetic
- Infection
- Local trauma
- Stress
- Smoking
- Light skin
- Alcohol
Investigations for psoriasis
- Clinical diagnosis
- Skin biopsy
Treatment of plaque psoriasis
- Mild
- topical corticosteroid and/or mild vitamin D anologue
- Moderate to severe
- phototherapy
- methotrexate (folic acid antagonist)
- oral retinoid
- ciclosporin
Treatment of erythrodermic psoriasis
Ciclosporin
Treatment of guttate psoriasis
- Phototherapy
- Methotrexate
- Oral retinoid
- Ciclosporin
Treatment of pustular psoriasis
- oral retinoid - isotretinoin
- re-PUVA - methoxsalen and ultraviolet A (PUVA) with an oral retinoid
What is acne vulgaris?
A skin disease affecting the pilosebaceous unit.
Characterised by:
- comedones
- papules
- pustules
- nodules
- cysts
- scarring
primarily of the face and trunk
What is the treatment of acne vulgaris?
- Topical retinoids or benzoyl peroxide
- Antibiotics, either systemically or topically
- Systemic retinoids
How does isotretinoin work?
- Isotretinoin is an oral retinoid used when acne is causing scars or has fiiled to respond to other treatments.
- It inhibits sebum secretion by causing temporary atrophy of the sebaceous glands.
- Following a 4 month course, generally sebum secretion does not return to pre-treatment levels for several years.
What is melanoma?
A malignant tumour arising from melanocytes.
It is among the most common forms of cancer is young adults.
Early stage melanoma has an overall survival rate of nearly 100% while metastatic melanoma can be rapidly fatal.
How does melanoma typically present?
- A new of changing deeply pigmented skin lesion
- Lesions are often on sun-exposed anatomical locations in fair skinned people
How is melanoma diagnosed?
Diagnosis is by physical examination and confirmed by histopathological analysis of a biopsy.
Treatment of non-metastatic melanoma
Surgical exision +/- sentinal lymph node biopsy
Treatment of metastatic melanoma
- Surgical exision of systemic melanoma metastasis
- Systemic immunotherapy
- Clinical trial
- Local radiotherapy
- Systemic chemotherapy
