Dermatology Flashcards
What is eczema?
Inflammatory skin condition characterised by dry, pruritic skin with a chronic relapsing course
What are some endogenous causes of eczema?
Atopic Seborrheic dermatitis Discoid Pomphylx Juvenile plantar dermatitis
What is the diagnostic criteria for atopic eczema?
Eczema for 2 months + 2 of
- onset <2
- flexural distribution
- generally dry skin
- FH/other atopic disease
What is the presentation of seborrheic dermatitis?
Usually <6 months
Scalp and proximal flexures
What is the presentation of pomphylx eczema?
Palms and soles of feet
Intensely itchy
What are some examples of exogenous eczema?
Allergic contact dermatitis
Irritant contact dermatitis
What kins of reaction if allergic contact dermatitis?
Type 4 hypersensitivity
What are the risk factors for eczema?
Age <5
FH
Atopy
Smoke exposure
What is the presentation of eczema?
Pruritus
Dry skin
Erythema, scaling, vesicles, papules
Lichenification, hypo pigmentation, plaques, fissures
What is the stepwise management of eczema?
- topical emollients and steroids
- phototherapy
- systemic medications
- biologics
What are the types of topical steroid?
- hydrocortisone
- eumovate
- betnovate
- dermovate
What systemic medications can be used for eczema?
Methotrexate
Ciclosporin
What is psoriasis?
Chronic immune mediated disease
Increased production of skin cells via autoimmune reaction, leading to build up of skin
What are the types of psoriasis?
1= familial, early onset, common 2= related to other autoimmune conditions and environment, older onset
What is the histology of psoriasis?
Hyperkeratosis
Dilated dermal capillaries
Neutrophils and T cell infiltration
What are the clinical features of psoriasis?
Sharply demarcated, circumscribed erythematous plaques- scaly, white superficial layer, erythematous
Often symmetric
What are the classic psoriasis sites?
Extensor surfaces
Scalp
Nail changes
What type of psoriasis if often seen in children and adolescents?
Guttate psoriasis
Multiple pink papules with fine scale
What is the stepwise management of psoriasis?
- topical emollients and vit D analogues
- phototherapy
- Systemic medications
- Biologics
What systemic medications can be taken for psoriasis?
Methotrexate
Ciclosporin
Retinoids
What is the management of erythrodermic psoriasis?
Fluids and systemic treatment
Thick great ointments and emollients
What are molluscum contagiosum?
Very common
Viral
What is the presentation of molluscum contagiosum?
Small raised papules
Characteristic dimple in middle
Itchy
What are common locations of molluscum contagiosum?
Armpit
Behind knees
Groin
What is the management of molluscum contagiosum?
Observation- will disappear in about 18 months
If bothersome- curettage or topical destructive agents
What is impetigo?
Superficial bacterial skin infection, usually caused by staph aureus
What is the presentation of impetigo?
Golden crust= classic
Bollous= common in <2s, systemically unwell
Non bullous= systemically well, often around mouth and nose
What is the management of impetigo?
Topical fusidic acid
Severe/bullous= Oral/IV flucloxacillin
What are the complications of impetigo?
Easily spread
Staph scalded skin syndrome
Who is staph scalded skin syndrome seen in?
Usually <5yo
What is the presentation of staph scalded skin syndrome?
Generalised patches of erythema followed by formation of bull which burst
Similar appearance to burns
Gentle rubbing of skin causes it to peel away
Systemically unwell
What is the management of staph scalded skin syndrome?
IV antibiotics and fluids
What is the chicken pox?
Highly contagious generalised vesicular rash caused by VZV
What is the presentation of chicken pox?
Widespread erythematous raised vesicular blistering lesions- starts on trunk/face and spreads outwards over 2-5 days
Fever, itch
What is he management of chickenpox?
Self limiting
Itch- calamine lotion, antihistamine
Aciclovir if- neonate, immunocompromised, at risk of complications
What are the complications of chickenpox?
Bacterial superinfection
Encephalitis
Shingles
What causes hand, foot and mouth?
Coxsackie virus A
What is the presentation pf hand, foot and mouth?
Early- URT symptoms
1-2 days later- painful mouth ulcers, itchy blistering red spots across body
What is the management of hand, food and mouth?
Resolves in 1 week-10 days
Fluids and analgesia
What is scabies?
Very common and contagious parasitic mite
What is the presentation of scabies?
Incredibly itchy small spots
Track marks
Classic location= finger web
What is the management of scabies?
PErmethin cream twice, 1 week apart
Anihistamine for itch
What is a complication of scabies?
Crusted scabies
What is crusted scabies?
Serious scabies in immunocompromised patients
Patches of red skin that turn into scaly plaques
What is slap cheek also known as?
Parovirus B19
When is slap cheek contagious?
Before rash develops
What is the presentation of slap cheek?
Early= mild fever, coryza and non specific symptoms
2-5 days later= diffuse bright red rash n both cheeks
What is the course of slap cheek?
Self limting
Fades over course of 1-2 weeks
What are the complications of slap cheek?
Aplastic anaemia
Pregnancy complications
What is the presentation of the measles?
Early= fever, coryza, conjunctivitis
2 days later= Koplik spots- greyish white spots on buccal mucosa
3-5 days later= erythematous macular rash starting on face, classically behind ears
What is pathognomonic of measles?
Koplik spots- greenish white spots on buccal mucosa
What is the management of measles?
Self limiting
Notifiable disease
What is scarlet fever associated with?
Group A strep, usually tonsillitis
What is the presentation of scarlet fever?
Red pink blotchy macular rash with sandpaper skin, starts on trunk and spreads
Strawberry tongue
What is the management of scarlet fever?
10 days phenoxymethylpenicillin
Notifiable disease
What is the presentation of Rubella?
Mild erythematous macular rash- starts on fave and spreads to rest of body, lasts ~3 days
Mild fever, jolt pain, lymphadenopathy
What is the management of rubella?
Self limiting
Notifiable disease
