Dermatology Flashcards
1
Q
Cutaneous adverse drug reactions
A
- Antibiotics maculopapular erythematous
- Erythema= flushing
- Morbilliform= measles like
- Maculo= distinct flat areas
- Papular= raised lesions
- Urticaria (nettle rash)
- Erythema multiforme (Stevens-Johnson syndrome and toxic epidermal necrolysis are life-threatening)
- Sulphonamides, allopurinol, meloxicam, piroxicam, CBZ, lamotrigine, phenytoin and phenobarbitone
2
Q
Penicillin allergy
A
3
Q
Cutaneous adverse drug reactions
A
- Fixed drug eruptions- flat and purple-brown
- Usually only 1 lesion on first exposure. If repeated lesion re-occurs in the same place. Possible only ADR where rechallenge is safe
- Systemic lupus erythematosus (SLE) butterfly rash on face
- Acneform- androgens in women
- Photosensitivity- doxycycline, phenothiazines
- Hair disorders- anticonvulsants- alopecia
4
Q
Fixed drug eruption
A
5
Q
Redman syndrome- vancomycin
A
6
Q
Acne vulgaris
A
- Chronic inflammatory disorder of the sebaceous glands
- Common- affects 80% of the population between 11-30 years
- The increasing resurgence in women in 4th & 5th decade
- Often confined to face (99%), but also back (60%) and chest (15%)
- Concern- can lead to scarring
- Acne effects chest and back rosacea doesn’t important to distinguish between the two
7
Q
Acne- aetiology
A
- Increased sebum production (Often related to puberty)
- Obstruction of the pilosebaceous cyst (comedone)
- The colonisation of the anaerobe Propionibacterium acnes
- Inflammation
- MILD- comedones closed (whiteheads), open (Blackheads)
- MODERATE- open and closed comedones, papules and pustules
- SEVERE- papules, pustules, nodules and cysts
- Can lead to scarring
8
Q
Scarring
A
*
9
Q
treatment of acne
A
- Self-help
- Tropical agents- benzoyl peroxide (essentially peels skin exposes anaerobic bacteria to air = they die) it is very important to gradually increase time you have this on skin for start at 2 minutes and increase to 30 and place on entire area you get spots not just the spot itself, azelaic acid, retinoids, antibiotics
- Comedones- retinoid first
- Inflammatory- benzoyl peroxide first
- Moderate and likely to scar: Oral antibiotics (Tetracyclines/Macrolides) & topical BPO or retinoid
- Cyproterone acetate + ethinylestradiol
- Oral isotretinoin
10
Q
Oral isotretinoin- consultant dermatologist
A
- Teratogenicity- a pregnancy test must be negative up to three days before treatment, every month during treatment and for five weeks after stopping. Treatment should be started on day 2-3 of the menstrual cycle. Barrier methods should not be used alone and progestogen-only contraceptives are not sufficiently effective
- Prescription- Only 30 days may be prescribed at a time. It can’t be faxed and is only valid for seven days. Course- up to 16 weeks
- Avoid exposure to UV light. Use high factor sunscreen and lip salve from the start of treatment
- Can increase both triglycerides, increasing the risk of pancreatitis and ChE, with lowering HDL
- May raise liver transaminase, avoid in hepatic impairment
11
Q
Acne vulgaris- skin care tips
A
- Wash face BD with mild cleanser/antibacterial face wash with lukewarm water, pat dry
- Don’t scrub face or use facial scrubs
- Use light oil-free/ non-comedogenic moisturiser
- When applying topical acne treatment- apply thin film to whole area not just individual spots- washing hands before and after applying
- Make up- use non-comedogenic
- Shaving- wash face in acne wash before- use light moisturiser as a shaving lotion
12
Q
Rosacea
A
- Latin for roses
- Spectrum of facial skin and vascular changes, characterised by
- Flushing- Erythema
- Burning/Tingling sensation
- Telangiectasia
- Skin papules/Lesions
- Rhinophyma
- Central face- usually spares the peri-oral/ peri-orbital area
- Can be continuous or variable flushing episodes
- Avoids folds of the nose
13
Q
A
14
Q
rosacea
A
- Typically presents from 30-60s most common 40s and 50s
- More common in women than men
- Rhinophyma more common in men
- More common in Caucasians, rare in Asians and Africans
- Prevalence about 12%
- Cause uncertain- damage to dermal connective tissue, linked to migraine, susceptibility to Demodex mite
15
Q
Rosacea- 4 types
A
- Erythemato-terlangiecatctic- redness of the central face (Transient or permanent) affected skin feels rough, sometimes telangiectasia, may tingle/burn
- Papulo-pustular- Acne vulgaris, Papules and pustules mainly over cheecks and nose (also forehead, chin and around eyes)
- Phymatous- Lump/swelling, usually of nose (commoner in men)
- Ocular- co-ecists with rosacea
16
Q
Seborrhoeic dermatitis
A
- Nasolabial folds
- Eyebrows, hairline, behind ears; also scalp and upper trunk
- Scaly patches, greasy appearance, rather than discreet lesions
- Yeast- treat with antifungal
