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Year 4 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How is UV involved in carcinogenesis?

A 
UVB = causes direct DNA damage 
UVA = produces oxidative damage
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2
Q

p53 mutation is associated with what (3)

A

Actinic keratoses
Carcinoma in situ (Bowens)
SCC

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3
Q

SSC is associated with (2)

A

Precursor lesions

Transplant patients

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4
Q

What virus is SSC associated with?

A

HPV

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5
Q

What virus is Kaposi’s sarcoma associated with?

A

HHV 8

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6
Q

Types of BCC

A

Nodular
Superficial
Infiltrative

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7
Q

Common appearances of BCC

A

Raised, pearly edge
Telangiectasia
Central ulceration

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8
Q

What is Moh’s surgery?

A

Excision and examination with pathology then going back in for revision surgery
Often used when margins aren’t clear e.g. nasal lesions

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9
Q

Pathology of actinic keratoses

A

Dysplastic keratinocytes

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10
Q

Pathology of Bowen’s disease

Common site

A

Full thickness dysplasia

Lower leg

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11
Q

Types of melanoma (4)

A

Superficial spreading
Lentigo maligna
Nodular
Acral lentiginous

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12
Q

Presentation of superficial spreading melanoma

A

Lower limbs

Associated with intermittent high UV

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13
Q

Presentation of lentigo maligna melanoma

A

Face

Associated with cumulative UV exposure

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14
Q

Presentation of nodular melanoma

A

Trunk

Associated with intermittent high UV

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15
Q

Presentation of acral lentiginous melanoma

A

Common on the palms, soles and nails

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16
Q

Growth phase - which type of melanoma STARTS with a vertical growth phase?

A

Nodular

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17
Q

Breslow thickness =

A

Measures the deepest tumour cell from the granular dermis

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18
Q

Sturge Weber Syndrome is associated with

A

Port Wine Stains

= usually seen in the CN V1 distribution, stain associated with ipsilateral vascular malformation

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19
Q

Presentation of Strawberry Naevus

A

= benign soft tissue tumour
Usually a single lesion presenting in the first month of life, often the head and the neck
Complications: peri-ocular lesions can affect vision, large tumours can cause airway obstruction

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20
Q

What can a strawberry naevus indicate?

A

Underlying defect e.g. spina bifida

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21
Q

Cafe au lait macules (CALMs) are associated with…

A

Neurofibromatosis Type I

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22
Q

Skin features in neurofibromatosis type I (3)

A

CALMs
Neurofibromas
Axillary/inguinal freckling

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23
Q

Ash leaf macules are associated with…

A

Tuberous sclerosis

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24
Q

Skin and nail features in tuberous sclerosis (4)

A

CALMs
Facial angiofibromas
Periungal fibromas
Shagreen patch

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25
Q

Histological findings in Psoriasis

A

Thickened parakeratotic corneal layer
Munro microabscesses
Abscence of granular layer

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26
Q

Auspitz’s sign =

A

removing scale reveals pin point bleeding

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27
Q

Presentation of guttate psoriasis

A

Associated with streptococcal sore throat

See multiple small lesions on the trunk

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28
Q

Presentation of erythrodermic psoriasis

Management

A

> 90% of the skin surface is red, usually occurs in patients with known or deteriorating psoriasis
Mx: need fluid balance, rest, emollients and systemic immunosuppressants

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29
Q

Example of Vitamin D analogue

A

Calcipotriol e.g. dovobet

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30
Q

Pathogenesis of Acne (4)

A

Increased sebum production
Poral occlusion
Dermal inflammation
Bacterial colonisation (p. acnes)

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31
Q

Management of Acne Vulgaris

A
  1. Topical treatments
  2. Oral AB e.g. doxycycline or erythromycin
  3. Isotretinoin
    Can try OCP in women
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32
Q

Management of Acne Rosacea

A

Avoidance of dietary triggers
Topical metronidazole
May consider oral antibiotics

33
Q

Presentation of atopic eczema

Infants VS Children

A

Infancy - extensor surfaces, face, nappy region often spared
Children - flexor pattern

34
Q

Example of a mild steroid

A

Hydrocortisone 1%

35
Q

Example of moderate steroid

A

Clobetasone butyrate 0.5%

36
Q

Example of potent steroid

A

Betamethasone valerate 0.1%

37
Q

Example of very potent steroid

A

Clobetasol proprionate 0.05%

38
Q

Other topical steroid sparing agents used in eczema

A

Calcineurin inhibitor

e.g. Tacrolimus

39
Q

Management of eczema herpeticum

A

Oral aciclovir

Urgent referral

40
Q

Causes of acanthosis nigricans

A

Diabetes/insulin resistance
Obesity
GI/GU cancer

41
Q

Mycosis fungoides =

A

Cutaneous T-cell lymphoma

Starts as a patch, if progresses can become a plaque and then an overt tumour

42
Q

Associations with erythema nodosum (5)

A 
URTI/streptococcus 
Oral contraceptive pill 
Inflammatory bowel disease 
Sarcoidosis 
Penicillins
43
Q

Management of seborrheic dermatitis

A

Ketoconazole 2% cream

+/- mild topical steroid

44
Q

Variable pigmentation differential

A

Vitiligo

Pityriasis versicolour

45
Q

Management of itch in CKD

A

UVB can be useful

46
Q

Presentation of polymorphic light eruption

A

= itchy spotty rash brought on by the sun

Settles when out of the sun

47
Q

ABPI indicating vascular disease

A

<0.8

48
Q

ABPI indicating calcification

A

> 1.3

49
Q

Management of Bowen’s disease

A

5-FU topical

50
Q

Investigation of choice for dermatitis herpetiformis

A

Diagnostic biopsy with immunofluorescence

51
Q

Presentation of pityriasis rosea

A

Associated with viral infection

Often starts as a larger ‘herald’ lesion which then fades before smaller more widespread lesions appear on the trunk

52
Q

Management of lichen planus

A

Emollient

Strong steroid

53
Q

Complication of impetigo

A

Blistering producing bullous impetigo

Can result in staphylococcus scalded skin syndrome

54
Q

Management of impetigo (1st line)

A

Topical fusidic acid

55
Q

Management of neglected/difficult to excise BCC

A

Radiotherapy

56
Q

What is a partial thickness loss of skin called?

A

Erosion

57
Q

What is a full thickness loss of skin called?

A

Ulceration

58
Q

What is a keratoacanthoma?

A

Appears like an SCC, developing very rapidly, but will almost completely resolve

59
Q

Association with erythema multiforme (2)

A

Herpes simplex

Mycoplasma

60
Q

Skin signs of lymphoma (2)

A

Erythroderma

Ichthyosis

61
Q

Findings in bullous pemphigoid

A

Linear IgG and complement on the basement membrane

62
Q

Pathogenesis in pemphigus vulgaris

A

Antibodies formed against desmoglein 3

63
Q

Management of pemphigus vulgaris

A

Cyclophosphamide 500mg IV every 4 weeks

High dose dexamethasone

64
Q

Findings in dermatitis herpetiformis

A

Granular deposits of dermal papillary IgA

65
Q

Management of anaphylaxis

A

IM Adrenaline (1:1000)
High concentration O2
IV Anti-Histamine
200mg IV hydrocortisone

66
Q

Where are melanocytes found?

A

Dermo-epidermal junction

67
Q

Management of lentingo melanoma

A

Iquimod

Watchful waiting

68
Q

Difference in location of salmon patches VS port wine stain

A

Salmon patches are usually central

69
Q

Presentation of frontal fibrosing alopecia

A

Affects the front of the forehead, produces a shiny clear cut line
Sometimes get involvement of the eyebrows

70
Q

What is ‘dress’?
What is it associated with?
Potential complications?

A

A drug related rash with eosinophilia
Associations = carbamazepine, lamotrigine, co-trimoxazole
Complications = liver necrosis, lymphadenopathy, pericardial effusion

71
Q

Nikolsky’s Sign

A

= press on the blister and it will spread laterally

72
Q

How is erythema multiforme classified?

Differences between?

A

Major and minor

Major is associated with mucosal involvement

73
Q

Examples of sedating antihistamines (2)

Use of sedating anti-histamine

A

Chlorphenamine
Hydroxyzine
Useful for itch (non-sedating won’t have an effect)

74
Q

Presentation of pyoderma gangrenosum

A

Seen as an initial red papule which becomes a necrotic ulcer
Can be associated with IBD or connective tissue disease

75
Q

Pityriasis versicolour

  • Cause
  • Worsened by…
A

= fungal

Made worse by the sun

76
Q

Pyoderma gangrenosum

  • Presentation
  • Association
A

= starts as a red papule > open ulceration

Association: rheumatoid arthritis, ulcerative colitis, vasculitis

77
Q

Management of rosacea

A

ORAL antibiotics

78
Q

Management of dermatitis herpetiformis

A

Dapsone

= antibiotic

Year 4 (27 decks)

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