Dermatology Flashcards by Mia Nicole Sewell

RF for atopic dermatitis

PH/FH of allergies/hayfever/asthma

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Atopic dermatitis is what type of hypersensitivity reaction and what immunoglobulin is it categorised by?

Type 4 - IgE

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What medication can be given to combat itching in itchy skin conditions?

Antihistamines

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What can be given during an eczema flare up?

Topical steroid alongside standard emollient

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Irritant contact dermatitis is caused by

Chemicals - Detergents, paint, oils

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Allergic contact dermatitis is caused by

Allergies to cosmetics, metals, steroids, suncream

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3 differences between irritant and allergic contact dermatitis?

Irritant is 1) immediate onset and 2) rash is localised. Allergic contact dermatitis has a delayed onset and is due to 3) type IV hypersensitivity reaction.

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Complication of nappy rash

Candidiasis

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Peri-oral dermatitis presents with erythematous ? and typically affects?

Papules, affects the mouth/nose in women

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Seborrheic dermatitis is caused by

Malassezia yeast colonisation

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Antifungal that can treat fungal skin complaints such as seborrheic dermatitis?

Clotrimazole

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Seborrheic dermatitis is also known as

Cradle cap or dandruff/pityriasis capititis

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Discoid eczema can be caused by what 3?

Contact dermatitis
Staph aureus
Chronic alcoholism

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3 specific findings in venous eczema

Atrophie blanche (white scars around red spots)
Champagne bottle shape legs - lipodermatosclerosis
Orange-brown macular pigmentation

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Actinic keratitis presents with

A thickened plaque that is white/yellow and sometimes scaly/warty

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Cause of tinea versicolor and where does it affect?

Malassezia yeast and stratum corneum on the face/back/chest.

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Macular lesions of altered hyperpigmentation affecting the chest and back are a sign of

Tinea versicolor

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What can tine versicolor cause in immunocompromised patients?

Lung issues

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Dermaphyte infections are caused by

Tinea. rubrum

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Tinea corporis is also known as

Ringworm infection

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Tinea pedis is also known as

Athlete’s foot

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Tinea capititis is ringworm infection of the

Scalp - causes round, scaly plaques and alopecia in affected area

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Pityriasis rosea tends to present at what time of year?

Spring and autumn

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Salmon coloured macule that begins on the chest then spreads 2 weeks later is…

Pityriasis rosea

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A Harold patch is

Large, red patch on the back/chest

Christmas tree pattern refers to

Small symmetrical lesions that appear 2 weeks later on the trunk/neck/peripheries in pityriasis rose

5 causes for pityriasis rosea

1. Fungal infection 2. Herpes 6/7 3. HPV or diphtheria vaccine 4. Metronidiazole 5. NSAIDs

What STI must be ruled out in pityriasis rosea?

Syphillis

5 environmental causes of psoriasis

1. Cold weather 2. Skin infection 3. Aspirin 4. Sunlight 5. Stress

Pathophysiology of psoriasis

1. Autoimmune - excess TNF-a and excessive T cell activity promotes 2. Keratinocytes proliferate 3. This causes parakeratosis 4. Stratum corneum cells are poorly adhered - flaking and scales

Chronic plaque psoriasis is the most common type of psoriasis. Where does it affect?

Scalp and flexor regions

Pustular psoriasis causes what 2 findings on the hands/feet

1. Pustules on palms/soles | 2. Nail pitting and thickening

Guttate psoriasis presents with red scales over the body and is caused by

URTI - group A beta haemolytic streptococcus

5 steps of management for psoriasis

1. Avoid triggers 2. Emollients 3. Vitamin D supplements 4. Steroid creams (reduce inflammation) 5. Salicylic acid (lifts off scales)

Lichen planus presents with shiny purple papules with what across?

Wickham striae

2 virus that predispose a woman to lichen planus?

Herpes and Hep B

Most common bacteria in acne

P. acnes

What antibiotics must be avoided in acne due to resistance to P. acnes?

Macrolide - erythromycin

Benzoyl peroxide MOA

Kills P. acnes bacteria

Topical retinoids MOA

Reduce sebum production

Rosacea red flags

1. Impaired vision 2. Painful eyes Can be a sign of keratitis/cornea inflammation

Bacteria that causes folliculitis

Staph. aureus

Androgenic alopecia in females tends to cause

Hair thinning

3 conditions that pre-dispose a female to hair thinning

Diabetes Hypopituitarism Polycystic ovary syndrome - due to excess male hormones

A purulent nail fold with erythema and swelling, and in chronic cases nail plate irregularities is?

Paronychia

Tinea unguium is

Onychomycosis

5 RF for onychomycosis

1. Men 2. Excess perspiration 3. PAD 4. Diabetes 5. Nail injury in damp public place

Onychomycosis must be treated as it can cause cellulite. What is the 1st and 2nd line?

1st: Oral terbinafine 2nd: Itraconazole

Oral herpes is caused by

HSV-1

Herpes gingivostomatitis causes what 3 symptoms?

1. Cold sores 2. Tingling/burning sensation at sore 3. Fever

Herpetic whitlow causes a

Finger lesion

Molluscum contagiosum is caused by what family of viruses?

Poxvirus

A small raised papule with a dimple in the centre clustered around the flexor regions is a sign of

Verrucae are caused by

HPV

Verruca vulgaris is a

Common wart: Round shape, fir, raised

Verruca plana is a

Flat ward

Verruca plantaris is

A wart on the sole of the foot

Pathophysiology behind VZV infection

1. VZV multiples in lung epithelial cells and spread around the body 2. Primary viraemia: Infects liver and spleen, infects lymph nodes and causes fever. 3. Secondary viraemia: Causes skin lesions and infects skin sensory neurones 4. Lies dormant in dorsal root ganglion

Chickenpox symptoms begin how many weeks post-initial infection?

2 weeks

A red macule that elevates to a papule then pustule is a sign of

Chickenpox

Chickenpox often proceeds a

URTI

Postherpetic neuralgia is

Pain in the affected dermatome after shingles infection (6 weeks)

What age group receives a shingle vaccine?

70-78 year olds

What medication must be avoided in chickenpox/shingles?

NSAIDs/aspirin - Reye's Syndrome - toxic build up of ammonia/serious skin infection

Condyloma acuminatum refers to

Genital warts caused by HPV

HPV 6/11 cause

Genital warts

HPV 16/18 cause

Anogenital cancers

Cellulitis is caused by which 2?

Staph. aureus and strep. progenies

Erysipelas is

Superficial cellulitis with lymphatic involvement - very well demarcated

Management for cellulitis in a healthy person/no comorbidities/no systemic toxicity?

High dose oral Abx - flucloxacillin or clarithromycin

2 safety netting pieces of advice for someone with Class I cellulitis?

Go to hospital if cellulitis spreads or you start to feel unwell

Class II cellulitis management

Systemically unwell or well but with comorbidity that complicates treatment - Admission to hospital - IV flucloxacillin

Class IV cellulitis causes

Sepsis or necrotising fasciitis

Most common type of impetigo and bacteria that cause it

Non-bullous, S. aureus +/- S. pyogenes

Impetigo can go onto cause

Glomerulonephritis (post-strep infection)

The less common bullies impetigo is caused by

S. aureus

2 management points for impetigo

1. Avoid immunocompromised people/work/school until 48 hours after initial treatment 2. Medication - 1st: Hydrogen peroxide 1% - 2nd: Topical flucloaxcillin and fusidic acid - 3rd: Oral flucloxaccilin and mupriocin acid

White spots attached to hair is a sign of

Headliace

Scabies is caused by the parasite mite...

Sarcoptes scabiei

Red papule rashes in skin creases, with itchiness that worsens at night is a sign of

Scabies

2 key differences that diagnose scabies

1. Itching that worsens at night | 2. Affected family members

3 characteristics of a BCC

1. Pearly nodule 2. Telangiectasia 3. Ulceration with rolled edge

In situ SCC is called

Bowen's Disease

Melanomas metastasise to

Brain, liver, bones, abdomen, lymph nodes

Weighted 7 point checklist in melanoma

3+ = 2 week cancer referral Major (2) - Diameter changes - Irregular shape - Irregular colour Minor (1) - Largest diameter > 7 - Inflammation - Oozing

Anaphylaxis management (3)

1. IM adrenaline 2. IV hydrocortisone 3. IV antihistamine

5 causes of erythema multiform

1. Mycoplasma pneumonia 2. Anticonvulsants 3. Lidocaine 4. Antimalarias 5. Vaccines to varicella or hepB

Symmetrical bull's-eyes lesions that develop 24 hours post vaccine are a sign of

Erythema multiform

Acute onset of a rash with ulcerations on the mucosa, and sloughing epidermis (Nikolsky's) is a sign of

Stevens-Johnson Syndrome (<10%) or toxic epidermal necrolysis (> 30%)

Symmetrical depigmentation with halo naves is a sign of

Vitiligo

5 causes of vitiligo

1. Autoimmune thyroid disease 2. SLE 3. Pernicious anaemia 4. Koeber's phenomenon 5. T1DM

Hidadentitis suppurative tends to affect

Obese women with a family history who smoke

Blotchy brown pigmentation on the skin is a sign of

Melasma

Melasma is caused by

- Pregnancy - Contraception - Thyroid disease