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Dermatology Flashcards

1
Q

When performing an examination of the skin what are the four steps?

A

inspect describe palpate systemic check

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2
Q

what acronyms are used in the describe step of investigating a lesion

A

SSCAMM: size shape colour associated secondary changes morphology and margin plus if the lesion is pigmented ABCD asymmetry irregular border two or more colours within the lesion diameter >6mm

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3
Q

the presence of which features of a lesion would indicate melanoma

A

asymmetry irregular border two or more colours within the lesion and a diameter greater than 6 cm

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4
Q

what are the layers of the epidermis

A

stratum corneum stratum lucidum stratum granulosum strarym spinosum stratum basale

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5
Q

what is the composition of the stratum basale

A

actively dividing cells

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6
Q

what is the composition of the stratum spinosum

A

differentiating cells

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7
Q

What is the composition of the stratum granulosum

A

differentiated cells begin to use the nucleus and contain granules of keratohyaline which secrete lipids into the intracellular spaces

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8
Q

what is the composition of the stratum lucidum?

A

this is found only in areas of thick skin such as the soles of feet and consists of paler compacted keratin

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9
Q

what is the composition of the stratum corneum

A

layers of keratin it is the most superficial layer

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10
Q

what with three ways in which pathology can occur in the epidermis

A

changes in theepidermal turnover time (e.g. psoriasis has decreased turnover time)/changes in skin surface or epidermal loss (e.g. crusting exudates ulcers)/changes in skin pigmentation

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11
Q

what substances are found in the dermis of the skin ? And what is their function?

A

collagen and elastin glycolosaminoglycans - allow for elasticity and strength / immune cells nerves skin appendages such as her and lymphatic tissue and blood vessels

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12
Q

what synthesises glycolosaminoglycans in the skin?

A

fibroblasts

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13
Q

what are the ways in which pathology can occur in the dermis?

A

changes in skin control or loss of dermis (e.g. papules nodules skin atrophy and ulcers) disorders of skin appendages (hair and sebaceous glands) changes related to lymphatic and blood vessels (erythema urticaria and purpura)

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14
Q

how would you describe this image below?

A

a wheal - a transient raised lesion due to dermal oedema

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15
Q

how would you describe the image below?

A

a discrete lesion – individual lesions separate from each other

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16
Q

how would you describe the image below

A

confluent – lesions are merging together also known as maculopapular

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17
Q

how would you describe the image below?

A

Linear common scabies or scratch

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18
Q

how would you describe the image below?

A

target – like a bull’s-eye or dartboard

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19
Q

how would you describe the image below?

A

annular – a ring/hollow cycle

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20
Q

how would you describe the image below?

A

discoid/nummular - around lesion

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21
Q

what does the term naevus mean?

A

localised malformations of tissue structures for example moral

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22
Q

what does the term commedone mean

A

a plug-in the sebaceous follicle causing altered Seaburn, bacteria and cellular debris deposit which can be open (blackhead) or closed (Whitehead)

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23
Q

what is meant by flexor distribution

A

usually found in the body folds

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24
Q

what is meant by an extensive distribution

A

usually found on the knees and elbows shins

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25
Q

what is the definition of a dermatome

A

and area of skin supplied by single nerve (spinal)

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26
Q

what is meant by term Köeber Phenomenon?

A

linear eruption arising from the site of trauma mainly found in psoriasis

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27
Q

what is the function of the skin

A

a protective barrier against environmental insults cosmetic appearance immuno survey temperature regulation vitamin D synthesis and sensation

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28
Q

what are the four stages of wound healing

A

haemostasis inflammation proliferation remodelling

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29
Q

what occurs in the haemostasis stage of wound healing

A

vasoconstriction and platelet aggregation clot formation

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30
Q

what occurs in the inflammatory stage of wound healing

A

vasodilation migration of neutrophils and macrophages phagocytosis of cellular debris and invading bacteria

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31
Q

what is the mechanism of the proliferative stage of wound healing

A

fibroblasts are proliferating and causing granulation tissue to form (synthesised by fibroblasts) and angiogenesis occurs / epidermal cell proliferation and migration then allows for re-epithelisation

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32
Q

what occurs in the remodelling stage of wound healing

A

there is collagen fibre reorganisation and scar maturation the freshly healed epidermis will be slightly red

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33
Q

what are the two types of urticaria

A

immunological or non-immunological which means there is no IgE involvement

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34
Q

what is the pathophysiology of urticaria

A

inflammation occurs in response to a trigger increasing permeability of the small manuals inflammatory mediators especially histamine released from mast cells and other driving force in the inflammatory reaction resulting in the swelling of the dermis and raising the epidermis

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35
Q

which layer of skin is urticaria occur in

A

in the dermis however the swelling of the dermis has knock-on effect causing swelling of the epidermis

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36
Q

what are the common triggers of urticaria?

A

food drugs insect bites contact with chemicals or latex viral or parasitic infections autoimmune hereditary

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37
Q

what drugs commonly cause urticaria

A

penicillin contrast media and ACE inhibitors

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38
Q

what can be a severe consequence of urticaria

A

angioedema which is a red flag for anaphylaxis

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39
Q

what is angioedema

A

a swelling of the dermis and deeper tissues which occurs in the face and lips

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40
Q

what is the management for urticaria

A

antihistamines and if there is severe reactions give corticosteroids (usually of angioedema is present)

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41
Q

what is the criteria for acute urticaria?

A

less than six weeks and linked to allergen or viral infections

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42
Q

what is the criteria for chronic urticaria

A

over six weeks without any links to allergens/viruses

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43
Q

what are usually the triggers for chronic urticaria

A

cold or heat sun aquagenic cholinergic

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44
Q

what is erythema nodosum?

A

hypersensitivity response to various stimuli

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45
Q

what is the image below show

A

urticaria

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46
Q

what is image below show

A

erythema nodosum

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47
Q

what is the presentation of erythema nodosum

A

discrete tender nodules which appear for one – two weeks and then leave a bruise -like discolouration because they resolve most commonly occurring at the shins

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48
Q

what are some causes of erythema nodosum?

A

primary TB pregnancy malignancy IBD group a beta haemolytic strep chlamydia leprosy sarcoidosis

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49
Q

what does the image below show

A

erythema multiforme

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50
Q

what is erythema multiforme?

A

atypically acute self-limiting but often relapsing inflammatory condition

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51
Q

what are the two most common causes of erythema multiforme

A

drug reactions or post infectious (herpes simplex and Mycoplasma pneumoniae)

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52
Q

what is the characteristic presentation of erythema multiforme

A

target lesions that resemble a bull’s-eye erupting over 24 – 48 hours lasting for 1 – 2 weeks

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53
Q

what is the image below show

A

SJS

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54
Q

what is Stevens Johnson syndrome

A

characterised by mucocutaneous necrosis with more than two sites involved where there is skin detachment and mucocutaneous involvement

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55
Q

why the presentation of SJS

A

severe erythema mucocutaneous necrosis and detachment of skin

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56
Q

what sign is usually present in SJS

A

Nikolskys signs

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57
Q

what is nikoskys sign

A

epidermal layer easily slows off when pressure is applied to the blister or erythema to this area

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58
Q

what is the difference between SJS and TENS

A

SGS there is less than 10% skin involvement whereas TENS there is a larger proportion of skin involved and thus has a higher mortality rate

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59
Q

what usually triggers SJS

A

infections or drug reactions

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60
Q

do drug reactions usually cause SJS or TENS

A

TENS

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61
Q

why is the mortality rates are high in TENS

A

often due to: sepsis easily occurs electrolyte imbalances and multisystem organ failure and shock

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62
Q

what is the management of both TENS and SJS

A

stop any reactive agents / IV fluid nutritional support/ IVIg/ /analgesia/PPI (stress-related gastritis)/ dressings topical antibiotics and the millions/ U+E close monitoring and eeplacing deficiencies/ urgent ophthalmological evaluation

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63
Q

what investigations are required in SJS/TENS

A

Cultures for ? Causative agent / U+E for derrangement and monitoring organ function / ECG for electrolyte abnormalities affecting heart / SKIN BIOPSY - diagnostic

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64
Q

what is the image below show

A

classic rash associated with meningococcacemia

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65
Q

what pathogen usually causes meningitice septicaemia

A

nesseria meningitidis

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66
Q

what is the description of the rush associated with meningitis septicaemia

A

non-blanching maculopapular purpuric rash - although at the start of the disease it may be blanching / usually found on trunk and extremities and can rapidly progress

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67
Q

what is the presentation of meningitic septicaemia?

A

will undertake symptoms (headaches fever next) hypotension fever myalgia tachycardia and other symptoms of septicaemia plus the rash

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68
Q

what does the rash rapidly progress to in meningitic septicaemia?

A

echymoses aka brusing, haemorrhagic bullae and tissue necrosis

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69
Q

who is most likely to get meningitic septicaemia

A

those under five teenagers aged 11 to 22 years over 65s

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70
Q

what investigation team into performing in ?meningitis

A

blood cultures/ urine cutures / FBC / U+E / LFT and coag panel / VBG/ actate - FULL SEPTIC SCREEN

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71
Q

what is the management of meningitic septicaemia?

A

cephalosporin (ceftriaxone) ampicillin and vancomycin adj. corticosteroids IV dexamethosone

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72
Q

what does the image below show

A

erythroderma

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73
Q

what is erythroderma

A

an exfoliative dermatitis involving 90% of the skins surface

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74
Q

what is the presentation of erythroderma

A

inflamed oedematous scaly peeling skin with systemic features of lymphadenopathy and malaise

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75
Q

what are common causes of erythroderma?

A

most commonly drug reactions but also: eczema and psoriasis lymphoma or idiopathic

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76
Q

which drugs commonly cause erythroderma

A

sulphanamides / gold/ penicillin / allopurinol / captopril

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77
Q

what is the management of erythroderma

A

stop causative agent / underlying cause / only ends and wet wraps/IV fluids and any nutritional support/ topical steroids/systemic steroids if appropriate/watch out for any secondary infections give topical antibiotics if necessary and moving up to Ivy

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78
Q

what are consequences of erythroderma

A

secondary infections fluid loss electrolyte imbalance hypothermia high cardiac output heart failure and capillary leakage syndrome

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79
Q

how do you monitor the complications associated with erythroderma

A

fluid balance / U+E / FBC / skin biopsy + serum albumin

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80
Q

how does psoriasis or eczema cause erythroderma?

A

usually from steroid withdrawal or triggered by use of beta-blockers, lithmus and antimalarials

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81
Q

what is eczema herpeticum?

A

a widespread eruption caused by HSV when there is a concordant skin disease/underlying pathology usually axeman

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82
Q

eczema herpeticum is usually a manifestation of a _______ HSV infection

A

1ry

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83
Q

what does the image below show

A

eczema herpeticum

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84
Q

what is the presentation of eczema herpeticum

A

extensive crusted papules blisters and erosions as well as systemic features of malaise and fever

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85
Q

what is a diagnostic test for eczema herpeticum

A

swab and culture with PCR

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86
Q

What is the management of eczema herpeticum

A

acyclovir and cover for any secondary infections if they can occur with antibiotics

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87
Q

what are complications which can arise because of eczema herpeticum

A

herpes hepatitis herpes encephalitis secondary infections DIC

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88
Q

what are the two types of HSV

A

type I causing and skin lesions Type II causing genital lesions

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89
Q

what is the presentation of a primary infection of HSV

A

is usually asymptomatic but may present with high fever sore throats myalgia cervical lymphadenopathy also said appear a few days later on the Fangio and mouth mucosa

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90
Q

what is a typical presentation of HSV eruption

A

has prodromal tingling and burning and then a vesicular lesion which can turn ulcerative

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91
Q

what is a serious complication of a primary infection of HSV

A

HSV aseptic meningitis

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92
Q

what investigations should be performed in HSV meningitis

A

anyone suspected of having central nervous system HSP should have CSF HSP PCR as well as viral cultures in any active lesions

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93
Q

what can trigger an eruption of HSV vesicle?

A

UV lights or trauma

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94
Q

what other symptoms of genital HSV

A

dysuria tingling and burning can be with or without recurrent genital ulceration and ulcers can range from asymptomatic to painful there can be discharged and proctitis in males

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95
Q

how does the presentation of genital HSV differ in male and female

A

females tend to have stronger symptomatic response on primary infection and so will have more systemic symptoms such as fever constipation neuralgia and lower back pain or pain down the back of the legs

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96
Q

what investigations are diagnostic for genital herpes?

A

active lesions should be swamped for HSV and then PCR

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97
Q

what investigations are needed for oral herpes?

A

Nan into their clinical diagnosis however H is the culture/swab and PCR should be performed if there is any doubt

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98
Q

what is the management of a primary genital HSV infection

A

oral acyclovir or valacyclovir

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99
Q

how does the management differ in HSV for immunocompetent and immunocompromised patients

A

if immunocompromised give foscernet

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100
Q

what is the management of oral HSV?

A

oral acyclovir or valacyclovir topical antivirals may be used and can be bought over-the-counter however this is not typically recommended

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101
Q

what is the management of HSV in a woman who is 36 weeks gestation

A

prophylactic acyclovir

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102
Q

what are the indications for IV acyclovir in HSV infection

A

visceral involvement: pneumonitis hepatitis CNS (meningitis) eczema herpeticum corneal scarring from eye involvement

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103
Q

what is necrotising fasciitis?

A

rapidly spreading infection of the deep facia with secondary tissue necrosis

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104
Q

what pathogens usually cause necrotising fasciitis

A

group A haemolytic strep or mic of aerobic and anaerobic

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105
Q

what is the most common precipitating factors of necrotising fascitis?

A

recent abdominal surgery or with many medical comorbidities such as diabetes and pregnancy immunosuppressed

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106
Q

what is the presentation of necrotising fasciitis?

A

severe pain erythematous blistering necrotic skin and cellulitis systemic features of sepsis presence of crepitus

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107
Q

what would crepitus indicate in necrotising fasciitis

A

subcut emphysema

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108
Q

what investigations are necessary in necrotising fasciitis

A

CT/MRI blood and tissue cultures and septic screen especially checking U+E and Lactate

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109
Q

what would you see on CT/MRI in necrotising fasciitis?

A

oedema along fascial plane and soft tissue gas

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110
Q

what features would indicate circulatory collapse in necrotising fasciitis?

A

hyponatraemia lactate and creatine kinase ++

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111
Q

what is the management of necrotising fasciitis?

A

surgical debridement and IV antibiotics

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112
Q

what are the most common pathogens which cuase bacterial skin infectons?

A

streptococcal staphylococcal

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113
Q

what are the most common pathogens which cause viral skin infections?

A

HPV HSV

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114
Q

was the most common pathogens which cause fungal skin infections?

A

Candida Tinea

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115
Q

what are the most common types of infestations of skin ?

A

lice scabies cutaneous leishamaniasis

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116
Q

what is cellulitis

A

infection of the deep subcutaneous tissue

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117
Q

what is erysipelas?

A

acute superficial form of cellulitis involving only the dermis and the upper subcutaneous tissue

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118
Q

what pathogens are usually caused cellulitis

A

strep pyogenes and Staphylococcus aureus

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119
Q

what risk factors are associated with cellulitis

A

prior episode of cellulitis lymphadenoma ulcer/wound up Tinea pedis venous insufficiency

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120
Q

what is the image below show

A

cellulitis

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121
Q

what is the presentation cellulitis

A

swelling warmth erythema pain systemic symptoms of malaise and rigors

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122
Q

how does a presentation between cellulitis and erysipela differ?

A

cellulitis has a less well-defined red border

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123
Q

what are complication associated with cellulitis

A

local necrosis abscesses and septicaemia

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124
Q

what is management of cellulitis

A

flucloxacillin +/- vancomycin for MRSA cover + supportive care including rest like elevation sterile dressings and analgesia

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125
Q

what is staphylococcal scalded skin syndrome

A

skin infection which produces an acute scolded the skin -like appearance

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126
Q

what is the pathophysiology behind staphylococcus scalded skin syndrome

A

staphylococcus produces an epidermolytic toxin

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127
Q

what is the picture below show

A

staphylococcal scalded skin syndrome

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128
Q

what is the presentation of staphylococcus called skin syndrome

A

onset of hours – days tends to be worse on face neck axilla and groin skin has a scolded appearance with redness, large flaccid bulla painful lesions intra epidermal blistering and perioral crusting

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129
Q

what is the management of staphylococcal scalded skin syndrome

A

Iv flucloxacillin or erythromycin + vancomycin if ?MRSA / analgesia / top emmolients and Abx + skin hydiene

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130
Q

what is impetigo

A

a highly common and contagious bacterial infection caused by either strep or staph

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131
Q

what is image below show

A

impetigo

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132
Q

what is the presentation of impetigo

A

vesicles/bullae with golden crusting and associated erythema

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133
Q

what is the management of impetigo

A

usually resolves spontaneously but topical abx given or topical antiseptics –> PO abx

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134
Q

what three types of fungal infections which can happen on skin most commonly?

A

dermatophytes (tinea/ringworm) yeasts (candidiasis malassezia) moulds (aspergillus)

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135
Q

where does tinea corporis affect?

A

trunk and limbs

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136
Q

where does tinea cruris affect?

A

groin and natal cleft

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137
Q

where does tinea pedis affect?

A

athletes foot

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138
Q

where does tinea manum affect

A

hand

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139
Q

where does tinea capitis affect

A

head

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140
Q

where does tinea ungium affet

A

nails

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141
Q

where does tinea incogneto affect

A

wherever there has been inappropriate treatment of a tinea infection with topical or systemic steroids it is ill-defined and less scaly

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142
Q

what is the presentation of tinea corpsris

A

itchy circular or annular lesions with a clearly defined raised scaly edge

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143
Q

what is a presentation of tinea cruris

A

itchy circular or annular lesions with a clearly defined raised scaly edge

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144
Q

what is the presentation of tinea pedis

A

moisture scaling and for sharing in web spaces spreading to the sole and dorsal aspect with itching

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145
Q

what is the presentation of tinea manum

A

scaling and dryness of palmar creases and itching

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146
Q

what is a presentation of tinea captis

A

patches of broken hair scaling and inflammation

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147
Q

what is the presentation of tinea ungium

A

yellow discolouration and thickened crumbling nail

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148
Q

what is the image below show

A

tinea captis

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149
Q

what is image below show

A

tinea gruris

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150
Q

what is the image below show

A

althletes foot/tinea pedis

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151
Q

what does the image below show

A

tinea manum

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152
Q

what does the image below show

A

tinea captis

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153
Q

what does the image below show

A

tinea ungium

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154
Q

how word candidiasis at present as a skin infection

A

white plaques on mucosal areas erythema and satellite leasions in flexures

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155
Q

what is the presentation of pitryasis

A

scaly brown patches on the upper trunk that failed to turn on sun exposure they are usually asymptomatic

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156
Q

how would you diagnose a fungal skin infection

A

skin scraping her toenail clippings or skin swabs as appropriate

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157
Q

what is the management of fungal skin infections

A

topical antifungal is terbinofine cream / oral antifungal if a severe widespread infections

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158
Q

what is the management of a tinea captis

A

oral and topical antifungal

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159
Q

what is scabies

A

and intensely itchy skin infestation caused by the human parasite sarcoptes scabiei

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160
Q

what causes the symptoms of scabies

A

immune response to the mites and their saliva eggs or faeces

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161
Q

what is the image below show

A

scabies

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162
Q

what is a presentation of scabies

A

pruritus particularly at night linear boroughs with wavy threadlike whitish lines connecting them symmetrical erythematous papules which are often excoriated common in the inter-digital web spaces or extensors

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163
Q

how would the presentation of scabies differ if it is present on the scrotum penis buttocks or groin or axilla

A

there may be nodules which are violet in colour and intensely itchy

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164
Q

where is scabies most common on the body

A

into digital web spaces expenses folds of skin but can be anywhere especially in elderly and young children

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165
Q

what is crusted scabies

A

are hyper infestation with thousands or millions of mites which are present in exfoliating scales of skin caused by immunodeficiency

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166
Q

what is the image below show

A

crusted scabies

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167
Q

what risk factors are associated with scabies

A

family or close contacts also having scabies overcrowded living conditions children and elderly

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168
Q

what test is diagnostic for scabies

A

Inc Barrow test plus microscopy of skin scrapings

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169
Q

what is the management of scabies

A

if under two months of age: paediatric dermatologist referral non-crusted scabies: topical insecticide - permethrin cream 5%

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170
Q

What are the two types of skin cancer

A

melanoma and non-melanoma

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171
Q

what subtypes are there of non-melanoma skin cancer

A

Basal cell carcinoma’s claim as cell carcinoma

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172
Q

which have skin cancer usually has the highest mortality

A

melanoma

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173
Q

what does the image below show

A

nodular basal cell carcinoma

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174
Q

what does the image below show

A

superficial basal cell carcinoma

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175
Q

what does the image below show

A

pigmented basal cell carcinoma

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176
Q

what does the image below show

A

morphoeic basal call carcinoma

177
Q

what does the image below show

A

basosquamous basal cell carcinoma

178
Q

which is the most common type of basal cell carcinoma

179
Q

what is the description of a nodular basal cell carcinoma

A

small and skin coloured papule or nodule with superficial telangactasia (mai=king appearance slightly red) and pearly rolled edges can have a necrotic or ulcerated core

180
Q

what are risk factors associated with basal cell carcinoma

A

UV exposure increased age male immunosuppression history of skin cancer genetic predisposition frequent or severe sunburn in childhood skin type I

181
Q

person describes the skin is very pale which always burns never tans what type of skin type is this

A

skin type I

182
Q

what complications usually arise because basal cell carcinoma

A

local tissue invasion and destruction

183
Q

what is the treatment of most types of basal cell carcinoma

A

excision and radiotherapy

184
Q

does the image below show

A

squamous cell carcinoma

185
Q

what cells do squamous cell carcinomas affect

A

epidermal keratinocytes + appendages

186
Q

describe the appearance of a squamous cell carcinoma

A

keratoic appearance (scaly +custy) and ill-defined nodule which may ulcerate

187
Q

what is the treatment of squamous cell carcinoma

A

surgical excision with 5 mm margins and radiotherapy for large non-respectable tumours

188
Q

what are the risk factors associated with squamous cell carcinoma

A

UV exposure pre-malignant skin conditions (aka actinic keratoses) chronic inflammation ( leg ulcers, wound scars) immunosuppression genetic predisposition

189
Q

what is actinic keratosis

A

a premalignant skin condition which is strongly associated with sun exposure

190
Q

what is the image below show

A

actinic keratosis

191
Q

what risk factors are associated with actinic keratosis

A

chronic sun exposure skin type I older age immunosuppression

192
Q

describe the appearance of actinic keratosis

A

typically ill-defined irregularly shaped small scaly macules/papules however can also be skin coloured or pigmented i.e. yellow

193
Q

how would you diagnose actinic keratosis

A

usually a clinical diagnosis however demonstrably or skin biopsy can be used if unsure/ in atypical cases

194
Q

what is the management of actinic keratosis

A

topical therapies (flurocil) unless there are many thick lesions in which case a cryo surgery in widespread lesions which attain chemical peels and topical diclofenac

195
Q

what is malignant melanoma

A

and invasive malignant tumour of epidermal melanocytes which has strong potential to metastasise

196
Q

what are the risk factors associated with malignant melanoma

A

UV exposure skin type I history of multiple moles atypical moles family history or previous melanoma

197
Q

what our early warning signs of cancer

A

asymmetrical mole moles of the blurry or jagged border moulds with multiple colours models with a diameter larger than a pencil eraser (6 mm) a mole that has gone through a sudden change size shape or colour

198
Q

what are the types of malignant melanoma

A

superficial spreading nodular melanoma lentigo melanoma acral lentigious melanoma

199
Q

where is superficial spreading melanoma most common and in which age group

A

in the lower limbs and in the younger patient

200
Q

where is nodular melanoma most common and in which age group

A

common in the trunk and younger patients

201
Q

where is Lentigo melanoma most common and in which age group

A

common in the face and in elderly patients

202
Q

where is acral lentigios melanoma most common and in which age group

A

, in the palms and soles of feet as well as nail beds

203
Q

what is different about the risk factors associated with acral lengigious melanoma compared to other types of melanoma

A

no clear relation to UV exposure is the most common melanoma in darker skin types

204
Q

how do you diagnose melanoma

A

with biopsy

205
Q

how would you describe the staging of melanoma (TNM)

A

T1 just in the upper epidermis T2 reaching the stratum basale of the epidermis T3 reaching through the dermis T4 reaching the fat under the dermis

206
Q

what advice can you give to prevent melanoma from occurring

A

always use SPF 30 with UVB protection and high style UVA protection have protective clothing and sunglasses the initiate from 11 AM to 3 PM keep children out of direct sunlight and avoid all tanning

207
Q

what are differentials of acral lentigious melanoma

A

black nails/ trauma and haemorrhage or fungal infection

208
Q

what is the management on Acral lentigious melanoma

A

amputation and the extent of which is decided through biopsy and margins

209
Q

what are the names of inflammatory skin conditions

A

eczema acne psoriasis

210
Q

describe how the itch scratch cycle worsens inflammatory skin conditions

A

there is a compromised skin barrier irritants and allergens and the skin barrier causing inflammation which causes further itching which causes further scratching which further compromises the skin barrier

211
Q

describe the physiology of the skin barrier

A

in the epidermis the outermost layer is made out of corneocytes and lipids which accumulate in a brick -like structure the skin lipids consist of caramide, cholesterol and fatty acids and has a lamellar structure in which several layers are stacked on top of one another

212
Q

what is image below show

213
Q

described the presentation of eczema

A

itchy Erica Matthaus dry scaly patches which can be excoriated and weepy

214
Q

how does the distribution of eczema differ in adults to children

A

in infants tend to be on extensor surfaces on anyone older than infant tends to be on instances can be on the face in both age groups

215
Q

describe the presentation of acute lesions of eczema

A

the lesions are erythematous vesicular and exudative

216
Q

describe the appearance of chronic lesions in eczema

A

excoriation and lichenification

217
Q

what other features (apart from skin manifestations) can there be in ecxema?

A

nail piercing and ridging

218
Q

what risk factors are associated with eczema

A

past medical history of ATP family history of ATP primary genetic skin defect in the skin barrier or function exposure to exacerbating factors such as chemicals found in sweat heat or stress

219
Q

works general advice can you give to someone suffering from eczema

A

avoid itching avoid known exacerbate his use of frequent invariants

220
Q

describe the stepwise management of eczema

A

basic advice –> low potency/mild potency topical corticosteroids +/ or topical calcineurin inhibitors –> may destroy high potency corticosteroid +/- top CI –> systemic therapy or UV therapy

221
Q

give examples of calcineurin inhibitors

A

tacrolimus

222
Q

what is an example of a mild corticosteroid

A

hydrocortisone

223
Q

what is an example of a moderate corticosteroid

A

clobetasome (Euvmovate)

224
Q

what is an example of a potent corticosteroid

A

betamethosone (betnovate)

225
Q

give an example of a very potent topical corticosteroid used in dermatology?

A

clobetasol (dermovate)

226
Q

what are signs that there is a secondary bacterial infection affecting eczema

A

there is a crusted weepy lesion

227
Q

what are secondary viral infections which can affect eczema

A

molluscum contagiosum viral warts eczema herpeticum

228
Q

what does the image below show

A

molluscum contagiosum viral warts eczema herpeticum

229
Q

what is contact dermatitis

A

an inflammatory skin condition which occurs as a result of exposure to an external irritant or allergen

230
Q

what type of hypersensitivity reaction is contact dermatitis

231
Q

describe the meaning of type 4 hypersensitivity reaction

A

there is sensitisation and subsequent exposure to specific allergen which causes an immune response

232
Q

what is the difference between irritant contact dermatitis and contact dermatitis

A

irritant contact dermatitis is non-immunological it does not require prior sensitisation and it is caused directly by the physical and toxic effects of irritant substance

233
Q

what substances can cause irritant contact dermatitis

A

repeated prolonged exposure to water detergents and cleaning agents with acids and alkalis and certain plants

234
Q

what are common triggers for contact dermatitis

A

cosmetics skincare nail varnishes fragrances and heard I metals commonly nickel topical medications such as antibiotics or corticosteroids plants such as sunflower

235
Q

what is the difference in presentation between acute dermatitis and chronic dermatitis

A

acute dermatitis: erythema and visiculations + dryness scaling and bullae chronic: dryness lichenification and fissuring - but presentation is usually mixed

236
Q

how do you diagnose contact dermatitis

A

identifies the cause of the contact dermatitis (thorough history) definitive diagnosis is through patch testing however it not always needed if irritant is clear

237
Q

what is the management contact dermatitis

A

avoiding contact with the stimulus liberal application of ammonia consider prescribing topical corticosteroids if severe treating any secondary skin infections

238
Q

when would a referral to a dermatologist be necessary for contact dermatitis

A

is associated with occupation severe or chronic dermatitis especially if on the hands or face newly unstable dermatitis atypical or unresponsive dermatitis

239
Q

what must an employee do if their employee develops contact dermatitis because of their workplace

A

it is an employer’s legal duty to report a case of occupational skin disease to the health and safety executive

240
Q

acne vulgaris is inflammation of the XXXXXXX

A

pilosebacious follicle

241
Q

describe the pathophysiology of acne vulgaris

A

mainly caused by androgen hormones which increase sebum production because of abnormal follicular keratinisation and with us because bacterial colonisation and inflammation

242
Q

what are the two types of acne vulgaris

A

noninflammatory and inflammatory

243
Q

what are examples of noninflammatory acne vulgaris

A

open or closed comedones

244
Q

what are examples of inflammatory acne vulgaris

A

papules pustules and nodules or cysts considered moderate/severe acne

245
Q

what is the stepwise management of acne vulgaris

A

Top benzyl peroxie –> Top retinoids —-> Top Abx (usually for those who don’t want oral therpay) —> oral therapy Abx —-> oral retinoids

246
Q

what antibiotics are used in treatment of acne vulgaris

A

doxycycline/ tetracycline or doxycycline/ Lymecyclin (if pregnant Erythromycin) —-> trimethoprim but must be initiated by specialists

247
Q

what is the name of the oral retinoid used in very severe acne

A

isoretinoin aka acutane

248
Q

what endocrine abnormalities can induce acne

A

PCOS cushings congenital adrenal hyperplasia

249
Q

what medication can induce acne

A

systemic and topical steroids progesterone only contraception anabolic steroids lithium phenytoin isoniazid

250
Q

what are the side effects and risks associated with isotretninoin

A

dry skin light sensitivity muscle/joint aches mild increase in blood fats/liver inflammation (ideally avoid alcohol) rarely can cause: mood disturbances depression suicidal ideation hepatitis or pancreatitis intracranial hypertension

251
Q

how do you avoid intracranial hypertension in a patient prescribed isotretinoin

A

avoid concomitant use with tetracycline

252
Q

what is rosacea

A

chronic rash involving the centre of the face characterised by papules pustules and telangiectasia

253
Q

what does the image below show

254
Q

what are the types of rosacea

A

erythematotelangiectatic Papulopustular phymatous occular

255
Q

what is the image below show

A

phymatous changes

256
Q

describe the presentation of rosacea

A

flushed skin which can be dry and flaky skin is very sensitive and easily blushes that each subtype will have a predominant feature of erythema telangiectasia papules pustules phymatous and occular involvement

257
Q

what complications can occur due to rosacea

A

ocular rosacea rhinophyma mobian disease

258
Q

what is ocular rosacea

A

read gritty eyelids and sties due to posterior blepharitis with an increased chance of conjunctivitis keratosis or a episcleritis

259
Q

what is rhinophyma

A

an enlarged unshaped knows due to sebaceous hyperplasia and vigourous thickening

260
Q

how do you diagnose rosacea

A

usually clinical diagnosis but occasionally biopsies required

261
Q

what would biopsy show in rosacea

A

chronic inflammation and vascular changes

262
Q

what is the non pharmacological management of rosacea

A

avoid facial flushing and triggers + use SPS use water-based make-up only and avoid all use of oil based products

263
Q

what is the pharmacological management of rosacea

A

clonidine alpha-2 reductase inhibitor

264
Q

what is contraindicated in the management of rosacea

A

lavatory with steroids

265
Q

how can you manage pastulopapular changes in rosecia

A

metronidazole gel azaelic acid ivermectin —> tetracycline or metranidazole PO –> iroretinoin

266
Q

how you manage eryhtematoustelengactasia manifesttations of roseacia

A

metronidazole gel azaelic acid –> lazer

267
Q

how to manage rhynophyoma?

A

isotretinoin –> surgery

268
Q

What is the pathophysiology of psoriasis?

A

a chronic inflammatory skin disease due to hyperproliferation of keratinocytes and inflammatory cell infiltration

269
Q

what are the types of psoriasis

A

chronic plaque Guttate Sebhorric Flexural Pustular Erythrodermic

270
Q

what does the image below show

271
Q

what can precipitate an attack of psoriasis

A

trauma infections drugs alcohol and stress

272
Q

where are psoriatic lesions usually found

A

on extensor surfaces and on the scalp

273
Q

what is the presentation of psoriasis

A

well demarcated erythematous skinny black lesions which can be itchy burn or be painful

274
Q

what signs and symptoms may be present apart from skin manifestations

A

50% have associated nail changes – pitting or Oncholysis , psoriatic arthropathy

275
Q

what is the presentation of psoriatic arthropathy

A

an asymmetrical polyarteritis with asymmetrical oligomonoarthritis - can be lone distel interpharyngeal disease

276
Q

what does the picture below show

A

arthritis mutilans

277
Q

what is the management of mild psoriasis

A

topical therapy: vitamin D analogues , corticosteroids, retinoids, keratolytics (then things like dithranol or coal tar preparations)

278
Q

how do vitamin D analogues help psoriasis

A

regulate the immune system and slow skin growth

279
Q

how do corticosteroids help psoriasis

A

decrease inflammation and itching and slow down skin growth

280
Q

what would you use as management for extensive disease that is not yet classed as severe

A

phototherapy

281
Q

what is the management of extensive and severe psoriasis

A

methotrexate PO: retinoids cyclosporin is biological agents fumaric acid acretin

282
Q

describe the psoriasis severity scoring

A

insert picture page 35

283
Q

what conditions does psoriasis also increase the risk of

A

cardiovascular disease/metabolic syndrome and ETS

284
Q

how would METS present

A

abdominal obesity hypertension type II diabetes mellitus non-alcoholic fatty liver disease

285
Q

describe the stepwise treatment of psoriasis

A

general measures and Moulin topical treatments phototherapy traditional systemic therapy biologics

286
Q

what are the main risks and side effects of methotrexate

A

risk of overdose side effects include GI discomfort tiredness mouth ulcers liver and lung fibrosis alcohol and is contraindicated in pregnancy

287
Q

What are the side effects associated with acitretin

A

dry skin hair thinning tiredness myalgia deranged liver function lipids iCI in pregnancy

288
Q

what are the main side-effects associated cyclosporins

A

hypertension and kidney function failure

289
Q

what is image below show

A

flexural psoriasis

290
Q

what does the image below show

A

Guttate psoriasis

291
Q

what is a presentation of Guttate psoriasis

A

tear drop shape

292
Q

where is sebhorric dermatitis most common

A

naso labial + retro aurticular

293
Q

Where does pustual psorias most commonly occur

A

palmar plantar

294
Q

where does erythrodermic psoriasis usually occur

A

everywhere !! A medical emergancy

295
Q

the image below show

A

particular psoriasis

296
Q

what is the picture below show

A

seborrhoeic psoriasis

297
Q

how does the management of flexura; psoriasis differ from other types of psoriasis

A

only use steroids +/- adj antifunal and ABx

298
Q

what is lichen planus

A

an autoimmune chronic inflammatory skin condition affecting skin and mucosal surfaces

299
Q

whilst are the risk factors associated with lichen planus

A

genetics physical and emotional stress injury to skin localised skin disease systemic viral infection drugs

300
Q

what drugs can predispose to lichen planus

A

gold quuinine captopril

301
Q

what infections can predispose to lichen planus

A

hepatitis C but many more

302
Q

what is the presentation of cutaneous lichen planus

A

papules and polygonal plaques crossed with fine white lines

303
Q

what is the presentation of oral lichen planus

A

painless white streaks with accompanying painful and persistent erosions/ulcers and can have disquamative gingivitis

304
Q

XXXXX is the more common type of lichen planus

305
Q

what is the image below show

A

cutaneus lichen planus

306
Q

what does the image below show

A

oral lichen planus

307
Q

where are the areas which mucosal lichen planus can occur

A

mouth Volvo penis or any other mucosal site

308
Q

what are the types of lichen planus

A

cutaneous mucosal/oral nail pigmentosis

309
Q

what is the presentation of nail lichen planus

A

ridging of the nail oncholysis or scarring of the cuticle

310
Q

what is the presentation of pigmentosis lichen planus

A

ill-defined oval greyish brown marks which can occur anywhere on the body without prior inflammatory phase

311
Q

what is the management of lichen planus

A

topical steroid / Tacrolimus ointment / Topical Retinoids –> PO sterois —> methotrexate (Adj. Phototherapy at any stage)

312
Q

what is prickly heat

A

heat rash or miliaria rubra caused by excess sweating

313
Q

where does prickly heat usually occur

A

shoulders chest or folds of the skin

314
Q

what does the image below show

A

prickly heat

315
Q

describes a rash that occurs in prickly heat

A

discrete papules that may blister

316
Q

what is the management of prickly heat

A

Calamine lotion –> top. Steroids + loose fitting clothing + avoiding skin products with petrolium + mineral oil

317
Q

What are common blistering disorder?

A

immunobullous diseases (bullous penphoid or pemphgus vulgaris) blistering skin infections (HSV HZV) impetigo insect bites vesicular eczema and burns

318
Q

what is vesicular exczema?

A

Dyohydrotic eczema cantact with irritant causes vesicular eruptions

319
Q

where does vesicular exczema usually occur?

A

hands or feet - usually around the edges

320
Q

What are the usual triggers for vesicular exczema

A

vesicular eruptions itching and burning once blister peels thhere are red painful fissues

321
Q

what other manifestations are there (apart from skin) in vesicular exczema?

A

dystrophy and paronychia

322
Q

how do you diagnose vesicular eczema

A

clinical unless looks uncertain then do skin scrape/ patch testing (is chronic then biopsy)

323
Q

what is a common DD for vesicular eczema?

A

tinea pedia

324
Q

how do you manage vesicular eczema?

A

cold packs / emmolients / proper fitting footwear with x2 soxks and bandages to reduce moisture —> top CS and anticholinergic if caused by hyperhydrosis —> systemic CS then for severe disease

325
Q

what does the image below show?

A

bullous pemphigoid

326
Q

What is bullous pemphigoid?

A

a blistering skin disorder usually affecting the elderly

327
Q

what is the pathophysiology of bullous pemphigoid?

A

autoantiodies against antigens found between the epidermis and dermis causing a sub epidermal split in the skin

328
Q

Describe the presentation of bullous pemphigoid?

A

fluid-filled blisters on an erythematous base lesions are often itchy and proceeded by non-specific skin rash usually found on the trunks and limbs

329
Q

what is the management of bullous pemphigoid?

A

topical steroids –> oral therapy: steroid tetracycline and niacinamide immunosuppression

330
Q

what is pemphigoid vulgaris?

A

a bullous pemphigoid found in those who are middle-aged with a slightly different presentation to normal bullus pemphigoid

331
Q

what is the image below show

A

pemphigoid vulgaris

332
Q

what is the presentation of pemphigoid vulgaris?

A

flaccid easily personal blisters once they burst because erosions and crusts painful lesions usually are mucosal areas but then spread to normal skin

333
Q

what is the management of pemphigoid vulgaris?

A

monitoring and wound care good oral hygiene high-dose oral corticosteroids and immunosuppressants

334
Q

what are the three types of leg ulcer

A

venous arterial neuropathic

335
Q

history of: ulcer that is painfulmore painful on standing and the history of varicose veins and DVT suggest which type of ulcer

336
Q

A history of and also which is painful especially at night and pain gets worse when legs elevated and has a history of arteriosclerosis suggests which type of ulcer

337
Q

a history of and also which is often painless and there is little sensation to the foot and patient has a history of diabetes/neurological disease suggest which type ulcer

A

neuropathic

338
Q

which type of ulcer is most common on the malleolar area (eps medial)

339
Q

which type of ulcer is most common on pressure and trauma sites such as pre-tibial supramalleolar (especially lateral) and at close

340
Q

which type of ulcer is most common on the soles of feet heal toes and metatarsal heads

A

neuropathic ulcer

341
Q

which type of ulcer is shown below

342
Q

which type of ulcer is shown below

343
Q

which type of ulcer is shown below

A

neuropathic

344
Q

and also which is large shallow and irregular with and exudative and granulating base describes which type of ulcer?

345
Q

and also which is small sharply defined and deep with a necrotic base defines which type of ulcer

346
Q

an ulcer which can be either large or small and can be superficial or deep but has a granulating base and is surrounded by or is underneath a hyperkeratotic lesion eg callus describes which type of ulcer

A

neuropathic

347
Q

patient with an ulcer has once again normal peripheral pulses signs of leg oedema and areas of brown pigmentation as well as areas of white scarring with dilated capillaries (atrophie blanche) this patient is most likely to have which type of ulcer

348
Q

what is the ABPI of a patient with a venous ulcer

349
Q

what is the management of a venous ulcer

A

compression bandages

350
Q

what must you exclude before applying compression bandages to a venous ulcer

A

arterial insufficiency

351
Q

a patient with an ulcer has called skin weak or absent peripheral pulses shiny pale skin and loss of hair on the shins type of ulcer are they most likely to have

352
Q

what is the ABPI a patient with an arterial ulcer

A

low: <0.8 - arterial insufficiency

353
Q

what further investigations might you want to perform in a patient with arterial ulcer

A

Doppler studies and angiography

354
Q

what is the management of an arterial ulcer

A

vascular reconstruction

355
Q

what is contraindicated in the management of arterial ulcers

A

compression bandages

356
Q

a patient with an ulcer present and they have warm skin normal peripheral pulses but on examination you note there is peripheral neuropathy what is the most likely type of ulcer?

A

neuropathic

357
Q

what is the ABPI like in a neuropathic ulcer

A

normal usually

358
Q

a patient with a history of diabetes presenting with an ulcer who has diminished peripheral pulses and a low ABPI - was the most likely type of ulcer

A

neuro ischaemic

359
Q

what further investigations would you want to in a patient who has a neuropathic ulcer

A

x-ray to exclude osteomyelitis especially in deep ulcers

360
Q

what is a management of a neuropathic ulcer

A

wound to bride meant regular repositioning appropriate footwear and good nutrition

361
Q

what is a sebhorreic wart?

A

are benign condition which is common in middle-aged/elderly where there are multiple asymptomatic warty greasy papules on the skin which appear stuck on with well defined edges management is rarely needed

362
Q

What’s acid substances typically cause chemical burns

A

sulphuric acid nitric acid hydrochloric acid

363
Q

what alkali substances usually cause chemical

A

sodium hydroxide ammonia phosphate sodium and calcium hypo chloride

364
Q

why are gaseous chemicals more dangerous if ingested than liquid

A

take longer to digestive and liquids causing more severe burns

365
Q

what is the presentation of a chemical burn

A

redness irritation burning pain or numbness vision changes can have low blood pressure muscle twitching/seizures cardiac arrest/arrhythmias feeling weak dizzy or having a headache or cough/shortness of breath

366
Q

what feature of a chemical burn presentation would suggest an alkali burn

A

deep tissue injury due to liquefaction necrosis

367
Q

what feature of a chemical burn presentation would suggest an acid burn

A

formation of black dead skin eschar

368
Q

how would you manage a chemical burn

A

remove contaminated clothing irrigates for 20 minutes once reached the hospital treat as a thermal burn

369
Q

when weight irrigation be contraindicated in the management of a chemical burn

A

if the burn involves elemental metals such as sodium magnesium lithium or potassium

370
Q

management of a band which involves elemental metals is…?

A

soaking with mineral oil instead of irrigation

371
Q

describes the thickness of a first-degree burn

A

it is superficial only reaching the epidermis

372
Q

what are the characteristic features of a thermal 1st° burn

A

pain redness mild swelling

373
Q

What other characteristic features of a thermal second-degree burn

A

pain blisters splotchy skin and severe swelling

374
Q

describe the thickness of a second-degree burn

A

reaches the dermis specifically the papillary region

375
Q

describe the thickness of a third-degree burn

A

is deep reaching the dermis reticular region

376
Q

what is the presentation of a third-degree burn

A

white leathery relatively painless

377
Q

described the thickness of a 4° burn

A

full thickness reaching the hypo dermis a.k.a. subcutaneous tissue

378
Q

what is the presentation of a fall/4th° burn

A

child insensate tissue with formation of black dead skin – eschar

379
Q

what is the management of a thermal burn

A

evaluate the airway taking care to secure and maintain circulatory support once the patient is stable (ABC DEF approach specifically looking at the airway loss of fluids/electrolytes and thermal regulation)

380
Q

how would you evaluate severity of burns

A

look at the depth of the ban and evaluate the extent of the ban using the ruke of 9s

381
Q

if a patient requires in patient management after thermal burn what would be the management

A

wound the bride meant and facilitating the closure of wound unless there is a full thickness burn which must be removed fully. Closure is used with autografts. Gave antibiotics wound cleansing etc

382
Q

describe how male pattern baldness occurs

A

it is to do with androgenic alopecia with an ineffective androgenic pathway due to issues with five alpha reductase

383
Q

how does male pattern baldness differ from female pattern baldness in its pathophysiology

A

although females also develop it doesn’t share an androgenic pathway

384
Q

describe the pattern of male pattern baldness

A

thinning of the temporal areas advancing to the Crown

385
Q

describe the pattern of female pattern baldness

A

diffuse thinning

386
Q

how do you manage male pattern baldness

A

topical minoxidil +/- PO finesteride

387
Q

how do you manage female pattern baldness

A

topical minoxidil and for women with hyper androginism use androgen suppressants such as spinoro lactone

388
Q

what is image below show

389
Q

what the pathophysiology of alopecia

A

and autoimmune condition are targets hair follicles

390
Q

describe the presentation of alopecia

A

round patchy onset of sudden hair loss with a distinct border

391
Q

how do you diagnose alopecia

A

a positive pull test and presence of exclamation marks (these are short broken hairs) you might want to perform the scalp biopsy which will show peri follicular inflammation

392
Q

what is the management of alopecia

A

topical or intra-lesional corticosteroids

393
Q

what is tricholomania

A

manifestation of OCD resulting in the pulling out of hairs

394
Q

what does the image below show

A

chickenpox

395
Q

XXXXXX is the virus which causes chickenpox

A

varicella zoster virus

396
Q

in which people would chickenpox be dangerous

A

all the children/adults pregnant women immunosuppression neonates

397
Q

what is the presentation of chickenpox

A

a vesicular rash initially appearing centrally before spreading to the extremities lesions filled with clear fluid and surrounded by erythema and appearing in crops so different groups of lesions will be at different stages by day seven – 10 lesions are completely crusted over has prodromal symptoms of fever fatigue headache and sore throat

398
Q

what are the complications which can occur due to VZV infection

A

pneumonia hepatitis secondary bacterial infection that encephalitis cerebro-meningitis intercranial vasculitis hepatitis Reyes syndrome

399
Q

how would you diagnose chickenpox

A

usually clinical findings are sufficient to make a diagnosis

400
Q

in which individuals would you want to do further investigations for chickenpox

A

atypical presentations or high risk individuals

401
Q

what investigations would you want to perform in certain individuals with chickenpox

A

skin swab and PCR all lumbar puncture and CSS PCR. You can perform a culture but you have to wait 21 days for diagnosis

402
Q

what is the management of chickenpox in an uncomplicated patient

A

a self-limiting disease treated symptomatically: paracetamol alien antihistamines and calamine lotion

403
Q

what is management of chickenpox in a complicated patient

A

antiviral therapy acyclovir (PO- moderate IV - severe/complications)

404
Q

what does the image below show

405
Q

what is image below show

A

Cherry angiomaa

406
Q

what does the image below show

A

pyogenic granuloma

407
Q

how do you treat the pyogenic granuloma

A

usually resolve on their own can be removed with a curette and then cauterise

408
Q

what is a pyogenic granuloma

A

reactive proliferation of capillary blood vessels

409
Q

who is most at risk of getting a pyogenic granuloma

A

children or pregnant women

410
Q

describe the pathophysiology of venous leg ulcers

A

begins with venous pathology i.e. reflux or varicose cveins. This causes a backflow of blood causing venous hypertension/pooling of blood and entrapment of leucocytes causes chronic inflammation as they become activated and pro-inflammatory this breaks down the skin and the capillaries causing an ulcer

411
Q

why is the diagnosis of eczema in infants younger than two months and likely

A

because it is usually seborrhoeic dermatitis

412
Q

What type of brthmark is a salmon patch?

413
Q

what is the management of asalmon patch

A

nothing - they usually dissapear within months unless they are on the face and neck (then upto4y)

414
Q

what does the image below show?

A

salmon patch / stork mark

415
Q

What is the image below show

A

a strawberry mark/infantile haemangioma

416
Q

what type of birthmark is a infantile haemangioma

A

vascular birthmark

417
Q

described how an infantile haemangioma will change over time

A

will rapidly increase in size around six months but then disappear around seven years

418
Q

What is the management of an infantile haemangioma

A

nothing wait for it to disappear over few years surgery is only required if affecting vision or feeding

419
Q

what does the image below show

A

a port wine stain

420
Q

give a description of port wine stain

A

flat red or purple mark which can be small to very large and is usually unilateral

421
Q

what causes a port wine stain

A

capillary malformations making its avascular birthmark

422
Q

how does a port wine stain change over time

A

they deepen in colour with age and hormonal changes they do not usually disappear

423
Q

what is the management of a port wine stain

A

laser therapies can be used to help reduce the appearance of port wine stain

424
Q

what does the image below show

A

Mongolian spot

425
Q

where do Mongolian spots usually occur

A

lower back or buttocks

426
Q

how does a Mongolian spot change over time

A

usually disappear around for years of age and are harmless however look like bruises which can cause ?child abuse

427
Q

what does the image below show

A

a congenital Melanocytic nevus

428
Q

describe the appearance of a congenital militaristic nevus

A

a relatively larger black or brown mould presenting at birth which can be very extensive

429
Q

what causes congenital anaesthetic naevus

A

overgrowth of melanocytes

430
Q

how word a can gentleman anaesthetic nevus change over time

A

tends to get smaller with age

431
Q

what is the management of a congenital melanocytic naevus

A

surgery or laser is used depending on where it is found

432
Q

what are the risks associated with a congenital melanocytic naevus

A

increased risk of skin cancer

433
Q

What does the image below show?

A

nappy rash

434
Q

what causes nappy rash

A

by babys skin being in contact with urine or faeces for a long time + nppy is rubbing against the babys skin or using aggressive soaps, wipes or detergents (esp. alcohol based stuff) or not cleaning the nappy area enough

435
Q

is nappy rash painful

A

usually not unless it is severe

436
Q

how can you avoid nappy nash

A

changing asap after urination or defication and changing them regularly. Wiping front to back and drying baby gently after washing do ot use soaps or ralcum powder but you can use rash creams

437
Q

what does the image below show?

A

millia aka milk spots

438
Q

where are millia found

A

nose and eyes most (+ face in general) commonly

439
Q

what is the management of millia

A

nothing heal spontanously after a few weeks of birth

FINALS (24 decks)

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