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Year 4 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is eczema herpeticum

A

HSV infection of eczematous skin

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2
Q

Who typically presents with eczema herpeticum

A

children and infants

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3
Q

What are the possible complications of eczema herpeticum

A
  • blindness
  • organ failure
  • death
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4
Q

What is a differential for eczema herpeticum

A

impetigo

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5
Q

What is erythroderma

A

and inflammatory skin condition which causes red, hot painful skin covering 90% of the body

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6
Q

What type of patient is more likely to get eryhroderma

A

those with inflammatory skin disease eg psoriasis

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7
Q

How should erythroderma be managed

A

cool, wet dressings and emollients

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8
Q

What is erythema multiforme

A

a type 4 hypersensitivity reaction, usually to infection, that typically affects the palms and soles and has targetoid lesions

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9
Q

describe the signs you look for in erythema multiforme

A

targetoid lesions on the palms and soles, and sometimes haemorrhagic crusting on the lips

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10
Q

What usually causes erythema multiforme?

A

infection (>70% HSV)

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11
Q

What is the treatment for erythema multiforme?

A
  • treat underlying cause
  • give rehydration
  • analgesics
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12
Q

What is the difference between Stevens-Johnson syndrome and Toxic epidermal necrolysis

A

TEN is the more severe form and covers >30% of the body

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13
Q

What % of the skin should be affected for a diagnosis of SJS

A

> 10%

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14
Q

What is SJS

A

A type 4 hypersensitivity reaction covering >10% of the body in macules, blisters or sheets of desquamation

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15
Q

Describe the changes that occur to the skin in SJS and TEN

A

macules form, then become blisters, then sheets of desquamation

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16
Q

What is Nikolsky’s sign? Is it positive or negative for SJS/TEN

A

Gentle rubbing of the skin causes desquamation

Positive in SJS/TEN

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17
Q

What causes SJS/TEN?

A

Change in medication

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18
Q

What is the management of SJS/TEN

A

Stop meds, monitor fluids, analgesics

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19
Q

What type of bacteria is most likely to cause skin infections?

A

gram positive (staph, group A strep)

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20
Q

What is impetigo?

A

A skin infection that causes bullae and honey-coloured crust

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21
Q

what usually causes impetigo?

A

staph aureus

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22
Q

What treatment should be given for impetigo?

A

hydrogen peroxide cream or topical antibiotic

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23
Q

What is staphylococcal scalded skin syndrome?

A

generalised form of impetigo causing a widespread, erythematous rash

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24
Q

what bacteria usually causes staphylococcal scalded skin syndrome?

A

staph aureus

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25
Q

What is erysipelas?

A

infection of the upper layer of the dermis and lymphatics

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26
Q

What does erysipelas look like?

A

erythematous lesion with clear demarcation

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27
Q

What is cellulitis?

A

infection of the deep dermis and subcut tissue

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28
Q

What does cellulitis look like?

A

Fast-spreading erythematous lesion with indistinct margins

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29
Q

what is the visual difference between cellulitis and erysipelas

A

erysipelas has clear demarcation of the lesion whereas cellulitis has indistinct borders

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30
Q

What should be given to treat cellulitis or erysipelas

A

anitbiotics

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31
Q

What is a skin abscess?

A

A walled-off infection with a collection of pus

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32
Q

What is atopic dermatitis?

A

eczema

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33
Q

What is eczema

A

a pruritic rash on flexor surfaces and exposed skin (eg face) caused by type I hypersensitivity reaction

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34
Q

Where would areas of eczema be found?

A 
flexor surfaces (eg backs of knees, insides of elbows)
exposed skin (eg face and hands)
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35
Q

What is the treatment for eczema

A

emollients and moisturisers

- topical corticosteroids can be used in acute flare ups

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36
Q

why are topical corticosteroids not suitable for long term use in eczema

A

they will cause skin atrophy

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37
Q

What are the three most common types of leg ulcers?

A
  • venous ulcers
  • arterial ulcers
  • neuropathic ulcers
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38
Q

What type of leg ulcer is common in diabetes

A

arterial/neuropathic

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39
Q

What other types of leg ulcers apart from venous, arterial, and neuropathic ulcers, might you get

A
  • pyoderma gangrenosum
  • infectious cause (eg syphillus)
  • malignant cause
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40
Q

What causes venous ulcers

A

venous valve incompetence causes blood stasis which increased blood pressure in the veins, leading to compression and ischaemia which causes tissue death

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41
Q

What kind of ulcers might you see in venous ulcers? where?

A

shallow, mildly painful ulcers

found in the gaiter area

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42
Q

What is the gaiter area? what type of leg ulcers are commonly found there?

A

the area on the leg above the medial maleolus

venous leg ulcers

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43
Q

What other findings might you find on inspection of the leg in venous ulceration

A
  • varicose veins
  • oedema
  • brown discoloured skin
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44
Q

What are some risk factors for venous ulceration

A
  • old age
  • female
  • pregnant
  • obese
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45
Q

What treatment is used for venous ulceration

A
  • compression bandages
  • elevation
  • possibly surgery
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46
Q

What causes arterial leg ulcers

A

peripheral vascular disease causes ischaemia in the leg which causes tissue death, resulting in ulceration. Usually ulcers result from small wounds that don’t heal

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47
Q

What other signs might point towards arterial ulceration?

A
  • cold limb

* pulseless

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48
Q

Where are arterial ulcers commonly found?

A

On bony prominences eg the heel or the toe

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49
Q

What is treatment for arterial ulcers

A

Surgical revasculisation

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50
Q

What is neuropathic ulcer?

A

peripheral neuropathy causing loss of sensation which may result in ulcers on pressure points (eg the sole of the feet) going unnoticed and presenting late

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51
Q

What is the main cause of neuropathic ulcer>

A

diabetes mellitus

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52
Q

Describe what the ulcers usually look like in neuropathic ulcer
What is a distinctive characteristic

A

They are “punched out” and painless

53
Q

What is pyoderma gangrenosum

A

an inflammatory and ulcerating skin condition usually caused by an underlying condition eg inflammatory bowel disease/arthritis
It is a diagnosis of exclusion

54
Q

What is psoriasis

A

an inflammatory condition of the skin which causes itchy or painful plaque formation with ‘silvery scales’ on extensor surfaces and around scalp and trunk

55
Q

Where are classic locations for psoriatic plaques?

A
  • scalp
  • trunk
  • buttocks
  • extensor surfaces (eg elbows)
56
Q

What is koebner’s phenomenon?

A

psoriatic plaque at sign of trauma

57
Q

What is Auspitz’s sign?

A

removal of the top of a psoriatic scale will reveal pinpoint bleeding

58
Q

What signs might be noticed on the hands in psoriasis?

A
  • plaques
  • joint swelling
  • nail pitting
59
Q

What other condition can occur with psoriasis

A

psoriatic arthritis

60
Q

What is first line treatment for psoriasis?

A

emollients and topical corticosteroids

61
Q

What is second- and third- line treatment for psoriasis

A
  • systemic biologics
  • systemic non-biologics
  • phototherapy
62
Q

What systemic non- biologics can be given for psoriasis

A
  • methotrexate
  • cyclosporine
  • Acitretin
63
Q

What systemic biologics can be given

A

TNFa-inhibitors:

  • adalimumab
  • etanercept
  • infliximab

anti-interleukin agents
* brodalumab

64
Q

What is found on exam of acne vulgaris?

A
  • erythematous papules, pustules, cysts and nodules commonly on the trunk and face, sometimes with scarring
65
Q

What happens to the skin in acne vulgaris?

A
  • plug formation of dead keratinocytes
  • sebum overproduction
  • bacterial colonisation
66
Q

What is a whitehead

A

a closed comedone

67
Q

What is a blackhead

A

an open comedone

68
Q

What factors can worsen acne?

A
  • androgen (eg puberty)

* products that block pores

69
Q

How do androgens worsen acne

A

Increase sebum production

70
Q

What conditions are associated with acne vulgaris

A
  • PCOS
  • cushing’s
  • congenital adrenal hyperplasia
71
Q

How is acne treated?

A
  • topical retinoids
  • topical antibiotics
  • oral antibiotics
  • isotretinoin
72
Q

What age of patient is most common for acne rosacea

A

adults

73
Q

What might be found on exam in rosacea?

A
  • erythematous face
  • blushing
  • telangiectasis
  • papules and pustules
74
Q

What non-skin findings might be found in rosacea

A

ocular involvement

  • conjunctivitis
  • telangiectasis on eyelids
75
Q

How common is ocular involvement in acne rosacea

A

> 50%

76
Q

What might exacerbate rosacea

A
  • spicy foods
  • alcohol
  • heat
  • sun exposure
77
Q

Give a differential for acne rosacea

A

lupus erythematosus

78
Q

What lifestyle advice can be given for rosacea

A
  • avoid spicy food/ alcohol

* use sunblock and avoid sun exposure

79
Q

What treatment can be given for rosacea

A
  • topical brimodine (an alpha-adrenergic agonist)
80
Q

What are small blisters called

A

vesicles

81
Q

what are large blisters called

A

bullae

82
Q

give some examples of generalised blistering skin disorders that do not cause systemic symptoms

A
  • pemphigoid
  • bullous impetigo
  • dermatitis herpetiformis
83
Q

What is pemphigoid

A

And autoimmune blistering skin reaction

84
Q

give some examples of generalised blistering skin disorders that do cause systemic symptoms

A
  • disseminated herpes zoster (chickenpox)
  • SJS + TEN
  • scalded skin syndrome
  • paraneoplastic pemphigoid
85
Q

Give some examples of localised blistering skin disorders

A
  • contact dermatitis
  • erythema multiforme
  • herpes zoster
  • friction blisters
  • HSV
86
Q

What is urticaria also known as

A

hives

87
Q

What duration is acute uritcaria

A

<6 weeks

88
Q

Describe urticaria in appearance

A

red, raised, itchy rash

89
Q

What duration is chronic urticaria

A

> 6 weeks

90
Q

What are the types of chronic urticaria

A
  • spontaneous urticaria
  • autoimmune urticaria
  • inducible urticaria
91
Q

describe inducible urticaria

A

rash can be induced by physical stimuli

92
Q

What treatment can be given for acute urticaria

A

antihistamine or topical corticosteroids

93
Q

What usually causes acute urticaria?

A

allergic reaction

94
Q

What are the three main types of skin cancer?

A
  • squamous cell carcinoma
  • basal cell carcinoma
  • melanoma
95
Q

What cells cause basal cell carcinoma

A

cells in the stratum basale

96
Q

Describe the appearance of basal cell carcinoma

A

Typically a pearly nodule with a raised, red, edge

Can be plaque-like, may be shiny, may not be raised

97
Q

What is the treatment for basal cell carcinoma

A

excision

98
Q

What is squamous cell carcinoma

A

cancer of the squamous cells of the epidermis

99
Q

Describe the appearance of squamous cell carcinoma

A

A hard, scaly dome like lesion that is often eroded at the centre

100
Q

How is squamous cell carcinoma easily differentiated from a wart

A

typically larger and may be painful

101
Q

What is the precursor to squamous cell carcinoma called

A

actinic keratosis

102
Q

What is the name for squamous cell carcinoma in situ

A

Bowen’s disease

103
Q

What is the treatment for squamous cell carcinoma

A

excision

104
Q

What should you look for in examination of a mole?

A 
Asymmetry
Borders
Colours
Diameter
Evolution/enlargement
105
Q

What about a mole’s borders would concern you on examination?

A

Irregular borders

106
Q

What colouration of a mole would concern you?

A

multiple colours

107
Q

What is alopecia areata?

A

A chronic autoimmune non-scarring hair loss disorder

108
Q

What does presentation in alopecia areata look like?

A

discreet circular patches of hairloss without pain or itchiniess

109
Q

What other non-hair signs might be found in alopecia areata

A

nail bedd pitting

110
Q

What conditions are associated with alopecia areata

A

other autoimmune conditions

111
Q

What might happen to the disorder in alopecia areata?

A

hair may grow back or may proceed to alopecia totalis

112
Q

what is erythema nodosum

A

painful erythematous nodular lesions on the anterior shins

113
Q

What might cause erythema nodosum

A
  • sarcoidosis
  • drugs
  • bacterial infection
114
Q

What is erythema marginatum?

A

pink coalescent rings which come and go on the trunk

115
Q

what is erythema marginatum associated with

A

rheumatic fever

116
Q

What is erythema chronicum migrans also described as

A

bulls eye mark

117
Q

what is erythema chronicum migrans a sign of?

A

Lyme disease

118
Q

what are common associated with vitiligo?

A

organ specific autoimmune conditions

119
Q

What is pyoderma gangrenosum

A

nodule or pustule ulceration

120
Q

what is pyroderma gangrenosum associated with

A
  • UC + crohn’s

* RA

121
Q

What skin manifestations might you find in crohn’s disease

A
  • perianal/vulval ulcers
  • pyoderma gangrenosum
  • erythema nodosum
122
Q

What skin manifestation might you see of coeliac’s

A

dermatitis herpetiformis

a very itchy erythematous rash

123
Q

Describe pretibial myxoedema

A

red oedematous discolouration of the shin

124
Q

What condition causes pretibial myxoedema

A

hyperparathyroidism

125
Q

what is acanthosis nigricans

A

pigmented rough skin in axillae or groin

126
Q

what is acanthosis nigricans associated with

A

stomach cancer

127
Q

what might cause cutaneous vasculitis?

A
  • drugs
  • serum sickness
  • infection
128
Q

What might patients present with in cutaneous vasculitis

A
  • purpura
  • petechiae
  • urticaria
  • shallow ulcers
  • nodules

Year 4 (13 decks)

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