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Year 5 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Pathophysiology of eczema

A

Immune response to irritants/allergens
Causes inflammation in the skin
This causes breakage in the skin barrier
This results in water to escape and the skin becomes dry and itchy

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2
Q

Features of eczema

A

Pruritis
Scaling/dryness
Erythema
Thickening of lichenified skin - occurs in chronic eczema

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3
Q

Most common type of eczema

A

Atopic eczema - most commonly occurs in childhood

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4
Q

What factors exacerbate eczema

A 
Stress
Sweat
Climate 
Infection 
House dust
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5
Q

If atopic eczema is present in a child, does it progress to adulthood

A

10-20% children have it, only 1-2% of adults do
As children grow, skin disease tends to improve
It may disappear all together or remain dry and easily irritated

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6
Q

Which protein is mutated in 50% of cases of severe eczema

A

Filiggrin (FLG)

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7
Q

Which area of the body is eczema more common

A

Flexure surfaces

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8
Q

Management of eczema

A

Avoid triggers
Emollients - used generously e.g, diprobase
Topical steroids - applied sparingly 30 mins after emollients

In more severe eczema can use topical calcineurin inhibitions e.g, tacrolimus or phototherapy

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9
Q

Information to give patients about applying emollients

A 
Apply generously 
Use clean spoon or spatula to remove from tub to reduce risk of infections 
Apply in downwards motion 
Apply after showering 
Apply before steroids
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10
Q

What is eczema herpeticum?

A

Skin infection by herpes simplex virus 1/2 seen in patients with atopic eczema
Potentially life threatening
Presents as rapidly worsening painful eczema with punched out erosions

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11
Q

Management of eczema herpeticum

A

Hospital admission

IV aciclovir

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12
Q

What is pompholyx eczema

A

Type of eczema affecting hands and feet
May be precipitated by humidity (sweating and high temps)
Presents as small blisters on palms and soles

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13
Q

What is seborrhoeic dermatitis

A

Type of eczema
Caused by fungal infection
Presents with eczematous lesions on scalp, periorbital, auricular and nasolabial folds

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14
Q

Management of seborrhoeic dermatitis

A

Topical antifungals e.g, ketoconazole

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15
Q

What is psoriasis

A

Autoimmune skin condition
Inflammation in the skin leads to rapid turnover of keratinocytes (only take 3-5 days to migrate to surface, should take 23)
This leads to accumulation of immature skin cells on the surface which leads to to scaly thick skin

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16
Q

What is the auspitz sign in psoraisis

A

If skin of psoriasis is scraped off it reveals dilated blood vessels underneath

This accounts for much of the erythema in psoriasis

17
Q

Features of psoriasis

A

Red, scaly silver patches found on skin (commonly extensor surfaces)
Nail changes - pitting, onycholysis
Arthritis may also be present

18
Q

Types of psoriasis

A

Plaque - most common
Flexural - in flexor folds, in contrast to plaque, skin is smooth
Guttate - transient teardrop rash occurring in response to streptococcal infection
Pustular - commonly occurs on palms and soles

19
Q

Exacerbating factors for psoriasis

A

Trauma
Alcohol
Medication - beta blocks, lithium, antimalarials
Streptococcal infection - may trigger guttate psoriasis

20
Q

Management of psoriasis

A

Emollients
Topical potent steroid e.g, betnovate
Topical vitamin D analogue e.g, calcipotrol

For more severe non responsive to initial therapies can use coal tar preperations or dithranol

21
Q

Management of psoriasis which is non responsive to topical therapies

A

Phototherapy - UVB or PUVA light 3x a week

Systemic treatment - methotrexate, biological agents

22
Q

Pathophysiology of ache

A

Sebaceous glands in hair follicles become blocked and inflamed

Hormones e.g, androgens can increase the amount of oil produced in the glands which can cause them to become blocked

23
Q

Clinical Features of acne vulgaris

A

Comedomes - open and closed
Inflammation
Papules
Pustules

24
Q

Difference between open and closed comedomes

A

Open - blackheads

Closed - white heads (plugged follicles)

25
Q

Classification of acne vulgaris

A

Mild - open and close comedomes without inflammation
Moderate - widespread inflammatory lesions and numerous papules and pustules
Severe - extensive inflammation which may include nodules, pitting and scaring

26
Q

Stepwise management of acne vulgaris

A

Single topical - topical retinoid or benzoyl peroxide
Topical combination - topical abx, topical retinoid, benzoyl peroxide
Oral abx - tetracycline for 3 months max (erythromycin in pregnancy)
COCP
Oral isotretinoin - only under specialist

27
Q

Councelling women starting on oral isotretinoin

A

Teratogenic - need to make sure pt is using contraception

Must wait 3 months after coming off before trying to get pregnant

28
Q

Features of acne rosacea

A

Typically affects nose, cheeks and forehead
Flushing
Telangiectasia
May develop into erythema with papules and pustules
Rhinophyma (red bumpy nose) may be present in severe disease
Sunlight can exacerbate symptoms

29
Q

Management of acne rosacea

A

Topical metronidazole
Topical brimonidine gel - may be used in predominant flushing
Systemic abx e.g, oxyteracycline may be used for severe disease

30
Q

What are acinitic keratoses

A

Premalignant skin lesions that develop as a consequence of chronic sun exposure

31
Q

Features of actinic keratoses

A

Small crusty, scaly lesions
May be pink, brown or red
Typical present on sun exposed areas e.g, ears, head

32
Q

Management of acitinic keratoses

A

Fluorouracil cream

33
Q

Features of basal cell carcinoma

A

Pearly shiny lesions
Characteristic rolled edge
Telangiectasia
May later ulcerate leaving a central crater

34
Q

Bowen’s disease is a risk for which skin cancer

A

Squamous cell carcinoma

35
Q

Name of ulcer that is risk factor for SCC?

A

Marjolin’s ulcer - long standing leg ulcers

36
Q

Appearance of SCC

A

Nodular
Crusting, ulcerated
Hyperkeratotic

37
Q

Differences between BCC and SCC

A

BCC - slow growing

SCC - rapidly growing, painful, markedly hyperkeratotic

38
Q

Most common type of malignant melanoma

A

Superficial spreading

Year 5 (17 decks)

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