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Phase 2a - Dermatology > Dermatology Conditions A > Flashcards

Dermatology Conditions A Flashcards

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Dermatology Board Prep flashcards
1
Q

Acne - Description

A

inflammation of pilosebaceous follicles

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2
Q

Acne - Risk Factors (5)

A

1) 12-24 years old
2) family history
3) iatrogenic (e.g. androgens, corticosteroids, lithium)
4) endocrine disorders (e.g. polycystic ovary syndrome, precocious puberty)
5) diet

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3
Q

Acne - Pathophysiology (10)

A

1) hypercornification
2) narrowing of hair follicle
3) increased androgen sensitivity of hair follicle
4) increased sebum production
5) sebum traps in hair follicle
6) Propionibactrium acne colonies anaerobic hair follicle
7) P. acne breaks down sebum lipids into free fatty acids
8) free fatty acids cause inflammation
9) neutrophil attraction
10) pus formation

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4
Q

Acne - Signs (5)

A

1) face, chest, upper back
2) closed comedone papules (whiteheads)
3) open comedone papules (blackheads)
4) pustules
5) tender skin lesions

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5
Q

Acne - Complications (2)

A

1) scarring

2) dyspigmentation

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6
Q

Acne - Investigations (0/2)

A

consider

1) skin swab MS+C
2) hormonal tests (female)

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7
Q

Acne - Management (3/4/0)

A 
conservative
1) avoid overwashing
2) don’t pick
3) healthy diet
medical
1) TOP retinoid (mild)
2) TOP benzoyl peroxide (moderate)
3) PO retinoid (severe)
4) antiandrogens (e.g. combined oral contraceptive) (female hormone related)
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8
Q

Eczema - Description

A

inflammation of skin due to thinning stratum corneum, characterised by dry pruritic skin

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9
Q

Eczema - Risk Factors (4)

A

1) <5 years old
2) family history
3) hayfever
4) asthma

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10
Q

Eczema - Types (2)

A

1) atopic dermatitis (endogenous)

2) contact dermatitis (exogenous)

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11
Q

Eczema - Triggers (4)

A

1) infection
2) detergents
3) pets
4) stress

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12
Q

Eczema - Symptoms (1)

A

1) pruritus

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13
Q

Eczema - Signs (6)

A

1) esp. face, neck , flexure surfaces
2) xerosis
3) erythema
4) scaling
5) papules
6) vesicles

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14
Q

Eczema - Investigations (0/3)

A

consider

1) allergy testing
2) serum IgE (high, 80%)
3) skin biopsy

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15
Q

Eczema - Diagnosis (Atopic Dermatitis) (6)

A

1) clinical diagnosis
2) high serum IgG
3) pruritus past 6 months
+ 3 of:
1) history of flexure surface involvement
2) history of xerosis
3) childhood onset
4) asthma or hayfever

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16
Q

Eczema - Management (3/3/1)

A 
conservative
1) avoid triggers
2) emollients (moisturiser, e.g. E45)
3) bath soap substitutes
medical
1) TOP corticosteroid (1st)
2) TOP calcineurin inhibitor (e.g. tacrolimus) (2nd)
3) antihistamines
surgery
1) UV light therapy
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17
Q

Psoriasis - Description

A

chronic inflammation of skin due to hyperproliferation of keratinocytes characterised by scaly erythematous plaques

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18
Q

Psoriasis - Risk Factors (7)

A

1) genetic
2) infection (group A Streptococci)
3) local trauma (Koebner phenomenon)
4) stress
5) smoking
6) alcohol (esp. beer)
7) light skin

19
Q

Psoriasis - Pathophysiology (3)

A

1) T cell activation upregulates proinflammatory Th1 cytokines (e.g. growth factors)
2) increased epidermal cell turnover
3) uncontrolled hyperproliferation of keratinocytes

20
Q

Psoriasis - Symptoms (2)

A

1) pruritus

2) skin discomfort

21
Q

Psoriasis - Signs (4)

A

1) scalp, elbows, knees, lower back
2) circumscribed salmon-silver scaly erythematous plaques
3) nail pitting
4) onycholysis

22
Q

Psoriasis - Complications (4)

A

1) psoriatic arthritis
2) cardiovascular disease (e.g. MI)
3) lymphoma
4) depression

23
Q

Psoriasis - Investigations (0/1)

A

consider

1) skin biopsy

24
Q

Psoriasis - Management (2/4/1)

A 
conservative
1) avoid triggers
2) emollients (moisturiser, e.g. E45)
medical
1) TOP corticosteroids (mild)
2) TOP vitamin D analogue (mild)
3) methotrexate (moderate—>severe)
4) anti-TNF biological agents (refractory, severe)
surgery
1) UV light therapy (moderate)
25
Q

Basal Cell Carcinoma - Description

A

malignant proliferation of basal epidermal keratinocytes

26
Q

Basal Cell Carcinoma - Risk Factors (3)

A

1) older age
2) UV exposure
3) skin type 1 (burns, doesn’t tan)

27
Q

Basal Cell Carcinoma - Signs (Nodular*) (5)

A

1) sun exposed areas (esp. head, neck)
2) pearly papule
3) rolled edges
4) associated telangiectasia
5) may ulcerate (rodent ulcers)

28
Q

Basal Cell Carcinoma - Signs (Superficial) (3)

A

1) trunk, shoulder
2) scaly erythematous plaque
3) raised smooth edge

29
Q

Basal Cell Carcinoma - Investigations (1/0)

A

initial

1) skin biopsy*

30
Q

Basal Cell Carcinoma - Management (0/0/2)

A

surgery

1) cryotherapy (superficial)
2) wide border excision (+ histology to ensure clear tumour margin)

31
Q

Squamous Cell Carcinoma - Description

A

malignant proliferation of squamous epidermal keratinocytes

32
Q

Squamous Cell Carcinoma - Risk Factors (6)

A

1) older age
2) UV exposure
3) skin type 1 (burns, doesn’t tan)
4) premalignant skin conditions
5) immunocompromised
6) male

33
Q

Squamous Cell Carcinoma - Signs (4)

A

1) sun exposed areas
2) scaly, crusty nodule
3) ill defined edges
4) may ulcerate

34
Q

Squamous Cell Carcinoma - Complications (1)

A

1) metastasis

35
Q

Squamous Cell Carcinoma - Investigations (2/2)

A 
initial
1) skin biopsy
2) lymph node examination (metastasis)
consider
1) body CT (metastasis)
2) sentinel lymph node biopsy (metastasis)
36
Q

Squamous Cell Carcinoma - Management (0/1/1)

A

medical
1) radiotherapy (non-resectable)
surgery
1) wide border excision (+ histology to ensure clear tumour border margins)

37
Q

Melanoma - Decsription

A

malignant proliferation of epidermal melanocytes

38
Q

Melanoma - Risk Factors (8)

A

1) UV exposure
2) skin type 1 (burns, doesn’t tan)
3) red/blonde hair
4) freckles
5) atypical moles
6) multiple moles
7) immunocompromised
8) alcohol

39
Q

Melanoma - Symptoms (2)

A

1) pruritus

2) bleeding

40
Q

Melanoma - Signs (2)

A

1) back, chest (male)

2) lower legs (female)

41
Q

Melanoma - Diagnosis (ABCDE)

A 
A) asymmetrical
B) border irregularity
C) colour irregularity (very dark —> black)
D) diameter >6mm
E) evolution of lesion
42
Q

Melanoma - Complications (1)

A

1) metastasis (esp. lung, liver, brain)

43
Q

Melanoma - Investigations (2/2)

A 
initial
1) dermatoscopy (prior to biopsy)
2) skin biopsy
consider
1) body CT (metastasis)
2) sentinel lymph node biopsy (metastasis)
44
Q

Melanoma - Management (0/2/2)

A 
medical
1) chemotherapy (iplimunab) (metastatic)
2) radiotherapy (non-resectable)
surgery
1) wide border excision (+ histology to ensure clear tumour margins)
2) lymph node excision (metastatic)

Phase 2a - Dermatology (2 decks)

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