Dermatology- Cutaneous Horn Flashcards
What is cutaneous horn?
Cutaneous horns (cornu cutaneum) are uncommon lesions consisting of keratotic material resembling that of an animal horn. Cutaneous horn may arise from a wide range of the epidermal lesions, which may be benign, premalignant or malignant
It is a clinical sign
Differentials for cutaneous horn? (types of cutaneous horn)
Viral wart
Seborrhoeic keratosis
Actinic kerotosis
Bowen’s disease
Squmous cell carinoma
What is curettage?
Curettage involves scraping the lining and removing uterine contents with a long,
What is cryotherapy?
Cryotherapy is the use of extreme cold to freeze and remove abnormal tissue. Doctors use it to treat many skin conditions (including warts and skin tags) and some cancers, including prostate, cervical and liver cancer. This treatment is also called cryoablation
What does this look like?
Tx?
Viral Wart
FInger like projections (filoforms)
If asymptomatic you can scrape it of under local anesthetic (curettage)
What does this look like?
Is common or not?
Tx?
Seborrhoeic Keratosis
Very common
Tx- curettage
Which is precancerous?
Actinic keratosis
What does this look like?
Tx
Actinic Keratosis
In one of the main sun exposed sights.
Skin around is pink and scaly -sun damaged
Tx- cryotherapy
WHat does this look like
Tx?
Bowen’s disease
bulk and elevated
there is red sclay plaque present
Tx- Excision biposy to rule out malignancy
What does this look like
SCC-squamous cell carcinoma
You can see there is something underneath the horn
Tx- excision
What does this look like
SCC-squamous cell carcinoma
You can see there is something underneath the horn
Tx- excision
What is this?
SCC
Differentials for red scaley skin (clinical sign)?
Inflammatory- Psoriasis, Discoid eczema
Neoplastic- Bowens Disease, Superficial basal cell carcinoma
What could this indicate?
Tx?
Bowens disease
Tx- 5-flurouracil cream
warn the patient of an inflammatory reaction
What does these look like?
Tx-
Superfical basal cell carinoma
Tx- curettage, excision, imiquimod cream if no to surgery,
What is psoriasis?
Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales.
What are some psoriasis creams that you can think of?
- emollients (all patients should use this anyway)
- Vitamin D analogue (dovonex/silkis)
- Steroid
- Tar
- Dithranol
Common places psoriasis can occur
These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
What is the first line treatment for psoriasis?
Dovonex or silkis
Dovobet or Enstilar
What does Dovonex come as?
gel/ointment
What does enstilar come as?
Foam
TRUE OR FALSE
Dovonex and silkis are steroid free
TRUE
difference between eczema and psoriasis
Eczema usually look like rough, red patches, which can become crusty and infected. Psoriasis can cause similar red patches too, but it can also cause silvery, scaly patches and areas of thickened and severely inflamed skin. Eczema tends to appear in creases of skin around your joints.
psorisis is more sore where as eczema is itchy
WHat would you recommend for a patient with psoriasis in the ear?
Mild or moderate topical steroid
Recommendation for scalp psoriasis?
using tar shampoo
Topical steroid if severe
Sebco?
WHat is this?
Tx?
guttate psoriasis
Tx- Exorex
What if the patient has psoriasis in sensitive areas? What would you use?
Eumovate
Trimovate
What is eczema?
Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include: discoid eczema – a type of eczema that occurs in circular or oval patches on the skin. contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
What are the key topical treatment options for eczema?
Emmolients for dryness
Soap substitute
Anti inflammatory -steroid and calcineurin inhibitor
What features of emollients?
- consider the degree of greasiness
- some good for soap substitute
- no Limit to frequency for application
- paraffin for very dry skin
Examples of topical steriods
less potent to very potent (top to bottom)
Eczema on the eyelids Tx?
Delicate site:
midly potent
Calcineurin inhibitor
Eczema in popliteal fossa?
Thin Skinned site:
Mild moderate ptency
Calcineurin inhibitor
Eczema in popliteal fossa?
Thin Skinned site:
Mild moderate ptency
Calcineurin inhibitor
Eczema on the forearm/wrist?
Lichenification requires higher ptency.
Potent or even very potent
Eczema on the hand?
Very thick skin
Very potent- dermovate
What are the differential diagnosis of a facial rash?
- Atopic eczema
- Allergic contact dermatitis
- Seborrhoeic dermatitis
- Rosacea
- Systemic lupus erythematosus
- Angio-oedema
- Superior vena cava obstruction
WHat does this look like
Rosacea
history of flushing is common
lots of pustules around the cheek (small blisters containing pus) WHICH is why it is not SLE
What is this indicative of?
SLE
How do you differentiate between SLE and Rosacea
Rosaea has pustules whereas SLE doesnt
What is this?
Atopic eczema
What is this?
Allergic contact dermatitis
What is this?
Seborrhoeic dermatitis
Could check the scalp too
What is this red swollen leg suggestive of?
hx: feels heavy and there is some discomfort
DVT
What is this suggetsive of?
Hx: unilateral, fever, proximal edge, shiny
erysipelas which is a variant of cellulitis
erysipelas implies what type of bacteria?
strepococcal
What is this suggestive of?
cellulitis
What is this suggestive of?
Gravitational Eczema
also known as varicose eczema, stasis eczema or dermatitis eczema
Some surface changes
What is this suggestive of?
Hx: bilateral, chronic,
Lipodermatosclerosis
is cellulitis unilateral or bilateral
unilateral
Lymphoedema
swollen
Hx: affected areas are VERY tender
erthema nodosum
What are the available acne treatments?
Topical: benzoyl peroxide, retinoid, antibiotics
Oral: Antibiotics, COCP, Retinoid
What treatment would this lady need for her acne?
Oral isotretinoin
look up side effects
Tx for this acne?
Why?
Topical retinoid
Tx?
Options:
topical retinoid
Epiduo
Duac
Lymecycline plus topical
Tx?
Oral isotretinoin
Tx?
Benzoyl peroxide
Erythromycin
