Dermatology Medicine incorrects Flashcards
actinic keratosis learn to identify vs sebhorreic keratosis
sebhorreic keratosis are coloured - brown
multiple red brown papules on the back after immunosupression and organ transplantation 3 months ago is most likely?
kaposi sarcoma!!!
scc = sun exposed area and unlikley for multiple in short space of time
first line treatment for non inflammatory acne?
treatment for inflammatory acne?
treatment for nodular cystic acne?
topical retinoid = salicylic, azelaic or glycolic acid
mild = topical retinoid + benzoyl peroxide
moderate = add topical antibiotics eg clindamycin, erythromycin
severe = add oral antibioitcs
as inflammatory acne. if severe = oral isotretinoin
cold sore last week
patient now has painful blisters and bullae in and around mouth (can also be genital) and on hands
most likely diagnosis?
investigations?
erythema multiforme
clinical diagnosis
how does necrobiosis lipoidica present?
pretibial plaque with erythematous border
typically affects diabetics
a recurrent puritic, VESICULAR rash affecting the palms and soles and sides of digits that can desquamate
no occupational exposures
most likely diagnosis?
dishydrotic eczema = acute palmoplantar eczema
treatment= emollients, corticosteroids
89 YO with purpural lesions, all blood tests platelets clotting normal.
most likley diagnosis?
senile purpura -> perivacular connective tissue atrophy
which covers more body surface area? SJS or TEN?
TEN (Ten is 10/10)
(in reality TEN is if >30% of body area involved)
pityriasis versicolor treatment?
topical selenium sulfide!!!!!
(or topical terbenafine or topical ketoconazole)
which medications can induce lichen planus?
ace inhibitors
thiazide diuretics
(hypertensive meds)
28 year old patient with history of lupus. on oral prednisolone, hydroxychloroquine and nsaids
reports 1-3mm erythematous papules on back shoulders and upper arms
what is the most likely cause?
medication adverse effect!!!
drug induced acne!!!! -> common side effect of systemic glucocorticoids!!!!
only resolves when you stop the agent
papule with indented centre on the thigh of a 26 YO sexually active woman is most likely molluscum contagiosum
first line treatment?
liquid nitrogen!!! -> cryotherapy
or curettage
or topical cantharidin or podophyllotoxin
Erysipelas has sharp RAISED borders vs cellulitis = flat
tinea corporis treatment?
TOPICAL antifungal eg terbinafine, fluconazole, miconazole
fatigue, elevated LFTS, arthralgias, porphyria cutanea tarda
further evaluation will reveal what underlying condition?
what else could be seen as a result of the condition?
chronic hepatitis C infection
lichen planus, mixed cryoglobulinemia (palpable purpura, glomerulonephritis, low complement levels)
sudden severe onset psoriasis may mean what underlying diagnosis?
HIV
nummular eczema presentation
roundish plaque - red, puritic, scaly
are mucocutaneous blisters present in pemphigus vulgaris or bullous vulgaris
diagnostic investigation?
pemphigus vulgaris!!! -> rupture and form erosions in mouth (pemfeedus)
mucosal involvement is rare in bullous. in addition bullous typically affects patients > 60
skin biopsy
both allergic contact dermatitis and sporotrichosis can develop after exposure to plants. describe the difference in symptoms
sporotrichosis = ulcerating NODULES. vesicles and bullae are not characteristic. direct inoculation eg thorn of a plant asymptomatic so not puritic!!!
allergic contact dermatitis - intensely puritic, erythematous, vesicular rash
nickle in belts watches and jewelry is a common trigger for allergic contact dermatitis -> region affected mid lower abdomen, earlobes, wrists
in the acute stage bullae, veiscles, but in the chronic stage Lichenification!!! fissuring!!
treatment?
topical corticosteroids and allergen avoidance
tinea pedis diagnostic test?
potassium hydroxide microscopy of skin scraping
patient out on the beach, an hour in the sun, burning sensation, erythema and vesicles of face, anterior neck, upper chest, dorsal surface of hands and forearms
recently started a treatment for facial acne
most likely cause?
doxcycline induced photosensitivity!!!
other drugs with photosensitive reactions:
-> antibiotics = tetracyclines eg doxy
-> antipsychotics = chlorpromazine, prochlorperazine
-> Diuretics = furosemide, hydroxchlorothiazide
others: amiodarone, promethazine, piroxicam
patients with SJS/TEN typicall y have fever and different causative drugs
there are two types of contact dermatitis: allergic contact dermatitis as described previously and irritant contact dermatitis
how does irritant contact dermatitis present? triggers?
fissures, scaly skin on hands, lichenification
soap, detergent, chemicals, acid/alkali
so a job as a janitor is a risk
tingling following sun exposure, erythema of face and small papules and pustules are signs of papulopustular rosacea. how do you manage this?
topical metronidazole!!!!!
or azelaic acid or ivermectin
seborrheic dermatitis in adults management?
topical LOW potency corticosteroids
topical antifungals
ichthyosis vulgaris
second line if emollients dont work?
topical alpha hydroxy acid!!!!
topical urea
topical salicylic acid
how does small plaque psoriasis present?
small pustules with overlying silvery scales
seen on the scalp and bilateral dorsal hands
bullous pemphigoid 1st line treatment?
high potency topical corticosteroid eg topical clobetasol
post pregnancy hair loss
widespread thinning of hair but shafts and scalp appear normal
most likely cause?
Telogen effluvium!!! - diffuse non inflammatory hair loss
stressful events are triggers -> weight loss, pregnancy, major illness or surgery or psychiatric trauma
first step in management of a recurrent tinea cruris infection?
examine other parts of the body for autioinfection eg skin between the toes
21 YO. painful blisters of palms after golf lessons, foot blisters after hiking
history of oral ulcers as an infant
bullae and erosions on both palms on examination
most likely diagnosis?
epidermollysis bullosa - inherited, triggered by minor trauma
not bullous or pemphigus vulgaris as they do not affect palms and soles and do not manifest in infancy
dermatitis herpetiformis management?
dapsone immediate term + gluten free diet
white lesions in mouth for last several MONTHS. burning sensation, worse when eating hot or spicy foods. most likely diagnosis?
lichen planus
apthous stomatitis/canker sores. in contrast are acute, lasting only a few days
what blood test should be taken in patients with vitiligo?
serum TSH level
risk of autoimmune thyroid disease!!!
