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Year 4 Exams > Dermatology - Over Simplified > Flashcards

Dermatology - Over Simplified Flashcards

1
Q

Herpes simplex

A 
cause:
Herpes simplex virus 1/2
Presentation:
Vesicles -> weeping -> yellow crusting
Treatment: Acyclovir
Complications:
Superinfection with staph, dissemination in primary infection
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2
Q

Varicella zoster

A

cause:
Herpes simple virus 2/chickenpox in children
Presentation;
Unilateral vesicles along dermatomes, dissemination in immune compromised
Treatment: Acyclovir
Complications: Neuralgia, superinfection

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3
Q

Viral warts

A 
Cause:
Human papilloma virus
Presentation:
Papilomous cauliflower like lesions with moist macerated vascular surface Coalesce to form huge fungatating plaques
Treatment:
Preventative with HPV vaccine
Imiquimod - immune modulator that causes wart regression
Complications:
Cervical, facial, vaginal, anal cancers
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4
Q

Molluscum contagiosum

A 
Cause: Pox virus
Presentation: Umbilicated pappules with dimpled center
Treatment:
Destructive methods, iodine
Complications: Superinfection
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5
Q

Lichen planus

A

Cause:
T lymphocytes produce cytokines (ICAM-1) in the dermo-epidermal junction causing keratinocytes apoptosis
Drugs (beta blockers, quinine, captopril), hepatitis
Presentation:
Planar (flat-topped), purple, polygonal, pruritic papules and plaques on extremities
Treatment:
Stop drugs or any cause
Topical steroids (clobetasol), retinoids
Antihistamines → for itch
Systemic prednison + UVA/B → 1-3 months

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6
Q

Dermatopyte infection

A

Cause:
Trichophyton, microsporum, epidermophyton
Presentation:
Foot- soggy interdigital plaques, diffuse dry scaling on soles, reoccurring vessication Nails- yellow, crumbly nails, spereation of nail from bed, thickening of nail,
Groin- sharp, well demarcated plaques with peripheral scaling
Trunk/limbs- plaques with scaling and erythema
Scalp inflammation, bald spots with scaling
Treatment:
Clotrimazole, fluconazole, intraconazole, griseofusin
Complications:
Permanent scaring alopecia

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7
Q

Onychomycosis

A

Thickening of nail that leads to nail bed separation seen in fungal nail infections such as tineapedis

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8
Q

Candida

A

Cause:
Candida albicans
Presentation:
Oral thrush usually in immune compromised, nail bed infection
Treatment:
Topical or systemic imidazoles, fluconazole, amphotericin

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9
Q

Pityriasis versicolor

A

Cause:
Commensal yeast (pityrosporium orbiculare)
Presentation:
Flaky discoloured patches on chest and back
Treatment:
Imidazoles, fluconazole

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10
Q

Erysipelas

A

Cause:
Streptococcus pyogenous infection of dermis/hypodermis
Presentation:
Flu like symptoms, well defined advancing edges of redness, blistering of skin
Treatment:
Penicillins, anti staph penicillins
Complications: Sepsis

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11
Q

Staph skin infection

A

Cause: Staphylococcus aureus
Impetigo- bulbous with well demarcated borders
Furcolosis- infection of hair follicles, red tender nodules with puss Carbuncle- swollen, painful, pussing hair follicles
Scaled skin syndrome/toxic shock syndrome
Treatment:
Penicillin to vancomycin to 4th gen cefalosporins

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12
Q

Scabies

A

Cause: Mites
Presentation:
Itch, fissure on skin with eggs
Treatment: Permethrin

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13
Q

Atopic dermatitis

A 
Cause:
IgE response to certain stimuli
Presentation:
Itch, leathery dry skin that started with vesicles and weeping, on flexor surfaces
Treatment:
Emollients, topical steroids
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14
Q

Contact eczema

A

Cause:
Delayed type 4 hypersensitivity due to contact with known stimulus, ie. Poison ivy
Presentation:
Erythema, vesicles, weeping at the sight of contact with allergen
Treatment:
Stay away from allergen
Topical corticosteroids fo temporary relief

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15
Q

Seborrhoeic eczema

A

Cause:
Body overreaction to yeast that lives on skin, stress, cold dry weather, immune system response
Presentation:
Dry scales around nose, scalp, or trunk. Dandruff
Treatment:
Shampoo with ketoconazole, hydrocortisone, topical corticosteroids/calcineurin inhibitors tacrolimus

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16
Q

Angioedema

A

Cause:
Diffuse swelling due to edema in subcutaneous tissue
Presentation:
Abrupt and short-lived swelling of the skin and mucous membranes. All parts of the body may be affected but swelling most often occurs around the eyes and lips
Treatment:
antihistamines, oral corticosteroids (prednisone), immunosuppressants (ciclosporin)

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17
Q

Types of urticaria

A 
Cause:
Mast cell degranulation due to interaction with potential stimuli
Presentation:
red itchy Wheel lasting less than 24h
Types:
Physical (cold, solar, heat, cholinergic, dermatographism, delayed pressure) Hypersensitivity
Autoimmune
Parmalogical
Contact
Treatment: Antihistamines,
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18
Q

Stevens Johnson syndrome and Toxic epidermal necrolysis

A

Difference:
1-10% of body covered is SJS, >30% is TEN
Cause:
Drugs (sulfonemides, antiepileptics, allopurinol)
Presentation:
Prodromal period with fever/ malaise
Painful macular exanthem (skin is red, painful, detaches in sheets) Nikolski sign positive
Treatment:
Identify and stop cause
Symptomatic management (topical steroids, emollients)

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19
Q

Erythema Nodosum

A

Cause:
Inflammation of subcutaneous fat due to a type 4 hypersensitivity in response to an infection
Presentation::
Tender red nodules on the legs and forearms
Treatment:
Identify and eliminate cause Symptomatic treatment, NSAIDs, potassium iodide

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20
Q

Leucocytoclastic vasculitis

A

Cause:
Damage to small vessels due to lodged immune complexes
Presentation:
Painful palpable purapura pappules with centers of necrosis
Treatment:
Identify and remove cause
Antihistamines
Colchine/ dapsone
Systemic steroids if there is other organ involvement

21
Q

Polyarteritis nodosa

A

Cause:
Certain drugs, B cell lymphoma, immunotherapy, hep B/C cause necrotizing vasculitis of medium sized vessels
Presentation:
Tender subcutaneous nodules along lines of arteries
Ulceration or stealth patches of necrosis or purpura on nodules
treatment:
Systemic steroids/cyclophosphamide
Low dose systemic steroids if purely cutaneous

22
Q

Wegeners granulomatosis

A 
Cause:
Unknown cause of vasculitis
Presentation:
Symmetrical ulcers or papules on extremities Antineutrophil antibodies (C-ANCA w/ anti-PR3)
Treatment:
Cyclophosphamide w/ systemic steroids
23
Q

Erythema multiforme

A 
Cause:
Infection (HSV) or drugs
Presentation:
Annular non scaling plaques on acral sites Lesions may overlap to cause target lesions (iris looking)
Treatment:
Find and remove cause
Symptomatic treatment with antihistamines, topical steroids if mucous membranes involved
Systemic steroids in severe cases
24
Q

Pityriasis rosea

A

Cause:
Reactivation of HSV 7 or HSV 8
Presentation:
Herald plaque on lower back Round red/pink scaly plaques
Treatment: Self limiting, symptomatic treatment, Most cases resolve within days to weeks.

25
Pityriasis rubra
Cause: Epidermal hyperproliferation Presentation: Erythema and scaling on face and scalp spreading to limbs and trunk Red/orange plaques join Perifolicular papules and follicular plugs Treatment: Emollients, keratolytics, systemic retinoids, TNF alpha inhibitors
26
Pemphigoid
Cause: Autoimmune with IgG to hemidesmosomes bp180 and bp230 Presentation: Itchy blistering disease Smooth itchy red plaques that evolve into tense vesicles or bullae Treatment: Mild can be controlled with potent topical steroids Predisone Azathioprine, methotrexate, dapsone if not responding
27
Pemphigus
Cause: IgG to antigens within the epidermis ie. Desmoglandin 1/3 Presentation: Flaccid blisters that easily rupture leaving erosions Treatment: Predisone Azathioprine, cyclophosphamide, mycophenylate mofetil
28
Dermatitis herpetiformis
Cause: Granular deposits of IgA and C3 in the tips of dermal papillae and in basement membrane Closely associated with celiac disease Presentation: Very itchy grouped vesicles on elbows, knees, buttocks, and shoulders Treatment: Gluten free diet Dapsone or sulfapyridine
29
Linear acquired IgA bulbous disease
Cause: IgA deposits in basement membrane Autoantibodies directed towards bp180 Presentation: Blisters on urticarial plaques on extensor surfaces String of pearls in some affected children Treatment: Dapsone
30
Acquired epidermolysis bullosa
Cause: Autoantibodies to type 7 collagen in the dermis Presentation: Blisters in response to trauma on normal skin Milia on healing skin
31
Epidermolysis bullosa
Cause: Genetic mutations Presentation: Blisters on skin after minimal trauma but each type on a different layer of skin Types - layer- mutation: Simplex- intraepidermal- keratin 5/14 Junctional- lamina lucida- hemidesmasome anchoring filament Dystrophic- below lamina densa- type 7 collagen Acquired- dermal side of lamina densa Treatment: Avoidance of skin trauma Symptomatic treatment
32
Acrosclerodermia - Limited scleroderma
Cause: Autoimmune condition Presentation: Usually only on extremities and face Raynaud’s phenomenon -> immobile, hard, shiny fingers -> abnormal calcium deposits over pressure points -> telangiectasia on fingers and flat mat like on face Treatment: Symptomatic Immunosuppressants Physical therapy
33
Systemic sclerosis - systemic scleroderma
``` Cause: Autoimmune Anti DNA topo -1 antibodies Presentation: Raynaud’s phenomenon concurrent with skin changes and sclerodactyly sclerosis on face, scalp, trunk Beak like nose Wrinkles around the mouth Loss of hair follicles Treatment: Symptomatic Immunosuppressants Physical therapy ```
34
Lichen sclerosus
``` Cause: Autoimmune Antibodies to extracellular matrix 1 Presentation: Non indurated white shiny macules with plugging in follicles Ivory colored lesions around vulva and anus in women Adhesions between foreskin and glandus of penis in men Treatment: Topical corticosteroids ```
35
Mixed connective tissue disease
``` Cause: Overlap of SLE and scleroderma or dermatomyositis Presentation: Swollen hands and sclerodactyly Alopecia Treatment: Treatment based on what organs involved ```
36
Dermatomyositis
``` Cause: Autoimmune Presentation: Discoloration around eyes Malar erythema and edema Lilac scaly papules over knuckles (Gottrons papules) Weakness of muscles Treatment: Systemic steroids Immunosuppressants ```
37
Pyoderma gangreosum
Cause: IBD - Inflammatory bowel disease Conditions that cause polyarthritis Hematological malignancies Presentation: Inflamed nodule or pustule break to form central growing ulcer Bluish edge May have pustular or bulbar lesions Treatment: Systemic or topical steroids Cyclosporine Anti TNF- alpha agents
38
Acne Vulgaris
Cause: (1) follicular epidermal hyperproliferation with subsequent plugging of the follicle (2) excess sebum production (3) the presence and activity of Propionibacterium acnes) (4) inflammation Presentation: Blockage and/or inflammation of hair follicles and sebaceous gland Noninflammatory Open or closed comedones and by inflammatory papules, pustules, and nodules Treatment: Erythromycin, topical dapsone Retinoidlike agents - adapalene Antibiotics doxycycline Estrogen/progestin combination oral contraceptive pills
39
Acne rosacea
Cause: Genetic, Blood vessels damage by sunlight, Bacteria (H. pylori) Presentation: Redness on your cheeks, nose, chin, and forehead Blood vessels might show through your skin, which can thicken and swell up Treatment: Mirvaso - Tighten blood vessels Azelaic acid Metronidazole (Flagyl) and doxycycline - Antibacterial Ivermectin
40
Sunburn
Cause: Sun stimulates release of pro inflammatory cytokines and enzymes -> increase in nitric oxide -> dermal vasodilation and redness Presentation: Skin turns red and hurts. Severe burn, you can develop swelling and sunburn blisters Treatment: Menthol gell, NSAIDs (ibuprofen), Hydration, vitamin D
41
Melasma (chloasma)
Cause: Hormonal changes - “mask of pregnancy”, oral contraception - usually hispanic women Presentation: Hyperpigmented plaques on the face Treatment: hydroquinone topically, sunscreen
42
Porphyria cutanea tarda
Cause: Genetic predisposition. Appears in alcoholics (men), estrogen treatment (women), hep C, iron overload Presentation: Blisters, erosions one sun-exposed areas (face, hands Leads to scars, hair loss Treatment: Avoidance of cause (alcohol, estrogen, iron)
43
Ichthyosis vulgaris
Cause: Mutation in filaggrin gene —> defective desquamation Presentation: Dry, scaly skin, especially on the extensor surfaces and trunk. Associated with atopic dermatitis Treatment: Emollients, Take baths in salt water, Remove dead skin with a product that contains salicylic acid
44
Keratosis pilaris
Cause: Genetic predisposition Presentation: Follicular plugs with perifolicular erythema on extremities Treatment: Keratolytics (salycilic acid, uric acid), emollients
45
Acanthosis nigricans
Cause: Epidermal hyperplasia Associated with insulin resistance/visceral malignancies (gastric cancer) Presentation: Velvety, hyperpigmented plaques on the axilla and posterior neck No treatment: Management Weight management (reduce insulin), stop birth control pills
46
Keratoderma of palms and soles
Cause: Metabolic diseases, potentially cancers (esophageal). Symptoms of other derm diseases (pytiriasis rubra pilaris, lichen planus) Presentation: Thickening of the skin of palms and soles Types: Punctuate, diffuse, striate Treatment: Emollients, keratolytic agents, topical retinoids, topical vitamin D, oral retinoids
47
Darier’s disease (keratosis follicularis)
Cause: Genetic - high concentration of calcium in the Endoplasmic reticulum Presentation: Small pink/brown papules on trunk and behind ears, wart-like lesions on the backs of the hands, pits on palms and soles, nail dystrophy Treatment: Laser excision, topical keratolytics, prevention of infections
48
Hailey-Hailey disease
``` Cause: Genetic - suprabasal acantholysis Presentation: Flaccid vesicles, erosions that form plaques at the sites of skin friction Treatment: Topical steroids, antibiotics ```

Year 4 Exams (11 decks)

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