Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BDS5 Oral Med > Facial Rashes > Flashcards

Facial Rashes Flashcards

1
Q

What is a Macule?

A

= localised area of colour or textural change (flat, not raised)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a Papule?

A

= small solid elevation of skins <5mm in diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Nodule?

A

= small firm lumps, >10mm in diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Herpes Labialis?

A

= aka cold sores or fever blisters, are small, painful blisters caused by the HSV-1 that typically appear on the lips or around the mouth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are symptoms of Eczema Herpeticum?

A
  • malaise
  • fever
  • lymphadenopathy
  • spreading, burning, vesiculopapular facial rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Eczema Herpeticum?

A

= skin condition involving herpes simplex virus on a pt w/ a background of pre-existing eczema

(other RF for developing EH = pregnancy + immunosuppression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are RF of developing cutaneous viral infections (rx HSV1 + 2)?

A

Pt w/ other inflammatory skin diseases:
eczema
seborrhoeic dermatitis
psoriasis
irritant contact dermatitis
burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Eczema/ Atopic Dermatitis?

A

common in young children
- vesicular rash

Other symptoms:
malaise, fever, lymphadenopathy
assoc. w/ lactose intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Severe Eczema Herpeticum?

A

Classically dome shaped papulovesicles

After 1-2 weeks, blisters dry + form crusts that fill eroded pits

Diagnosis of EH = important because life threatening complications can occur:
1. Keratoconjunctivitis = sight loss
2. Viraemia, meningitis, or encephalitis (all fatal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Kaposi Sarcoma? (KS)

A

= disease of endothelial cells of blood vessels & lymphatic system

(No longer classified as a tumour (which is a malignant tumour of mesenchymal origin) as it is due to multi-centric vascular hyperplasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the different types of Kaposi Sarcoma?

A

= several types

Peripheral type (affects hand and feet, not related to HIV)

HIV-associated Kaposi sarcoma:
- primarily caused by infection with Kaposi Sarcoma Herpesvirus (KSHV aka HHV8)
- most common = men who have sex w/ men (MSM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does CD4 cell count look like in Kaposi’s Sarcoma?

A
  • Decreasing CD4 cell count strongly assoc. w/ AIDS
  • CD4 cell count <200/mm3 i.e. the greater the immunosuppression the more extensive/aggressive the KS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the clinical presentation of Kaposi’s Sarcoma?

A
  • purplish macules, papules & nodules anywhere on skin or mucous membranes
  • Presenting on other organs (lungs or gut - causing haemorrhage -> life threatening)-
  • Initially, lesions small and painless, but with growth they can ulcerate + become painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperpigmentation:

What is Melasma?

A

= symmetrical pigmentary disorder affecting facial skin of women

affects forehead first, then cheeks + chin

assoc. w/ pregnancy + women taking OCP

  • Pregnancy stimulates melanocytes (thus, nipples, lower abdomen + existing melanocytic naevi has heightened pigmentation)

Tx:
- improves spontaneously post pregnancy or OCP cessation
- sunscreens & camouflage cosmetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyperpigmentation:

What is Peutz-Jeghers syndrome?

A

= rare autosomal dominant condition

(Mutation of LKB1 gene (tumour suppressor gene) on chr 19 which codes for a serine-
threonine kinase (plays a role in apoptosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperpigmentation:

How does Peutz-Jeghers syndrome present?

A

Multiple small perioral & vermilion freckles
Freckling fades w/ age
-Pigmented spots also occur:
○Intraorally
○On extremities, palms, soles, nasal & rectal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperpigmentation:

What is the tx for Peutz-Jeghers syndrome?

A

Melanotic spots do not require tx & do not transform to melanoma

Suggests presence of hamartomatous intestinal polyps (abdominal pain due to
obstruction & rectal bleeding)

Risk of development of internal malignancy (gut 15 fold increased risk, breast, genital)

Tx:
Counselling & monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hyperpigmentation:

What is Addison’s disease?

A

Adrenal cortical atrophy & insufficiency caused by autoimmune/infection (TB/HIV)

Pigmentation due to secondary melanocyte stimulation by increased levels of ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hyperpigmentation:

How does Addison’s disease present?

A

Streaks or patches of blue-black oral pigmentation (water spaniel) if long standing

Cutaneous diffuse bronzing in sun-exposed areas with hyperpigmentation of scars +
flexures

Genital pigmentation

Vitiligo

Weakness, weight loss, salt craving, nausea, vomiting, hypotension also present

Pigmentation in Addison’s more pronounced in sun exposed areas

(more marked in areas exposed to friction, nails + hair may be affected)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperpigmentation:

What is the tx for Addison’s Disease?

A

Lifelong steroid HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does Rocasea present?

A

Earliest symptom= flushing

Erythema, telangiectasia w recurrent pustules over light exposed areas

Veseels in palpebral conjunctivae often congested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Rocasea?

A

= chronic inflammatory facial dermatosis characterized by erythema & pustules

(Confined to face, unknown cause, common in middle age, most seen in North Western European population)

Exacerbated by: topical corticosteroid + sunlight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are common complications of Rocasea?

A

Keratitis

Rhinophyma (hyperplasia of nasal sebaceous glands + connective tissue)

Blepharitis + Conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the tx of Rosacea?

A

Persists for many yrs but responds well to tx:

Topical metronidazole gel bd

Oral tetracycline for 2-3 months (Erythromycin alternative)

Rhinophyma= permanent so often needs plastic surgery

25
What is Seborrhoeic dermatitis?
= Chronic, scaly inflammatory eruption affecting scalp & face Can be secondarily infected w/ C. albicans Eruption usually affects sebaceous gland areas of scalp, face & chest Caused by: overgrowth of commensal yeast Pityrosporum Ovale - severe in some pts w/ AIDS
26
What is the facial presentation of Seborrhoeic Dermatitis?
- XS dandruff - Itchy, scaly erythematous eruption -Sides of nose, scalp margin, eyebrows & ears -Blepharitis - Young adult male
27
What is the tx of Seborrhoeic Dermatitis?
Tx: Scalp - medicated shampoo e.g. ketoconazole) Facial lesions - imidazole or antimicrobial often combined with 1% hydrocortisone cream Recurrence is common so tx may require to be repeated
28
What is Perioral Dermatitis?
small red papules w tiny pustules first appears on nasolabial folds or lip commissures + then around the mouth (leaves CLEAR ZONE adjacent to vermillion border) F ages 15-25yrs affected occasionally seen in children + young mean Often assoc. w/ use of potent topical corticosteroids Tx: reassure, stop all topical corticosteroids, oral TCA for 8-10w
29
What is Eczematous cheilitis?
= Inflammation of lips w/ redness, dryness & scaling 2 major groups: Endogenous e.g. Atopic Eczema Exogenous e.g. irritant contact cheilitis or allergic contact cheilitis
30
What is irritant contact cheilitis?
aka lip licking dermatitis - seen in 7-15 yrs old - repeated licking of skin around mouth - Scaly pink skin circumorally which is continuous w/ the vermillion border
31
What is allergic contact cheilitis? (to lip cosmetics)
Allergic reaction ¼ cases of eczematous cheilitis Common allergens: ○Lipsticks & other lip care products ○Toothpaste & dental materials ○Foods ○Medications ○Nail varnish Tx: - Careful history & examination -Patch testing for standard & extended (toothpastes, lipsticks) series -Need to test patients own products -Exclude exogenous causes -Moisturisers & topical corticosteroids -Treat any superficial infections
32
What is Varicella Zoster Virus (HHV3)?
= Herpes virus causing chickenpox + shingles Primary infection = chickenpox in non-immune (affecting ~90% of children) Recurrence= reactivation as SHINGLES (reactivation = sign of underlying malignancy or immunosuppression)
33
How does Shingles (Herpes Zoster recurrence) present?
Presents unilaterally affecting on trunk, affecting a single dermatome - occasion bilateral presentation on both sides if pt = immunosuppressed (AIDS, oral transplant, Hodgkins Lymphoma) - Predilection for CN 5 + 7 + thoracic spinal nerves
34
How does IO herpes zoster virus present?
normally sharply defined unilateral distribution of painful vesicles breakdown to leaver herpetic ulcers that coalesce over time
35
How does Herpes Zoster affecting V1 and V2 divisions of the trigeminal nerve (CN5) present?
vesicles affecting facial skin + mucosa up to midline affected (may be preceded pain in teeth + gingivae) Assoc w. other systemic signs of: lymphadenopathy, malaise + pyrexia
36
How does CNV 1 (ophthalmic) Herpes Zoster present?
Risk: corneal scarring w/ result lost of vision Action: Urgent referral to Ophthalmology (some pt's develop post inflammatory pigmentation on face)
37
How does CNV II Ramsey Hunt syndrome present?
= Herpes zoster affecting geniculate ganglion Lower motor neuron facial paralysis Vesicular lesions involving external auditory meatus (pinna, fauces) Altered taste Deafness
38
What are the 2 types of Lupus Erythematosus?
SLE (Systemic) DLE (Discoid)
39
What is SLE?
=Systemic Lupus erythematosus multi systemic autoimmune disease autoantibodies generated against a variety of autoantigens e.g. ANA involves vascular + connective tissues
40
State key facts about SLE? (6)
F:M ratio 8:1 75% have skin features Multisystem involvement w/ serological or haematological changes Facial butterfly rash (~ affecting 2/3 pt) Photosensitivity, discoid lesions, diffuse alopecia + vasculitis ! - sun exposure may tigger acute systemic symptoms + hormonal changes (puberty or pregnancy) RF: African Americans, genetics, hormonal changes + environment
41
What is the cutaneous presentation of SLE?
Malar rash (2/3 pts) Rash= fixed erythema (flat or raised) that tends to spare nasiolabial folds Can be painful or pruritic Other cutaneous features: Photosensitivity Discoid rash (in sun-exposed areas) Alopecia of temporal regions
42
What is DLE?
Discoid lupus erythematosus = scaly atrophic plaques in sun-exposed skin
43
State key facts about DLE?
may involve GENITAL MUCOSA, SKIN + HAIR F:M 2:1 Appearance: round or oval plaques- red, scaly, w/ keratin plugs scarring may cause alopecia ~10% of cases evolve to SLE
44
What is the IO presentation of DLE?
= Similar to OLP less well demarcated erythematous areas surrounded by border of fine white striae - lesions may ulcerate - lesions present BILATERALLY on labial, buccal or alveolar mucosa + vermillion border - Lesions on palate seen in SLE (rare for lichen planus - therefore you can tell this way)
45
What is the cutaneous presentation of DLE?
Scaly atrophic plaques in sun-exposed skin
46
What is the tx for SLE + DLE?
Tx: potent topical or intralesional corticosteroids antimalarials SPF (+ sun protection in general)
47
SUN-RELATED SKIN CHANGES: What is Photodamage?
extrinsic ageing caused by chronic ultraviolet (UV) radiation exposure, smoking and pollutants Superimposed on intrinsic skin ageing process Affects habitually exposed areas of the body, such as the individual's face, neck, and arms Skin may be rough, sallow, deeply wrinkled dyspigmentation with senile purpura, telangiectasia and benign and malignant skin lesions Hyper pigmented lesions: include diffuse mottling, freckles, lentigines and & seborrheic keratoses Deep wrinkles found on forehead + peri-orbital region
47
SUN-RELATED SKIN CHANGES: What is Actinic (solar) Keratosis?
= single or multiple discrete scaly hyperkeratotic skin Appearance: rough surface, <1cm diameter, found on sun-exposed areas i.e. hands, face + neck - more common in fair-skinned individuals, can regress spontaneously, can progress to SCC Tx: curettage, excision or application of 5 fluorouracil
48
SUN-RELATED SKIN CHANGES: What is Solar Elastosis?
= prolonged sun damage causes yellowing, thickening & wrinkling of skin affecting sailors, famers (outside) presenting on neck (furrowed or rhomboidal patterns) senile comedones can occur can result from smoking Histology: degradation of elastic fibres Tx: SPF, smoking cessation
49
CUTANEOUS MALIGNANCIES List the 4 types of malignant skin tumours?
Basal cell carcinoma (BCC) Squamous cell carcinoma (SCC) Malignant melanoma Cutaneous lymphoma
50
CUTANEOUS MALIGNANCIES What are the predisposing factors of BCC + SCC?
UV radiation (i.e. sun exposure in childhood) Skin type I or II (freckles) Ionising radiation Burn/vaccination scars Immunosuppression Arsenic ingestion in tonics
50
CUTANEOUS MALIGNANCIES What is a Basal Cell Carcinoma (BCC)?
= Locally invasive cancer of epidermal basaloid cells (Delay in presentation (denial) results in increased growth increased extent of facial tissue involvement)
51
CUTANEOUS MALIGNANCIES What is the presentation of BCC?
Spontaneous ulcer that fails to heal Non-healing asymptomatic lump or sore throat or sore spot that grows slowly May bleed w/ crust formation (can separate during sleep + leave blood 🩸 on pillow)
52
CUTANEOUS MALIGNANCIES What are the two types of BCC?
1. Nodular (most common BCC) - mainly affecting H+N - pearly papule w/ rolled edge, telangectasia + central depression +/- ulceration 2. Superficial BCC - slow growing scaly pink patch or plaque - can mimic eczema or psoriasis
53
CUTANEOUS MALIGNANCIES What are predisposing factors for BCC?
M>F >40yrs Outdoor occupation Immunosuppression (esp. organ transplant pt) Solar elastosis Facial trauma Naevus Sebaceous Gorlins Syndrome
54
CUTANEOUS MALIGNANCIES What is the prognosis of BCC?
- slow growing + non-aggressive - IF longstanding or neglected can behave like 'rodent ulcers\ + destroy skin + deep tissues Rare metastasis 3yr risk of developing a 2nd primary lesion in ~44% cases
55
CUTANEOUS MALIGNANCIES What is Squamous Cell Carcinoma? (SCC)
= Malignant tumour of keratinocytes Usually arises in areas of damaged skin e.g. assoc. w/ Actinic Keratosis >55yrs May METASTASISE
56
CUTANEOUS MALIGNANCIES What is the appearance of SCC?
Sun exposed sites eg face, neck, forearm, hand Starts within an area of ‘actinic keratosis’ as a small papule– ulcerates & crusts Lower lip= MOST COMMON SITE
57
CUTANEOUS MALIGNANCIES What are the predisposing factors of SCC? (6)
Common in elderly Erythema ab igne Chronic granulomas / ulcers Tar Albinism Xeroderma pigmentosa

BDS5 Oral Med (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions