General Flashcards
Which acronym can be used for skin history?
SOCRATES!
What method can you employ for systematic approach to rashes?
Colour Size Morphology Pattern Distribution
Name examples of terminology for morphology
Elevation- macule or patch
Elevated- pustule, wheal, vesicle, bullae, nodule, papule , plaque
Provide examples of secondary lesions/skin changes
excoriation, scale, crust, scar, ulcer, fissure
What are the four main types of rashes?
- Maculopapular
- Erythematous
- Petechial/purpuric
- Vesiculo-bulous
How can the pattern of a rash be desrcibed?
demarcated/indistinct linear target/bulls-eye annular/ring shaped discoid/disc-shaped
How can distribution be described?
generalised/localised
central/peripheral
flexural/extensor
site-specific e.g. pressure area, photosensitive site
After taking a history and observing the rash, how would you complete the examination?
palpate
associated signs- temp, oedema, crepitus
systems examination (as appropriate) scalp/hair, nails, mucosal membranes, joints, eyes
Which drug is associated with red man syndrome?
vancomycin- widespread urticarial erythematous rash
What is adult onset stills disease?
Adult-onset Still’s disease (AOSD) is a form of Still’s disease, a rare systemic autoinflammatory disease characterized by the classic triad of fevers, joint pain, and a distinctive salmon-colored bumpy rash.
What is erythroderma?
redness all over, >80%
Name four differentials for erythroderma
psoriasis, aczema, pityriasis rubra pilaris, cutaneous adverse drug reaction
Name 5 investigations you would conduct in a patient with erythroderma
routine bloods (FBC), bacterial skin swab, body temp, CRP, blood pressure, fluid balance
Which drugs may worsen psoriasis?
antimalarials, B blockers, lithium
Which scoring system is used for psoriasis to determine psychological effects?
DLQI
Name 5 sites that you should pay close attention to when examining for psoriasis
extensors, nails, scalp, joints, genital regions, post-auricular regions
Name four nail changes that can arise in psoriasis
pitting, oncholysis, subungal hyperkeratosis, leukonoychia, oil drop
Name three patterns of psoriasis
guttate flexural ?? (not extensor??) pustular erythrodermic palmoplantar
Name three arthropathies associated with psoriasis
asymmetric mono/oligoarthritis
spondylitis/sacroilitis, RF seronegative arthritis
Discuss the management of psoriasis
Topical treatments: emollients, topical steroids, vit D analogues, cool tar
Weight loss
Reduce alcohol
Phototherapy
Biologics
Name four dermal manifestations of SJS/TEN
diffuse erythema, macule, targetoid lesions, skin detachment, erosions and flaccid blisters
What is the Nikolsky sign?
blisters and erosions appearing when the skin is rubbed gently/top layers of the skin slip away from the lower layers when rubbed
Name four drugs/classes associated with SJS/TEN
NSAIDs, abx, anti-epileptic, allopurinol
Investigations for suspected SJS/TEN?
FBC (anaemia, leukopaenia, neutropaenia can arise), U+Es (effect of fluid loss), LFTs (transaminitis and hepatitis), blood cultures, bacterial skin swab, viral skin swab, skin biopsy
Which severity scoring system is used in SJS/TEN?
SCORTEN
Name the components of the SCORTEN score
age >40 cancer heart rate >120 >10% epidermal detachment high urea high glucose low bicarb
Describe the management in SJS/TEN
ID + stop culprit drug fluid balance temp control glycaemia control skin care mouth and eye care analgesia
Prophylaxis for which event should be commenced in SJS/TEN?
VTE
Which blood tests must be monitored during isotretinoin treatment?
LFTs- can cause transaminitis
For which indication is patch testing available for dermatology referral?
contact dermatitis, delayed hypersensitivity, type 4
Which topical treatments are available in dermatology?
emollients- water based (better to apply to weepy/watery wounds), ointments (oil based)
What chemical is used in cryotherapy?
liquid nitrogen
What are the indications for cryotherapy?
precancerous skin conditions and early stage skin cancer, retinoblastoma, skin conditions like warts skin tags and dark spots
Other cancers: cervical, liver, prostate
What are the complications of cryotherapy?
bleeding, bone fractures, nerve damage, swelling, scarring, skin infections
Name a very potent steroid. What are side effects of this?
betnovate- skin atrophy, striae, increased risk of infection
List three subtypes of acne
comedonal, papulopustular, nodulocystic
Which mechanisms of acne do treatment target?
bacterial growth, plugging, and sebum production
List three common side effects of isotretinoin
dry lips, nose bleeds, myalgia
List two serious effects of isotretinoin
liver function damage, teratogenicity
What is the treatment for rosacea?
avoid sun exposure
topical azelaic acid
oral doxy
What is the severity scoring tool in atopic dermatitis?
SCORAD- eczema
Which is the severity scoring tool for psoriasis?
PASI- psoriasis area and severity index
Which is the severity scoring tool for general dermatology life quality?
DLQI
List three common drugs that result in acute drug rashes
antibiotics e.g. penicillin and trimethoprim, NSAIDs, antiepileptic drugs carbamazepine, cardiac drugs e.g. BB, ACE, anticoag
Name five types of common skin drug reactions
- Maculopapular (change in colour and raised) 2. Urticaria (hives e.g.nettle rash) 3. Morbilliform (measles erruption) 4. Papulosquamous (raised areas with dry flakiness) 5. Photo-toxic (UV light+drug)
What are the triggers of vasculitis?
infection, drugs, autoimmune connective tissue disease e.g. RA
The bull’s eye rash is a typical skin manifestation of which disease?
lyme’s disease
Two triggers for acne rosacea?
Sunlight
Food
Drugs
Pregnancy
One treatment for athlete’s foot?
topical metronidazole
One treatment for acne rosacea?
topical metronidazole
Name a complication of acne rosacea that affects the nose?
rhinopyma (knobbly nose)
Acanthosis nigricans is most commonly associated with which diseasE?
gastric carcinoma
Which organism causes molloscum contagiosum?
pox virus
What is the gaiter area?
skin below knee and above ankle
Lichen sclerosis can be a precursor to what?
SCC
