general derma Flashcards
what percentage of teenagers will experience acne
90%
by 40 what percentage of men will still have lesions?
1%
by 40 what percentage of women will still have lesions?
5%
what genetic syndromes result in increased risk of acne?
XYY genotype, polycystic ovarian syndrome, hyperandrogenism, hypercortisolism
mild acne total lesion count
total <30
<20 comedones
moderate acne features
lesion, papules, pustules, nodules and cysts
total lesion count for moderate acne
total 30-125
20-100 comedones
severe acne total lesion count
> 125
total comedone count >100
demodex folliculorum is associated with?
Rosacea
rosacea is missing what form of lesion in comparison to acne?
no comedones
what are the variants of rosacea
vascular
inflammatory
phymatous
ocular
causes of erythroderma
psoriasis eczema drugs cutaneous lymphoma hereditary
what percentage of inpatients can have dermal drug reactions
5%
how long after exposure to drug for a reaction to be noticeable
1-2weeks
what drugs may stimulate SJS or epidermal necrolysis
antibiotics
anticonvulsants
allopurinol
NSAIDS
Nikolsky sign means
outer epidermis separates easily from basal layer
SCORTEN score for SJS and epidermal necrolysis
age >40 malignancy HR >120 epidermal detachment serum urea >10 serum glucose >14 serum bicarbonate >20
long term complications of SJS and epidermal necrolysis
pigmentation changes scarring eye disease, blindness nail and hair loss joint contractures
erythema multiforme commonly caused by
HSV then mycoplasma pneumonia
self limiting time frame for erythema multiforme
2 weeks
mortality percentage for DRESS
10%
staphylococcal scalded skin syndrome, the staphylococcus produces a toxin that targets what?
desmoglein 1
majority of acute urticaria is caused by
idiopathic then infection
what drugs should be avoided in acute urticaria
opiates and NSAIDS
what is the majority cause of chronic urticaria
autoimmune/idiopathic
time frame for classifying chronic urticaria
> 6 weeks
pros of cryotherapy
cheap and easy
cons of cryotherapy
scarring or failure
different types of cyst
epidermoid pilar steatocystoma dermoid hidrocystoma ganglion
dermatofibroma is caused by
fibroblasts
dimple sign means
when lesion is squeezed a dimple can be elicited
percentage of Bowen’s disease risk of becoming malignant
5%
photo-dynamic therapy means
photochemical reaction using red light to selectively destroy cancer cells
imiquimod mechanism
stimulate cytokine
pros of imiquimod
a way to avoid surgery, good cosmetic result
cons of imiquimod
6 weeks
significant inflammation
failure
minimum SPF for suncream
30/ 4 star
factors that affect absorption
concentration vehicle chemical properties thickness and hydration of stratum corneum temperature skin site occlusion
retinoids are analogues for what vitamin
A
isotretinoin - retinoid is used in what?
acne
acitretin - retinoid is used in what?
psoriasis
Bexarotene - retinoid is used in what?
cut. T cell lymphoma
alitretinoin - retinoid is used in what condition?
hand eczema
name all 4 orally used retinoids
isotretinoin
acitretin
bexarotene
alitretinoin
side effects of retinoids
teratogenic dry lips dry skin increased triglycerides psychiatric
derma immunosuppressants
oral steroids azathiopurine ciclosporin methotrexate mycophenolate mofetil
what function tests should you do with immunosupression
FBC
renal function
liver function
suffix CEPT stands for
receptor binding
MAB suffix stands for
monoclonal antibodies
infix ZU stands for
humanised
infix IX stands for
chimeric
infix U stands for
fully human
infix LI/L stands for
immunomodulator
infL-IX-i-MAB stands for
immunomodulator chimeric monoclonal antibodies
biologic for spontaneous urticaria
omalizumab
Eczema biologic
Dupilumab
plaque psoriasis biologic
Adalimumab
biologic side effects
infection
no vaccines
malignancy
TNF I - demyelination
endogenous eczema types
atopic discoid venous seborrheic dermatitis pompholyx juvenile plantar dermatitis asteatotic
allergic contact dermatitis type of hypersensitive
type 4
type 4 hypersensitivity regulated by
clonal expansion of T cells in response to hapten/allergen
occupational risk of irritant contact dermatitis
hairdressers NHS staff cleaners ring soap nappy rash
potent topical steroid
betamethasone
calcineurin inhibitor names
pimecrolimus
tacrolimus
hair cycle stages
anagen
catagen
telogen
anagen for hair cycle refers to
active growing phase
catagen phase for hair cycle refers to
growth stops, follicle shrinks
telogen phase in hair cycle refers to
resting phase
chromosome responsible for determining age of onset for psoriasis
chromosome 6
psoriasis susceptibility region gene
PSORS1-9
psoriasis histology findings
hyperkeratosis neutrophils in corneum hyperplasia- acanthosis dilated dermal capillaries T cell infiltrate
psoriasis Koebner phenomenon refers to
skin lesions on lines of trauma
woronoff’s ring
blanched halo of uniform width following treatment for psoriasis
sub types of psoriasis
chronic palmo-plantar guttate scalp nail flexural pustural erythrodermic psoriasis
differentials for psoriasis
seborrheoic dermatitis
lichen planus
mycosis fungoides
PsArthritis treatment
methotrexate
what percentage of excess mortality is there in winter in the UK
40%
risk factors for skin cancer
UV photochemotherapy P-UVA carcinogens radiation HPV familial immunosupression
high risk signs of SSC
immunosuppression >20mm diameter >4mm depth ear, nose, eyelid perineural invasion poorly differentiated
ipilimumab mechanism and use
CTLA-4 and melanoma metastatic
pembrolizumab mechanism and use
PD-1 and metastatic melanoma
vemurafenib and dabrafenib mechanism and use
metastatic melanoma and B-RAF
sezary cells refer to
atypical T cells
prognosis for sezary syndrome
2-4 years
extracorporeal photophoresis refers to
WBC drawn and mixed with psoralen to make sensitive to UVA radiation and then treated, re-infused
commonest skin cancers
BCC, SCC
impetigo bacterial causes
staph Aureus
erysipelas bacterial cause
group A streptococci
cellulitis bacterial cause
Str. pyogenes
complication of shingles
post-herpetic neuralgia
viral warts cause
HPV
molluscom contagiosum cause
POX virus
pityriasis versicolor cause
malassezia
scabies causitive agent
sarcoptes scabiei
