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Dermatology > General Dermatology Conditions > Flashcards

General Dermatology Conditions Flashcards

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Dermatology Board Prep flashcards
1
Q

Wickham Striae and nail ridging buzzword for…

A

Lichen lanus

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2
Q

Lichen planus eruptions are typically described as (3)

A

-Violaceous -Flat-topped -Shiny

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3
Q

Lichen planus common sites include (3)

A

-Volar wrist/forearm -Shin -Ankle

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4
Q

Bullous pemphigoid is a split in which area?

A

Through the DEJ (remember pemphigoiD is Deeper)

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5
Q

Bullous pemphiguS is a split in which area?

A

Intra-epidermal (remember pemphiguS is Superficial)

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6
Q

Nikolsky’s sign is… What does it indicate?

A

Top layers of skin slip away from lower when slightly rubbed. Indicates a plane of cleavage within the epidermis (think pemphigus, also SJS and TEN)

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7
Q

Nikolsky’s sign can be used to differentiate between….

A

Bullous pemphiguS (positive) and bullous pemphigoiD (negative)

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8
Q

Bullous pemphigoid tends to scar. True/false?

A

False

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9
Q

Why are pemphigus lesions so problematic? (2)

A

-Itchy -When burst are very prone to infection (very high mortality if untreated)

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10
Q

Does pemphigoid carry the same infection risk as pemphigus?

A

No

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11
Q

Tetracycline may be used in pemphigoid but NOT pemphigus. True/false?

A

True

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12
Q

The 5 layers of skin on the scalp are arranged thusly (5)

A

-S Skin -C Connective tissue -A Aponeurosis -L Loose periosteum -P Periosteum

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13
Q

Slow injection leads to more pain. True/false?

A

False

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14
Q

Curettage tends to require stitches. True/false?

A

False

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15
Q

Shave excisions require anaesthetising an area before proceudre. True/false?

A

True

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16
Q

In an elliptical biopsy, there should be a what degree angle between the edges of excision?

A

30 degrees

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17
Q

In elliptical biopsy, the scalpel should cut at which degree to the skin?

A

90 degrees

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18
Q

CD is mediated by IgE, T/F?

A

False

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19
Q

Is irritant contact dermatitis an immunological process?

A

No (it’s skin abrasion/ debridement)

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20
Q

Which % of hospitalised patients will have a cutaneous drug eruption?

A

3%

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21
Q

Which % of drug reactions are cutaneous?

A

30%

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22
Q

Pemphigoid is what type of immune reaction (Gel & Coombs)?

A

Type II

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23
Q

Cutaneous side effect of doxycycline

A

Phototoxic rash

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24
Q

Most common cause of an exanthematous drug eruption (2)

A

Penicillin antibiotics, NSAIDs

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25
Q

Beta-lactam antibiotics are associated with which clinical disease?

A

Urticaria

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26
Q

Acne can be exacerbated by steroids, T/F?

A

True - steroid acne

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27
Q

Bullous pemphigoid can be triggered by which drug class?

A

ACE inhibitors

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28
Q

Sulfonamide antibiotics and cephlasporins are associated with which syndromes?

A

SJS, TEN

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29
Q

Which drugs may exaggerate sunburn?

A

Quinine

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30
Q

Skin testing is indicated for type 3 & 4 adverse reactions, T/F?

A

False - can trigger SJS & TEN or DRESS

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31
Q

General treatment options for an acute cutaneous allergy to a drug (3)

A

1) Remove drug 2) Topical steroids 3) Antihistamines

32
Q

Spot Diagnosis

A

Lichen planus (T-cell, often a response to Koebner)

Typical appearence: Plaques have fine white lines (Wickham’s striae), papules, scale plaques

33
Q

Spot diagnosis

A

Psoriasis vulgaris

34
Q

What sign is this?

A

Auspitz’

35
Q

What is this?

A

Koebner phenonemon (trauma worsens)

36
Q

Spot diagnosis

A

Psoriasis vulgaris

37
Q

Spot diagnosis

A

Guttate psoriasis

38
Q

Spot diagnosis

A

Palmopustular psoriasis

39
Q
A
40
Q

Spot diagnosis

A

Erythrodermic psoriasis (severe)

41
Q

What is this sign called? What is it associated with?

A

Onycholysis and psoriasis

42
Q

Describe the psoriatic nail changes

A

Dystrophy, subungual hyperkeratosis, onycholysis, pitting

43
Q
A
44
Q

Spot diagnosis

A

Acne (pustules and papules)

45
Q

Spot diagnosis

A

Rosacea (erythema, pustules, papules in older patients. NO comedones c.f. acne).

46
Q

Spot diagnosis

A

Lichen planus (notice Wickham striae) - shiny, flat topped, purple/pink papules and plaques

47
Q

Spot diagnosis

A

Lichen planus

48
Q

Spot diagnosis

A

Bullous pemphigoid

49
Q

Spot diagnosis

A

Pemphigus vulgaris

50
Q

Spot diagnosis

A

Ruptured bullous pemphigus (erosions on right)

51
Q

Is lichen planus itchy?

A

Yes, intensely

52
Q

How is lichen planus treated?

A

Topical steroids (PO if severe) but generally self-limiting within 12-18 months

53
Q

What is the cause of lichen planus?

A

Unknown (possibly autoimmune)

54
Q

How are bullous diseases managed (e.g. pemphigoid)?

A

Systemic steroids (pemphigoiD, not pemphigus, is treatable with tetracycline).

Emollients, topical steroids and antisepsis.

55
Q

How can pemphigus/goid be diagnosed?

A

Skin biopsy with immunofluoresence

56
Q

“Flaccid, thin-roofed bullae” likely indicates what

A

Pemphigus (vulgaris)

57
Q

Does pemphigus involve mucosa?

A

Yes, commonly eyes and genitals. (compared to pemphigoid which does not)

58
Q

Spot diagnosis

A

Scabies burrows

59
Q
A
60
Q

What are the 5 layers of scalp?

A

S - skin

C - Connective Tissue

A - Aponeurosis

L - Loose connective tissue

P - Parietal Bone

61
Q

What’s an alternative treatment to surgery in non-melanoma skin cancer?

A

Imiquod cream

62
Q

Biopsy of a rash is always definitive, T/F?

A

False - many rashes can have the same histological appearence

63
Q

What is the maximum safe dose of lignocaine?

A

50mL 1%

64
Q

Lignocaine w/ adrenaline should be avoided in which patients?

A

Those with cardiac or psychotic disease

65
Q

Describe some techniques to make injections less painfil

A

Relax patient, topical local, fine needle bore, warm local anaesthetic, slow injection, massage skin, omit adrenaline

66
Q

Skin tags are commonly removed via which minor surgery?

A

Snip excision using electrosurgery

67
Q

Does a shave biopsy require a local?

A

Yes

68
Q

Does curettage & cautery require local?

A

Yes

69
Q

When would a punch biopsy be useful?

A

If the lesion is macular (flat - e.g. lentigo maligna as a precurosor to melanoma)

70
Q

Does shave exicision biopsy require local?

A

Yes

71
Q

When would a shave biopsy be useful?

A

When lesion is wide & flat

72
Q

What’s a drawback to curettage & cautery?

A

Doesn’t show margins of specimen well

73
Q

What’re some drawbacks to punch biopsy?

A

Round hole doesn’t tend to heal well and it’s difficult to judge where the edges of a lesion are

74
Q

In biopsy, what angle should the wound edges have to each other?

A

30 degrees

75
Q

Which disease presents with linear IgA at the dermal papilla?

A

Dermatitis herptiformis

Dermatology (15 decks)

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