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General Dermatology Conditions 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
Beta-lactam antibiotics are associated with which clinical disease?
Urticaria
26
Acne can be exacerbated by steroids, T/F?
True - steroid acne
27
Bullous pemphigoid can be triggered by which drug class?
ACE inhibitors
28
Sulfonamide antibiotics and cephlasporins are associated with which syndromes?
SJS, TEN
29
Which drugs may exaggerate sunburn?
Quinine
30
Skin testing is indicated for type 3 & 4 adverse reactions, T/F?
False - can trigger SJS & TEN or DRESS
31
General treatment options for an acute cutaneous allergy to a drug (3)
1) Remove drug 2) Topical steroids 3) Antihistamines
32
Spot Diagnosis
Lichen planus (T-cell, often a response to Koebner) Typical appearence: Plaques have fine white lines (Wickham's striae), papules, scale plaques
33
Spot diagnosis
Psoriasis vulgaris
34
What sign is this?
Auspitz'
35
What is this?
Koebner phenonemon (trauma worsens)
36
Spot diagnosis
Psoriasis vulgaris
37
Spot diagnosis
Guttate psoriasis
38
Spot diagnosis
Palmopustular psoriasis
39
40
Spot diagnosis
Erythrodermic psoriasis (severe)
41
What is this sign called? What is it associated with?
Onycholysis and psoriasis
42
Describe the psoriatic nail changes
Dystrophy, subungual hyperkeratosis, onycholysis, pitting
43
44
Spot diagnosis
Acne (pustules and papules)
45
Spot diagnosis
Rosacea (erythema, pustules, papules in older patients. NO comedones c.f. acne).
46
Spot diagnosis
Lichen planus (notice Wickham striae) - shiny, flat topped, purple/pink papules and plaques
47
Spot diagnosis
Lichen planus
48
Spot diagnosis
Bullous pemphigoid
49
Spot diagnosis
Pemphigus vulgaris
50
Spot diagnosis
Ruptured bullous pemphigus (erosions on right)
51
Is lichen planus itchy?
Yes, intensely
52
How is lichen planus treated?
Topical steroids (PO if severe) but generally self-limiting within 12-18 months
53
What is the cause of lichen planus?
Unknown (possibly autoimmune)
54
How are bullous diseases managed (e.g. pemphigoid)?
Systemic steroids (pemphigoiD, not pemphigus, is treatable with tetracycline). Emollients, topical steroids and antisepsis.
55
How can pemphigus/goid be diagnosed?
Skin biopsy with immunofluoresence
56
"Flaccid, thin-roofed bullae" likely indicates what
Pemphigus (vulgaris)
57
Does pemphigus involve mucosa?
Yes, commonly eyes and genitals. (compared to pemphigoid which does not)
58
Spot diagnosis
Scabies burrows
59
60
What are the 5 layers of scalp?
S - skin C - Connective Tissue A - Aponeurosis L - Loose connective tissue P - Parietal Bone
61
What's an alternative treatment to surgery in non-melanoma skin cancer?
Imiquod cream
62
Biopsy of a rash is always definitive, T/F?
False - many rashes can have the same histological appearence
63
What is the maximum safe dose of lignocaine?
50mL 1%
64
Lignocaine w/ adrenaline should be avoided in which patients?
Those with cardiac or psychotic disease
65
Describe some techniques to make injections less painfil
Relax patient, topical local, fine needle bore, warm local anaesthetic, slow injection, massage skin, omit adrenaline
66
Skin tags are commonly removed via which minor surgery?
Snip excision using electrosurgery
67
Does a shave biopsy require a local?
Yes
68
Does curettage & cautery require local?
Yes
69
When would a punch biopsy be useful?
If the lesion is macular (flat - e.g. lentigo maligna as a precurosor to melanoma)
70
Does shave exicision biopsy require local?
Yes
71
When would a shave biopsy be useful?
When lesion is wide & flat
72
What's a drawback to curettage & cautery?
Doesn't show margins of specimen well
73
What're some drawbacks to punch biopsy?
Round hole doesn't tend to heal well and it's difficult to judge where the edges of a lesion are
74
In biopsy, what angle should the wound edges have to each other?
30 degrees
75
Which disease presents with linear IgA at the dermal papilla?
Dermatitis herptiformis

Dermatology (15 decks)

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