Gp gammon Flashcards
Rashes
ERythema Macula Papule Nodule Plaque Vesicle Bullae Pustule Petechiae
RED FLAGS: Meningism Non blanching Fever Young or old Immunocompromised lympahdenopathy Diffuse erythroderma Mucosal/oral lesions Hypotension Severe localised pain or tenderness New drug use Arthralgia
Meningococcal Viral exanthem Arboviruses Cutaneous drug eruption Secondary syphilis Hand foot and mouth Erythema multiforme Dermatitis Rosacea Acne Tinea
Contact Dermatitis
High potency topical steroids
Intralesional triamcinolone injection
oral prednisolone
Oral antibiotics
Atopic dermatitis
Avoid exacerbating factors
Topical anti-inflammatory - topical corticosteroids
Moisturisers and additives for baths
Wet dressings
Investigations and treatment of infection
Education - for life but good prognosis
Discussion - maybe allergy testing,
- Only for severe cases with reactions to food
- Difficult to reduce airborne allergens
Psoriasis
Topical anti-inflammatory
Topical tar
Dithranol - irritating - stains, only temporary use
Investigation and teramtnet of infection
Skin cancer
Exposure to radiation, chemicals such as coal, petrol, dyes and arsenic - chronic irritation, hyperthermia, tobacco, HPV
Actinic changes
Solar keratosis - thickened, scaly or awry coloured, red lesions
Solar lentigos- brown macules
Guttate hypomelanosis - white patches
BCC - arise from otherwise normal appearing skin, raised pearly edge - bleed and ulcerate easily
- Nodular, superficial, morpheic (scar like plaque), ulcerative (looks like an ulcer), pigmented (papule, nodules or plaques with a foci of pigment)
SCC - well differentiated - CHRONIC SUN DAMAGE, indurated nodules, keratitis surface
- Firm, crusted, rolled edge, ulceration, recurrent bleeding, MAY BE PAINFUL
Intraepidermal SCC - irregular, flat, red and scaly patches -
Melanoma - superficial spreading, lentigomaligna (not pigmented), aural lengitgous (not sun related), nodular (pigmented nodule), non pigmented
- If stage 3 or more need to do CT and PET
Dysplastic naves - risk factor for melanoma, or melanocytes nave
- other ddx - dermal naves, solar keratosis, psoriasis, sebhorrhiec keratosis, moles
ABCDE
Clark level - 1,2,3,4, 5
SDPRF
- Situ, Dermis, Pappillary, Retiruclar, Fat
SCC - 4mm margin
BCC - 3mm margin +/- radiotherapy
AK - 5-10 seconds cryotherapy
IEC - 30 seconds cryotherapy - 3mm margin
IEC from biopsy –> can give imiquimod and effudix
BCC - curettage superficial or nodular, can give superficial imiquiomod
Melanoma is 5mm in situ, 1cm for <1.5mm depth, 2cm if >1.5mm depth
- Can give chemo if needed
