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Year 4 Dermatology > Hair and nails > Flashcards

Hair and nails Flashcards

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Dermatology Board Prep flashcards
1
Q

the nail matrix is proximally/distally?

A

proximally

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2
Q

can you use a dermatosope on nail?

A

yes

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3
Q

what can looking at the proximal nail fold tell you

A

signs of rheumatological conditions e.g. dilated capillaries

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4
Q

functions of nails

A

protection
tool
counter pressure - sensation

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5
Q

signs of nail changes on examination

A 
number of nails 
brittle 
thickening 
separation 
colour 
ridging 
striations 
growth 
systemic disease 
drugs
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6
Q

fungal vs melanoma in nails vs haemorrhage

A

single vs multiple

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7
Q

signs of fungal nail disease

A 
black pigmentation 
yellow pigmentation  
thickened 
brittle 
look for tinea pedis between toes
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8
Q

how can you differentiate between fungal nail disease and periungual melanoma

A

melanoma - usually a single nail

fungal - usually multiple nails

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9
Q

RF for fungal nail infection

A

elderly
immunosuppressed
starts off in 1 nail then progresses to others

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10
Q

features of subungal haematoma

A 
dark pigment 
asymmetric 
nail fold involvement 
pain if acute 
chronic repetitive trauma 
D.Dx melanoma 
dermatoscope - streaky, red/brown colour
review consultation if concerned
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11
Q

signs of acral / periungual melanoma

A

streaks of dark pigment
involvement of proximal nail fold - Hutchinsons sign
thick and thin pigment

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12
Q

what is melanonychia and what are some causes

A

benign pigment in the nail
antimalarial drugs
chemotherapy

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13
Q

features of a myxoid pseudocyst

A 
benign growth around the nail 
fluid filled 
telangiectasia 
D.Dx BCC 
may recur despite treatment
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14
Q

features of lichen planus of nails

A 
trachonychia (looks like nail has been sandpapered)
angel winging 
disfiguring 
topical steroids 
check elsewhere for signs
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15
Q

What are Beau’s lines?

A

transverse ridging of the nail
can occur during times of stress
arrest of nail growth at nail matrix

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16
Q

what is paronychia

A

infection of nail tissue

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17
Q

why do hair bearing regions heal better

A

presence of stem cells near the follicle

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18
Q

what is the anagen phase of hair

A

growing

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19
Q

What is the catagen phase of hair

A

starts to detach from blood supply

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20
Q

what is the telogen phase of hair

A

stage where it can fall out

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21
Q

in humans, hair loss is a/synchronous

A

asynchronous hair loss

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22
Q

non-scarring hair loss features on dermatoscope

A

see follicles on dermatoscope

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23
Q

questions to ask in a history of hair loss

A 
timing
how much loss - little vs clumps
localised vs generalised
who noticed 
brushing, shower, shedding or thinning 
where - facial and body hair 
itch, tingling
infection, stress, pregnancy, drugs 
PMH - autoimmunity
DH 
FH 
hair care products - heat use, chemicals
diet
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24
Q

androgenic alopecia

A 
thinning 
follicles present 
minoxidil 
anti androgen drugs 
hair transplant
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25
Q

scarring hair loss features

A

lose hair follicle
hair wont grow back
scalp looks smooth and shiny

26
Q

non-scarring hair loss features

A

see follicles on dermatoscope

27
Q

causes of non-scarring hair loss

A 
androgenic alopecia 
telogen effluvium 
alopecia areata 
traction alopecia 
trichotillomania
tinea capitus
28
Q

features of androgenic alopecia

A 
thinning 
follicles present 
minoxidil 
anti androgen drugs 
hair transplant
29
Q

features of telogen effluvium

A 
generalised hair loss 
hair regrowth 
pregnancy 
iron levels 
in time it grows back
30
Q

features of alopecia areata

A 
exclamation mark hairs 
patches of hair loss 
hair can grow back on its own 
can grow back as white hair
topical dermovate 
IL steroids
31
Q

features of traction alopecia

A

not scarring - may if over a long period of time
tight pony tails
tight braids
relax the hair

32
Q

features of trichotillomania

A 
hair pulling intentionally 
mental health conditions underlying - OCD, anxiety 
atypical distribution 
hairs of different lengths 
hair does grow back 
behavioural modification
33
Q

examples of scarring alopecia

A

kerion
CDLE
lichen planopilaris / FFA

34
Q

CDLE features

A

chronic discoid lupus erythrematosus
highly potent steroids
leaves large smooth plaques behind
sunlight - trigger

35
Q

features of lichen planopilaris / FFA

A 
lichen planus of the scalp
clear cut 
affects front of head 
erythema around hair follicle 
females 
doesnt regrow
36
Q

mechanism of folliculitis decalvans and

dissecting cellulitis of the scalp

A

neutrophil mediated
looks like a toothbrush
antibiotics

dissecting cellulitis of the scalp - more aggressive, painful
associated with other adnexal diseases - acne, HS

37
Q

types of excess hair growth

A

hirsutism

hypertrichosis

38
Q

describe hirsutism

A

male pattern excess hair growth

39
Q

describe hypertrichosis

A

congenital

acquired - ciclosporin, phenytoin

40
Q

DRESS - severe

A 
fever
liver 
necrosis 
cardiac 
lungs 
lymphadenopathy 
blood count - eosinophilia 
2 week history 
carbamazepine, lamotrigine, keppra, sulpha drugs
41
Q

features of morbilliform drug eruption - mild

A 
most common 
penicillin 
allopurinol 
sulpha drugs 
cranial caudal distribution 
erythematous papules that becomes confluent 
intensely itchy 
emollients, topical steroids
42
Q

features of DRESS drug eruption - severe

A 
fever
liver 
necrosis 
cardiac 
lungs 
lymphadenopathy 
blood count - eosinophilia 
2 week history 
carbamazepine, lamotrigine, keppra, sulpha drugs
43
Q

what is the difference between SJS / TEN

A

of body surface area:
SJS <10%
TEN >30%

44
Q

features of SJS

A

mucosal involvement
mouth or eye pain
genitalia involvement

45
Q

erythema multiforme

A

targeoid lesion
children - HSV
older - HIV, drugs, reactive

46
Q

features of fixed drug eruption - allergic

A

beefy red inflamed blistering lesion
recurrent
can be sore
remove offending drug and they resolve on their own

47
Q

features of erythema multiforme

A

targetoid lesion
children - HSV
older - HIV, drugs, reactive

48
Q

types of erythema multiforme

A

major - mucosal surfaces involved

minor

49
Q

types of urticaria

A

acute - allergic

chronic

50
Q

causes of urticaria

A

foods
drugs - penicillin, sulpha, anticonvulsants
intensely itchy

51
Q

drug cause of angioedema

A

ACEI - non-allergic mediated

52
Q

causes of phototoxic drug reactions

A

tetracyclines
thiazides
psoralin for UVA treatment
fruits - citrus

53
Q

areas affected by phototoxic drug reactions

A

face
neck
dorsal hands
sharp cut off

54
Q

cause of drug induced LE

A

PPIs

55
Q

drug induced bullous pemphigoid

A

furosemide

SGLT2 inhibitors

56
Q

drug induced bullous pemphigoid causes

A

furosemide

SGLT2 inhibitors

57
Q

erythema nodosum causes

A

penicillin

sulpha drugs

58
Q

drug induced pigmentation

A

amiodarone - slate grey
minocycline - irreversible
antimalarials - melanonychia
chemo, mushrooms - flagellate erythema

59
Q

drug induced pigmentation causes

A

amiodarone - slate grey
minocycline - irreversible
antimalarials - melanonychia
chemo, mushrooms - flagellate erythema

60
Q

cause of oil drop sign on nails

A

psoriasis

Year 4 Dermatology (16 decks)

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