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MD2 Dermatology > Introduction to Dermatology > Flashcards

Introduction to Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

Chronic lichenified eczema

A

With prolonged rubbing or scratching, the outer layer of the skin (the epidermis) becomes hypertrophied and this results in thickening of the skin and exaggeration of the normal skin markings, giving the skin a leathery bark-like appearance

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2
Q

Acute guttate psoriasis

A

Guttate psoriasis is characterized by the acute onset of small, 1-10 mm diameter, droplike, erythematous-to-salmon-pink papules, usually with a fine scale

Primarily occurs on the trunk and the proximal extremities, but it may have a generalized distribution

URTI from GAS often precedes the eruption by 2-3 weeks

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3
Q

Urticaria

A

??

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4
Q

Lichen planus

A

AI disease of the skin and/or mucous membranes that resembles lichen

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5
Q

Early signs of melanoma

A

Asymmetry

Border irregularity

Colour change/irregularity

Diameter >7mm

Evolution (new or changing), elevation

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6
Q

What is scale?

A

An abnormal accumulation of keratin on the surface of the skin

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7
Q

Give 5 examples of dermatological conditions which produce scale and the characteristics of the scale

A

Psoriasis (thick, silvery scale)

Asteatotic eczema (scaly skin)

Pityriasis versicolor (fine scale)

X-linked icthyosis (plate-like scale)

Tinea corporis (has a scaly “active” edge)

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8
Q

What is a macule?

A

A flat, impalpable area of altered skin colour

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9
Q

Give 2 examples of dermatological conditions which present with macules

A

Freckles

Vitiligo (depigmented macules)

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10
Q

What is a papule?

A

Elevated palpable lesion <5mm

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11
Q

Give 3 examples of dermatological conditions which present with papules

A

Keratosis pilaris

Molluscum contagiosum

Closed comedones in acne vulgaris

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12
Q

What is a nodule? What is a cyst?

A

Nodule: elevated palpable lesion >5mm

Cyst: fluctuant nodule

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13
Q

Give 3 examples of dermatological conditions which present with nodules and/or cysts

A

BCC can be nodular and ulcerated

SCC can present with hyperkeratotic nodules

Nodulocystic acne

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14
Q

What is plaque? Give an example of a dermatological condition which may present with plaque

A

Circumscribed, elevated area of skin where broadness > thickness

Psoriasis

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15
Q

What is a wheal?

A

Area of localised oedema of skin

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16
Q

What is a vesicle vs a bullae?

A

Fluid-filled blister within the epidermis (superficial, easily ruptured)

Fluid-filled blister >5mm within the dermis (deeper, not as easily ruptured)

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17
Q

Give an example of a condition which presents with vesicles

A

Herpes zoster

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18
Q

Give 2 examples of dermatological conditions which present with bullae

A

Acute eczema

Bullous pemphigoid

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19
Q

What is a pustule?

A

A vesicle or bulla containing pus

NB pus may be sterile

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20
Q

Give 2 examples of dermatological conditions presenting with pustules

A

Infective folliculitis

Pustular psoriasis (pustules are sterile in this case)

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21
Q

What is an erosion? Will an erosion cause scarring?

A

A superficial loss of epidermis, does not cause scarring

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22
Q

Give 2 examples of dermatological conditions presenting with erosions

A

Pemphigus vulgaris (erosions of mucosa and skin)

Impetigo

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23
Q

What is an ulcer? Will an ulcer cause scarring?

A

An area of tissue loss through dermis, can cause scarring

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24
Q

Give an example of a dermatological condition presenting with ulcers

A

Pyoderma gangrenosum (but not infectious, does not cause gangrene!)

Seen in IBD, RA, Wegener’s granulomatosis, idiopathic

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25
Q

What is a crust?

A

A scab produced by dried exudate from an erosion or ulcer

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26
Q

Give 3 examples of dermatological conditions which may present with crusts

A

Eczema herpeticum

Impetigo

Infected eczema

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27
Q

What is telangiectasia?

A

Dilated and broken capillaries, often the result of rosacea and sun damage

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28
Q

List 2 dermatological conditions which may present with telangiectasia

A

Rosacea

BCC

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29
Q

What are petechiae? Give an example of a cause of petechiae

A

Areas of pinpoint bleeding into the skin or mucosae (present as small red dots which do not blanch)

Caused by raised intravascular pressure e.g. coughing

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30
Q

What is purpura?

A

Discolouration of skin or mucous membranes due to bleeding from small vessels (do not blanch)

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31
Q

Distinguish between petechiae and purpura

A

Purpura > petechiae

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32
Q

What should be suspected as a cause of purpura when the purpura are a) flat, or b) palpable?

A

a) may indicate coagulopathy
b) characteristic of leucocytoplastic/cutaneous vasculitis

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33
Q

What is the most common cause of hair loss?

A

AI (alopecia areata)

34
Q

Give 3 examples of dermatological conditions causing alopecia

A

Alopecia areata (most common)

Tinea capitis (most commonly childhood)

Discoid lupus (causes scarring alopecia)

35
Q

What is sclerosis?

A

Hardening of the SC tissue and dermis

36
Q

Define sclerodactyly

A

Sclerosis of the digits

37
Q

Give an example of a dermatological conditon presenting with atrophic plaques

A

Morphoea (localised scleroderma)

38
Q

Give examples of dermatological conditions predominantly affecting the flexor and extensor surfaces respectively

A

Flexor: eczema

Extensor: psoriasis

39
Q

What is the common name for tinea corporis?

A

Ringworm

40
Q

How does tinea corporis present?

A

Scaly annular lesions; itchy and spreading with central clearing

41
Q

List 3 common pathogens causing tinea corporis

A

Trichophyton rubrum

Microsporum canis

Epidermophyton floccosum

42
Q

What is tinea unguium (onychomycosis)?

A

Fungal infection of the nails

43
Q

What is tinea cruris?

A

Fungal infection of the groin

44
Q

How can tinea cruris and intertrigo be distinguished?

A

Tinea cruris has expanding scaly edge

45
Q

What is kerion? How is it treated?

A

Raised, spongy lesions caused by host’s response to dermatophyte infection in tinea capitis; can be potentially scarring

Requires aggressive treatment with systemic antifungals and oral steroids

46
Q

How should tinea be managed (in the case of skin infections, extensive skin infections, tinea of the scalp and onychomycosis)?

A

Diagnosis via skin scrapings for microscopy and culture

Skin infections: topical imidazole or terbinafine creams bd for 3-4 weeks

Extensive skin infections: oral antifungals (e.g. griseofulvin, terbinafine, itraconazole or fluconazole) for 4 weeks

Tinea of the scalp: oral antifungals for 2 months

Onychomycosis: oral antifungals for 3-6 months

47
Q

What is molluscum contagiosum and how does it present?

A

Skin infection caused by molluscum contagiosum virus (MCV), classically presenting with polymorphous umbilicated skin-coloured papules

48
Q

How is molluscum contagiosum commonly spread?

A

Swimming pools due to fomites; common in childhood, spreads through families

49
Q

How should molluscum contagiosum be treated?

A

Treat concurrent eczema with topical steroids to prevent scratching

Treat with topical irritants (e.g. salicyclic acid wart paint) or immunostimulants (e.g. dilute imiquimod cream), or via destructive methods (e.g. tape stripping, topical cantharidine treatment, curettage)

50
Q

Give 6 examples of warts. Which of these is the most common?

A

Verruca vulgaris (commonest)

Plane

Periungal

Filliform

Mosaic

Anogenital

51
Q

How can plane warts be treated?

A

May benefit from retinoic acid

52
Q

What is the risk with anogenital warts?

A

Carcinogenic potential in females

53
Q

What 3 factors are important to consider when treating warts?

A

Spontaneous remission rates (in immunocompetent patients)

Risk of scarring with treatment

Trauma of treatment (esp with children)

54
Q

How are warts treated?

A

Often used combination therapy

Can use destructive or topical treatments

55
Q

Give 4 examples of destructive therapies for the treatment of warts.

A

Liquid nitrogen cryotherapy

Diathermy (scars)

Curettage (scars)

Tape

56
Q

Give 3 examples of topical therapies for the treatment of warts

A

Salicyclic acid wart paint

DCP immunotherapy

Imiquimod (for genital warts)

57
Q

Which bacteria cause the majority of cutaneous skin infections?

A

Staph aureus

GAS

58
Q

What is the typical causitive organism in folliculitis? How can this be confirmed?

A

Staph aureus

Swab and MCS; look for carriage in nares, axillae and groin

59
Q

How is folliculitis treated?

A

Systemic Abx

Eradicate carriage (antiseptic washes may be helpful in maintenance)

60
Q

What causes impetigo?

A

Usually eczema infected with staph aureus

Exfoliative toxin produces superficial blistering

61
Q

How should impetigo be treated?

A

Avoid contacts (highly contagious)

May just need to remove crust and treat with antiseptic

May need anti-staph Abx (e.g. flucloxacillin, cephalexin)

62
Q

What causes cellulitis? What is the pathophysiology?

A

GAS

Hyaluronidase cleaves connective tissue, causing spread

63
Q

How should cellulitis be treated?

A

Oral or IV antibiotics

Severe cases require surgical intervention

64
Q

How does shingles present?

A

Dorsal ganglion reactivation causes unilateral dermatomal rash with eruption of papules, vesicles and then crusts, with a prodrome of pain and tingling

65
Q

How is shingles diagnosed?

A

Zoster PCR (from lesions, or blood PCR if zoster sine herpete or disseminated herpes zoster)

66
Q

How is shingles treated?

A

Early systemic antivirals (e.g. valacyclovir, famiciclovir, acyclovir) to reduce risk of neuralgia

Can be prevented with shingles vaccine (more potent varicella vaccine)

67
Q

List 2 possible complications of herpes zoster

A

Post-herpetic neuralgia

Opthalmic involvement

68
Q

How is herpes simplex 1 treated?

A

Topical or systemic acyclovir or other antivirals

69
Q

How is herpes simplex 2 diagnosed?

A

HSV PCR (from swab of unroofed lesions)

To establish infection (e.g. in STI screening), can perform serological assay for HSV1/HSV2 Abs

70
Q

What are the 2 options for herpes simplex 2 treatment?

A

Intermittent treatment for flares

Longterm suppression treatment (better due to contagiousness)

71
Q

How is herpes simplex 2 treated?

A

Systemic antivirals (may require prophylactic antivirals to reduce recurrence)

Acyclovir, famciclovir, valacyclovir

Daily if longterm suppression, 7-10 days for short course

72
Q

Keratosis pilaris

A

Very common form of dry skin characterised by hair follicles plugged by scale

73
Q

Molloscum contagiosum

A

Viral infection of the skin or occasionally of the mucous membranes, sometimes called water warts; caused by a DNA poxvirus called the molluscum contagiosum virus (MCV)

74
Q

Pemphigus vulgaris

A

Rare autoimmune disease that is characterised by blisters and erosions on the skin and mucous membranes, most commonly inside the mouth (most common subtype of pemphigus)

75
Q

Impetigo

A

Highly contagious bacterial skin infection most common among preschool children (usually caused by Staph aureus or GAS)

76
Q

Eczema herpeticum

A

Disseminated viral infection (HSV 1 or 2) characterised by fever and clusters of itchy blisters or punched-out erosions; most often seen as a complication of atopic dermatitis/eczema

77
Q

4 oral antifungals

A

Griseofulvin

Terbinafine

Itraconazole

Fluconazole

78
Q

2 topical antifungals

A

Imidazole

Tolnaftate

79
Q

Herpes zoster opthalmicus

A

Occurs if virus infects the trigeminal nerve (or reactivation occurs within opthalmic branch)

May cause conjunctivitis, keratitis, corneal ulceration, iridocyclitis, glaucoma, and blindness

Treat with antivirals within 72 hours after the onset of the rash to reduces the incidence of complications by 25%

Lubricating eye ointment should be given to patients when the blinking reflex has been affected, to prevent damage to the corneal epithelium

80
Q

Antivirals for treatment of herpes simplex and zoster

A

Famciclovir

Valacyclovir

Acyclovir

81
Q

What Abx are used in the treatment of cellulitis?

A

Flucloxacillin, cefalexin, cefazolin (vancomycin if concerned about MRSA or if pt severely unwell)

MD2 Dermatology (3 decks)

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