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MD2 Dermatology > Introduction to Dermatology > Flashcards

Introduction to Dermatology 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
What is a crust?
A scab produced by dried exudate from an erosion or ulcer
26
Give 3 examples of dermatological conditions which may present with crusts
Eczema herpeticum Impetigo Infected eczema
27
What is telangiectasia?
Dilated and broken capillaries, often the result of rosacea and sun damage
28
List 2 dermatological conditions which may present with telangiectasia
Rosacea BCC
29
What are petechiae? Give an example of a cause of petechiae
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
30
What is purpura?
Discolouration of skin or mucous membranes due to bleeding from small vessels (do not blanch)
31
Distinguish between petechiae and purpura
Purpura \> petechiae
32
What should be suspected as a cause of purpura when the purpura are a) flat, or b) palpable?
a) may indicate coagulopathy b) characteristic of leucocytoplastic/cutaneous vasculitis
33
What is the most common cause of hair loss?
AI (alopecia areata)
34
Give 3 examples of dermatological conditions causing alopecia
Alopecia areata (most common) Tinea capitis (most commonly childhood) Discoid lupus (causes scarring alopecia)
35
What is sclerosis?
Hardening of the SC tissue and dermis
36
Define sclerodactyly
Sclerosis of the digits
37
Give an example of a dermatological conditon presenting with atrophic plaques
Morphoea (localised scleroderma)
38
Give examples of dermatological conditions predominantly affecting the flexor and extensor surfaces respectively
Flexor: eczema Extensor: psoriasis
39
What is the common name for tinea corporis?
Ringworm
40
How does tinea corporis present?
Scaly annular lesions; itchy and spreading with central clearing
41
List 3 common pathogens causing tinea corporis
Trichophyton rubrum Microsporum canis Epidermophyton floccosum
42
What is tinea unguium (onychomycosis)?
Fungal infection of the nails
43
What is tinea cruris?
Fungal infection of the groin
44
How can tinea cruris and intertrigo be distinguished?
Tinea cruris has expanding scaly edge
45
What is kerion? How is it treated?
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
How should tinea be managed (in the case of skin infections, extensive skin infections, tinea of the scalp and onychomycosis)?
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
What is molluscum contagiosum and how does it present?
Skin infection caused by molluscum contagiosum virus (MCV), classically presenting with polymorphous umbilicated skin-coloured papules
48
How is molluscum contagiosum commonly spread?
Swimming pools due to fomites; common in childhood, spreads through families
49
How should molluscum contagiosum be treated?
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
Give 6 examples of warts. Which of these is the most common?
Verruca vulgaris (commonest) Plane Periungal Filliform Mosaic Anogenital
51
How can plane warts be treated?
May benefit from retinoic acid
52
What is the risk with anogenital warts?
Carcinogenic potential in females
53
What 3 factors are important to consider when treating warts?
Spontaneous remission rates (in immunocompetent patients) Risk of scarring with treatment Trauma of treatment (esp with children)
54
How are warts treated?
Often used combination therapy Can use destructive or topical treatments
55
Give 4 examples of destructive therapies for the treatment of warts.
Liquid nitrogen cryotherapy Diathermy (scars) Curettage (scars) Tape
56
Give 3 examples of topical therapies for the treatment of warts
Salicyclic acid wart paint DCP immunotherapy Imiquimod (for genital warts)
57
Which bacteria cause the majority of cutaneous skin infections?
Staph aureus GAS
58
What is the typical causitive organism in folliculitis? How can this be confirmed?
Staph aureus Swab and MCS; look for carriage in nares, axillae and groin
59
How is folliculitis treated?
Systemic Abx Eradicate carriage (antiseptic washes may be helpful in maintenance)
60
What causes impetigo?
Usually eczema infected with staph aureus Exfoliative toxin produces superficial blistering
61
How should impetigo be treated?
Avoid contacts (highly contagious) May just need to remove crust and treat with antiseptic May need anti-staph Abx (e.g. flucloxacillin, cephalexin)
62
What causes cellulitis? What is the pathophysiology?
GAS Hyaluronidase cleaves connective tissue, causing spread
63
How should cellulitis be treated?
Oral or IV antibiotics Severe cases require surgical intervention
64
How does shingles present?
Dorsal ganglion reactivation causes unilateral dermatomal rash with eruption of papules, vesicles and then crusts, with a prodrome of pain and tingling
65
How is shingles diagnosed?
Zoster PCR (from lesions, or blood PCR if zoster sine herpete or disseminated herpes zoster)
66
How is shingles treated?
Early systemic antivirals (e.g. valacyclovir, famiciclovir, acyclovir) to reduce risk of neuralgia Can be prevented with shingles vaccine (more potent varicella vaccine)
67
List 2 possible complications of herpes zoster
Post-herpetic neuralgia Opthalmic involvement
68
How is herpes simplex 1 treated?
Topical or systemic acyclovir or other antivirals
69
How is herpes simplex 2 diagnosed?
HSV PCR (from swab of unroofed lesions) To establish infection (e.g. in STI screening), can perform serological assay for HSV1/HSV2 Abs
70
What are the 2 options for herpes simplex 2 treatment?
Intermittent treatment for flares Longterm suppression treatment (better due to contagiousness)
71
How is herpes simplex 2 treated?
Systemic antivirals (may require prophylactic antivirals to reduce recurrence) Acyclovir, famciclovir, valacyclovir Daily if longterm suppression, 7-10 days for short course
72
Keratosis pilaris
Very common form of dry skin characterised by hair follicles plugged by scale
73
Molloscum contagiosum
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
Pemphigus vulgaris
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
Impetigo
Highly contagious bacterial skin infection most common among preschool children (usually caused by Staph aureus or GAS)
76
Eczema herpeticum
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
4 oral antifungals
Griseofulvin Terbinafine Itraconazole Fluconazole
78
2 topical antifungals
Imidazole Tolnaftate
79
Herpes zoster opthalmicus
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
Antivirals for treatment of herpes simplex and zoster
Famciclovir Valacyclovir Acyclovir
81
What Abx are used in the treatment of cellulitis?
Flucloxacillin, cefalexin, cefazolin (vancomycin if concerned about MRSA or if pt severely unwell)

MD2 Dermatology (3 decks)

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