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Dermatology > IPE > Flashcards

IPE Flashcards

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Dermatology Board Prep flashcards
1
Q

What are some important Q to ask in a dermatology history?

A

Is it changing
Any itching, swelling, fever, pain or discharge?
Any changes with joint, mouth, nails or scalp?
Any systemic changes?
Travel history
Sex history
Any changes in topical preparations

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2
Q

How would you describe the colour of a lesion?

A
  • Erythema
  • Purpura
  • Hypopigmentation
  • Hyperpigmentation
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3
Q

How would you describe a flat patch?

A

Macule

Papule >5mm

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4
Q

How would you describe a raised area of skin?

A

Papule v nodule v plaque

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5
Q

How would you describe a fluid filled area of skin?

A
  • Vesicle v bulla
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6
Q

What are the red flag signs for skin lesions?

A
  1. Asymmetry
  2. Irregular border
  3. Two or more colours within the lesion
  4. Diameter >6mm
  5. Evolving
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7
Q

What are the different allergy tests that can be done

A

Skin prick tests - wheal formation - skin pierced and substance added - food allergen and pollen
Skin patch test - contact dermatitis - takes 96 hours

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8
Q

What are the salient features of a malignant melaoma?

A

UV exposure on pale skin
frequently metastasize to lymph nodes
Breslow depth predicts mortality based on invasion depth
Chemo and radiotherapy have minimal benefits – laser therapy and immunotherapy are common

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9
Q

What are the salient features of a SCC?

A

RF- acitinic keratosis, smoking,, previous skin cancer
May metastasize
May occur in long standing leg ulcers - Marjlon Ulcers
Bowen’s disease - SSC in situ - well demarkated scaly patch of slow growing area
surgical treatment

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10
Q

What is a BCC?

A 
Most common skin cancer
Rarely metastasize
light exposed areas 
usually treated with wide base excision
Initially a pearly flesh coloured papule with telangectasia that ulcerates leading to a central crater
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11
Q

What are some differentials for skin cancer lesions?

A
  • Seborrhoeic keratosis - stuck on appearance - management is reassurance and removal
  • Keratocanthoma - dome shaped erythematous base that develops over days and grow rapidly ( need biopsy to check)
    -Acitinic keratosis - pre malignant - atypical keratocytes in the epidermis from chronic Uv exposure
    May need Fluro-uracil creams and avoid the sun
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12
Q

What are cherry hemanigomas?

A

Campbel de morgan spots
Skin lesions which contain an abnormal proliferation of capillaries
non blanching and not on mucosal surfaces
no treatment needed

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13
Q

What is the pathophysiology of acne vulgaris and where is it seen?

A

Follicular epidermal proliferation –> colonisation by anaerobic bacterium and inflammation
Occurs mainly on the face, neck and back

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14
Q

How are the lesions in acne vulgaris described?

A

Comedones - white and black heads
Papules and pustules
Nodules
on erythematous base

Severe acne may result in ice pick and hypertrophic scars

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15
Q

What is the treatment of acne vulgaris?

A

Reassurance and advice about washing face
Benzoyl peroxide/ topical retinoids
Topical combination therapy - one of above and topical antibiotic
Oral Abx- tetracylcine
Could consider anti-androgen - dianette in females
Oral retinoid if scarring

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16
Q

What are the side effects of oral retinoids?

A 
teratogenic 
dry skin
nose bleeds 
low mood 
hair thinning 
photosensitivity
17
Q

Describe the rash seen in ezcema

A

papules and vesicles on erythematous base

seen on face and extensors in infants and flexors in children and adults

18
Q

What is the treatment for ezcema?

A 
Avoid trigger
Emollients 
steriod cream - weakest that controls
Topical immunomodulators - tacrolimus
Phototherapy and oral immunomodulators - ciclosporin

Antihistamines, Abx and antivirals for infection

19
Q

What is the long term problem with erythema ab igne?

A

increased risk of SCC

20
Q

What virus causes shingles? How and what does this mean about the rash?

A

Herpes Zoster virus
reaactivation along the dermatome in which the virus is reactivated.
The rash is unilateral and in the region of one dermatome

21
Q

What is the management of shingles?

A

nothing in normally healthy people unless in the opthalmic division of CN5
Aciclovir

22
Q

When can children return to school with chicken pox?

A

5 days after the rash has developed

23
Q

What are the causes of impetigo?

A

Staph aureus and strep pyrogenes

24
Q

What is the manangement of impetigo?

A

Fusidic acid topical or flucoxacillin

25
Q

Where does lichen sclerosis occur and what is its management?

A

Genitalia of females - white plaques
Topical steriods
increased risk of vulvular cancer

26
Q

What are port wine stains and how should they be managed?

A

Vascular birth marks that tend to be unilateral- deep red or purple
Do not resolve spontaneously and therefore need cosmetic camoflague or laser therapy

27
Q

What are strawbery naevi? How are they treated ?

A

erythematous rasied and mutilobar tumour
typically resolve before 10 years
usually not treated unless symptomatic and then given propanolol

28
Q

What is the pathophysiology in psoarasis and what can trigger it?

A

Abnormal T cells stimulate proliferation

May be worsened by stress, cold and drugs (NSAIDs and B blockers)

29
Q

What are the subtypes of psoarasis?

A

Plaque - well demarkated red scaly patches on exensor surfaces
Flexor
Guttate - post strep throat - multiple red tear shaped lesions
Pustular - palms and soles

30
Q

What is the management of plaque psoarasis?

A

regular emolients
topical corticosteriods and vit D analogues
coal tar - inhibits DNA replication
short acting dithranol

in 2ndary care

  • narrow band UVB
  • Psoralen and PUVA
  • MTX, ciclosporin and systemic retinoids
31
Q

What is the treatment of scabies and what is important to inform the patient?

A

Permerithin –> Malatrion
Important to treat all close contacts
Itching will remain for 4-6 weeks

32
Q

What is the management of acne roseca?

A

Mild and moderate - topical metrondiazole

Severe or treatment resistant - oral tetracycline

33
Q

What is erythema mutliforme?

A

Hypersensitivity reaction triggered by infection
usually lesions on the back of the hands or feet and spread to torso
Major - involves the mucosa

34
Q

What is the first line management of hyperhydrosis?

A

aluminum chloride - roll on at night times

Botulinum toxin injections and glycopyrrolate agent can be used in secondary care

35
Q

what rash is associated with coeliac and how does it present?

A

Dermatitis herpetiformis Autoimmune blistering disorder caused by IgA deposition in the skin

36
Q

What features of a lipoma suggest a sarcomatous change?

A

size >5cm
Increasing size
Pain
Deep anatomical location

37
Q

What is acne rosacae?

A

Chronic skin disease
Flushing occurs first followed by skin disease over the nose, cheek and forehead
Persistent erythema with pustules and papules

Dermatology (1 decks)

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