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Rapid Reference - Dermatology > Limbs > Flashcards

Limbs Flashcards

1
Q

What sites are commonly affected by atopic eczema

A

Antecubital fossa
popliteal fossa
face
hands

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2
Q

What sites are commonly affected by psoriasis

A

Elbows
knees
trunk
scalp

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3
Q

What causes folliculitis

A

infection of hair follicles by staph aureus

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4
Q

What does tinea corporis signify

A

a fungal infection with the characteristic annular appearance of “ringworm”

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5
Q

Where does Lichen plans often involve

A

the wrists

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6
Q

What is Bowen’s disease

A

in-situ squamous cell carcinoma

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7
Q

Where is Bowen’s disease typically found

A

On the shins of elderly ladies

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8
Q

Where is the most common site for malignant melanoma to appear

A

Lower leg

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9
Q

What is atopic eczema

A

A remitting itchy inflammatory dermatitis, often associated with a personal history of asthma or allergic rhinitis

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10
Q

What are the most common clinical signs of atopic eczema

A

Scratching or rubbing especially at night

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11
Q

What general advice can you give to a patient with a new diagnosis of eczema

A

General measures: loose cotton clothing and avoid wool and excessive heat.
Keep nails short
Career advice: avoid wet work jobs e.g. nursing, hairdressing and cleaning

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12
Q

What emollients are used for eczema

A

Moisturisers such as aqueous cream
E45
Diprobase

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13
Q

How do emollients work in eczema

A

They re-establish the surface lipid layer and enhance rehydration of the epidermis
The desire to scratch is also reduced

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14
Q

What does the choice of emollient come down to

A

the patients choice - whether t is greasy or tolerable - often patients need to try different products to see what they prefer

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15
Q

What is the rule about topical steroids and eczema

A

prescribe the least potent strength steroid that is effective

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16
Q

How often should topical steroids be applied

A

Usually twice a day

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17
Q

What is the wet wrap technique

A

wetted tubifast dressings, applied over a topical steroid or emollient for a short time in exudative eczema

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18
Q

What are some third line treatments for patients with eczema

A

PUVA
UVB light
immunosuppressive drugs

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19
Q

What is folliculitis

A

an acute pustular infection of multiple hair follicles often on the legs due to staph aureus

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20
Q

What are the clinical features of folliculitis

A

follicular pustules in hair-bearing areas often in areas that are shaven

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21
Q

What is the treatment for folliculitis

A

Acute Staphylococcal infections - antibiotics both systemic and topical
Chronic and recurrent - topical antibiotic , regular showering

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22
Q

What is a more common name of urticaria

A

hives

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23
Q

What is urticaria

A

a common eruption characterised by transient usually pruritic, wheals due to acute dermal oedema from extravascular leakage of playma

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24
Q

What are the clinical features of chronic urticaria

A

itchy, pink wheals,

round or annular papule or plaques

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25
What might cause a sudden onset of urticaria
IgE mediated reaction from an allergen such as eggs, fish, peanuts, latex or a drug
26
What is characteristic of cholinergic urticaria
small intensely itchy papule that appear in response to sweating, induced by heat, exercise, emotion or spicy food
27
What is the treatment for urticaria
Avoid exacerbating factors histamine type 1 receptor blockers Adrenaline in anaphylactic shock Diet: salicylates in food aggregate chronic urticaria
28
Where does Tinea corporis occur
limbs and trunk
29
where does tinea pedis occur
feet
30
what are the clinical features of tinea corporis
single or multiple plaques with scaling and erythema especially at the edges
31
What are general measures in the treatment of fungal infections
humid and sweaty conditions e.g. occlusive footwear | Dusting pwder may help to keep the feet or body folds drug
32
What is the topical treatment for fungal infection
Clotrimazole (canesten) for 3-6 weeks
33
What systemic therapy may be required for fungal infection
Oral anitfungals
34
What is lichen plans
a relatively common pruritic papular dermatosis
35
What does lichen plans involve
flexor surfaces, mucous membrane genitalia
36
Describe the clinical appearance of lichen plans
Symmetrical on limbs especially wrists very itchy flat topped polygonal papule
37
What is the therapy for Lichen plans
usually self-limiting | moderate to high potency topical steroids usually produce symptomatic improvement
38
What is discoid eczema
Eczema of an unknown aetiology characterised by coin shaped lesions on the limbs
39
What is the treatment of discoid eczema
Moderately potent or potent topical steroid
40
What causes venous eczema
incompetence of the deep perforating veins increases the hydrostatic pressure in the dermal capillaries
41
Venous eczema always affects children. True or false
False - usually middle aged or elderly
42
What is the usual treatment for venous eczema
Emollient alone or with a mild or moderatley potent steroid ointment
43
Who is affected by leg ulcers more commonly. Men or women
Women (twice)
44
What are the majority of leg ulcers
Venous
45
What is venous disease predisposed to by
obesity and thrombosis
46
What are some skin changes seen in a venous disease/ ulcer
Brown haemosiderin deposits from extravasated red cells Telangectasia and white lacy scars occur at the ankle Eczema
47
Where do venous ulcers usually arise
Medial malleolus
48
Initially, venous ulcers are exudative. True or false
True
49
When are systemic antibiotics indicated for leg ulcers
When there is a purulent discharge rapidly advancing ulcer edge cellulitis septicaemia
50
Describe the appearance of an arterial ulcer
deep painful gangrenous located on the foot or mid-shin
51
What are the general measures for treating a venous ulcer
walking dieting for obese analgesia
52
What do compression bandages do
reduce oedema | promote venous return
53
How long are compression bandages left on for
2-7 days
54
What makes up a 4 layer bandage
orthopaedic wool standard crepe Elset elasticated bandage elasticated cohesive bandage
55
What is cellulitis
An infection of the subcutaneous tissues often due to streptococci
56
What are the cardinal features of cellulitis
``` swelling redness local pain systemic upset fever ```
57
What is the treatment for cellulitis
Phenoxymethylpenicillin (500mg x4/day) with flucloxacillin (250mg x4/day)
58
What is dermatofibromas
Common dermal nodules that are usually asymptomatic
59
What do dermatofibromas represent
reaction pattern to an insect bite or other trauma
60
Where do dermatofibromas usually occur
lower legs
61
Describe the appearance of a dermatofibroma
Firm dermal nodules (5-10mm) may be pigmented enlarge slowly if at all
62
Previous exposure to what predisposes to Bowen's disease
Arsenicals
63
What are the clinical features of Bowen's disease
pink or lightly pigmented scaly plaques
64
Transformation of Bowen's disease into squamous cell carcinoma is infrequent. True or false
True
65
What is malignant melanoma
a malignant tumour of melanocytes usually arising in the epidermis
66
What clinical signs or symptoms suggest malignant melanoma
Size: recent increase Shape: irregular Colour: variation, darker or lighter Inflammation: may be at the edge Itch
67
How is locall invasion of a malignant melon assessed
Breslow method - measures the distance between the granular ell layer to the deepest identifiable malignant cell in the dermis
68
What are the four main types of malignant melanoma
superficial spreading malignant melanoma Lentigo malignant melanoma Acral lentiginous malignant melanoma Nodular malignant melanoma
69
What is the primary treatment for malignant melanoma
Surgical excision
70
What might be necessary to close the defect
A skin graft
71
If a tumour is more than 1mm thickness how much clearance is required
1-2cm
72
1cm If a tumour is 1mm or less, what is the required clearance margin
1cm

Rapid Reference - Dermatology (4 decks)

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