Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ICSM Year 6 + edits > Medicine - Dermatology > Flashcards

Medicine - Dermatology Flashcards

1
Q

How can you differentiate between SJS and TEN?

A 
SJS = up to 10% skin involvement
TEN (Toxic epidermal necrolysis) = \>30% skin involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Nikolsky’s sign?

A

Epidermis separates with mild lateral pressure - secondary to adverse drug reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How should SJS or TEN be managed?

A

Stop the cause
Transfer to ITU
IV Ig
Immunosuppression (eg ciclosporin and cyclophosphamide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which drugs are most likely to cause SJS?

A

Never Press Skin As It Can Peel
NSAIDs
Phenytoin
Sulphonamides
Allopurinol
IV Ig
Carbemazapine
Penicillins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is erythroderma?

A

Any rash involving >95% of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Recall 3 possible complications of erythroderma

A

Dehydration
High output heart failure
Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the cause of adult seborrhoeic dermatitis?

A

Fungus called malassezia furfur

Humidity & sweating linked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 2 skin conditions can be caused by malassezia furfur?

A

Seborrhoeic dermatitis (pic below)
Pityriasis versicolor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 1st and 2nd line options for treating scalp seborrhoeic dermatitis?

A

1st line = zinc pyrithione (‘head and shoulders’)
2nd line = ketoconazole

Zinc increase copper levels, damaging sulphur clusters needed for fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which pathogen is the most common cause of impetigo?

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 3 classes of impetigo and their respective management?

A

Localised, non-bullous: topical H2O2 1% cream / topical fusidic acid

Widespread, non-bullous: oral flucloxacillin or topical fusidic acid

Widespread, bullous: oral flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long should children with impetigo be excluded from school?

A

Until lesions crusted over or 48 hours after antibiotics started

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the lay terms for open and closed comedones?

A 
Open = blackheads 
Closed = whiteheads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recall some conservative management options for acne

A

Avoid over-cleaning face - bd with gentle soap is okay
Make up - use emollients and cleansers, non-comedonegenic preparations
Avoid picking and squeezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long should each acne medication be tried for to give it chance to work?

A

8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Recall the stepwise medical management of acne

A

Mild acne:
1st line: topical retinoid and or benzyl peroxide +/- topical clindamycin (which is never prescribed alone)

2nd line: azelaic acid 20%

Moderate (if not responding to topicals) acne:
- oral tetracycline + BPO/retinoid
OR
- oral COCP + BPO/retinoid

Dermatologist referral:
- Oral isotretinoin (roaccutane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Once acne has cleared, how should this be maintained?

A

Topical retonoids and azelaic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Roaccutane?

A

Synthetic vitamin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What pregnancy prevention plan should be in place for Roaccutane?

A

2 forms of contraception as it is very teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recall some side effects of Roaccutane

A

Dry skin
Raised triglycerides
Hair-thinning
Intracranial HTN
Photosensitivity
Low mood
Suicidal ideation

DR HIPLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What accumulated dose should you aim for with Roaccutane?

A

Body weight in kg x 100 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the progression of symptoms of rosacea?

A 
1st = flushing 
2nd = symmetrical facial rash with telangiectasia 
3rd = persistent pustulopapular erythema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How should rosacea be managed?

A 
Mild-moderate = topical metronidazole 
Severe = oral tetracycline

Metronidazole- inhibits protein synthesis stopping growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the aetiology of hidradenitis supparativa?

A

Chronic inflammatory occlusion of folliculopilosebaceous units that obstructs the apocrine glands and prevents keratinocytes from properly shedding the follicular epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In lay terms, what is hidradenitis supparativa?

A

Abscesses that form near hair follicles in places where we tend to sweat more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 2 biggest risk factors for hidradenitis supparativa?

A

Smoking and obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Rarely, what inflammatory disease is associated with
hidradenitis supparativa?

A

Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can hidradenitis supparativa be managed?

A

Conservative: weight loss, stop smoking, hygeine
Acutely: steroids PO, flucloxacillin, I&D
Chronically: topical clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What pathogen causes pityriasis versicolor?

A

Malassezia furfur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does pityriasis versicolor appear?

A

Hypopigmented patches on trunk
Mild pruritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is pityriasis versicolor managed?

A

Topical ketoconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How does vitiligo appear?

A

Well demarctaed, depigmented skin patches usually affecting the peripheries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Recall some associations of vitiligo (don’t need to know in detail)

A

T1DM
Addison’s
Autoimmune thyroid
Pernicious anaemia
Alopecia areata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How can vitiligo be managed?

A 
Sunblock 
Topical corticosteroids (reverses changes if applied early)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What pathogen causes pityriasis rosea?

A

HHV-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the presentation of pityriasis rosea

A

Recent viral infection –> herald patch
Then erythematous, oval scaly patches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How should pityriasis rosea be managed?

A

It is self-limiting (6-12w) so no need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Broadly describe the 4 types of psoriasis

A

Plaque - most common, is well-demarcated red and scaly - affects scalp, back, extensors
Guttate - following a strep infection, “tear drop” lesions
Pustular - affects palms and soles
Flexural - skin is smooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Recall some factors that exacerbate psoriasis

A

Trauma
EtOH
Certain drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which drugs can exacerbate psoriasis?

A

INFLAME
Infliximab
NSAIDs
For HTN (beta blockers)
Lithium
ACE inhibitors
Malarial drugs
EtOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How should chronic plaque psoriasis be managed in primary care? (give 1st, 2nd and 3rd line)

A

1st line: 4w trial of OM potent corticosteroid and ON (once daily) vitamin D analogue

2nd line: after 8w (so 4w break): OM potent corticosteroid and BD (twice daily) vitamin D analogue

3rd line: 4w trial of BD potent corticosteroid OR coal tar

Use emollients as an adjunct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the maximum duration of use of topical potent and very potent steroids before a break is needed?

A

Potent = 8w
Very potent = 4w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How can chronic plaque psoriasis be managed in secondary care?

A 
Phototherapy/photochemotherapy 
Systemic immunosuppression (eg infliximab, etanercept, ustekinumab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe the distribution of eczema in infants vs children vs young adults

A

Infants: face and trunk
Child: extensors
Young adult: flexures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Describe the different severities of eczema in terms of physical symptoms

A

Mild: infrequent itching, some areas of dry skin and a little redness
Moderate: frequent itching, lots of redness and some excoriation
Severe: widespread dryness, incessant itching, redness, excoriation, thickening, cracking, alteration of pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How should eczema be investigated?

A

Consider food allergy and contact dermatitis
Skin prick tests
Patch tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How long should flares of eczema be treated for?

A

Treat ASAP and for 48 hours after resolution of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Recall the management of mild, moderate and severe eczema

A

Mild: emollients, mild potency topical corticosteroids

Moderate: emollients, moderate potency topical corticosteroids, topical calcineurin inhibitors (tacrolimus) and bandages

Severe: emollients, potent topical corticosteroids, topical calcineurin inhibitors, bandages and phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How should infected eczema (not herpeticum) be managed?

A

Skin swab and culture
Flucloxacillin PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How should eczema herpeticum be managed?

A

Oral aciclovir
If around eyes, same day referral to ophthalmologist
Looks similar to impetigo so ALSO treat for that with oral aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How should topical emollients and steroids be applied

A

Emollients applied liberally
Wait 30 mins
then apply steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Recall 2 examples of topical calcineurin inhibitors that can be used to manage eczema

A

Mild-moderate - pimecrolimus
Moderate - severe - tacrolimus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Recall some points for PACES counselling for eczema

A

Explain diagosis (dry, itchy skin)
Explain epidemiology (very common, many grow out of it)
Explain management
Encourage frequent, liberal use of emollients and use of emollients as a soap substitute
Advise avoidance of triggers
Avoid scratching if poss (eg mittens for infants)
Safety ned about signs of infection
Info: itchysneezywheezy.co.uk shows how to apply emollients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What type of pathogen causes tinea?

A

Dermatophyte fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What pathogen causes tinea?

A

Trichophytum rubrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How should scabies be managed?

A

Permethrin - full body treatment that you wash off after 8-12 hours - treat all household/close contacts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How should headlice be managed?

A

Malathion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How should tinea be managed?

A

Mild –> topical antifungals (terbinafine)
Mod–> hydrocortisone 1%
Severe–> oral antifungals (eg terbinafine)
If tinea capitis –> oral antifungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How long should children with tinea be excluded from school?

A

No need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Recall 2 risk factors for shingles

A

Increasing age
Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Describe the symptoms of shingles

A

Prodromal burning pain over the affected dermatome for 2-3 days +/- fever, headache, lethargy
Rash begins erythematous, macular –> vesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

For how long is shingles infectious?

A

Until vesicles have crusted over (about 5-7 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How should shingles be managed?

A

PO aciclovir if <72 hours from symptom onset and >50y/in lots of pain/ immunocompromised

Analgesia: paracetamol/ NSAIDs –>amitriptyline

Emergency referral if serious complications suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Recall 3 possible complications of shingles

A

Post-herpetic neuralgia
Herpes zoster ophthalmicus (affects ocular division of CNV)
Herpes zoster oticus (Ramsay Hunt syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are the 2 pre-malignant conditions for squamous cell carcinoma known as?

A

Actinic keratoses and keratocanthomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Where do actinic keratoses appear?

A

sun-exposed areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How can actinic keratoses be managed medically?

A

Fluorouracil + topical hydrocortisone
Topical diclofenac/imiquimod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are some surgical options for managing actinic keratoses?

A

Cryotherapy
Curettage and cautery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is a keratocanthoma?

A

Pre-malignant skin condition (for SCC) with rapid growth (around 1 week)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

How should keratocanthomas be managed?

A

Excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the causative organism in fungal nail infections 90% of the time?

A

Trichophytum rubrum (dermatophyte)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How can fungal nail infections be investigated?

A

Nail clipping MC&S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

How should fungal nail infections be managed?

A

Must first confirm infection by MC&S in order to commence treatment
- Can do nothing (if pt not bothered)

  • Can do PO terbinafine (2nd line itraconazole)
  • finger = 6w-3m
  • toe = 3-6m
  • If candida infection –> topical antifungals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How does lichen planus appear?

A

Rash is:
Purple
Pruritic
Papular
Polyglonal
Also can get thin, white lines in the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Where does lichen planus tend to affect?

A

Flexor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Recall some causes of lichen planus

A

Gold
Thiazides
Quinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

How should lichen planus be managed?

A

Topical steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

How does lichen sclerosus appear?

A

Itchy white spots typically on the vulva of elderly womenn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

How should lichen sclerosus be managed?

A

1st: clobetasol proprionate ointment
2nd: tacrolimus and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Which 2 pathogens are most likely to cause cellulitis?

A

Strep pyogenes
Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What classification system is used for cellulitis?

A

Eron classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

How should cellulitis be managed?

A

Mild/mod: flucloxacillin
Severe: co-amox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Describe the 4 severities of cellulitis under the Eron classification

A

I - no signs of systemic toxicity, person has no uncontrolled comorbidities
II - systemically unwell OR systemically well with an uncontrolled comorbidity
III - significant systemic upset such as acute confusion, tachycardia/tachypnoea, hypotension, unstable comorbidity
IV - sepsis/ necrotising fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is the cause of erysipelas?

A

Strep pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

How should erysipelas be managed?

A

PO flucloxacillin

86
Q

What is the cause of erythrasma?

A

corynebacterium minitissimu

87
Q

How can erythrasma be investigated?

A

Wood’s slit lamp –> coral-red fluorescence

88
Q

How should erythrasma be managed

A

Topical miconazole

89
Q

Recall some causes of pyoderma gangrenosum

A

IBD
Connective tissue disorders
Myeloproliferative disorders

90
Q

Describe the classical natural history of pyoderma gangrenosum

A

Small red papule –> later deep, red, necrotic ulcers with a violaceous border

91
Q

How should pyoderma gangrenosum be managed?

A

PO steroids

92
Q

In what patient population is necrobiosus lipoidica diabeticorum seen and how does it appear?

A

Diabetics
Shiny, painless area of yellow/red skin on shins

93
Q

What are antibodies directed against in bullous pemphigoid?

A

Basement membrane (dermo-epidermal junction)

94
Q

How can bullous pemphigoid be managed?

A

Oral corticosteroids

95
Q

How can bullous pemphigoid and pemphigus vulgaris be differentiated?

A

Bullous pemphigoid = tense blisters with no oral involvement
Pemphigus vulgaris = flaccid blisters with oral involvement

96
Q

What are antibodies directed against in pemphigus vulgaris?

A

Desmosomes

97
Q

What is this?

(Source: Derm Net NZ)

A

Guttate psoriasis

98
Q

What is this?

(source: Derm Net NZ)

A

Pityriasis versicolor

99
Q

What is this?

(source: Derm net NZ)

A

Impetigo

100
Q

What is this?

(source NHS)

A

Hidradenitis supparativa

101
Q

What is this?

(source: Derm Net NZ)

A

Vitiligo

102
Q

What is this?

(source: Derm Net NZ)

A

Pityriasis rosea

103
Q

What is this?

(source: NHS)

A

Plaque psoriasis

104
Q

What is this?

A

Guttate psoriasis

105
Q

What is this?

(Source: Derm Net NZ)

A

Pustular psoriasis

106
Q

What is this?

(Source: Derm Net NZ)

A

Flexural psoriasis

107
Q

What is this?

(Source: Derm Net NZ)

A

Tinea corporis

108
Q

What is this?

(Source: Derm Net NZ)

A

Scabies

109
Q

What is this?

(Source: Derm Net NZ)

A

Actinic keratosis

110
Q

What is this?

(Source: Derm Net NZ)

A

Keratocanthoma

111
Q

What is this?

(Source: Derm Net NZ)

A

Lichen planus

112
Q

What is this?

(Source: Derm Net NZ)

A

Erysipelas

113
Q

What is this?

(Source: Derm Net NZ)

A

Erysipelas

114
Q

What is the recommended margin for excision of a malignant melanoma?

A

When the breslow thickness is known = 2mm

115
Q

Recall 3 causes of Koebner’s phenomena

A

Vitiligo

Psoriasis

Lichen planus

116
Q

Which type of skin lesion commonly appears in response to traume eg an insect bite?

A

Dermatofibroma

117
Q

What type of infection is:
1. Guttate psoriasis
2. Pitryasis rosea

proceeded form

A
  1. bacterial
  2. viral
118
Q

What is wickhams striae?

A

rash often polygonal in shape, with a ‘white-lines’ pattern on the surface

a sign of lichen planus

119
Q

Main signs of lichen planus

A

planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common

120
Q

What formula is required to calculate the volume of IV fluid required for resus over the first 24 hrs post burn

A

parkland formula

121
Q

How is hyperhidrosis managed?

A

topical aluminium chloride (roll on) at nighttime - SE skin irritation
Botulinum for axillary
endoscopic transthoracic sympathectomy - compensatory sweating

122
Q

what is this

A

bullous pemphigoid
ig3 and c3 at dermoepidermal junction
oral corticosteroids

123
Q

Adverse affects of psoralen + PUVA therapy

A

skin ageing, squamous cell cancer

mutagenic affect on keratinocytes

124
Q

What is this?

A

SCC of the skin
sunlight, acintic keratoses, bowens, immunosuppression, smoking, marjolins ulcer
surgical excision
MOhs in high risk patients

125
Q

What is this?

A

Malignant melanoma
superficial spreading = most common, young
nodular = most aggressive, old, bleeds

126
Q

What is this?

A

seborrhoeic keratoses - basal cell papilloma
benign
can remove: curettage, cryosurgery & shave biopsy

127
Q

What skin condition is associated with inflammatory disease?

A

pyoderma gangrenosum - insect like bite growing
lower legs
rheum, haem, pbc, granulomatosis with polyangitis
oral steroids, immunosuppression

128
Q

Management of venous ulceration

A

compression bandagin
oral pentoxxifylline

129
Q

Causes of erythema nodosum

A

infection e.g. strep, tb, brucellosis
systemic disease e.g sarcoid, ibd
malignancy
drugs e.g. penicillins, sulphonamides, cocp
pregnancy

130
Q

Pigmentation of nail bed affecting proximal nail fold

A

Acral lentigninous melanoma
hutchinsons sign

arises in areas not associated with sun exposure

131
Q

What is this?

A

erythema multiforme
infections
target lesions
HSV can lead to this rash other bacteria and drugs, connective tissue

132
Q

What are the 4 D’s of pellagra

A

diarrhoea
dermatitis
dementia
death

think tb izonazid therapy

133
Q

What is this?

A

lipoma
smooth, mobile, painless
if more than 5cm uss to rule out liposarcoma

134
Q

% of body covered in burns required for IV fluids

A

10% children
15% adults

135
Q

Benefit of using anti-virals for shingles

A

within 72 hrs
reduce incidence of post-herpetic neuralgia

136
Q

What is leukoplakia

A

premalignant presents as white, hard spots on mucous membranes of mouth - common in smokers

137
Q

Investigation of choice for allergic contact dermatitis

A

patch testing

138
Q

What are side effects of ketoconazole

A

gynecomastia - supresses androgens
hepatotoxicity

139
Q

severe papule rosacea treatment

A

topical ivermectin + oral doxycycline

140
Q

Eczema herpaticum virus

A

Hsv type 1

141
Q

causes of acanthosis nigricans

A

diabetes
gi cancer
obesity
pcos
acromegaly
cushings
hypothyroid
familial
prader willi
cocp, nicotinic acid

insuline resistance stimulates keratinocytes

142
Q

urticaria first line

A

non sedating antihistamines
prednisolone if severe

143
Q

Associated conditions with seborrhoeic dermatitis

A

HIV
parkinsons
scalp, periorbital, auricular and nasolabial folds regions
Otitis externa and blepharitis

144
Q

First line for rosacea

A

topical brimonidine gel - predominant flushing but limited telangiectasia

145
Q

sign of zinc deficiency

A

acrodermatitis red crusted lesions
alopecia
short
hypogonadism
hepatosplenomegaly
geophagia - eating clay

146
Q

First line for candida infection

A

oral itraconazole

147
Q

acne vulgaris in pregnancy

A

oral erthryomycin

148
Q

what is livedo reticularis

A

discolouration of skin resulting from reduced bloodflow through the arterioles supplying cutaneous capillaries - linked to lupus

149
Q

When should early intubation be considered with burns?

A

deep burns to face or neck, blisters or oedema of the oropharynxx

150
Q

How does periorificial dermatitis present and how is it treated?

A

topical or oral antibiotics
steroids worsen symptoms

151
Q

what is the most accurate diagram to assess burns area

A

lund and browder chart

152
Q

Who should be transferred to a burns center? If respiratory problems?

A

burns involving the hand perineum, face and burs in 10% adults, 55 children

escharotomy

153
Q

what is pompholyx

A

type of eczema that affects hands and feet
sweating
small blisters, pruritic,
cool compresses, emollients and topical steroids

154
Q

first line treatment for scalp psoriasis

A

topical betamethasone valerate

155
Q

keloid scars

A

dark skin
sternum most common site
intra lesional steroids e.g. triamcinolone

156
Q

What do extensive burns cause?

A

secondary infection
ards
risk of ulcers
hypoalbuminiemia - plasma leakage into interstitial space due to loss of capillary integrity

157
Q

Complications associated with psorialitic arthritis

A

CVS disease

158
Q

What is erythema ab igne

A

caused by infrared radiation and commonly accosied with hot water bottles

can develop into squamous cell carcinoma

159
Q

What drugs are linked with erythema multiforme?

A

penicillin, sulphonamides, carbamazepine, allopurinol, nsaids, oral contraceptive, nevirapine

160
Q

Venous ulceration is typically seen above where

A

medial malleolus

161
Q

How is Acne Vulgaris classified?

A

mild: open and closed comedones with or without sparse inflammatory lesions

moderate acne: widespread non-inflammatory lesions and numerous papules and pustules

severe acne: extensive inflammatory lesions, which may include nodules, pitting, and scarring

162
Q

How is mild - moderate acne treated?

A

12 week combination therapy:
* topical adapalene with benzoyl peroxide (can be used mono)
* topical tretinoin with clindamycin
* topical benzoyl peroxide with clindamycin

163
Q

How is moderate to severe acne treated?

A

12 week course of:
* mild treatment combos
* mild + either oral lymecycline or oral doxycycline
* topical azelaic acid + oral lyme/doxycycline

164
Q

What should be considered about ABs when treated moderate to severe acne?

A
  1. Avoid tetracyclines: pregnant and under 12 (use erythromycin)
  2. Stop treatment at 6 months
  3. Topical retinoid co-prescribed to reduce AB resistance
  4. no topical + oral AB
165
Q

Why is Minocycline not used in Acne vulgaris treatment now?

A

Irreversible pigmentation

166
Q

What is a complication of long term AB use in Acne Vulgaris? What do you use if this occurs?

A

Gram-negative folliculitis
Trimethoprim

167
Q

What is used as a alternative to oral ABs in Acne vulgaris treatment?

A

COCP (need topical agents with them)

168
Q

What is the risk of using Dianette? Give its name as well

A

Co-cyprindiol
anti -androgen properties
increase risk of VTE
only give for 3 months

169
Q

Which patients with Acne need refering to a dermatologist?

A

patients with acne conglobate acne: a rare and severe form of acne found mostly in men that presents with extensive inflammatory papules, suppurative nodules (that may coalesce to form sinuses) and cysts on the trunk.

patients with nodulo-cystic acne

170
Q

Which Acne patients should be considered for referal to a dermatologist?

A

Not responding to 2 treatments
Not responding to AB
scarring
persistent pigmentary changes
psychological stress

171
Q

What are the symptoms of Rosacea?

A

typically affects nose, cheeks and forehead
flushing is often first symptom
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma (nose enlarge, red and bumpy)
ocular involvement: blepharitis
sunlight may exacerbate symptoms

172
Q

What is this?

A

Rosacea

173
Q

What is this?

A

Rosacea

174
Q

What are the simple measures to manage Rosacea?

A

High factor sunscreen

175
Q

How is Rosacea with predominant flushing treated?

A

Topical brimonidine (alpha-adrenergic agonist) gel if limited telangiectasia as well

Use as required, reduces in 30 minutes

176
Q

How are mild to moderate papules in rosacea treated?

A

Topical Ivermectin

Alternative topical metronidazole / azelaic acid

177
Q

When should referral be considered with Rosacea?

A

Symptoms not improve with management or has Rhinophyma

Laser therapy - telangiectasia

178
Q

What are the main features of Seborrhoeic dermatitis?

A

Eczematous lesions on sebum rich areas:
1. scalp
2. periorbital
3. auricular
4. nasolabial folds

Otitis externa and blepharitis linked

179
Q

What is this?

A

Seborrhoeic dermatitis

180
Q

What is Seborrhoeic dermaittis associated with?

A

HIV
Parkinsons disease

181
Q

What treatments are used for face and body management in Seborrhoeic dermatitis?

A

Topical fungal
Topical steroids - short period

182
Q

What is Eczema Herpeticum?

A

HSV1 / 2
children with atopic eczema
rapid progressing rask
monomorphic punched out erosions (circular, depressed, ulcerated lesions)
IV aciclovir

183
Q

What is this?

A

Eczema herpeticum

Monomorphic punched-out erosions

184
Q

What is Erythema nodosum?

A

Inflammation of subcutaneous fat
tender, erythematous, nodular lesions
shins
6 weeks then resolves
heal with no scar

185
Q

What are the causes of Erythema Nodosum?

A

Infection - Strep, TB, brucellosis
Systemic - sarcoid, IBD, behcets
Malignancy - lymphoma
Drugs - penicillin, sulphonamide, COCP
Pregnancy

186
Q

What is this?

A

Erythema Nodosum

Tender, erythematous, nodular lesions

187
Q

How is Chonic Plaque Psoriasis managed?

A

Emollients
1. Potent CS + Vit D analogue
* One in morning and one evening
2. 4 weeks, then 4 week break - Vit D twice daily
3. 8-12 weeks - CS twice daily or coal tar prep
4. Short acting dithranol
5. Phototherapy - psoralen + PUVA - ageing + SCC
6. Systemic therapy - methotrexate, ciclosporin, infliximab, ustekinumab

188
Q

How is Scalp psoriasis managed?

A

Potent topical CS once daily 4 weeks
if not work, different forumulation

189
Q

How is facial psorasis treated?

A

Mild CS once / twice 2 weeks

190
Q

Risks of potent CS therapy

A

Skin atrophy
Striae

191
Q

What is Dithranol?

A

Inhibtis DNA synthesis
wash off after 30 mins
burning and staining effects

192
Q

Indications to refer burns to secondary care

A

all deep dermal and full-thickness burns.
superficial dermal burns of more than 3% TBSA in adults, or more than 2% TBSA in children
superficial dermal burns involving the face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck
any inhalation injury
any electrical or chemical burn injury
suspicion of non-accidental injury

193
Q

What are the features of Lichen Planus?

A

itchy, papular rash most common on the palms, soles, genitalia and flexor surfaces of arms
rash often polygonal in shape, with a ‘white-lines’ pattern on the surface (Wickham’s striae)
Koebner phenomenon may be seen (new skin lesions appearing at the site of trauma)
oral involvement in around 50% of patients: typically a white-lace pattern on the buccal mucosa
nails: thinning of nail plate, longitudinal ridging

194
Q

Mainstay of treating Lichen Planus

A

Topical Steroids

195
Q
A

Lichen Planus

196
Q

Pyoderma gangrenosum first line

A

oral steroids

197
Q

What is the commenst skin disorder found in pregnancy?

A

Atopic eruption
eczematous, itchy red rash

198
Q

What is this?

A

Pruritic last trimester
abdominal striae
emollient etc

polymorphic eruption of pregnancy

199
Q

Severe complication of Acne

A

Acme fulminans

200
Q

Signs of hereditary haemorrhagic telangiectasia

A

pulmonary, hepatic, cerebral and spinal AVMs

201
Q

What is the most common malignancy of the lower lip?

A

SCC

202
Q

What type of surgery is least invasive?

A

Mohs micrographic surgery

203
Q

Oral AB of choice to treat Erythrasma

A

Erythromycin

204
Q

Main treatments for Actinic keratosis

A

Diclofenac / 5-fluorouracil

205
Q

Raised white pearly edges

A

Basal cell carcinoma

206
Q

what skin tumour has a rapid growth phase

A

keratoacanthoma

207
Q

What is a common precipitant for pyogenic granuloma

A

trauma - bleeding

208
Q

Treatment for athletes foot

A

Topical miconazole

209
Q

What uncommonly causes eczema herpeticum

A

Coxsackie virus

210
Q

What is Erysipelas?

A

Strep pyogenes
raised well defined border

211
Q
A

ICSM Year 6 + edits (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions