MRCP Derm Flashcards
1
Q
NF1
A
multiple cutaneous nodules
cafe au lait spots
axillary freckling
Chr 17
2
Q
Ulcerating papule involving nasal septum
A
mucocutaneous leishmania
3
Q
Bullous penphigoid
A
old patient
blister in limbs
autoimmune ab against hemidesmodome between epidermis and dermis
4
Q
Lupus pernio
A
sarcoidosis
purple lesion outside the nose
5
Q
Visceral leishmania
A
hepatosplenomegaly
6
Q
Shiny pearly edged with central telangiectasia
A
BCC (rodent ulcer)
7
Q
Erythema nodosum
A
painful
red nodule
extensor surface
8
Q
Erythema multiforme
A
target lesion
acral sites
9
Q
Scabies rash in…. treated with…
A
burrows (linear crusted lesion)
web spaces
permethrin cream
10
Q
Nail dystrophy and scaly plaques
A
psoriasis
11
Q
Erythema migrans
A
Lyme target lesion
12
Q
NF2
A
Chr 22
bilateral acoustic neuroma
multiple tumour in brain and spinal cord
13
Q
Acne vulgaris
A
pilosebaceous disorder
XS sebum
commensal bacterium (propionibacterium) in hair follicle
comedone form (blocked duct)
14
Q
Management of acne
A
Mild to moderat:
1) 12 weeks of topical first:
- topical adapalene +bezoyl persoxide
- topical retinoin +clindamycin
- topical benzoyl peroxide + clindamycin
moderate to severe:
1) 12 weeks of:
- topical adapalene +bezoyl persoxide
- topical retinoin +clindamycin
- topical adapalene + benzoyl + PO lymecycline/doxy
Failed topical:
- oral antibiotic - tetracycline for 3 months
If 2 abx fail for oral isotretinoin
Pregnancy:
- avoid tetracycline
- avoid retinoid
- can use erythromycin
Isoretinoin -> teratogenic
15
Q
Melasma
A
increased skin pigmentation over sun exposed areas
16
Q
Lentigo maligna
A
melanoma confined to epidermis
17
Q
Vitiligo
A
skin depigmentation
autoimmune destruction of melanocytes
18
Q
Orf
A
Poxvirus
pustular dermatitis
hands
from sheeps
19
Q
Dermatitis herpetiformis
A
Coeliac
IgA deposit
20
Q
HUS
A
buttock and lower leg purpura
21
Q
Alopecia areata
A
single or multiple
discrete round baldness
BTOB
exclamation mark hairs- short hair
nail pitting
22
Q
Lichen planus
A
itchy
polygonal, flat rash
wrist and ankles
lacy white network in mouth- Wickham striae
23
Q
Management for lichen planus
A
topical/oral steroid
24
Q
Pityriasis rosea
A
herald patch
christmas tree rash in trunk
self limiting
25
Dermatitis artefacta
linear rash
self inflicted rash
common in psych patients
26
Pityriasis versicolor
tinea versicolor
malassesia furfur
ketoconazole shampoo
27
Pemphigus antibodies
- envoplakin - paraneoplastic
- periplakin
- bullous pemphigoid antigen 1
- desmoplakin
- plectin
- alpha2 macroglobulin like 1
28
Pemphigus vulgaris ab
desmoglein 3
29
Anti HU
PARANEOPLASTIC CEREBELLAR DEGENERATION
30
Pyoderma gangrenosum
blood blister--> become ulcer --> painful ---> deep necrotic
associated with autoimmune conditions
31
PBC
anti mitochondrial
32
Donovan body
granuloma inguinale
- due to klebsiella granulomatis
- painless nodule --> ulcer
- STI
- treat with doxy/co-trimox
33
Buboes
Lymphogranuloma venerum
- chlamydia strain
- painless ulcer
- painful enlarged inguinal LN (buboes)
34
Urticaria managmenet
First non sedating antihistamine
- loratadine/cetrizine
- 6 weeks after acute ep
sedating antihistamine
- chlorphenamine at night on top of above
prednisolone if severe/resistant
- 40mg for 7days
Secondary care:
- leukotriene (montelukast)
- cyclosporine
- tacrolimus
35
Molluscum
bacterial infection
sharing towels
topical abx/oral
36
sebaceous cyst
painless
can become inflamed and painful
fluid filled
slow growing
37
Management of pyoderman gangrenosum
**First line: oral steroids**
Other: immunosuppressant
- peristomal --> topical tacrolimus
Topical fail
- cyclosporine
38
Lichen sclerosis
genitalia
elderly female
atrophy of epidermis with white plaque
itchy
scarring
39
Melanoma ABCDE criteria
Asymmetry
Border- irregular
Colour- diff shades
Diameter- >6mm
Evolving- changing shape/size/colour/bleeding
40
Acute intermittent porphyria
Autosomal dominant
Defect in porphobilinogen deaminase (for haem)
Toxic accumulation of delta aminolaevulinic acid + porphobilinogen
abdo pain
hypertension
psych disturbance
- IV haem arginate for acute attack
41
4 Ps of AIP
Painful abdo
Polyneuropathy
Psychiatric symptoms
Port wine (red) urine on standing
42
HLA CW6
Psoriasis
43
HLA DR3
T1DM
44
HLA DR4
T1DM
RA
SLE
Autoimmune hepatitis
45
Heliotrope rash
dermatomyositis
46
Mycoplasma rash
erythema multiforme
- target lesion
47
Toxic epidermal necrolysis
MOST severe drug eruption
extensive skin loss with mucosa
48
Tinea
tinea capitis - scalp
tinea corporis - trunk, legs or arms
tinea pedis - feet
tinea crurus - groin or thigh
49
Tinea corporis (ringworm)
Trichophyton rubrum and Trichophyton verrucosum (e.g. From contact with cattle)
well-defined **annular**, erythematous lesions with pustules and papules
may be treated with oral fluconazole
50
Eczema management with superimposed bacterial infection
- topical abx and topical steroid
51
Eczema herpeticum management
rapidly progressing painful rash
IV aciclovir
52
Eczema managmenet
Mild:
- emollient, mild topical steroid (hydrocortisone)
Moderate:
- emollient, moderate topical steroid (betamethasone)
Severe:
- emollient, potent topical steroid (bethamethasone or dermovate)
53
Topical abx for bacterial skin infx with eczema
fusidic acid
mupirocin
neomycin
54
potency of topical steroid
Hydrocort
Eumovate (clobetasone)
Betnovate (betamethasone)
Dermovate (clobetasol)
55
Pyoderma gangrenosum strongly associated with...
IBD
RA
Haem: myeloid leukaemia, mylofibrosis, myeloma
Diabetes
56
Malassezia furfur (yeast)
hypopigmented scaly areas
chest back abdo
Mx: topical antifungal (cotrimazole)
57
Rosacea improved with...
avoiding alcohol
58
Rosasea
nose cheek forehead
flushing
telangiectasia
englarged red nose
59
Skin lesion with amiodarone
sun exposure--> red rash
60
Erysipelas
localised skin infection
strep pyogenes
superficial cellulitis
Mx: fluclox
61
Pseudoxanothma elasticum
hereditory elastic tissue disorder
calcification
plucked chicken appearance skin
mitral valve prolapse
62
small cell lung cancer skin condition
dermatomyositis
63
Porphyra curanea tarda
Defect in uroporphyrinogen decarboxylase due to hepatic damage
**sun exposed sites**
blister
hyperpigmentation
64
PCT for porphyria cutanea tarda
Porhyria Cutanea Tarda -> PCT PCT
Pigmentation
Cutaneous changes
Trichosis- hairy
Pink fluorescent urine
Chloroquine
Take blood- venesection
65
SCC
Sun exposed skin areas
areas of keratosis/bowmens/chronic wound ---> marjolin ulcer
10% metastatise via lymphatics
66
Breslow thickness of melanoma
prognostic factor --> depth of lesion
67
American Leishmania
risk of later mucocutaneous disease
68
# [](http://)
Cutaneous leishmania...
does not progress to kala azar (visceral)
69
Management for molluscum
Usually not recommended...
If treating:
1. squeezing/piercing
2. cryotherapy
70
Pellagra
Triad (3D)
- diarrhoea
- dermatitis
- dementia
71
Mnagement of pellagra
niacin (B3)
72
Necrobiosis lipoidica
Complication of diabetes
necrosis of dermal collagen and connective tissue
shin- erythematous plaques--> yellow waxy --> atriphy and telangiectasia
Mx: poor response to treatment
73
Vitiligo associated with...
autoimmune disease
associated with alopecia areata
74
Nelson syndrome
bilateral adrenal resection for cushing's disease
causing pituitary adenoma development due to loss of -ve feedback
75
Buzz words for PCT
blistering rash
sun exposed
alcohol XS triggers
76
Reactive eruption
erythema multiforme (drug reaction)
77
Angioedema with ACEi
acquired
78
Onycholysis
| separating from nail bed
psoriasis
thyrotoxicosis
drugs: tetracyclines
79
Skin lesion seen in ... syphillis
secondary
80
Tinea capitis
scalp
exposed to animals
trichophyton
microsporum canis - green fluorescence on wood lamp
81
IL 17 targetted in...
psoriasis
82
Toxic epoidermal necrolysis
TEN
drug induced
eosinophilia
Causative Drugs:
- allopurinol
- aspirin
- NSAID
- lamotrigine
- lansoprazole
- penicillin
83
84
Pityriasis lichenoides et varioliformis acuta (PLEVA)
erythema rapidly into multiple pus filled papule
Associated:
- toxoplasmosis
- EBV
- HIV
- CMV
- Parvovirus
- s.aures
- GAS
Mx: topical tacrolimus
85
Leprosy skin lesion
hypopigmentation
sensory loss
Ix: skin biopsy
86
Sweet syndrome
neutrophilic dermatosis
fever
red plaques
raised white blood cell count
| mx: oral steroid
87
Diagnosis of pyoderma gangrenosum
biopsy of ulcer margin
87
Erythroderma
Erytho-der-ma = red-man
due to eczema and psoriasis
88
Isotretinoin precaution
avoid pregnancy during and for 1 month after treatment
89
Dermatitis herpetiformis managmenet
gluten-free diet
dapsone
90
Discoid lupus
scaly erythema plaque
sun exposed area
alopecia
hyper/hypopigmentation post inflammation
ANA -ve
91
Paraneoplastic pemphigus due to...
non hodgkin lymphoma
92
Ulcers
arterial: lateral lower limb, painful, deep, punched out
venous: medial lower limb, weepy, shallow, sloped edge
93
Allergy testing
patch test
94
Koebner phenomenon
lichen planus - rash developing at site of skin injury
95
Melasma causes
pregnancy
COCP
96
Granuloma annulare
a/w DM
pinkish plque
annular
97
Darier disease
warty papule
plaques in seborrhoeic areas
palpmar pits
nail dystrophy
| Mx: oral isotretinoin
98
isoretinoin action
reduce sebum prodcution and keratinisation
99
Acanthosis nigracans
benign
- insulin resistance
malignant
- cancer
100
Recurrent skin infection secondary to...
PVL producing staph aureus
101
Treatment for paraneoplastic pemphigus
high dose prednisolone
second line:
retuximab
azathioprine
mycophenolate
| Add on IVIG if above limited response
102
Staphylococcal scaled skin syndrome
TEN but spares mucosal membrance
103
Lichen sclerosis management
topical clobetasol
if fail for biopsy
104
Melanoma signs
asymmetrical pigmentation
irregular shape and border
multiple colours
bleeding without trauma
105
PBC
anti mitochondrial
106
cutaneous t cell lymphoma
itchy scaly patch
trunk and extremitis
Mx: phototherapy
107
photosensitising medications
doxycycline
amiodarone
108
109
Which antihypertensive exacerbate psoriasis
bisoprolol
110
Which medications flare psoriasis
lithium
antimalarial
NSAID
111
Investigation for scabies
Ink test
112
Pemphigus vulgaris
IgG
superficial split
113
Bullous pemphigoing
limb and trunk
skin biopsy: eosinophil
114
Subtypes of cutaneous T cell lymphoma
1. sezary syndrome
- widespread erythroderma
2. mycosis fungoides
- patches of erythroderma
present with erythroderma
115
Complication of pseudoxanthoma elasticum
UGIB
