Passmed/Pastest/Capsule Flashcards
what is pellagra
Vitamin D3 deficiency causing the 4 D’s:
diarrhoea
dermatitis
dementia
death
what causes pellagra
alcoholism
izoniazid
what type of burns require IV fluids
2nd/3rd degree burns covering >15% of the body surface (>10% in children)
what is a common coexisting factor for lichen planus
mucous membrane involvement (particularly oral mucosa)
what are features of lichen planus infection
4Ps papular polygonal purple pruitis
on FLEXOR surfaces, wickams striae on top
whats an example of a dermatophyte (90% of toenail infections)
trichophyon rubrum
what are features of spider naevi
Blanching
what causes spider naevi
liver failure
COCP
Pregnancy
whats curlings ulcer
stress ulcer in the duodenum of a child in response to a severe burn
what is hereditary haemorrhagic telangiectasia
autosomal dominant condition characterised by (as the name suggests) multiple telangiectasia over the skin and mucous membranes - 20% occurs without family history however
whats the diagnostic criteria for hereditary haemorrhagic telangiectasia
3/4 (definite) or 2/4 (probable)
telangiectasia - multiple at characteristic sites (lips, oral cavity, fingers nose)
recurrent epistaxis
visceral lesions - for example gastrointestinal telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM
family history of HHT
what topical treatments may be used in the treatment of mild actinic keratotis
topical diclofenac
fluorouracil cream
topical imiquimod
what are features of Pemphigoid gestationis
pruritic blistering lesions
often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms
usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy
oral corticosteroids are usually required
what are features of Polymorphic eruption of pregnancy
pruritic condition associated with last trimester
lesions often first appear in abdominal striae
management depends on severity: emollients, mild potency topical steroids and oral steroids may be used
what is pemphigus vulgaris
Autoimmune disease caused by antibodies directed against desmoglein 3, a cadherin-type epithelial cell adhesion molecule
what population is pemphigus vulgaris more common in
the Ashkenazi Jewish population
what are features of pemphigus vulgaris
mucosal ulceration is common and often the presenting symptom. Oral involvement is seen in 50-70% of patients
skin blistering - flaccid, easily ruptured vesicles and bullae. Lesions are typically painful but not itchy. These may develop months after the initial mucosal symptoms. Nikolsky’s describes the spread of bullae following application of horizontal, tangential pressure to the skin
acantholysis on biopsy
how do you treat pemphigus vulgaris
steroids first line
immunosuppressants
what causes Chondrodermatitis nodularis helicis
Trauma
pressure
cold
what do bullous lesions with no mucosal involvement tend to be
bullous pemphigoid
what is vitiligo commonly associated with
addisons disease
what is the best treatment for telangiectasia in acne rosacea
laser therapy
how do you treat lichen planus
topical steroids are the mainstay of treatment
benzydamine mouthwash or spray is recommended for oral lichen planus
extensive lichen planus may require oral steroids or immunosuppression
what is the treatment for rosacea
mild/moderate: topical metronidazole
severe/resistant: oral tetracycline
if erythema nodosum is suspected, what is an important next line investigation
Chest X-ray - exclude Tb and Sarcoidosis
whats the treatment for lichen sclerosis
topical steroids and emollients
what skin conditions are associated with hepatitis B
erythema multiforme
urticaria
polyarteritis nodosa
lichen planus
what skin conditions are associated with hepatitis C
erythema multiforme urticaria polyarteritis nodosa lichen planus cryoglobulinaemia porphyria cutanea tarda
what adhesive structure is attacked in bullous pemphigoid
hemidesmosomes
what is attacked in pemphigous vulgaris
desmoglein - antibodies are generated again desmosomes
what is a rodent ulcer
a BCC
what is a classic histological sign of pemphigus vulgaris
acantholytic keratinocytes
what does necrotising fasciits feel like if palpated
there is a crackling sensation
what is first line for hair lice treatment
dimeticone 4% gel
what is nikolskys sign
dislodgement of intact superficial epidermis by a shearing force, indicating a plane of cleavage in the skin at the dermal-epidermal junction
what is behcets disease
type of vasculitis causing mouth sores, eye inflammation, skin rashes and lesions, and genital sores.
what is first and second line treatment for scabies + how long are they applied for
1st - permethrin cream applied neck down for 8-14 hours
2nd - malathion cream for 24 hours
what is erythema chronicum migrans
rash associated with lyme disease
spreading target lesion
what is the most common cause for a raised red patch on an infant - occuring usually weeks after the birth
infantile haemoangioma - (strawberry mark)
what is the most common cause for a flat red/purple patch on an infant
capillary malformation
when do infantile haemoangiomas disappear
usually by 7 years old
when do infantile haemoangiomas need treatment
when they interfere with vision/feeding or rapidly nlarge
when do capillary malformations tend to enlarge
pregnancy, puberty, menopause
do capillary malformations go away
rarely
what is vitiligo most associated with
autoimmune thyroid disease
what is dovobet
topical steroid + vit D3 combo cream
what biological therapy is indicated for psoriasis if the patient has a history of tuberculosis
adalimumab
what is telogen effluvium
condition causing hair loss due to disruption in the hair cycle where hair shifts from the growing phase (anagen) to the shedding phase (telogen)
what triggers telogen effluvium
childbirth
trauma
major life events
bereavement
whats the prognosis for telogen effluvium
normally self resolves as telogen phase is about 100 days and the new hair is in the normal anagen phase - but it may take months for hair to grow back to normal
what is angagen effluvium
hair loss associated with specific medications
what medications are associated with anagen effluvium
chemotherapy TCAs allopurinol beta blockers retinoids
what is trichotillomania
psychatric condition where people pull out their own hair
what is the most common side effect for isotretinoin
dry skin/lips
what is erythema ab igne
rash caused by infrared radiation - usually people who sit by fires or have hot water bottles
what does erythema ab igne look like
reticulated erythema, hyperpigmentation, scaling and telangiectasias in the affected area.`
what is peutz-jeghers syndrome
autosomal dominant condition causing blue/black discoloration on the lips, clubbing, abdominal pain, meleana, vomiting
what does peutz-jeghers syndrome increase the chance of and by how much
cancer - particularly gastrointestinal cancer
15x chance
what specfic growths does peutz-jeghers syndrome cause
multiple intestinal hamomartomatous polyps
what is paronychia
Paronychia is an infection around the nail usually caused by Staphylococcus or Streptococcus
how do you treat paronychia
Oral Abx (flucloxacillin) Incision and drainage under local anaesthetic
do people with penicillin allergy get a rash if they’re exposed to amoxicillin
no - not often anyway
in what diseases does amoxicillin cause a rash
infectious mononucleosis
chronic lymphocytic leukaemia
