Pictures Flashcards
Pityriasis rosea herald patch
SJS/TEN
Scabies
Rosacea
Acne vulgaris
Seborrheic keratoses
Impetigo
Lichen planus
Pyogenic granuloma
Molluscum contagiosum
Actinic keratoses
Lichen sclerosis
Sebhorreic keratoses
Dermatitis herpetiformis
Pruritic, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
Skin biopsy shows deposition of IgA
Associated with Coeliac’s
Gluten free diet
Dapsone
Actinic keratoses
Pemphigoid gestationis
Lichen sclerosus
Pityriasis rosea secondary rash
Polymorphic eruption of pregnancy
Pruritic condiction associated with last trimester
Pruritic Urticarial Papules and Plaques of Pregnancy
Bullous pemphigoid
Guttate psoriasis
Pityriasis Versicolor
Well demaracated roughly symmetrical oval darkly pigmented lesion
Rough scaly surface
Stuck on appearance
Sebhorrheic keratoses
DDx - malignant melanoma - excision biopsy
Mx:
Benign nature
Cryotherapy
Curretage
Shave biopsy
Well defined erythematous areas on forehead.
Yellow white rough hyperkeratotic crumbly scaly lesion
UV exposure area - forehead of balding man
Actinic keratoses: partial thickness dysplasia of epidermis
DDx - Bowen’s disease: full thickness dysplasoia of epidermis
Pre-malignant
Mx:
Excision/punch biopsy any suspicious lesions
5-FU cream- inflammatory reaction (use with hydrocortiosne)
Topical imiquimod
Topical deiclofenac
Surgical excision
Cryotherapy - liquid nitrogen
Further risk reudction - sun avoidance, sunscreen use
Well defined pearly nodule with rolled telangiectasia edges
Central ulceration
Shiny - arborising blood vessel
Dx: Nodular basal cell carcinoma
Mx:
Excision biopsy with 4mm margin for complete clearance
Well defined erythematous lesion with rolled edges
Potential arborising vessels
Dx: superficial BCC
Mx:
Excision biopsy with 4mm margin
Curretage
Cryotherapy
Poorly defined erythematous lesion, pearly rolled edge, central ulceration
Dx: Morphoeic BCC
Mx: Full excision biopsy with 4mm
Mohs micrographic surgery - cut lesion out and ensure each section is BCC free - ensures BCC is completely removed
Well defined translucent nodule on the patients nasal alar
Arborising vessels
Dx: BCC
Mx:
Mohs micrographic surgery
Excision biopsy with 4mm margin
Well defined pigemented lesion
Central ulceration
Dx: Malignant melanoma, pigmented BCC
Mx: Urgent excision biopsy
30y/o male
Lower leg lesion
Well-defined erythematous plaque with silvery scale
DDx: psoriasis, discoid eczema, pityriasis rosea, sebhorreic dermatitis
Mx:
General: information leaflet and ELMS advice
Topical emollient, soap substitute
Betnovate (betamethasone)
Vitamin D analogue (Donovex)
Phototherapy (UVB narrowband)
Systemic - methotrexate, ciclosporin
Anti-TNF alpha
Measure surface area of psoriasis
Check psycho social function
Cx:
Psychosocial impact
Psoriatic arthritis - rheumatology referral
Anterior uveitis
CVS screen - increased risk of CVS disease - lipid profile
Psoriasis
Crusty erythematous rash antecubital fossa and cheeks and forehead
Papular
Excoriations
Hx/FHx: atopy
Past treatment, compliance with treatment
Feeding?
Exacerbated by staph aureus infection
Dx: Eczema
Mx:
General measures - information leaflet ELMS
Refer to specialist nurse
Large quantities of emollients 500g/week
Soap substitute - no fragrance/lather
Topical steroids - hydrocortisone, eumovate on body
Topical calcineurin inhibitors - can cause burning rash
Antihistamines for itch
Cx:
Eczema herpeticum - infection
Staph infection
Crusty erythematous rash antecubital fossa and cheeks and forehead
Papular
Excoriations
Hx/FHx: atopy
Past treatment, compliance with treatment
Feeding?
Exacerbated by staph aureus infection
Dx: Eczema
Mx:
General measures - information leaflet ELMS
Refer to specialist nurse
Large quantities of emollients 500g/week
Soap substitute - no fragrance/lather
Topical steroids - hydrocortisone, eumovate on body
Topical calcineurin inhibitors - can cause burning rash
Antihistamines for itch
Cx:
Eczema herpeticum - infection
Staph infection
Diffuse widepread ulcerated erythematous vesicular rash lesions on the face with central golen crusted ulceration
Vesicles have superadded infection
Dx: Eczema herpeticum - with superadded bacterial infection
Contact with cold sore recently? HSV transmission
Visual changes?
Mx:
Swab for viral PCR and MC&S
Antibiotics
Admission
Aciclovir
Ophthalmology referral
Well defined target lesions
Ceoncentric rings of erythema
Palms and mucosal membranes affected
Dx: Erythema multiforme
Caused by HSV, bacteria, orf virus, drugs
Mx:
Aciclovir
Admit
Haemodynamic support
Nutritional/fluid support
Well defined target lesions
Ceoncentric rings of erythema
Palms and mucosal membranes affected
Dx: Erythema multiforme
Caused by HSV, bacteria, orf virus, drugs
Mx:
Aciclovir
Admit
Haemodynamic support
Nutritional/fluid support
Desquamation of mucosal membranes
Ddx:
SJS
TEN - full thickness epidermal necrosis
Mx:
STOP causative factor
ITU
Intensive skin support - dressing and emollient
Haemodynamic support
Burns unit
Asymmetric irregular erythematous discrete patch on the ankle
Lichenification
Excoriation
Darker erythematous papules within
Venous varicosity
Dx: Venous stasis eczema
Mx:
Liberal emollient application
Topical corticosteroids - dermovate/betnovate
Compression/support
Refer to TVN for monitoring of skin for venous ulceration
Asymmetric erythematous raised lesion on the chin with a golden/brown crust
Dx: Impetigo - stpah aureus or strep pyogenes
Mx: Topical fuscidic acid
Topical retampulin
Topical murpilocin
Oral flucloxacillin/erythromycin
Bullae with erythematous base
Dx: Bullous impetigo
Mx:
Topical fuscidic acid
Erythematous rash of the face with papules and pustules on an erythematous base
Flushing
Telangiectasia
Nasolabial folds are sparded
Degree of rhinophyma
Can be belpharitis
Dx: Rosacea
Mx:
Topical metronidazole
Oxytetracycline
High factor sun screen
Camoflauge cream
Laser treatment for prominent telangiectasia (fill from the outside)
Discrete scaly patch of alopecia on the scalp
Dx: Tinea capitis
Caused by trichophyton or microsporum canis from cats/dogs
Mx: Oral Terbinafine
Oral grisefulvin for microsporum
Topical ketoconazole shampoo
Pinkish or pearly white papules with a central umbilication, which are up to 5 mm in diameter.
Dx: Molluscum contagiosum
Molluscum contagiosum virus (poxviridae)
Mx:
Not usually recommended - spont resolution in 18m
Contagious - don’t share towels, beds
No exclusion
Treat itchiness with emollient and topical steroid
Treat infection (oedema crusting) with fuscidic acid
Phemigus vulgaris vs bullous pemphigoid
