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Dermatology Board Prep flashcards
1
Q

Naevus sebaceous growth risks

A

Trichoblastoma
BCC
Syringocystadenoma papilliferum

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2
Q

Multiple facial tumours

A 
ANTTSS on the face
Adenoma sebaceum
Neurofibromas
Trichilemmoma
Trichoepithelioma
Syringoma
Sebaceous hyperplasia
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3
Q

CALM associations

A 
BATANS
Blooms
Albrights
TS
Ataxia telangiectasia
Neurofibromatosis
Silver-Russell syndrome
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4
Q

Acute attack porphyrias

A

VAH
Variegate porphyria
Acute intermittent
Hereditary coproporphyria

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5
Q

Porphyria acute attack triggers

A 
FIGBEANS
Fever
Infection
Griseofulvin
Barbituates
Oestrogen
Alcohol
Nutrition
Sulfonamides
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6
Q

Subepidermal blister with neutrophils

A 
Herpetic LIPS
Dermatitis herpetiformis
Lupus (bullous)
Linear IgA
Pemphigoid
Sweets
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7
Q

Subepidermal blister, cell poor

A 
Blistering APE
BP and ischaemic blister
Amyloidosis
PCT
EB
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8
Q

Septal panniculitis differentials

A 
Always Make Septal Panniculitis Easy Nowadays
Alpha 1 antitrypsin deficiency
Scleroderma/morphoea
PAN
EN
NLD
Migratory thrombophlebitis
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9
Q

Associations with EN

A 
NoDOSUM
No cause
Drugs - iodide, sulfonamide
OCP
Sarcoid, Lofgrens
Ulcer - Behcets, UC, Crohns
M - microbiology
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10
Q

Papillomatosis differential

A 
CAVES
CARP
Acanthosis nigricans, acrochordon, acrokeratosis verruciformis
Verruca vulgaris
Epidermal naevus
Seb k, syringocystadenoma
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11
Q

Colloidon baby

A 
Lamellar ichthyosis
Congenital ichthyosiform erythroderma
Sjogren Larson
Conradi Hunermann
Trichothiodystrophjy
Ectodermal dysplasia
Infantile Gaucher disease
Hay-Wells
Neutral lipid storage disease
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12
Q

Grenze zone ddx

A

LG
Leukaemia/lymphoma
Granuloma faciale, EED

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13
Q

Hairy tongue causes

A 
- Drugs
- Poor oral hygiene
- Smoking or chewing tobacco
- Drinking alcohol
- Cocaine
- Chlorhexidine or peroxidase-containing mouthwash
- Coloured beverages, including coffee
- Dehydration
- Hyposalivation (dry mouth)
- Radiation therapy
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14
Q

Elastosis perforans serpinginosa associations

A 
MADPORES
Marfans
Acrogeria
Down's syndrom
Pseudoxanthoma Elasticum
Osteogenesis Imperfecta
Rothmund Thompson
Ehlers Danlos
Scleroderma
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15
Q

Differential for facial papules

A

Hair and cysts: angiofibromas, trichoepithelioma, tricholemmoma, fibrofolliculoma, trichodiscoma, syringoma, hidrocystoma

acne, rosacea, acne agminata, perioroficial dermatitis, demodecosis

Lymphocytoma cutis, Jessners, lymphoma
Sarcoidosis 
TB, lichen scrofulosorum 
Sweets
Granuloma faciale 
LCH/nLCH
Amyloidosis, scleromyxoedema, lichen myxoedematosus

Erythromelanosis follicularis faciei

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16
Q

Brooke Spiegler three skin things they get

A

Cylindroma
Trichoepithelioma
Spiradenoma

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17
Q

Can you get hair loss in lichen striatus

A

Yes it can be peri follicular.

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18
Q

Complications of nethertons baby

A

Hypernatraemic dehydration

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19
Q

Sporotrichoid spread ddx

A

SLAMN

Sporotrichosis, sweets, sarcoidosis, staph, strep, sporothrix schenkii
Leishmaniasis, lymphoma
Actinomycosis, anthrax
M Marinum, mycobacteria TB etc, metastases
Nocardia
+ tuleraemia

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20
Q

Birt Hogg Dube mnemonic

A 
FAT TRAP
Fibrofolliculomas, FLCN gene
Acrochorcons 
Trichodiscomas 
Thyroid goiter, carcinoma 
Renal cancer
AD, angiolipomas 
Pulmonary cysts, pneumothorax
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21
Q

BRAF inhibitor adverse effects mnemonic

A

Rash - acneiform, maculopapular
Alopecia
Palmoplantar dysaesthesia, Photosensitivity
Itchiness
Dry skin
SCC, AK, KA, Seb-derm like eruption, also eruptive melanocytic naevi
KP-like eruption
Also: arthralgia, fatigue, nausea, headache, altered taste, hepatotoxicity

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22
Q

DDx for CALMS mnemonic

A 
TS
Neurofibromatosis 1 & 2 and Noonans
Fanconi anaemia, Familial
Bloom's
LEOPARD, Legius
Ataxia telangiectasia
McCune Albright, Maffucci’s syndrome
Endocrine neoplasia, multiple - MEN 2B
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23
Q

eGFR Reactions mnemonic

A

HANDI
Hair: curly, brittle hair, alopecia, hypertrichosis
Acneiform eruption
Nail changes: paronychia, pyogenic granuloma, onycholysis
Dryness
Itchiness

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24
Q

Eosinophilic fasciitis aetiologic factors mnemonic

A 
THIRDS
Thyroiditis
Haem malignancies / dyscrasias
Infection (Borrelia)
Radiation
Drugs (L-tryptophan, atorvastatin)
Strenuous exercise
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25
Q

Facial papules ddx

A 
BASKET IN CASE
Syndromic
BCC – Gorlin’s
Angiofibromas - TS
Sebaceous neoplasms – Muir Torre
KAs – Ferguson-Smith, Gryzbowski Epidemoid cysts – Gardner’s, Gorlin’s Trichoepitheliomas - BSS Tricholemmomas – Cowden’s Trichodiscomas - BHD
Non-syndromic
Cysts, Colloid milium
Acne, acne agminata, rosacea, POD, demodex folliculitis Sarcoid, syringomas
Eruptive milia
Other: lipoid proteinosis (along eyelid margin)
Infections (warts) Neurofibromas
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26
Q

Flushing causes ddx mnemonic

A 
TRAMPED
Thyrotoxicosis
Rosacea
Alcohol
Menopause, masocytosis, Malignancy (pancreatic, renal)
Physiological
Endocrine tumours eg phaeochromocytoma, medullary thyroid cancer, carcinoid syndrome
Drugs
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27
Q

Leonine facies ddx mnemonic

A

Carcinoid, CAD, Cutis verticis gyrata
Leishmaniasis, leprosy
Acromegaly, Amyloidosis, Alopecia mucinosis, Atopic dermatitis (Airborne)
MF, Multicentric Reticulohistiocytosis
Phymatous rosacea, Pachydermoperiostosis (genetic condition)
Sarcoidosis, Scleromyxoedema, Syphilis

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28
Q

Mastocytosis drugs to avoid ddx mnemonic

A 
ROMAN V
Radiocontrast
Opioids
Muscle relaxants, depolarising (suxamethonium)
Alcohol
NSAIDs inc aspirin
Vancomycin, venom
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29
Q

What to do with biológics psoriasis patient who wants to fall pregnant

And then if they are pregnant

A

Cimzia - Pegylated TNF alpha - unsure if available
General advise to cease pre conception - conservative advice is 6 month wash out

Biológic data so far reassuring particularly for TNF alphas- baby can’t have live vaccines until 6 months old

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30
Q

Is phototherapy fine in pregnancy?

A

UVB fine but ensure folic acid supplementation

PuVa not ok

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31
Q

Types of sarcoidosis - classic

A 
Angiolupoid 
Annular 
Papular 
Plaque 
Scar 
Subcutaneous- Darrier Roussy
EN
LUPUS PERNIO 
Maculopapular 
Modular
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32
Q

Types of atypical sarcoidosis

A 
Verrucous 
A
Lp or LE like 
Ulcerated 
Erythroderma 
Atrophic 
Hypo or hyperpigmentation 
PPK
Psoriatic 
Ichthyotic 
Mucosal 
Alopecia 
Nail
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33
Q

Where is angiolupoid sarcoid

A

Particularly face: marked telangiectatic component

Classic location is near the medial canthus

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34
Q

Most common cutaneous manifestation of sarcoid

A

Papular
Arises in crops
Face and extensor limbs
Favourable prognosis

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35
Q

Which cutaneous sarcoid represents systemic sarcoid changes

A

Scar sarcoid
So if worsening be concerned of systemic worseninf
Not itchy

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36
Q

Distribution of subcutaneous sarcoid (Darier Roussy)

A

Extremities: upper over lower
Systemic involvement usually present
Tender OR painless nodules

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37
Q

Associations of lupus pernio

A 
Respiratory tract sarcoidosis 
Bone cysts
Lacrimal gland involvement
Renal sarcoidosis
Hyperglobulinaemka 
Hypercalcaemia
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38
Q

Which sarcoid are chronic - ie worse

A

Plaque
Lupus pernio

EN is acute

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39
Q

Heerfordts syndrome

A 
Sarcoidosis:
Parotid gland enlargement 
Uveitis 
Fever
Facial nerve palsy
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40
Q

Specific findings for histo for sarcoid

A

Schaumann body (basophils)
Crystalline inclusion: colour less oval inclusions ? Precursor of Schaumann bodies
Asteroid bodies: eosinophilix

And then obviously non case aging sarcoidal granuloma

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41
Q

Utility of doing ACE level in sarcoidosis

A

Elevated in about 75% of untreated sarcoid
Poor sensitivity and specificity
Lots of other conditions cause elevation of
In terms of monitoring - unclear

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42
Q

UVB spectrum

A

290-320

43
Q

NBUVB spectrum

A

311-313

44
Q

Excimer laser nm

A

308 nm

45
Q

UVA1 spectrum

A

340-400

46
Q

UVA spectrum

A

320-400

47
Q

UVC spectrum

A

2000-290

48
Q

Lamellar ichthyosis mutation

A

TGM1

49
Q

Harlequin ichthyosis mutation

A

ABCA12

50
Q

Fabry disease associations

A

f - febrile episodes
A - angiokeratomas and alpha galactose
b - burning pain - peripheral neuropathy in hands and feet
R - renal failure and retinal abnormalities
Y - young death
C - cardiovascular and cerebrovascular disease
C - ceramide trihexoside

51
Q

REGISCAR Diagnostic criteria for DRESS

A 
>5 is definite, 4-5 is probably
6 clinical:
1. Fever
2. Cutaneous >50%
3. Cutaneous eruption that looks like DRESS
4. Lymphadenopathy
5. Resolution >15 days
6. Internal organ involvement
4 investigations:
1. Biopsy consistent with
2. Atypical lymphocytes
3. Eos >1.5
4. Negative for ANA, mycoplasma, chlamydia, hepatitis and blood cultures
52
Q

J-SCAR Diagnostic criteria for dress

A

4 clinical, 3 investigations
Clinical
1. Fever
2. Maculopapular rash >3 weeks after starting select medication
3. Lymphadenopathy
4. Long time to resolve once removal of medication
Investigations
1. HHV-6 reactivation
2. LFT derangement ALT >1000
3. Leukocyte abnormality: lymphocytosis, lymphocyte abnormalities, eosinophilia

53
Q

Drugs that cause acanthosis nigricans

A

OCP, growth hormone, niacin, steroids, protease inhibitors

54
Q

What is the glucagonoma syndrome

A

Consists of necrolytic migratory erythema, adult onset diabetes, weight loss and glossitis
Can also have anaemia and personality changes

55
Q

Medications that cause Telogen effluvium

A

OCP cessation
Retinoids
Anticoagulants- particularly heparin
Anti thyroid: propylthiouraxil, methimazole
Anti convulsants- valproate, carba, phenytoin
Heavy metals
Beta blockers

56
Q

What is diagnostic for Telogen effluvium

A

20% telogen count

57
Q

HLA for allopurinol

A

B*5801 for Han Chinese and Taiwanese

58
Q

HLa for carbamazepine

A

Han chinese 1502 SJS

59
Q

Lamotrigone hla

A

1502 for SJS - Taiwanese

60
Q

Most common cause of serum sickness like drug eruption

A

Cefaclor 1/2000 kids

61
Q

ANCA positive vasculitis drug causes

A

Propylthiouracil
Hydralazine
Levamisole
Minocycline

62
Q

AGEP medications

A 
CHANT:
Calcium channel blockers, carbamazepine, cetirizine 
Herbal medicines
Abx, acetaminophen, anti malarials 
NSAIDs
Terbinafine
63
Q

Medications that cause SWEETS

A 
Change
Checkpoint inhibitor, contraceptives
Hydralazine
Azathioptine and abx (Mino, TMP-SMX, quinolone)
GCSF
Efflux of fluid - frusemide
64
Q

Timeline for immunologically mediated drug reaction

A

8-21 days

65
Q

Exanthematous eruption time interval

A

4-14 days

66
Q

FDE time interval

A

1-2 week at first, re exposure <48 hours

67
Q

AGEP time

A

<4 days

68
Q

DRESS time

A

15-40 days

69
Q

Drugs that cause ANCA positive vasculitides

A

PTU
Hydralazine
Levamisole
Minocycline

70
Q

Drugs that cause sweets

A 
CHANGE
Checkpoint inhibitors, imatinib, contraceptives
Hydralazine
Abx TMP SMX minocycline quinolones 
GCSF
Efflux of fluid: frusemide
71
Q

Meds that cause FDE

A 
Abx sulfonamides tetracyclines over beta lactam
NSAIDS
Paracetamol
Azole anti fungals
PPI
Dapsone
Barbituates
72
Q

Drugs that cause linear IgA bullous dermatosis

A 
CAPPINPISS
Vancomycin
Captopril, cephalosporin, cyclosporine 
Amiodarone, allopurinol 
Phenytoin 
Interferon alpha
NSAIDS
Penicillins
Sulfonamides
Somatostatin

Frusemide
Lithium

73
Q

Drugs that cause BP

A 
Gliptins 
TNF alphas 
Abx - amoxicillin 
Anti PD1s
NSAIDS
Diuretics
74
Q

Drugs that induce pemphigus

A

Those with a thiol group - bind to desmosomal antigen complex
Penicillamines
Captopril and other ACEI
Gold

Non thiols
Beta lactams
Nifedipine
Propranolol

75
Q

Common phototoxic agents

A

STAND UP C**T

Sulfonamides 
Tetracyclines 
Triazole antifungals: voriconazole
Anti arrhythmics: amiodarone 
NSAIDS
Diuretics 
PDT and psoralens 
Calcium channel blockers - diltiazem 
Tars
76
Q

Drugs that cause pseudoporphyria

A 
FIND
Frusemide
Isotretinoin
NSAIDs
Dapsone and doxy
77
Q

Drugs that cause photoallergy

A

Sulfur moieties: thiazide diuretics, sulfonamide abx, sulfonylureas
Others: quinine, quinidine, TCA, griseo, NSAIDs

78
Q

Hydroxyurea cutaneous effects

A

Painful ulcerations of maleolar region of legs

79
Q

Drugs that cause alopecia

A 
Telogen:
Anticoagulants: heparin > warfarin
Beta blockers 
Interferons
Lithium
Retinoids
Anagen:
Anti neoplastics 
Arsenic 
Gold
Etc
80
Q

Drugs that cause SCLE

A

TTTCHANGE

Terbinafine, thiazides, TNF alpha
Calcium channel blocker, carbamazepine 
HMG coa reductase 
ACEI
NSAIDs
Griseo 
Esomeprazols 
Beta blockeds
81
Q

Meds that cause psoriasis

A 
Beta blockers
Lithium
NSAIDs
TNF alphas
Interferons
82
Q

Genes associated with HS

A

NCSTN PSEN1 and PSENEN

83
Q

Treatment for Erythema migrans

A

Can I actually diagnose
Cefuroxime 500 mg BD
Amoxicillin 500 mg TDS
Doxycycline 100 mg BD

84
Q

Medications that cause flushing

A

STOP CHIN MAD FAG

Sildenafil
Tamoxifen
Opiates
Prostaglandins
Calcium channel blockers, calcitonin, chlorpropamide, cyclosporine
Hydralazine
Nicotinic, nitrates
Monosodium glutamate, sodium nitrate
Alcohol
Disulfiram
Foods – fish
ACE inhibitor
Gold
85
Q

Antibodies for systemic sclerosis

A

Anti-topoisomerase I (anti-Scl70), anti-RNA polymerase III and anti-centromere

86
Q

Type 6 PRP

A

HIV associated follicular syndrome

HIV, PRP, nodulocystic acne, follicular spines including lichen spinulosis

87
Q

Ddx for follicular papules with keratotic picture

A 
Phrynoderma
Keratosis circunscripta 
Follicular ichthyosis 
juvenile PRP
Trichodysplasia 
Follicular mucinosis 
Demodex
88
Q

Antibodies for systemic sclerosis

A

Anti-topoisomerase I (anti-Scl70), anti-RNA polymerase III and anti-centromere

89
Q

Variants of vitiligo

A 
Vitiligo ponctue (confetti)
Trichome vitiligo
Blue vitiligo
Inflammatory vitiligo
Hypochromic vitiligo (seborrhoeic distribution)
Isomorphic Koebner phenomenon
Childhood vitiligo
90
Q

Subtypes of vitiligo

A

Generalized:
Vulgaris
Acrofacial
Universalis

Localized:
Focal
Segmental

Mixed

91
Q

What is Vogt Kayanagi Harada classified by

A
  1. Uveitis
  2. Aseptic meningitis
  3. Otic involvement - dysacusia (difficulty hearing because can’t process input)
  4. Vitiligo - particularly of face or sacral region, and associated poliosis
92
Q

Allezandrini syndrome - what is it classified by

A
  • Rare disorder, believed to be closely related to Vogt-Koyanagi-Harada syndrome
  • Characterized by unilateral whitening of scalp hair, eyebrows, eyelashes
  • Ipsilateral depigmentation of facial skin and visual changes
  • Affected eye: decreased visual acuity and an atrophic iris
93
Q

Gene associated with DH

A

HLA DQ2 or HLA DQ8

94
Q

Pathogenesis of hydroa vacciniforme

A

Trigger: sun
EBV implicated- When severe EBV –> evidence of NK cell lymphocytosis, exaggerated response to mosquito bites and haemophagocytic syndrome
- Subset of children and adults with EBV driven lymphorpoliferative disorder so screen for that: LN, hepatosplenomegaly, fever

95
Q

Hydro vacciniforme main clinicals

A

M>F
Within hours tender bullae, blisters, vesicles, plaques, papules. Heals with telangiectasias and varioliform scars
Can get fever, headache, malaise
Can’t play outdoors

  • Basically this will get worse with sun exposure, and result in facial swelling, ulcerated nodules, mosquito bite reactions ++. fevers, hepatosplenomegaly, pancytopaenias, deranged LFTs, increased NK lymphocytes, high EBV DNA load
  • Rarely, ocular findings may be present: such as photophobia, lacrimation, conjunctivitis, corneal infiltration with vascularization, keratitis, or uveitis [37-39]. Referral to an ophthalmologist is recommended if eye symptoms are presen
96
Q

Treatment for hydroa vacciniforme

A
  • ecalcitrant
  • Photoprotection: tinted windows, barriers
  • Anecdotal: phototherapy, PUVA, beta-carotene, antimalarials, azathioprine, thalidomide, cyclosporine, dietary fish oil
97
Q

CAD resolution

A

10% over 5 years, 50% of 15 years

98
Q

Rothmund Thompson gene and clinical features

A

RECQL4

  1. Teeth abnormalities
  2. Hypogonadism
  3. Ocular: bilateral cataracts
  4. Microcephaly
  5. Poikiloderma and photosensitivity
  6. Short stature, skin cancers
  7. Osteosarcoma 10-30% + other cancers: gastric, Hodgkin lymphoma, malignant eccrine poroma
  8. No hair, Sparse hair, hypoplastic nails, acral keratoses
99
Q

Systemic photoallergic agents

A
  • Antiarrhythmics: quinidine
  • Antimalarials: quinine
  • Antifungals: griseofulvin
  • Antimicrobials: sulfonamides
  • NSAIDs: piroxicam
  • Photoallergic reactions include: those with sulfur moiety
    • Thiazide diuretics
    • Sulfonamide abs
    • Sulfonylureas
    • Phenothiazines
    • Others: quinine, quinidine, TCA, griseo, NSAIDs
100
Q

Which ingredient in sunscreen is most common cause of photoallergy

A

Oxybenzone

101
Q

Associations with EPS

A

POO DAMPER: Penicillamine, Osteogenesis imperfecta, Downs, Acrogeria, Marfan, PXE, Ehlers Danlos, Rothmund Thomson

102
Q

HS genes

A

PSEN1, PSENEN, NCSTN

103
Q

Causes of interstitial granulomatous drug reactions

A

Calcium channel blockers
Statins
TNF alpha inhibitors

104
Q

Drugs that cause acne

A 
MISPLACE
MEK inhibitors (trametinib)
Iodides, isoniazid
Steroids
Phenytoin, progestins
Lithium
Anabolic steroids - danazol, testosterone
Corticotropin, cyclosporin
EGFR inhibitors

Derm (57 decks)

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