Brainscape's Knowledge GenomeTM

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


See full index

Dermatology > Rash clinical cases > Flashcards

Rash clinical cases Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

How should any rash be assessed?

A

Detailed history, examination (distribution/site affected, morphology, secondary features)

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

How common is psoriasis?

A

Occurs in 2% of adults

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

Is psoriasis curable?

A

No-has chronic course

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

What is the most common form of psoriasis?

A

Chronic plaque psoriasis (psoriasis vulgaris)

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

What are some features of chronic plaque psoriasis?

A

Symmetrical, commonly extensors (elbow/knee), scalp, sacrum, hands, feet, trunk and nails, sharply demarcated, scaly, erythematous plaques

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

What is the Koebner phenomenon?

A

Psoriasis develops in areas of skin trauma

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

What is the Auspitz sign?

A

Removal of psoriasis surface scale reveals tiny bleeding points (dilated capillaries in elongated dermal papillae)

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

What are some forms of psoriasis?

A

Guttate, palmoplantar pustular, erythrodermic or widespread pustular (rare)

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

What are some sign of psoriatic nail disease?

A

Nail pitting, subungal hyperkeratosis, dystrophy, onycholysis

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

What are some systemic effects of psoriasis, and what are some of the co-morbidities?

A

Biomarkers of systemic inflammation are raised; psoriatic arthritis, obesity, hypertension, diabetes, lipid abnormalities, Crohn’s, depression, cancer, uveitis

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

What is the life expectancy for patients with severe psoriasis?

A

About 4 years due to increased CV risk (3 x more at risk of MI)

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

Who controls the topical therapies for psoriasis?

A

GPs

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

What are some topical therapies for psoriasis?

A

Vitamin D analogues, Calcipotriol (Dovonex-for localised plaques), Calcitriol (Silkis-for flexures, less irritating), coal tar, dithranol, steroid ointments, emollients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is dithranol used to treat psoriasis?

A

If few localised plaques and short contact

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

What is the risk of using steroid ointments to treat psoriasis?

A

Can cause rebound if potent

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

What are some specialised treatments for psoriasis?

A

Phototherapy (narrowband UVB and PUVA), immunosuppression (methotrexate), immune modulation

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

What is acne vulgaris?

A

Chronic inflammation of the pilosebaceous unit

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

What is the typical age range of acne sufferers?

A

14-17 years old in females, 16-19 old years in males

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

What is the pathogenesis of acne?

A

Portal occlusion, bacterial colonisation of duct, dermal inflammation, increased sebum production

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

What does the distribution of acne reflect?

A

Sebaceous gland distribution (face, upper back, anterior chest)

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

What is the primary lesion in acne?

A

Comedones = open (blackheads), closed (whiteheads)

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

What are some of the skin changes that can form in acne?

A

Pustules and papules, cysts, erythema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What kinds of scarring can occur in acne?

A

Atrophic, ice-pick, texture changes, hypertrophic

24
Q

How is acne graded?

A 
Mild = scattered papules and pustules, comedones
Moderate = numerous papules, pustules and mild atrophic scarring
Severe = cysts, nodules and significant scarring
25
Q

What are some topical acne treatments?

A

Benzoyl peroxide (keratolytic, antibacterial), vitamin A derivatives (retinoids = drying effect), antibiotics (antibacterial and anti-inflammatory)

26
Q

How long should antibiotic treatment of acne last for?

A

At least six months

27
Q

What does Isotretinon do?

A

Oral systemic retinoid = effect on sebaceous gland activity

28
Q

What is an issue with systemic treatment of acne?

A

Lots of side effects including initial aggravation of acne

29
Q

Where does rosacea tend to affect?

A

Nose, chin and forehead

30
Q

What age group does rosacea tend to occur in?

A

Age 30-60

31
Q

What are some features of rosacea?

A

Papules, pustules, erythema, prominent facial flushing, enlarged/unshapely nose (rhinophyma), conjunctival/gritty eyes

32
Q

Why does rosacea not cause comedones?

A

It isn’t a disease of the pilosebaceous units

33
Q

What are some triggers of rosacea?

A

Sudden temperature change, alcohol, spicy food

34
Q

What are some ways to avoid the aggravating factors of rosacea?

A

Wear high factor sunscreens, avoid spicy foods and topical steroids

35
Q

What are some topical therapies for rosacea?

A

Metronidazole, ivermectin (for demodex mite)

36
Q

What are some oral therapies for rosacea?

A

tetracycline (long term), isotretinoin (low dose if severe)

37
Q

What are some additional treatments for rosacea?

A

Vascular laser for telangiectasia, surgery/ laser shaving for rhinophyma

38
Q

What characterises lichenoid eruptions?

A

Damage and infiltration between the epidermis and dermis

39
Q

What are two examples of lichenoid eruptions?

A

Lichen planus, lichenoid drug eruptions

40
Q

What age group commonly gets lichen planus?

A

Middle aged patients

41
Q

What occurs in lichen planus?

A

T cell mediated inflammation targeting an unknown protein within the skin and mucosal keratinocytes

42
Q

What is the skin manifestation of lichen planus?

A

Viloaceous (purple/pink) flat-topped shiny papules, intensely itchy

43
Q

Where does lichen planus typically affect?

A

The volar wrists/forearms, shins and ankles

44
Q

What is Wickhams striae as a sign of lichen planus?

A

Fine lace like pattern on surface of papules and buccal mucosa (often asymptomatic)

45
Q

How long does lichen planus typically last before burning out?

A

12-18months

46
Q

What is the management of lichen planus?

A

Check if possible drug precipitant, emollients, treat symptomatically (potent/very potent topical steroids, oral steroids if extensive), UVB phototherapy or PUVA

47
Q

What are bullous disorders?

A

Autoimmune diseases where damage to adhesion mechanisms in the skin results in blistering at various levels

48
Q

What are the main bullous disorders?

A

Bullous pemphigoid (split is deeper, through DEJ), pemphigus (split more superficial, intra-epidermal), dermatitis herpetiformis

49
Q

What are the features of dermatitis herpetiformis?

A

Associated with Coeliac, intensely itchy, vesicles removed by scratching leaving erosions, symmetrical on scalp, shoulders, elbows, knees and buttocks

50
Q

What is Nikolsky’s sign?

A

Top layers of skin slip away from the lower layers when slightly rubbed, indicates plane of cleavage within the epidermis

51
Q

What are the features of bullous pemphigoid?

A

Elderly patients, localised to one area/widespread on the trunk and proximal limbs, non-scarring, mucosal lesions unlikely, Nikolsky’s sign negative, itchy erythematous plaques and papules may be the presenting feature

52
Q

What are the features of Pemphigus vulgaris?

A

Typically affects scalp, face, axilla and groin, flaccid vesicles/bullae (thin roofed), lesions rupture and leave raw areas (increased infection risk), Nikolsky’s sign positive, mucosal involvement very common (eyes, genitals

53
Q

What is the prognosis of bullous disorders?

A

Chronic self-limiting course, duration varies from months to years, most patients achieve remission within 3-6 months, pemphigus has high mortality if left untreated, bullous pemphigoid has much lower risk

54
Q

What are the investigations for bullous disorders?

A

Skin biopsy with direct immunofluorescence, indirect immunofluorescence

55
Q

What is the general treatment for bullous disorders?

A

Systemic steroids and other immunosuppressive agents

56
Q

What is the treatment for pemphigus?

A

Tetracycline

57
Q

What topical treatments are used for bullous disorders?

A

Emollients, topical steroids, topical antiseptics/hygiene measures

Dermatology (31 decks)

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