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Phase 2 Mine > Revision List Dermatology > Flashcards

Revision List Dermatology Flashcards

1
Q

Pathophysiology of acne?

A
  1. Hair follicle narrow - hypercornification
  2. Increase sebum production –> greasy skin trapped in narrow follicles.
  3. Sebum stagnates at pit of follicle - no O2
  4. Proprionibacterium acnes –> break down triglycerides in sebum to 3FA
  5. Irritation, inflammation and attraction of neutrophils
  6. Pus formation and further inflammation
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2
Q

Clinical features of acne?

A
  1. Closed comedones
  2. Open comedones
  3. Papules
  4. Pustules
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3
Q

Differential diagnosis of acne

A
  1. Acne rosacea
  2. Milia
  3. Follliculitis
  4. Perioral dermatitis
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4
Q

Treatment of acne vulgaris?

A
  1. Keep face clean
  2. Benzoyl peroxide gel/cream
  3. Topical Abx: clindamycin /erythromycin gel
  4. Topical retinoids: tazarotene gel
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5
Q

Treating severe acne?

A
  1. oral tetracycline - 4 month min, contraindicated in pregnancy and children
  2. Hormonal treatment: anti-androgen Tx –> suppress sebum production
    e. g. oral co-cyprindiol
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6
Q

What is eczema?

A

Describe common group of inflammatory skin diseases - breakdown of skin due to thinning of stratum corneum –> risk of inflammation

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7
Q

Clinical presentation of eczema?

A
  1. Face and flexor surfaces of arm
  2. Itchy, erythematous and scaly patches
  3. Dry skin persist throughout life
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8
Q

Clinical presentation of infancy eczema?

A
  1. Face

2. Scalp

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9
Q

Clinical presentation of bacterial infection in eczema?

A
  1. Crusting
  2. Weeping
  3. Pustulation
  4. Cellulitis
    Sudden worsening
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10
Q

Clinical presentation of eczema herpeticum?

A
  1. Rapidly worsening painful eczema
  2. Clustered blisters
  3. Punched out erosions
  4. Fever, lethargy, distress
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11
Q

Diagnostic criteria for eczema?

A

Clinical diagnosis

  1. High serum IgE
  2. Must have itchy skin condition in past 6 months

Also 3 of more:

  1. History of itching in skin creases
  2. History of asthma/hay fever
  3. History of generally dry skin
  4. Onset in first 2 years of life
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12
Q

Treatment of eczema?

A
  1. Education - nails short, skin hydrated
  2. Emollient therapy e.g. E45 cream
  3. 1st line: topical corticosteroids
  4. 2nd line: topical calcineurin inhibitors
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13
Q

How do emollients work to treat eczema?

A

Occlusive emollients trap moisturise in skin , transiently increase in hydration
Artificial permeability barrier –> form above stratum corneum –> prevent water loss between corneocytes

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14
Q

Topical corticosteroids staging for eczema?

A
  1. Mild - hydrocortisone –> face/flexures
  2. Moderate: clobetasone butyrate
  3. Potent for severe eczema: fluocinonide
  4. Very potent: clobetasol propionate
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15
Q

Topical calcineurin inhibitors how they work?

A

Inhibit calcineurin which induce transcription factor –> for many interleukins e.g. IL2 –> activate in cells –> induce production of cytokines

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16
Q

How to treat moderate/severe/non-responsive eczema?

A
  1. Oral/ immune modulators:
    - ciclosporin - calcineurin inhibitor
    - azathioprine - aware of immunosuppression
  2. Oral steroids - prednisolone
  3. Abx - flucloxacillin
  4. Phototherapy with UVA
  5. Anti-histamines e.g. chlorphenamine
17
Q

Squamous cell skin cancer?

A

Locally invasive malignant tumour if the squamous keratinocytes
- more aggressive than basal cell carcinoma + higher metastatic potential

18
Q

What is Bowen’s disease?

A

In situ SCC confined to epidermis

19
Q

Risk factors for SCC?

A

UV exposure

Chronic inflammation e.g. wound scar and immunosuppression

20
Q

Clinical presentation of SCC?

A
  1. On sun exposed sites in later life
  2. Grow v rapidly
  3. Ulcerate lesions on lower lip/eat = more aggressive
  4. Examination of regional lymph nodes
21
Q

Treatment of SCC

A

Surgical excision

Radiotherapy

22
Q

Basal Cell Carcinoma

A

Most common malignant skin cancer

Tumour of basal keratinocytes

23
Q

Risk factors of BCC?

A
  1. UV exposure
  2. Skin type 1
  3. Ageing
24
Q

Clinical presentation of BCC?

A

Later life presentation
Less aggressive and metastatic than SCC
Border of ulcerated ulcers - raised with pearly appearance
Slow enlarging shiny nodule on head and neck area –> bleeds and doesn’t heal following minor trauma
Rodent ulcer

25
Q

Treatment of BCC?

A
  1. Surgically excised with wide borders and histology
  2. Can be non-surgical Tx:
    - cryotherapy
    - photodynamic therapy
  3. Radiotherapy - unable to surgery
26
Q

Malignant melanoma?

A

Malignant tumour of melanocytes

27
Q

Risk factors of MM?

A
  1. UV exposure
  2. Red hair, high density freckles, pale skin
  3. Skin type 1 –> skin burn and not tan
  4. Atypical moles
  5. Multiple melanocytic naevi
  6. Skin sensitivity
  7. Immunosuppresion
  8. Fx
28
Q

Clinical presentation of MM?

A
  1. Men - back chest
  2. Women - lower
  3. V dark colour, black or almost black
  4. Major signs: change in size, shape/colour
  5. Minor signs: inflammation, crusting/bledding, sensory change
29
Q

ABCDE changes in MM?

A
  1. Asymmetrical change
  2. Border irregularity
  3. Colour change/non-uniform
  4. Diameter > 6mm
  5. Elevation/evolution - change of lesion
30
Q

Types of melanoma?

A
  1. Superficial spreading
  2. Nodular
  3. Lentigo maligna
  4. Acreal
31
Q

Differential diagnosis of ?

A

Benign pigmented naevus
Seborrheic wart
Pyogenic granuloma

32
Q

Treatment of MM?

A

Surgical excision - wide margins
Limited sensitivity to radiotherapy
Metastases

Phase 2 Mine (12 decks)

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