Spotter Flashcards
Dx? [1]
Tx? [1]
Actinic keratoses
- hyperkeratotic papules on a background of sun-damaged skin
Topical fluorouracil:
- Actinic keratoses are premalignant skin lesions and therefore, often require treatment to prevent any further malignant changes.
Solar lentigo
Describe this [1]
What is the cause? [1]
Filiform wart (viral wart)
pityriasis versicolor
PMH: DM
Granuloma annulare
PMH: microtrauma at site
Dx? [1]
Pyogenic granuloma
Dx? [1]
Lichen planus
Dx? [1]
Discoid eczema
Desribe this [1]
Dx? [1]
Vesicles in crops
HSV-1
Dx? [1]
Herpatic whitlow
Which antibodies are
Bullous pemphigoid
Singular bullae
Insect bite - often caused by gram +ve bacteria
Name three drugs that can cause this skin change [3]
Erythema multiforme:
* penicillin
* sulphonamides
* carbamazepine
* allopurinol
* NSAIDs
* oral contraceptive pill
* nevirapine
Nodular prurigo
BCC
Dx [1]
condrodermative helicis nodularis
hidradenitis suppurativa
PMH: tonsilitis
Dx? [1]
Guttate psoriasis
PR
Mongolian blue spot
Some dermal nests of melanocytes haven’t migrated to epidermis - when they’re deep in the dermis they look blue
Describe this distribution [1]
BLASKOID distribution
Describe this [1]
Open comedomes (black heads)
What further test should you perform for this person? [1]
HIV
Dx: seborrheic dermatitis
Dx? [1]
Bed bugs
Breakfast lunch dinner distribution
Dx? [1]
Palmoplantar pustulosis is an uncommon chronic pustular condition affecting the palms and soles. It is also called pustulosis palmaris et plantaris. It is related to a common skin condition, psoriasis.
First line treatment? [1]
Topical fluorouracil cream
Dx: acitinic keratosis
Slow growing; asymptomatic
Dx? [1]
Main DDx? [1]
Dx:
Lentigo maligna is a type of melanoma in-situ. It typically progresses slowly but may at some stage become invasive causing lentigo maligna melanoma.
- The asymmetrical nature of the lesion would however point away from a diagnosis of solar lentigo.
DDx:
- Solar lentigo
Keratoacanthoma
Seborrhoeic keratoses
Actinic keratosis
Basal cell carcinoma
Pyoderma gangrenosum
Keratoacanthoma
Seborrhoeic keratoses
Actinic keratosis
Basal cell carcinoma
Pyoderma gangrenosum
Tx? [1]
ketoconazole shampoo
Pityriasis versicolor
7 year old girl; itchy
Dx? [1]
Main DDx? [1]
Tinea capitis - area without hair often have pustular, boggy masses which appear as numerous bright yellow areas with the skin surface surrounded by regions of hair loss and flakiness.
DDx: Alopecia areata - areas without hair are clear
Early treatment for this presentation? [1]
early keloids may be treated with intra-lesional steroids e.g. triamcinolone
Dx? [1]
Risk factors? [2]
Pompholyx is a type of eczema which affects both the hands (cheiropompholyx) and the feet (pedopompholyx). It is also known as dyshidrotic eczema.
Pompholyx eczema may be precipitated by humidity (e.g. sweating) and high temperatures.
Given the likely diagnosis, what needs to be screened for in this patient? [1]
Shingles is a disease caused by the reactivation of the varicella zoster virus, which lies dormant in nerve ganglia following primary infection (chickenpox). Shingles typically occurs in the elderly population; if shingles occurs in young adults (or children in this case), it is important to screen for immunological issues.
Dx? [1]
Risk factors? [1]
typical erythema ab igne rash.
- over exposure to infrared radiation (e.g. hot water bottle)
Dx? [1]
Causative organism? [1]
Athlete’s foot is also known as tinea pedis.
- It is usually caused by fungi in the genus Trichophyton.
slow-growing; often occur on sun-exposed areas such as the head
Dx? [1]
Bowen’s disease
NB: precursor to squamous cell carcinoma.
Dx [1]
Acute Eczema
* Acute flare ups can vary from vesicles to areas of poorly demarcated redness
Just because theres no scale doesn’t mean not eczema
Rhinophymatous rosacea
Bullous pemphigoid
Cherry haemangiomas (Campbell de Morgan spots)
Dermatitis herpetiformis.
Dx? [1]
How does this typically present? [2]
Eczema herpeticum
- Eczema herpeticum describes a severe primary infection of the skin by herpes simplex virus 1 or 2.
- rapidly progressing painful rash
- monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameter are typically seen.
Clinical emergency - should be admitted
Dx [1] and Tx? [1]
Erysipelas - flucoxacillin
Causative agent? [1]
Erysipelas is localised skin infection caused by Streptococcus pyogenes.
Dx? [1]
What is a typical history? [1]
Erythema ab igne is a skin disorder caused by over exposure to infrared radiation
A typical history would be an elderly women who always sits next to an open fire.
Name and description? [1]
Erythema multiforme
- Erythema multiforme is a hypersensitivity reaction that is most commonly triggered by infections. It may be divided into minor and major forms.
Dx? [1]
Seborrhoeic keratoses
Dx? [1]
- caused by an overgrowth of the diphtheroid []
Erythrasma
- generally asymptomatic, flat, slightly scaly, pink or brown rash usually found in the groin or axillae. It is caused by an overgrowth of the diphtheroid Corynebacterium minutissimum
NB: The brown or brick-red color may appear similar to acanthosis nigricans, but there is no velvety thickening of the skin with erythrasma.
What staining is being used? [1]
Dx? [1]
Tx? [1]
Erythrasma:
* coral-red fluorescence
* Treat with topical miconazole
Dx? [1]
Streptococcal 2 weeks prior
Guttate psoriasis
Hidradenitis suppurativa
Dx? [1]
Tx? [3]
Impetigo - Staphylcoccus aureus or Streptococcus pyogenes
Tx:
- Hydrogen peroxide 1% cream for ‘people who are not systemically unwell or at a high risk of complications’
- topical antibiotic creams: topical fusidic acid; topical mupirocin should be used if fusidic acid resistance is suspected
- Extensive disease: oral flucloxacillin; oral erythromycin if penicillin-allergic
keloid scar at the site of abdominal surgery.
Slow growing
Dx? [1]
Lentigo maligna
Leukoplakia
Lichen planus - pruritic eruption on the shins
Livedo reticularis
- Livedo reticularis describes an purplish, non-blanching, reticulated rash caused by obstruction of the capillaries resulting in swollen venules.
Milia are small, benign, keratin-filled cysts that typically appear around the face. They may appear at any age but are more common in newborns.
(not eczema or psoriasis)
Mycosis fungoides:
- Mycosis fungoides is a rare form of T-cell lymphoma that affects the skin.
- Proper differentation is by biospy
Dx is via what type of test? [1]
What type of HS? [1]
Skin p4tch test - HS4
Pemphigus vulgaris
Periorificial dermatitis
Pityriasis rosea
On the left a typical herald patch is seen. After a few days a more generalised ‘fir-tree’ rash appears
Targetoid lesions: erythema multiforme
SJS
DH:
- Allopurinol
SJS
TEN
children < 5 yrs
Staphylococcal Scalded Skin Syndrome (SSSS)
First line treatment? (if mild)
Topical hydrogen peroxide
Perioral Dermatitis
Acne conglobate
Acne fulminans
Acne conglobate
Rosacea
Folliculitis decalvans
Tinea corporis of the axilla
pityriasis rosea
Pityriasis versicolor
Pyogenic granuloma
Porphyria cutanea tarda (PCT) is a rare disorder characterized by painful, blistering skin lesions that develop on sun-exposed skin (photosensitivity).
PV
What is the first line treatment for this? [1]
Erythromycin is the oral antibiotic of choice to treat erythrasma
Dx? [1]
Key RF? [1]
Pyogenic granuloma
- commonly occur at the site of a minor injury such as a splinter.
Name this [1]
How do you differentiate from pyogenic granuloma? [1]
amelanotic melanoma
- occurs spontaneously, no hx of trauma
- More common in elderly
Pyogenic granuloma
- occurs after trauma
excessive osteoclastic resorption followed by increased osteoblastic activity
Name? [1]
Circinate balantis
Dx? [1]
Lichen sclerosus
Dx? [1]
Cherry Hemangioma
Seborrhea
Infantile eczema.
Sebaceous hyperplasia. Numerous tiny yellow-white papules on this infant’s nose will gradually fade without treatment.
Nevus flammeus (port-wine stain).
salmon patch
A patient is stung by a bee.
They present are extremely itchy and present with the following rash.
What medication would you give first and second line? [2]
non-sedating antihistamines (e.g. loratadine or cetirizine) are first-line
prednisolone is used for severe or resistant episodes
PMH:
- Multiple sunburns
Dx? [1]
Tx? [1]
Bowens disease - treat with topical 5-fluorouracil
Recurrent epistaxis (nosebleeds) are a common symptom of this patient.
Dx? [1]
Hereditary haemorrhagic telangiectasia
This skin condition is though to occur as a result of a reaction to which species? [1]
Seborrhoeic dermatitis - an inflammatory reaction to Malassezia furfur
Dx? [1]
Basal cell carcinoma
Ptx with PCOS.
1st line Tx? [1]
Topical eflornithine is the treatment of choice for facial hirsutism
Dx? [1]
Risk factor? [1]
Actinic keratoses
- common premalignant skin lesion that develops as a consequence of chronic sun exposure
Dx? [1]
seborrhoeic keratosis
What is the most appropriate treatment option for this patient?
Topical betamethasone valerate 0.1%
oral prednisolone
Acne rosacea
Painless ulcer. Dx? [1]
SCC - rapidly expanding painless, ulcerate nodules
Don’t be fooled into thinking this is a basal cell carcinoma (BCC) by the presence of telangiectasia near the lesion. With BCC’s these are generally found on the rolled edges of the lesion rather than being scattered around the periphery.
Seborrhoeic keratosis.
Malassezia furfur - pityriasis versicolor.
nodular Basal Cell Carcinoma
Tx? [2]
Lichen planus with oral involvement
- potent topical steroids, with benzydamine being used for oral involvement.
Tx? [1]
Topical potent corticosteroids
