Terms and Steroids in Dermatology

Question 1

What should be examined in a dermatology exam?

Answer 1

Examination should include skin, hair, scalp nails and mucus membranes. Can examine lesions closer using a dermoscope

Question 2

Papule

Answer 2

small lump (<5mm)

Question 3

Nodule

Answer 3

larger lump 5-20mm

Question 4

Vesicle

Answer 4

small water blister

Question 5

Bulla(E)

Answer 5

large water blister

Question 6

Pustule

Answer 6

pus filled vesicle

Question 7

Excoriations

Answer 7

scratch marks

Question 8

Striae

Answer 8

stretch marks

Question 9

Pruritis

Answer 9

itching

Question 10

Atrophy

Answer 10

Thinning

Question 11

Macule

Answer 11

Discoloured non raised area of skin <5mm

Question 12

Patch

Answer 12

macule >5mm

Question 13

Plaque

Answer 13

palpable flat topped area >2cm

Question 14

Erosion

Answer 14

loss of epidermis

Question 15

Ulceration

Answer 15

loss of epidermis and dermis

Question 16

Lichenification

Answer 16

thickening of the skin

Question 17

Filiform

Answer 17

thread = long irregular projections

Question 18

Seborrhoaeic

Answer 18

crusty

Question 19

Telangiectasia

Answer 19

small thread blood vessels

Question 20

Spider Naevus

Answer 20

a single telangiectasic arteriole in the skin

Question 21

Petechia

Answer 21

microhaemorrhages 1-2mm

Question 22

Purpura

Answer 22

purple rash caused by blood in the skin

Question 23

Generalised

Answer 23

all over the body

Question 24

Widespread

Answer 24

extensive

Question 25

Localised

Answer 25

restricted to one area of skin

Question 26

Flexural/Extensor

Answer 26

Flexural = body folds e.g. groin, neck, behind ears, popliteal and cubital fossa 
Extensor = knees, elbows and shins

Question 27

Pressure areas

Answer 27

buttocks, sacrum, ankles and heels

Question 28

Photosensative

Answer 28

affects sun exposed areas such as face, neck and back of hands

Question 29

Describe the Fitzpatrick classification of skin types

Answer 29

One
White/pale skin (freckles, blond/red hair)
Always burns, never tans

Two
Pale skin (blond hair, blue eyes)
Burns easily, tans poorly

Three
Darker white skin (dark hair, brown eyes)
May burn, tans lightly

Four
Olive skin e.g. Mediterranean
Burns minimally, tans easily

Five
Asian, middle eastern and Latin America
Rarely burns, always tans

Six
Black African
Never burns, tans darkly

Question 30

What questions should you always ask about in Dermatology?

Answer 30

Aggravating or relieving factors
Occupation
Sun exposure and sun beds
Family history of skin problems

Question 31

What’s the difference between a cream and an ointment?

Answer 31

Creams – emulsions of oil and water and well absorbed
Ointments – greasy preparations with no added water – can become contaminated with bacteria so do not insert hands into pot

Question 32

List the 4 common steroid creams in order of potency?

Answer 32

Hydrocortisone
Eumovate
Depnovate
Dermovate

Question 33

What counsel would you give a patient asking about sunscreen use?

Answer 33

Need protection against UVA and B. UVA penetrates windows and enters the skin more deeply than B but UVB is what is mostly responsible for sunburn and malignant melanomas. Sunscreen with high SPF (sun protection factor) helps block UVB. This is the same as the Factor 50 or Factor 30 you see on brands. Factor 30 is a satisfactory form of sun protection in addition to clothing and shade. As well as the factor there is a 0-5-star system for UVA protection. 4-5 stars alongside factor 30 is recommended. Note to achieve the full potential of these sunscreen apply liberally and often according to the advice on the package.