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FINALS - DERM > secondary skin changes > Flashcards

secondary skin changes Flashcards

1
Q

what is Acanthosis nigricans + where are they

A

symmetrical brown, velvet plaques // neck, axilla, groin

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2
Q

causes Acanthosis nigricans

A

T2DM // GI cancer // obesity // PCOS // acromegaly // cushings // hypothyroid

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3
Q

what meds can cause Acanthosis nigricans

A

COCP + nicotinic acid

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4
Q

pathology Acanthosis nigricans

A

insulin resistance –> raised insulin –> raised IGFR1 –> stimulation of keratinocytes

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5
Q

hisrutism vs hypertrichosis

A

hirsutism = androgen hair growth in women // hypertrichosis = excessive hair growth (not androgen dependent, men or women)

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6
Q

causes hisrutism

A

PCOS // congenital adrenal hyperplasia // androgen therapy // adrenal tumour // obesity

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7
Q

meds that cause hisrutism

A

phenytoin, steroids

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8
Q

assessment hisrutism

A

ferriman-Gallwey score

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9
Q

mx hisrutism

A

lose weight // COCP co-cyprindol (VTE risk)

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10
Q

mx facial hisrutism and contraindication

A

topical eflornithine - not in pregnancy or breastfeeding

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11
Q

causes hypertrichosis

A

anorexia // PCT // congenital // drugs eg ciclosporin

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12
Q

what is erythema nodosum

A

inflammation of subcut fat

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13
Q

symptoms + duration erythema nodosum

A

tender, red, nodular legions - usually on shins, no scars, last 6 weeks

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14
Q

causes of erythema nodosum

A

infectio (strep, TB) // sarcoid, IBD, Behcet’s // cancer // meds (penicillin, COCP) // pregnancy

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15
Q

symptoms + cause pretibial myoexedma

A

symmetrical, red, shiny orange peel - Graves disease

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16
Q

symptoms pyoderma gangrenosum

A

initiall small + red –> large, purple, necrotic ulcers

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17
Q

cause pyoderma gangrenosum

A

idiopathy // IBD, connective tissue, myeloproliferative

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18
Q

what is Necrobiosis lipoidica diabeticorum + what is it assoc with

A

shiny, painless red or yellow areas - diabetes

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19
Q

rash + skin changes SLP

A

butterfly phorosensitive rash (spares nasolavial fold) // discoid // alopecia // livedo reticularis

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20
Q

what is purpura

A

bleeding from small blood vessels –> non-blancing rash (petichea are small pupura)

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21
Q

underlying cause pupura

A

low platelets

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22
Q

children cause pupura

A

meningococcal // ALL // bleeding disorder // ITP // HSP

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23
Q

cause pellagra

A

nicotinic acid (b3) deficiency

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24
Q

RF pellegra

A

isoniazid, alcoholics

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25
Q

symptoms pellagra

A

dermatitis (brown scaly rash around sun areas) // diarrhoea // dementia + depression

26
Q

symptoms zinc deficiency

A

acrodermatitis (red, crust lesion around mouth + anus + distal limbs) // alopecia // short // hypogonad // cognitive impairment // eating clay or soil

27
Q

what is acrodermatitis enteropathica

A

recessive disease - defect in zinc absorption

28
Q

when does polymorphic eruption of pregnancy usually occur

A

last trimester

29
Q

symptoms polymorphic eruption of pregnancy + which area is spared

A

intense itch, pruitic rash, starts in abdomen, periumbilicus spared

30
Q

mx polymorphic eruption of pregnancy

A

emollients –> mild topical steroids –> oral steroids

31
Q

most common skin presentation in pregnancy

A

topic eruption

32
Q

symptoms atopic eruption

A

eczema like, itchy, red rash

33
Q

symptoms pemphigoid gestationas

A

itchy, blistering lesions in peri-umbilicus, trunk, back, buttocks, arms

34
Q

when does pemphigoid gestationas develop

A

2-3rd trimester

35
Q

mx pemphigoid gestationas

A

oral steroids

36
Q

important, systemic causes of itch (5)

A

liver disease // iron deficiency anaemia // polycythaemia // CKD // lymphoma

37
Q

symptoms and cause urticaria

A

allergy –> pale, pink, raised skin (hives, wheals), itchy

38
Q

mx urticaria

A

1) non-drowsy antihistamines 2) prednisolone

39
Q

drugs causes of urticaria

A

aspirin, penicillin, NSAIDs, opiates

40
Q

sedating histamines examples

A

chlorpheniramine

41
Q

SE sedating histamines

A

antimusciranic eg dry mouth, urinary retention

42
Q

examples non-sedating antihistamines

A

loratidine, certirizine

43
Q

what is erythroderma

A

any rash taht covers 95% of the skin

44
Q

causes erythroderma

A

eczema, psoriasis, drugs eg cold, leaukeamia, idiopathic

45
Q

what is erythroermic psoriasis

A

progresison to exfoliative phase with plaques over most of body - mild systemic upset

46
Q

what is acute degeneration erythroermic psoriasis

A

usually caused by steroid withdrawal –> admission

47
Q

what type of reaction is erythema multiforme

A

hypersensitivity

48
Q

causes erythema multiforme

A

virus (HSV), bacteria, drugs, SLE, sarcoidosis, malignancy

49
Q

what drugs can cause erythema multiforme

A

penicillin, sulphonamides, carbamazepine, NSAUDs, COCP

50
Q

most common cause erythema multiforme

A

HSV

51
Q

symptoms erythema multiforme

A

target lesions, start on hands –> torso, upper limb more common, not normally very itchy

52
Q

what is erythema multiforme major

A

severe form - mucosal involvement

53
Q

what drugs cause stevens-johnson

A

penicillin, sulphonamides, AEDs (lamotrigene, carbamezepine, phenytoin), allopurinol, NSAIDs, oral pill

54
Q

symptoms stevens-johnson

A

maculopapular, target lesions, nikolsy +ive, mucosal involvement, fever, arthralgia

55
Q

mx stevens-johnson

A

supportive

56
Q

drugs causing toxic epidermal necrolysis (TEN)

A

penicillin, sulphonamides, carbamezepine, phenytoin), allopurinol, NSAIDs

57
Q

symptoms TEN

A

systemically unewell, +ive nikolsy, looks like a burn

58
Q

mx TEN

A

stop drugs // Iv Ig // immunosupression eg ciclosporin or cyclophosphamide // plasmapheresis

59
Q

what is erythema ab igne

A

exposure to infrared radiaiotn

60
Q

symptoms erythema ab igne

A

red sipder webs with hyperpigmentation + telangiectasia - elderly women who sits next to open fire

61
Q

drugs causing photosensitivity

A

amiodarone!! // tetracycline, sulphonamide, cipro // NSAIDs // SUR // thiazide

FINALS - DERM (11 decks)

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