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Y2 Dermatology > Week 3.5 > Flashcards

Week 3.5 Flashcards

1
Q

What are chronic leg ulcers

A

open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks

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2
Q

What causes arterial leg ulcers

A

Peripheral arterial disease causing insufficient blood supply to lower limbs

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3
Q

Peripheral arterial disease often caused by

A

Atherosclerosis - narrows the peripheral arteries so less blood flow

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4
Q

Presentation of arterial ulcers

A

Deep
Punched out appearance (like someone made a hole)
Surrounding skin is cold and white
Intermittent claudication
Pain at night
Absent peripheral pulses

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5
Q

What may patients describe that they do at night to relief the pain caused by arterial ulcers

A

hang their legs off the end of the bed

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6
Q

What is claudication

A

Muscle pain triggered by activity and relieved by rest

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7
Q

Investigations for arterial leg ulcers

A

ABPI
Doppler ultrasound

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8
Q

What is the ABPI for arterial leg ulcers

A

< 0.9

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9
Q

Management for arterial leg ulcers

A

Statin
Antiplatelet
Treat hypertension
(the aim is to reduce the modifiable risk factors)

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10
Q

Which type of leg ulcer is the most common

A

Venous leg ulcer

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11
Q

What causes venous leg ulcer

A

Chronic venous insufficiency

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12
Q

Describe the pathophysiology of chronic venous insufficiency

A
  1. Elevation in venous pressure in legs causing veins to dilate and valves to become insufficient
  2. This causes varicose veins to develop
  3. The increased hydrostatic pressure in the vessels causes red blood cell leakage into tissues
  4. this causes venous dermatitis, swelling
  5. Skin does not heal well from the dermatitis due to poor blood supply hence it breaks down and forms an ulcer
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13
Q

Venous ulcers usually occur in

A

Above the medial malleolus = gaiter area

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14
Q

Presentation of venous ulcers

A

Superficial, shallow
larger than arterial ulcers
Warm
Exudative - oozing
Haemosiderin deposition (brown pigment)
Varicose veins

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15
Q

Investigations for venous ulcers

A

Clinical
ABPI and doppler ultrasound to exclude arterial cause

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16
Q

Management for venous ulcers

A

4 layer compression bandaging
Compression stockings
Pain relief
Leg elevation

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17
Q

What is the 4 layer compression bandaging

A

Graduated pressure - highest at the ankle lowest at the knee

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18
Q

Most common type of skin cancer

A

Basal cell carcinoma

19
Q

Basal cell carcinoma arise from

A

Basal keratinocytes

20
Q

Where does basal cell carcinoma usually occur on

A

Sun exposed sites such as head and neck

21
Q

Risk factors for BCC

A

Sun exposure
History of frequent / severe sun burn
Genetics
Skin type I and II
Immunosuppression
Increasing age
Ionizing radiation
Outdoor occupations / hobby

22
Q

What genetic conditions are associated with BCC and SCC

A

Xeroderma pigmentosum
Albinism

23
Q

4 Types of BCC

A

Nodular
Superficial
Infiltrative
Pigmented

24
Q

Features of BCC

A

Usually does not metastasize
Slow growing tumours

25
Q

Presentation of Nodular BCC - TURP

A

Telangiectasia
Ulceration at the center
Rolled edge
Pearly white

26
Q

What is the ulceration at the center of nodular BCC called

A

Rodent ulcer

27
Q

Presentation of superficial BCC

A

Erythematous plaque
Dry / crusted
May have bluish-tinge

28
Q

Presentation of infiltrative BCC

A

Thickened plaque
Whitish
Not well demarcated

29
Q

Where does infiltrative BCC usually occur

A

Upper trunk
Face

30
Q

Pigmented BCC often looks like

A

Melanoma

31
Q

Pigmened BCC often present in

A

Dark skin

32
Q

Investigations for BCC

A

Visual inspection
Narrow excision for histology

33
Q

Management for BCC

A

Wide excision
Curettege / cautery
Superficial BCC and low risk of BCC can be managed with non-surgical treatments

34
Q

Non-surgical treatments for BCC

A

Cryotherapy
Radiotherapy
Topical imiquimod

35
Q

Precursors of squamous cell carcinoma

A

Bowen’s disease
Actinic keratosis

36
Q

Where does squamous cell carcinoma arise from

A

Supra-basal keratinocytes

37
Q

Risk factors for squamous cell carcinoma

A

Skin type I or II
Sun exposure
Genetics
Premalignant conditions
Immunosuppression
Ionising radiation
Smoking
Increasing age

38
Q

SCC is most common among which group of people

A

Immunosuppressed population

39
Q

Where can SCC arise from

A

Sun exposed sites
Chronic leg ulcers
Sites of burns
Chronic lupus vulgaris

40
Q

What is lupus vulgaris

A

Cutaneous tuberculosis skin lesions

41
Q

Prognosis of SCC

A

generally well if detected early
Poor prognosis if metastasised

42
Q

Presentation of SCC

A

Irregular red nodule
Ulceration
Warty lump
May be painful
May bleed

43
Q

Difference between SCC and BCC

A

SCC grows faster than BCC
SCC can metastasise whereas BCC doesn’t usually spread
SCC arise from supra-basal keratinocytes whereas BCC arise from basal keratinocytes

Y2 Dermatology (5 decks)

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