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JG Year 2 > 224 Dermatology > Flashcards

224 Dermatology Flashcards

1
Q

Define macule

A

Flat localised area of colour/texture change

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2
Q

Define papule

A

Elevation of skin

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3
Q

Define nodule

A

Elevation of skin >5mm

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4
Q

Define bulla

A

Blister within or below epidermis >5mm

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5
Q

Define vesicle

A

Small blister

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6
Q

Define pustule

A

Collection of pus within the epidermis/dermis

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7
Q

Define cyst

A

Nodule of clear fluid/semi-solid material with an epithelial-lined cavity

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8
Q

Define wheal

A

Compressible papule/plaque of dermal oedema. Usually signifies urticaria

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9
Q

Define plaque

A

Palpable, plateau-like elevation of skin usually >2cm

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10
Q

Define scale

A

Accumulation of thickened horn layer kertin - detatchable fragments e.g. in psoriasis

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11
Q

Define ulcer

A

Skin loss extending to dermis due to impeded vascular supply

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12
Q

When does eczema usually present?

A

In infants 4-6 months old

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13
Q

What is the main R/F for an infant developing eczema?

A

1st degree relative with atopic disease

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14
Q

Which bacteria can sometimes cause a secondary infection in atopic eczema?

A

Staph aureus

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15
Q

How is eczema diagnosed?

A

Hx of itchy skin + 3 of the following: Involvement of skin creases/flexures Hx of asthma/hayfever FH in 1st degree relative (in infant) Dry skin in the past year Onset

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16
Q

What is the treatment for mild atopic eczema?

A

Emoliants and mildly potent corticosteroids

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17
Q

What is the treatment for moderate atopic eczema?

A

Emoliants + moderately potent corticosteroids +/- topical calcineurin inhibitors +/- bandages

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18
Q

What is the treatment for severe atopic eczema?

A

Emoliants + potent corticosteroids +/- topical calcineurin inhibitors +/- bandages +/- phototherapy +/- systemic therapy

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19
Q

What immunosuppressants are used to systemically treat atopic eczema?

A

Ciclosporin Azothioprine

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20
Q

Name the topical corticosteroids used to treat atopic eczema in order of potency

A

Hydrocortisone 1% Eumovate 0.05% Betnovate Dermovate 0.05%

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21
Q

Name 3 S/E of topical corticosteroids? (5 listed)

A

Skin thinning Hirsuitism Rebound flares Peri-oral dermatitis Systemic effects if area very large

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22
Q

What are elidel cream and protopic ointment examples of?

A

Topical immunodilator - decrease T cell activation

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23
Q

Name 2 complications of eczema

A

Eczema herpeticum Molluscum contagiosum

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24
Q

What is the incubation period of varicella?

A

2 weeks

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25
Q

In which viral infection are Koplic spots found?

A

Measles

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26
Q

Which parvovirus causes 5th disease?

A

B19

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27
Q

What physical signs can be seen in 5th disease?

A

Slapped cheeks + lacey rash

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28
Q

Which virus causes hand foot and mouth in children?

A

Coxackie A

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29
Q

What is permethrin used to treat?

A

Scabies

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30
Q

What can be added to permethrin to treat the symptoms of scabies?

A

Antihistamine to treat pruritis

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31
Q

What are benzoyl peroxide, topical retinoids and topical abx used to treat?

A

Acne vulgaris

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32
Q

What are the systemic treatments for acne?

A

PO abx e.g. tetracyclines/erythromycin OCP Isotretinoin

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33
Q

What should patients with acne vulgaris be advised when being treated with isotretinoin?

A

To use contraceptive methods as teratogenic (females)

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34
Q

In which group of patients is asteatotic eczema usually found?

A

Elderly

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35
Q

Which yeast is found in seborrhoeic eczema?

A

Melassezia furfur

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36
Q

Which antifungal is used to treat seborrhoeic eczema?

A

Ketoconazole

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37
Q

Which cytokines do keratinocytes express in eczema?

A

IL-1 IL-6 IL-8

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38
Q

Where is ICAM-1 expressed in eczema?

A

Endothelium

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39
Q

Which investigations can be performed to diagnose eczema?

A

IgE RAST Patch testing

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40
Q

What is rosacea?

A

Chronic inflammatory facial dematosis

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41
Q

Which topical antibiotic is used to treat rocacea?

A

Metronidazole

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42
Q

What can rosacea lead to?

A

Rhinophyma

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43
Q

Which abx are used to systemically treat rosacea?

A

Tetracyclines e.g. doxycycline

44
Q

What is hidradenitis suppuritiva?

A

Acne inversa - recurrent boil-like lumps in apocrine sweat gland bearing skin e.g. axillae/groin. Can cause painful abscesses and scarring

45
Q

What is lichen planus?

A

Itchy papular dematosis which affect wrists, palms, ankles, soles of feet and mucous membranes occasionally

46
Q

What is this and how is it treated?

A

Erythroderma = derm emergency. Treat underlying cause e.g. atopic eczema, psoriasis etc + steroids and emmollients + supportive care - fluid loss

47
Q

What emergency can be associated with this?

A

(Urticaria + angioedema) - associated with anaphylaxis.

48
Q

What is the cause of urticaria?

A

Widespread mast cell degranulation due to Type 1 hypersensitivity reaction

49
Q

What is the usual cause of this type IV sensitivity reaction?

A

Drug induced toxic epidermal necrosis/SJS

50
Q

What is the cause of this?

A

Stevens Johnson syndrome/TEN caused by drug reaction

51
Q

What is this?

A

Erythroderma multiforme - hypersensitivity reaction caused by HSV infection. Target/iris lesions

52
Q

What is this and how is it treated initially?

A

Necrotising fasciitis = infection spreading along fascial planes

Tx = urgent surgical debridement

53
Q

What disease is this?

A

Epidermolysis bullosa - inherited blistering skin condition where there is skin shedding due to trauma (delicate) and blistering sub-epidermally

54
Q

What is this and what is the treatment?

A

Bullous pemphigoid - either topical/Po steroids or immunosuppression eg MTX, azathioprine, mycophenolate mofetil)

55
Q

What is the cause of bullous pemphigoid?

A

IgG and T-lymphocytes attacking components of the BM, particularly BP1280 (BP antigen)

56
Q

What is this and what is the cause?

A

Pemphigus vulgaris - autoimmune disease with blistering and erosions on skin and mucous membranes. IgG binds to desmoglein 3 on desmosome

57
Q

Which bacteria causes impetigo, scalded skin syndrome and cellulitis (occasionally)?

A

Staph A

58
Q

What is the cause of staphylococcal scalded skin syndrome?

A

Exfoliative exotoxins released from toxigenic strains of the bacteria - attacks the desmosomes

59
Q

What is bactroban (mupirocin) used to treat?

A

Staph skin infecion e.g. MRSA

60
Q

Which bacteria can cause toxic shock syndrome and what is the mechanism?

A

Staph aureus or Strep pyogenes. Super antigen toxin causing polyclonal T cell activation

61
Q

What is this and which bacteria normally causes?

A

Ecthyma - skin infection characterised by crusted sored beneath which ulcers form - deep form of impetigo.

Normally caused by Strep pyogenes and/or Staph aureus

62
Q

Define furuncle

A

Small abscess formed by infection or >1 hair follicle i.e. boil

63
Q

Define carbuncle

A

Multiple heads of a boil, with abscess caused usually by Staph A

64
Q

What is erysipelas?

A

Superficial form of cellulitis (infection of dermis and subcut tissue) usually on face. Has a well demartated, raised border

65
Q

Which bacteria can cause cellulitis in the young?

A

Haemophilus influenzae

66
Q

Where do corenbacterium usually cause infection?

A

Moist areas of skin

67
Q

Name 2 corenbacterium infections

A

Erythrasma

Pitted keratolysis

68
Q

What is erythrasma?

A

Hyperpigmented macular patches caused by corenbacterium infection which is well demarcated and lichenified. Thickening of stratum corneum can be seen,

69
Q

What is this and whats the cause? Tx?

A

Pitted keratolysis - corenbacterium infection.

Tx = fusidic acid / metronidazole +/- antifungals

70
Q

What is this and which spirochete causes it?

A

Chancre (painless non-bleeding ulcer at the site of initial infection) - caused by syphilis

71
Q

What is the treatment of syphilis?

A

Penicillin

72
Q

How many months following chancre formation does the secondary rash happen in syph?

A

2-4 months

73
Q

What does borellia burgdoferi cause?

A

Lyme disease caused by tick bite - affects any part of the body. Growing bullseye with central clearance (erythema migrans) seen on skin.

74
Q

What is the treatment of Lyme disease?

A

Penicillin / Doxycyclin

75
Q

What is this and what is the cause?

A

Lupus vulgaris - persistent and progressive form of cutaneous TB. Small sharply defined reddish-brown lesions with gelatinous consistency. Lesions can persist for years and can lead to skin Ca

76
Q

Which organism causes this?

Tx?

A

Mycobacterium marinum

Minocyclin

77
Q

What type of rash is seen in candidiasis?

A

Vesiculo-pustular rash

78
Q

What are the treatments for oral candidiasis?

A

Amphotericin / nystatin

79
Q

What is the treatment for cutaneous candidiasis?

A

Clotrimazole

80
Q

What is the systemic treatment for candidiasis?

(3 listed)

A

Voriconazole / caspofungin / flucytosine + amphotericin

81
Q

Which yeast causes Pityriasis versicans?

A

Malassezia furfur

82
Q

What is the microscopic appearance of Pityriasis versicans?

A

Spaghetti and meatballs

83
Q

What type of fungus causes tinea corporis etc?

A

Dermatophyte - hyphal fungi

84
Q

What is the treatment for tinea corporis?

A

Clotrimazole

85
Q

What should be used to treat tinea unguium?

A

Systemic antifungals eg. terbenafine / itraconazole

86
Q

What does paramyxoviridae cause?

A

Measles

87
Q

Does measles virus have DNA or RNA?

A

-ve ss RNA

88
Q

Which DNA virus causes Kaposi’s sarcoma?

A

HSV8

89
Q

Which antiviral is used to treat HSV infections?

A

Aciclovir

90
Q

Which HPV causes the common wart?

A

HPV-2

91
Q

Which HPV infections are associated with CIN?

A

16 and 18

92
Q

Which HPV is sometimes treated with trichloracetic acid?

A

Genital warts i.e. HPV 1, 6, 16, 18

93
Q

What in headlice infestation causes pruritis?

A

Saliva

94
Q

Name 2 types of pre malignant skin lesions

A

Bowen’s disease

Actinic keratoses

95
Q

What percentage of Bowen disease progresses into invasive SCC?

A

3%

96
Q

What is this?

A

Actinic keratosis

97
Q

What is this?

A

Intraepidermal SCC (Bowen disease)

98
Q

Where are 80% of BCCs found?

A

Face and neck

99
Q

Which mutation can cause SCC?

A

TP53

100
Q

What is 5 flurouracil cream used to treat?

A

Skin ca - SCC and BCC

101
Q

What are the surgical margins for excising a melanoma?

A

~ 3 cm

102
Q

What is the 5year survival rate for a melanoma >3.5mm?

A

37%

103
Q

Name 2 R/F for developing melanoma

A

Family history

>50 ordinary naevi

104
Q

What does Breslow thickness measure?

A

Invasive melanomas. Measures the vertical thickness in mm from the top of the granular layer to the deepest point of tumour involvement. Strong predictor of outcome.

105
Q

What is Clark level of invasion?

A

Measures the anatomic plane of invasion i.e. related to the layers of skin:

  1. In situ melanoma
  2. Melanoma has invaded papillary dermis
  3. Melonoma has filled papullary dermis
  4. Melanoma has invaded reticular dermis
  5. Melanoma has invaded subcut tissue
106
Q

What is the treatment fot superficial spreading melanoma?

A

Surgical excision

107
Q

What are vemurefenib and dabrafenib used to treat?

A

Immune therapy for melanoma

JG Year 2 (28 decks)

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