Common Dermatological Problems Flashcards

1
Q

How much of the UK population is affected by skin diseases?

A

1/3rd - 25% consult for advice/treatment

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2
Q

What is dermatitis also known as?

A

Eczema - itchy skin condition

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3
Q

What other conditions does atopic eczema usually accompany?

A
  • Allergic rhinitis (hay fever)
  • Asthma (atopic tendency)
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4
Q

What consists of the initial treatment for atopic eczema?

A
  • Trigger avoidance + break itch-scratch-itch cycle
  • Moisturisers (lotion, cream, ointment)
  • Soap substitutes - aqueous cream, Dermol 500
  • Bath preparations (Oliatum, Balneum, Dermol 600)
  • Topical steroids (next card)
  • Other - topical calcineurin inhibitors, oral antibiotics, antihistamines
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5
Q

What intermittent topical steroids can be used for atopic eczema?

A
  • 1% hydrocortisone (mild)
  • Eumovate (moderate)
  • Betnovate, Elocon (potent)
  • Dermovate (very potent)
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6
Q

If there is very severe eczema or poor response to topical therapy, what can be done?

A
  • UV phototherapy
  • Systemic treatment - Ciclosporin, methotrexate, axathioprine
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7
Q

What are complications of atopic eczema?

A
  • Bacterial co-infection - impetiginisation
  • Viral co-infection - eczema herpecticum
  • Post-inflammatory hypo/hyper pigmentation
  • Scarring
  • Striae/skin atrophy from steroid use
  • Depression / psychosocial impact
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8
Q

In which areas of the body is psoriasis most common?

A
  • Extensor surfaces
  • Sacrum, scalp, ears, palms, soles
  • Nails
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9
Q

What is the topical treatment of psoriasis?

A
  • Emollients
  • Topical steroids
  • Coal tar
  • Salicyclic acid
  • Vitamin D analogues (Calcipotriol - dovonex)
  • Combo of above - Diprosalic, dovobet
  • Dithranol
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10
Q

Sometimes a dermatologist may prescribe biologics such as monoclonal antibodies against TNF, what are some anti-TNFs?

A
  • Etanercept (Enbrel)
  • Infliximab (Remicade)
  • Adalimumab (Humira)
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11
Q

Where does acne vulgaris affect?

A

Areas of skin w/ densest population of sebacous follicles - face, upper chest, back.

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12
Q

How is acne vulgaris graded?

A

I - IV

  • I - multiple open comedones (blackheads)
  • II - closed comedones (whiteheads) (mild acne)
  • III - extensive inflammatory papules/postules (moderate acne)
  • IV - large nodules, cysts, scarring (nodulocystic acne)
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13
Q

What are the topical treatments of acne vulgaris?

A
  • Topical retinoids (Adapalene, Tretinoin)
  • Topical antibiotics (Dalacin-T, Zineryt)
  • Benzoyl peroxide (duac)
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14
Q

What oral medications can treat acne vulgaris?

A
  • Oral antibiotics - erythromycin, oxytetracycline, lymecycline
  • Oral contraceptive pill - dianette
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15
Q

What is Isotretinoin (Roaccutane) and when is it used? Side effects?

A
  • Systemic retinoid
  • For severe cystic acne
  • Teratogenic (so can’t get pregnant)
  • Side effects - dry lips/skin, myalgias, hair thinning, depression
  • Baseline FBC, LFTs, lipids
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16
Q

Impetigo is the most common bacterial skin infection in children. What is mild/localised impetigo treated with?

A

Topical Fucidin

17
Q

What is extensive impetigo treated with?

A

Oral Flucloxacillin

18
Q

Which virus causes viral warts?

A

Human Papilloma Virus

19
Q

How are viral warts spread?

A

Direct or indirect contact - swimming pools, biting fingernails, shaving

20
Q

What is treatment of viral warts?

A
  • Nil - self-resolving
  • Duct tape
  • Salicyclic acid
  • Cryotherapy
21
Q

What is the treatment for tinea?

A
  • Topical azole (eg. clotrimazole) or allylamine (eg. terbinafine) for 2 weeks
  • Nails - Terbinafine for 6 weeks (fingernails) or 3-4 months (toenails)
  • Systemic therapy may be indicated if extensive, immunosuppression, resistance to topical therapy
22
Q

What is acitinic keratosis?

A
  • Common sun-indued scaly or hyperkeratotic lesion -> potential to become malignant
  • affects 23% Uk pop >60 years
23
Q

What creams and gels can be used to treat actinic keratosis?

A
  • 5-fluorouracil cream - Efudix
  • Imiquimod cream - Aldara
  • Diclofenac gel - Solaraze
24
Q

What is squamous cell carcinoma?

A
  • Result of cumulative sun exposure (incidence inc w age)
  • Dorsum of hands, forearms, ears, upper face, lower lip
  • Arise de-novo OR from AK/Bowmen’s
  • Refer immediately under 2ww for surgical intervention
25
Q

What is the ABCDE approach to skin surveillance for suspcious pigmented lesions?

A
  • Asymmetry - one side of lesion diff to other
  • Border irregularity - notched, uneven, blurred
  • Colour variation - diff to other moles, or diff shades/colours within
  • Diamete >6mm - and persistent growth
  • Extra features - itching, bleeding