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Dermatology > Rash > Flashcards

Rash Flashcards

1
Q 
John - 18
scaly plaques at elbows, knees and shins for 8 weeks
scaly scalp for 1 year
joint pains
smoker
40 units of alcohol a week
nail pitting and onycholysis

diagnosis?

A

psoriasis

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2
Q

katy - 21
acute onset widespread rash over past 2 days
using E45
tonsilitis 2 weeks ago - treated with oral penicillin

diagnosis?

A

guttate psoriasis

(the trigger to the condition is often a streptococcal (bacterial) sore throat followed within two to three weeks by the skin eruption)

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3
Q

is there a cure for psoriasis?

A

no

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4
Q

name 3 environmental causes of psoriasis

A

stress
drugs
infection

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5
Q

what is the commonest form of psoriasis?

A

chronic plaque psoriasis (psoriasis vulgaris)

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6
Q

psoriasis is symmetrical

true or false?

A

true

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7
Q

name the common site of psoriasis

A

extensors (elbow and knee)
scalp, sacrum, hands, feet and trunk
nails

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8
Q

psoriasis is sharply __________, scaly, ____________ plaques

A

psoriasis is sharply DEMARCATED, scaly, ERYTHEMATOUS plaques

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9
Q

psoriasis that develops in an area of skin trauma (stretch mark or scar) is known as what phenomenon?

A

Koebner phenomenon

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10
Q

removal of surface scale reveals tiny bleeding points (dilated capillaries in elongated dermal papillae) is known as what psoriatic sign?

A

Auspitz sign

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11
Q

name 4 psoriatic nail changes

A

onycholysis
nail pitting
dystrophy
subungal hyperkeratosis

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12
Q

name some psoriatic co-morbidities

A 
arthritis
obesity, hypertension, diabetes
crohns
cancer
depression
uveitis
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13
Q

name the 5 topical therapies for psoriasis

A 
vitamin D analogues - calcipotriol or calcitriol
coal tar
dithranol
steroid ointments
emollients
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14
Q

name the 2 other treatments for psoriasis

A

phototherapy - UVB and PUVA

immunosuppression - MTX
biologics

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15
Q

shona - 19
oily skin - blackheads
pustules and papules

diagnosis?

A

acne vulgaris

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16
Q

acne vulgaris is a chronic ____________ disease of the _____________ unit

A

acne vulgaris is a chronic INFLAMMATORY disease of the PILOSEBACEOUS unit

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17
Q

acne pathogenesis:

  1. increased _____ production
  2. dermal ____________
  3. bacterial colonisation of ____
  4. poral _________
A

acne pathogenesis:

  1. increased SEBUM production
  2. dermal INFLAMMATION
  3. bacterial colonisation of DUCT
  4. poral OCCLUSION
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18
Q

comedones:

open =
closed =

A 
open = blackhead
closed = whitehead
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19
Q

where is acne distributed?

A

face
upper back
anterior chest

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20
Q

name the 3 grades of acne

A

mild - scattered

moderate - numerous + mild scarring

severe - cysts + significant scarring

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21
Q

name the 3 topical treatments of acne vulgaris

A

benzoyl peroxide
topical vitamin A derivatives (retinoid)
topical antibiotics

22
Q

name the 2 systemic treatments of acne vulgaris

A

oral antibiotics

isotretinoin (oral retinoid)

23
Q

Wilma - 36
increasing redness of face over 1-2 years
aggravated by wine and curry
recurrent papule and pustules of central fat and chin
father has red face and enlarged nose

diagnosis?

A

rosacea

24
Q

rosacea treatment?

A

oral antibiotic - tetracycline

consider isotretinoin

25
Q

where does rosacea affect (be specific)

A

nose cheeks and forehead

26
Q

rosacea has papules, pustules and erythema with __ comedones

A

rosacea has papules, pustules and erythema with NO comedones

27
Q

rosacea is prominent facial ________ exacerbated by sudden ______ in ___________, alcohol and _____ food

A

rosacea is prominent facial FLUSHING exacerbated by sudden CHANGE in TEMPERATURE, alcohol and SPICY food

28
Q

an enlarged nose is known as what?

A

rhinophyma

29
Q

conjunctivitis/gritty eyes are seen in rosacea

true or false

A

true

30
Q

what is the management of rosacea?

A

reduce aggravating factors (topical steroids)

topical therapies - metronidazole

oral therapy - tetracycline and isotretinoin

31
Q

telangiectasia management?

A

vascular laser

32
Q

rhinophyma management?

A

surgery/laser shaving

33
Q 
karen - 40
8 week history of very itchy rash on lower legs, flexor wrists, abdo and thighs
discomfort in mouth
PMH of eczema and asthma
med - inhalers

diagnosis?

A

lichen planus

34
Q

what is the special striae in lichen planus called?

A

Wickham’s striae

35
Q

what colour of buccal mucous and what nail are seen in lichen planus?

A

white reticular network or buccal mucosa and nail ridges

36
Q

Lichenoid eruptions are characterized by damage and ____________ between the _________ and ______

A

Lichenoid eruptions are characterized by damage and infiltration between the epidermis and dermis

37
Q

name the 2 commonest types of Lichenoid eruptions

A

lichen planus and lichenoid drug eruption

38
Q

lichen planus has violaceous (____/______) flat-topped shiny papules typically affecting the volar wrists/________, shins and ______

A

lichen planus has violaceous (PINK/PURPLE) flat-topped shiny papules typically affecting the volar wrists/FOREARM, shins and ANKLES

39
Q

how long does lichen planus last?

A

12-18 months

40
Q

lichen planus treatment?

A

topical or oral steroids (extent of disease)

41
Q

name the 2 bullous disorders

A

bullous pemphigoid

pemphigus

42
Q

identify where the split is in the following bullous disorders:

(a) bullous pemphigoid
(b) pemphigus

A

(a) bullous pemphigoiD - split is Deeper - through DEJ

(b) pemphiguS - split is more Superficial - intra-epidermal

43
Q

‘the top layers of the skin slip away from the lower layers when slightly rubbed’

what sign is this?

A

Nikolsky’s sign

indicates plane of cleavage within the epidermis

44
Q

indicate whether or not nikolsky’s sign is positive or negative in:

(a) bullous pemphigoid
(b) pemphigus

A

indicate whether or not nikolsky’s sign is positive or negative in:

(a) bullous pemphigoid - negative
(b) pemphigus - positive

45
Q

choose the following which apply to bullous pemphigoid:

young/old patients?
small/large tense bullae on skin?
blisters that burst and leave/don't leave erosions?
scarring/non scarring?
itchy/non-itchy?
Nikolsky sign positive/negative?
mucosal lesions likely/unlikely?
A

choose the following which apply to bullous pemphigoid:

old patients
large tense bullae on skin
blisters that burst and leave erosions
non scarring
itchy
Nikolsky sign negative
mucosal lesions unlikely
46
Q

in early disease, bullous pemphigoid is seen as urticated itchy plaques rather than bullae

true or false?

A

true

47
Q

mucosal involvement (eyes and genitals) in pemphigus vulgaris is not common

true or false?

A

false

mucosal involvement and pemphigus vulgaris is VERY common

48
Q

which has a higher mortality rate:

pemphigus or bullous pemphigoid?

A

pemphigus - by far

49
Q

name the investigations performed in pemphigus/pemphigoid

A

dkin biopsy + direct immunofluorescence

or

indirect immunofluorescence

50
Q

outline the treatment of pemphigoid and pemphigus

A

systemic steroids
immunosuppressive agents

pemphigoid: tetracycline antibiotics
topicals: emollients, steroids, antisepsis/hygiene measures

Dermatology (19 decks)

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