Clinical dermatology cases Flashcards Preview

Year 2 > Clinical dermatology cases > Flashcards

Flashcards in Clinical dermatology cases Deck (58):
1

What are the key areas to consider in any skin condition?

Distribution
Morphology
Secondary features (e.g arthritis)

2

Psoriasis often starts in childhood. T/F

False - psoriasis is largely a disease of adulthood

3

Psoriasis is a chronic condition. T/F

True

4

What are the causes of psoriasis?

Genetic, stress, infection, Koebner phenomenon

5

What is the commonest form of psoriasis?

Chronic plaque psoriasis/psoriasis vulgaris

6

What are the typical features of plaque psoriasis rash?

Symmetrical distribution
Scaly, erythematous plaques (+/- silvery scale)
Sharp borders

7

Which sites does plaque psorasis commonly affect?

Extensors
Nails
Hands, feet
Trunk
Scalp
Sacrum

8

List the types of psoriasis

Guttate
Palmoplantar pustulosis
Nail disease
Erythrodermic/widespread pustular

9

What does guttate psoriasis look like?

Small, circular plaques

10

What are the features of psoriatic nail disease?

Pitting, onycholysis, dystrophy, subungal hyperkeratosis

11

How common is erythrodermic/widespread pustular psoriasis?

Uncommon

12

What is the koebner phenomenon?

Psoriasis arising from an area of trauma

13

What are the common treatments for psoriasis?

Vitamin D analogues
Coal tar
Topical steroids

14

List some vitamin D analogues

Calcipotriol
Calcitriol

15

What are the specialist treatments for psoriasis?

Narrowband UVB and PUVA
Retinoids
Immunosuppressants
Fumaric acid ester
Immune modulators

16

Alcohol can trigger psoriasis. T/F

True

17

Obesity and psoriasis can be linked. T/F

True

18

Guttate psoriasis often follows which respiratory infection?

Steptococcus

19

What is acne vulgaris?

Chronic inflammatory disease of the pilosebaceous unit

20

When does acne vulgaris present?

In adolescents (younger in females, older in makes)

21

Is there a genetic component to acne vulgaris?

Yes

22

What is the pathogenesis of acne vulgaris?

Pore occlusion -->
Colonisation of duct -->
Dermal inflammation -->
Increased sebum production

23

What are the common sites of acne vulgaris?

Face, upper back and chest

24

What is found in acne?

Comedones, pustules, papules, cysts

25

What are the secondary features of acne?

Atrophic scars, ice-picking, hypertrophic

26

How is acne graded?

Mild - scattered papules, pustules and comedones
Moderate - numerous papules, pustules and mild scarring
Severe - cysts, nodules, significant scarring

27

How is acne treated locally?

Benzoyl peroxide
Topical vitamin A/retinoids
Topical antibiotics

28

How is acne treated systemically?

Antibiotics
Oral retinoids (isotrenitoin)

29

What is a side effect of isotrenitoin?

Initial flare of acne

30

What is a retinoid used in acne?

Adapalene

31

Where is rosacea usually distributed?

Nose, chin, cheeks and forehead

32

How does rosacea typically present?

Papules, pustules, erythema without comedones
Facial flushing

33

What can exacerbated rosacea?

Temperature
UV exposure
Dietary (spicy food)
Alcohol

34

In which age group does rosacea typically present?

Middle aged

35

What is rhinopyma?

Thickening of the sebaceous tissue of the nose

36

How can you reduce the aggravating factors in rosacea?

Dietary avoidance
Wear sunscreen
Avoid topical steroids (make worse in long term)

37

What is steroid rosacea?

Rosacea induced by potent topical steroids

38

Which antibiotics may be prescribed in rosacea?

Topical metronidazole
Oral tetracycline

39

When might isotretinoin be used in rosacea?

Low doses can be used in severe rosacea

40

How can telangectasia be treated?

Vascular laser

41

How can rhinopyma be treated?

Surgically
Laser shaving

42

What is the memory aid to differentiate between bullous pemphigoid and pemphigus vulgaris?

Bullous pemphigoid - split is Deeper through DEJ
Pemphigus vulgaris - split is Superficial, Intra-epidermal

43

In which age group does bullous pemphigoid typically present?

Elderly

44

What is the typical distribution of bullous pemphigoid?

Localised to one area
Widespread on the trunk and proximal limbs

45

What is the typical appearance of bullous pemphigoid blisters?

Large, tense bullae (normal or erythematous skin) --> bursts to leave erosions

46

Does bullous pemphigoid scar?

No

47

How may bullous pemphigoid first present?

Itchy, erythematous plaques/papules

48

Is bullous pemphigoid Nikolsky negative or positive?

Negative

49

Mucosal lesions are typical in bullous pemphigoid. T/F

False

50

What is the typical distribution of pemphigus vulgaris?

Scalp, face, axillae and groin

51

What is the typical appearance of pemphigus vulgaris?

Flaccid, thin roofed vesicles/bullae --> ruptures to leave raw areas

52

Is infection risk increased in bullous pemphigoid or pemphigus vulgaris?

Pemphigus vulgaris

53

Is pemphigus vulgaris Nikolsky negative or positive?

Positive

54

Mucosal lesions are typical in pemphigus vulgaris. T/F

True

55

Where are the mucosal blisters in pemphigus vulgaris found?

Eyes, genitals

56

What is the prognosis for 1) pemphigoid and 2) pemphigus

If treated both conditions are chronic but self-limiting over a period of months-years. Untreated pemphigus has a high mortality rate due to the infection risk.

57

What investigations are indicated in suspected cases of pemphigus and pemphigoid?

Skin biopsy with direct immunofluorescence
Indirect immunofluorescence

58

How is pemphigus and pemphigoid treated?

Systemic steroids (mainstay)
Immunosuppression (methotrexate, azathioprine)
Tetracycline antibiotics (pemphigus specific)
Topical emollients
Topical steroids

Decks in Year 2 Class (72):