Flashcards in Clinical dermatology cases Deck (58):
What are the key areas to consider in any skin condition?
Secondary features (e.g arthritis)
Psoriasis often starts in childhood. T/F
False - psoriasis is largely a disease of adulthood
Psoriasis is a chronic condition. T/F
What are the causes of psoriasis?
Genetic, stress, infection, Koebner phenomenon
What is the commonest form of psoriasis?
Chronic plaque psoriasis/psoriasis vulgaris
What are the typical features of plaque psoriasis rash?
Scaly, erythematous plaques (+/- silvery scale)
Which sites does plaque psorasis commonly affect?
List the types of psoriasis
What does guttate psoriasis look like?
Small, circular plaques
What are the features of psoriatic nail disease?
Pitting, onycholysis, dystrophy, subungal hyperkeratosis
How common is erythrodermic/widespread pustular psoriasis?
What is the koebner phenomenon?
Psoriasis arising from an area of trauma
What are the common treatments for psoriasis?
Vitamin D analogues
List some vitamin D analogues
What are the specialist treatments for psoriasis?
Narrowband UVB and PUVA
Fumaric acid ester
Alcohol can trigger psoriasis. T/F
Obesity and psoriasis can be linked. T/F
Guttate psoriasis often follows which respiratory infection?
What is acne vulgaris?
Chronic inflammatory disease of the pilosebaceous unit
When does acne vulgaris present?
In adolescents (younger in females, older in makes)
Is there a genetic component to acne vulgaris?
What is the pathogenesis of acne vulgaris?
Pore occlusion -->
Colonisation of duct -->
Dermal inflammation -->
Increased sebum production
What are the common sites of acne vulgaris?
Face, upper back and chest
What is found in acne?
Comedones, pustules, papules, cysts
What are the secondary features of acne?
Atrophic scars, ice-picking, hypertrophic
How is acne graded?
Mild - scattered papules, pustules and comedones
Moderate - numerous papules, pustules and mild scarring
Severe - cysts, nodules, significant scarring
How is acne treated locally?
Topical vitamin A/retinoids
How is acne treated systemically?
Oral retinoids (isotrenitoin)
What is a side effect of isotrenitoin?
Initial flare of acne
What is a retinoid used in acne?
Where is rosacea usually distributed?
Nose, chin, cheeks and forehead
How does rosacea typically present?
Papules, pustules, erythema without comedones
What can exacerbated rosacea?
Dietary (spicy food)
In which age group does rosacea typically present?
What is rhinopyma?
Thickening of the sebaceous tissue of the nose
How can you reduce the aggravating factors in rosacea?
Avoid topical steroids (make worse in long term)
What is steroid rosacea?
Rosacea induced by potent topical steroids
Which antibiotics may be prescribed in rosacea?
When might isotretinoin be used in rosacea?
Low doses can be used in severe rosacea
How can telangectasia be treated?
How can rhinopyma be treated?
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
In which age group does bullous pemphigoid typically present?
What is the typical distribution of bullous pemphigoid?
Localised to one area
Widespread on the trunk and proximal limbs
What is the typical appearance of bullous pemphigoid blisters?
Large, tense bullae (normal or erythematous skin) --> bursts to leave erosions
Does bullous pemphigoid scar?
How may bullous pemphigoid first present?
Itchy, erythematous plaques/papules
Is bullous pemphigoid Nikolsky negative or positive?
Mucosal lesions are typical in bullous pemphigoid. T/F
What is the typical distribution of pemphigus vulgaris?
Scalp, face, axillae and groin
What is the typical appearance of pemphigus vulgaris?
Flaccid, thin roofed vesicles/bullae --> ruptures to leave raw areas
Is infection risk increased in bullous pemphigoid or pemphigus vulgaris?
Is pemphigus vulgaris Nikolsky negative or positive?
Mucosal lesions are typical in pemphigus vulgaris. T/F
Where are the mucosal blisters in pemphigus vulgaris found?
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.
What investigations are indicated in suspected cases of pemphigus and pemphigoid?
Skin biopsy with direct immunofluorescence