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Y6 Senior Med COPY > Derm > Flashcards

Derm Flashcards

(86 cards)

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1
Q

what is this

A

tinea corporis

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2
Q

investigation for fungal nail infection

A

nail clipping analysis

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3
Q

most common cause of Fungal nail infection (onychomycosis)

A

Trichophyton rubrum

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4
Q

what is the difference between SJS and TEN

A

SJS is LESS THAN 10% of skin involvement
TEN is >30% skin involvement

10-30% = SJS-TEN

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5
Q

TEN mx

A

 Stop precipitating factor
 Supportive care, usually in ITU
 IVIG is 1st line

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6
Q

what can cause SJS/TEN

A

Drugs:
* NSAID
* Anti-convulsants Phenytoin, lamotrigine
* Sulphonamide
* Allopurinol
* IVIG
* Carbamazepine
* Penicillin

infection
-HSV

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7
Q

clinical features of SJS

A

PRODROME = FLU LIKE SYMPTOMS
- sudden appearance of itching, burning, painful skin lesions (maculopapular eythematous)
- fever and mucous membranes (cornea, lips, genitalia)
- shock

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8
Q

what is Nikolsky sign

A

epidermis separates at mild pressure

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9
Q

hoow doo you manage SJS

A

stop precipitating factor, ITU, IV fluids

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10
Q

what is seborrhoeic dermatitis

A

chronic dermatitis caused by proliferation of a normal skin inhabitant, the fungus Malassezia furfur

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11
Q

How does seborrhoeic dermatitis present

A

eeczematous lesion of sebum rich areas (dandruff on scalp)

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12
Q

mx for seborrheic erma

A

Zinc (head and shoulders) and tar (neutrogena T) for scalp disease
topical antifungalls if on body

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13
Q

what does impetigo look like

A

gold crust appearance

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14
Q

what is the bacteriuim that causes impetigo

A

staph aureus

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15
Q

how do you manage impetigo

A

hygiene measures
topical HYDROGEN PEROXIDE 1% cream> 2% fusidic acid cream
give oral fluclox if widespread

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16
Q

step wise management for acne

A
  • Single topical therapy: retinoid or benzoyl peroxide
  • Topical combination therapy (choose 2 or more): topical retinoid, benzoyl peroxide, topical antibiotic
  • replace topical with oral antibiotic
  • oral isotretinoin (under specialist supervision - not in pregnancy)
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17
Q

what abx can you give for acne

A

topical doxycycline
clindamycin/erythromycin (if pregnant, breasteeding or <12 yo)

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18
Q

what is second line for mild acne

A

azelaic acid

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19
Q

side effects of roaccutane

A

dry skin, eyes and lips (most common) –> nose bleeds
teratogenic
hair thinning
photosensitivity
low mood and suicide ideation

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20
Q

what is the acne that middle aged people get called

A

acne rosacea = Chronic relapsing and remitting rash involving face

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21
Q

describe acne rosacea

A

erythema/flushing
symmetrical rash on nose, cheeks, forehead
telangectasia
pustules
papules

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22
Q

what can trigger flushing in rosacea

A

alcohol or spicy food

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23
Q

how do you manage acne rosacea

A

avoid sun exposure, spicy food and alcohol
Mild/moderate: topical metronidazole
Severe: oral doxycycline

  • Should clear up with Rx after 6-12 wks.
  • If not → refer to dermatoloy
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24
Q

what causes pytiriasis versiccolor

A

malassezia furfur

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25
what does pytiriasis versiccolor look like
hypopygmented patches mild pruritus after a SUNTAN TRUNK affected
26
how is pytiriasis versiccolor different to vitiligo
vitiligo is in pripheeries and a lot more confluent
27
how can you reverse vitiligo
with topical steroids but only if applied early
28
what causes pityriasis rosea
HHV7
29
sx of pityriasis rosea
recent viral infection herald patch on trunk erythematous oval scaly patches (fir tree appearance(
30
how do you treat pityriasis rosea
you dont its self limiting
31
what are the types of psoriasis that you can get
plaque - most common, with well demarcated red scaly patches guttate pustural flexural
32
what is guttate psoriasis due to
strep infection
33
what does guttate psoriasis look like
teardrop lesions on the back
34
how do you manage psoriasis
corticosteroid and vit D analogue consider emollients phototherapy, photochemotheray
35
where does psoriasis occur
ON EXTENSOR surfaces
36
where does eczema occur
on FLEXOR surfaces
37
sx of eczma
dry skin itching redness may become infected
38
how do you manage eczema
emollients topical corticosteroids fluclox oral if infected
39
how do you manage scabies
Permethrini x2, wash off after 8 hours treat al household contacts
40
how do you manage headlice
malathion (which is second line for scaabies)
41
tinea clinical features
ringed scaly itchy kerion red or silver
42
tinea management
oral antifungals e.g. TERBINAFINE topical ketoconazole shampoo
43
how do you mnag shingles
analgesia (paracetamol + NSAID) antivirals (PO acyclovir)
44
describe lichen planus
purple pruritic papular polygona rash itchy on palms, soles, genitalia, flexor surfaces of arms
45
hhow do you manage lichen planus
TOPICAL steroids (clobetasone)
46
what is lichen sclerosus
itchy white spots seen on vulva of elderly
47
hwow do you manage cellulitis
FLUCLOX if mild CO AMOX if sevre
48
how do you tell erysepelas apart from cellulitis
erysipelas is well demarcated
49
list the steroid ladder
Help Carol Become a Medic 1. Hydrocortisone 2. Clobetasone butyrate 3. Betamethasone 4. Mometasone
50
what causes bullous pemphigoid
ANTIBODIES againsst BM (at dermoepidemal junctin)
51
sx of bullous pemphigoid
TENSE bullae itchy NO oral involvement
52
Ix bullous pemphigoid
immunofluorescence (IgG, C3 at dermoepidermal junction)
53
how do you maage bullous pemphigoid
oral corticosteroids
54
Pemphigus vulgaris cause
Antibodies against desmosomes (superficial)
55
sx pemphigus vulgaris
flaccid blisters ORAL involvement
56
whatg is an actinic keratosis
pre-malignant skin condition for SCC
57
how does actinic keratosis present
small, crusty/scaly, on sun exposed area
58
Who and how do you manage actinic keratosis
GP if simple, urgent 2ww if immunosuppressed - fluorouracil cream + topical hydrocort - topical diclofenac - topical imiquinod
59
which areas are 9% of body for burns fluid calc
Head+neck each arm each anterior leg each posterior leg anterior chest post chest ant abdo post abdo
60
whaat is hidroadenitis suppurativa
chronic inflamm occlusion of pilosebaceious units > prevent keratinocytes from properly shedding
61
how does hidroadenitis suppurativa present
recurrent boiils in intertriginous areas (axilla, neck, thighs, ingluinal, breast) > plaques, scarring
62
how do you manage hidroadenitis suppurativa
good hygiene, loose clothing, smoking cessation Acute: steroids, fluclox chronic: clindamycin (topical), lymecycline (PO)
63
how long should the corticosteroid breaks be (at least) in psoriasis
4 weeks
64
causes of erythema multiforme
infection (90%) - HSV ***most common - mycoplasma drugs - NSAID - penicillins - sulphonamides, sulphonylureas - nitrofurantoiin
65
describe erythema multiforme appearance
target lesions initially on back of hands / feet, then torso upper limbs more likely than lower limbs pruritus occasionally
66
what is erythroderma
rash that involves >95% of the body
67
causes of erythema nodosum
SORE SHINS Streptococci, mycoplasma, EBV OCP Rickettsia Eponymous Behcets Sulphonamides, penicillins Hansen's disease (leprosy) IBD NHL Sarcoid and TB
68
what is the single most important prognostic factor for melanoma
breslow thickness
69
side effectss of topical corticosteroids
thin sskin skin depigmentation (esp if dark skin) excessive hair growth
70
what exacerbates psoriasis
trauma alcohol drugs (beta blockers, lithium, antimalaria, NSAID, ACEi, infliximab) withdrawal from steroids
71
what does a BCC look like
rodent ulcer: pearly papule with telangectasia ulcerates at the center to leave a crater
72
where do pygenic granulomas occur
after a small skin lesion e.g. a cut
73
what is a pyogenic granuloma
reactive proliferation of capillary blood vessel
74
what do pyogenic granulomas do if you touch them
bleed on contact
75
how long are shingles infectious for
until they have crusted over (usually around one week)
76
how long must you exclude from school someone wiht shingles
until lesions fully crust ovr OR 48 hours from start of antibiotics
77
explain features of dermatitis herpetiformis
itchy vescicular lesions on EXTENSOR SURFACES (knees, buttocks, elbows)
78
what is hirsutism
male like hair pattern in women (= androgen dependent hair growth)
79
most common cause of hirsutism
PCOS also cushings, CAH, androgen therapy
80
causes of acanthosis nigricans
T2DM / obesity , PCOS, acromegaly, Cushing's GI cancer
81
how do you manage pyoderma gangrenosum
ORAL steroids first becuase it has high potential to spread rapidly
82
all about superficial spreading melanoma (70%)
 Arises in a **pre-existing naevus**, expands in a **radial fashion** before a vertical growth phase  **Grow slowly, metastasise later**  **Arms, legs, back, chest**  Young-middle aged with intermittent UV exposure
83
all about nodular melanoma (15%)
 Arises **de novo or from pre-existing moles**  Sun exposed skin, middle aged people  **AGGRESSIVE**  NO radial growth phase – **vertical only**  **Red or black lump** which **bleeds or oozes**, becomes **itchy, ulcerated**  **Invade deeply and metastasise early**
84
all about lentigo maligna melanoma (10%)
 More common in **ELDERLY with sun damage**  Evolves from **pre-existing lentigo maligna (liver spots**)  **Large flat lesions with irregular borders** and **brown** in colour  **Progresses slowly**  Usually on the **face**
85
all about acral lentiginous melnoma (4%)
 Arise on **palms, soles and subungual areas **  Most common type in **NON-WHITE** populations – equal frequency in black and white patients  Subungual pigmentation (**Hutchinson’s sign**) or on palms or feet
86
ix and mx of malignant melooma
* Refer under **2 week wait** * Examination with **dermatoscope** in secondary care *** Full thickness excisional Biopsy** – definitive diagnosis * also treatment (based on breslow thickness)

Y6 Senior Med COPY (29 decks)

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