Derm 2 - Emergencies and skin infections Flashcards Preview

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Flashcards in Derm 2 - Emergencies and skin infections Deck (32):
1

Urticaria, angioedema and anaphylaxis are examples of which type of hypersensitivity reaction?

Type 1 hypersensitivity reaction - IgE-mediated

2

List some common triggers of urticaria/angioedema/anaphylaxis:

Foods: Nuts, shellfish, dairy
Drugs: Penicillin, contrast media, NSAIDs, morphine, ACEi
Insect bites
Contact: Latex
Autoimmune
Hereditary (angioedema)

3

How does urticaria present?

Itchy wheals

4

How does angioedema present?

Swelling of dermis, tongue and lips

5

How does anaphylaxis present?

- Bronchospasm
- Facial/laryngeal oedema
- Hypotension
- Wheeze
- Cyanosis

6

What is the management of urticaria?

- Trigger avoidance
- Anti-histamines
- Corticosteroids if severe acute

7

What is the management of angioedema?

- Trigger avoidance
- Corticosteroids

8

What is the management for anaphylaxis?

- Trigger avoidance
- Adrenaline - 500 ug
- Hydrocortisone - 200 mg
- Chlorphenamine - 10mg

9

List some causes of erythema nodosum:

- Sarcoidosis
- Strep throat
- TB
- Pregnancy
- Malignancy
- IBD - Crohns/UC
- Chlamydia
- Leprosy
- Drugs: COCP, Sulphonamide abc, NSAIDs

10

Describe the lesion seen in erythema nodosum:

Discrete tender nodules on the shins/ankles

11

What is Stevens-Johnson syndrome?

Acute skin reaction (type 4 hypersensitivity reaction) causing mucocutaneous necrosis, often triggered by drugs.
- Blistering skin
- Mouth ulcers
- Sore, ulcerating eyes
- Diarrhoea
- Cough

12

What is Toxic Epidermal Necrosis?

Acute widespread skin and mucosal necrosis in reaction to a drug - type 4 hypersensitivity reaction.
>30% mortality

13

Name the serious complication of atopic eczema, characterised by extensive crusty papule, blisters and erosions:

Eczema herpeticum

14

What is the infective agent causing eczema herpeticum? What is the treatment?

- Herpes simplex virus
- Aciclovir

15

Differentiate between cellulitis and erysipelas:

Cellulitis = bacterial infection of deep subcutaneous tissue
Erysipelas = Bacterial infection of dermis and upper subcutaneous tissue, which has a well-defined, red raised border.

16

What are the common infective agents causing cellulitis and erysipelas?

- Strep pyogenes
- Staph aureus

17

Which antibiotics should be given for cellulitis/erysipelas?

- Flucloxacillin or Benzylpenillin

18

What is tinea corporis?

Tinea infection of trunk and limbs.
- Itchy, circular lesions, with clearly defined, raised scaly edge

19

What is tinea cruris?

Tinea infection of groin and natal cleft
- Itchy

20

What is tinea pedis?

Athlete's foot = moist scaling and fissuring in toewebs

21

What is tinea manuum?

Tinea infection of the hand
Scaling and dryness in palmar creases

22

What is tinea capitis?

Patches on scalp of broken hair, scaling and inflammation

23

What is tinea unguium?

Tinea infection of nail
- Yellow, thickened, crumbly nail

24

What is the treatment for a tinea infection?

- Correct predisposing factors ie moist environment
- Topical antifungal - Terbinafine
- Oral antifungal - Itraconazole

25

Why shouldn't topical steroids be used on tinea infections?

Lead to tinea incognito

26

What is pityriasis versicolor?

Scaly brown patches on upper trunk which fail to tan on sun exposure

27

Hyperpigmentation and hyperkeratosis of skin folds...

Acanthosis nigricans

28

What conditions is acanthosis nigricans associated with?

Gastric cancer
Insulin resistance:
- Hyperinsulinaemia
- Cushing's
- Acromegaly
- PCOS

29

What is the infective agent in scabies?

Sarcoptes scabiei

30

What are the presenting features of scabies?

Extremely itchy rash, widespread tiny red spots and scratches, particularly in skin folds
May resemble eczema

31

What is Permethrin used to treat?

Scabies infestation

32

What is the management of scabies?

- Topical insecticide: Permethrin 5%
- Advise all close contacts to get tx
- Wash and dry bedding, towels and clothes >60'C