Derm Flashcards by American Mouse

Koebner phenomenon

linear eruption at site of trauma

How well did you know this?

Not at all

Perfectly

annular

circle or ring

How well did you know this?

Not at all

Perfectly

discoid/ nummular

coin lesion

How well did you know this?

Not at all

Perfectly

purpura

bleeding into skin, doesnt blanch on pressure

How well did you know this?

Not at all

Perfectly

macule

freckle

flat area of altered colour

How well did you know this?

Not at all

Perfectly

patch

large flat area of altered color or texture, vascular malformation

How well did you know this?

Not at all

Perfectly

papule

xanthomata

raised solid lesion < 0.5cm in diameter

How well did you know this?

Not at all

Perfectly

nodule

pyogenic granuloma

raised solid lesion > 0.5cm in diameter

How well did you know this?

Not at all

Perfectly

plaque

palpable scaling lesion over 0.5cm in diameter

How well did you know this?

Not at all

Perfectly

excoriation

loss of epidermis following trauma

eczema

How well did you know this?

Not at all

Perfectly

lichenification

roughening of skin with accentuation of skin markings

rubbing in eczema

How well did you know this?

Not at all

Perfectly

scales

flakes of stratum corneum

How well did you know this?

Not at all

Perfectly

types of melanomas & epidemiology
SUPERFICIAL SPREADING: 50-75%
NODULAR: 15-35%

LENTIGO MALIGNA MELANOMA: 5-15%

ACRAL LENTIGINOUS MELANOMA: 5-10%

How well did you know this?

Not at all

Perfectly

melanoma 5 yr survival rates

STAGE 1 (T <2MM THICK, N0, M0) - 90%, 
STAGE 2 (T>2MM THICK, N0, M0) – 80%, 
STAGE 3 (N≥1, M0) – 40- 50%,  
STAGE 4 (M ≥ 1) – 20-30%

How well did you know this?

Not at all

Perfectly

granuloma annulare

SLOW-GROWING RINGS OF SMALL, FIRM, FLESH-COLORED TO RED PAPULES WITH CENTRAL INVOLUTION
CHILDREN AND YOUNG ADULTS
A/W DIABETES
No Tx needed mostly

How well did you know this?

Not at all

Perfectly

pyogenic granuloma

BENIGN, VASCULAR, DOME-SHAPED PAPULE OR NODULE.
YELLOW TO RED, RAPIDLY GROWING LESION WITH MOIST TO SCALY SURFACE
SECONDARY TO TRAUMA OF SKIN OR MUCOUS MEMBRANES
TREAT WITH CURETTAGE AND CAUTERISATION

How well did you know this?

Not at all

Perfectly

actinic keratosis

ERYTHEMATOUS, SCALY, ROUGH PAPULES OR PLAQUES +/- ADHERENT YELLOW CRUST
CAN PROGRESS TO SQUAMOUS CELL CARCINOMA
INCLUDING CRYOTHERAPY/CURETTAGE AND CAUTERY, EXCISION, TOPICAL TREATMENTS (5-FLUOROURACIL OR IMIQUIMOD)

How well did you know this?

Not at all

Perfectly

Bowens disease

INTRAEPIDERMAL SQUAMOUS CELL CARCINOMA

IRREGULAR SCALY PATCH – ULCERATION

NON HEALING LESION

CAN PROGRESS TO SQUAMOUS CELL CARCINOMA

TREATMENT OPTIONS INCLUDE CRYOTHERAPY, SUPERFICIAL SKIN SURGERY, TOPICAL TREATMENT (5-FLUOROURACIL OR IMIQUIMOD THERAPY), PHOTODYNAMIC THERAPY

How well did you know this?

Not at all

Perfectly

keratoacanthoma

1-2.5CM DOME-SHAPED PAPULE OR NODULE WITH A CENTRAL KERATIN-FILLED CRATER

RAPIDLY GROWS (6-8 WEEKS) AND MAY LOOK LIKE A SQUAMOUS CELL CARCINOMA

MOST COMMON ON SUN-EXPOSED SKIN

MAY INVOLUTE ON ITS OWN LEAVING A SCAR

TREATMENT IS EXCISION

How well did you know this?

Not at all

Perfectly

HYPERKERATOTIC, SKIN-COLORED TO ERYTHEMATOUS PAPULE, NODULE, OR PLAQUE

SCALING ULCERATION CRUSTING

SCC

SECOND MOST COMMON SKIN CANCER
SUN-EXPOSED SKIN
5% METASTASISE LIP OR EAR
MORE AGGRESSIVE IN IMMUNOSUPPRESSED PATIENTS
Tx mohs micrographic surgery,
radiotherapy

How well did you know this?

Not at all

Perfectly

WAXY, PEARLY, TRANSLUCENT PAPULE WITH TELANGIECTASIA AND ULCERATION
VERY RARELY METASTASISES

NODULAR BCC IS THE MOST COMMON BCC

How well did you know this?

Not at all

Perfectly

4 types of BCC

nodular
superficial
pigmented
morpheaform

How well did you know this?

Not at all

Perfectly

BCC tx

SURGERY (INCLUDING MOHS MICROGRAPHIC SURGERY), RADIOTHERAPY, TOPICAL TREATMENTS (5-FLUOROURACIL OR IMIQUIMOD),
CRYOTHERAPY

How well did you know this?

Not at all

Perfectly

PAPULES OR VESICLES ON AN ERYTHEMATOUS BASE

dermatitis

How well did you know this?

Not at all

Perfectly

atopic eczema

develops in early childhood, resolves in teenage years | a/w FHx of asthma, allergic rhinitis, atopy

Eczema complications

SECONDARY BACTERIAL INFECTION EG IMPETIGINISED CRUSTY WEEPY LESIONS OR SECONDARY VIRAL INFECTION EG ECZEMA HERPETICUM)

eczema in infants

face and extensor surfaces

eczema in children and adults

flexor surfaces

atopic dermatitis tx general

AVOID KNOWN EXACERBATING AGENTS, FREQUENT EMOLLIENTS +/- BANDAGES AND BATH OIL/SOAP SUBSTITUTE

atopic dermatitis tx topical

STEROIDS* FOR FLARE-UPS; TOPICAL IMMUNOMODULATORS (E.G. TACROLIMUS, PIMECROLIMUS)

atopic dermatitis tx oral

ANTIHISTAMINES FOR SYMPTOMATIC RELIEF, ANTIBIOTICS (E.G. FLUCLOXACILLIN) FOR SECONDARY BACTERIAL INFECTIONS, AND ANTIVIRALS (E.G. ACICLOVIR) FOR SECONDARY HERPES INFECTION

atopic dermatitis tx phototherapy & immunosuppressants

ORAL PREDNISOLONE, AZATHIOPRINE, CICLOSPORIN

mild topical steroids

hydrocortisone | hydrocortisone acetate

moderate topical steroids | x2-25 as potent as hydrocortisone

clobetasone butyrate | triamcinolone acetonide

potent topical steroids | x100-150 as potent as hydrocortisone

betamethasone valerate betamethasone dipropionate hydrocortisone 17-butyrate Mometasone furoate

V potent topical steroids | x600 as potent as hydrocortisone

clobetasol propionate | betamethasone dipropionate

Seborrheic dermatitis

YEAST PITYROSPORUM OVALE, COMMON, AFFECTS 3-5% OF THE POPULATION WHITE-YELLOWISH GREASY SCALE ON ERYTHEMATOUS PATCHES OR PLAQUES. INDISTINCT MARGINS. CRADLE CAP in infants

Seborrheic dermatitis Tx

BABY SHAMPOO | ADULT KERATOLYTICS, TOPICAL ANTI-FUNGALS, TOPICAL STEROIDS OR TOPICAL TACROLIMUS

INFLAMMATION AND DEPOSITION OF HEME RESULTS IN THE ECZEMATOUS LESIONS PROXIMAL TO THE MEDIAL MALLEOLUS

Stasis Dermatitis- Venous Eczema

Stasis Dermatitis- Venous Eczema Tx

SUPPORT STOCKINGS, LEG ELEVATION, WEIGHT REDUCTION, EMOLLIENTS AND TOPICAL STEROIDS

SHARPLY DEMARCATED PRURITIC, ERYTHEMATOUS PLAQUES WITH OVERLYING SILVER SCALE SCALP, ELBOWS, KNEES (EXTENSOR)

psoriasis

psoriasis complications

ARTHRITIS (5-8% OF PATIENTS), SECONDARY INFECTION, ERYTHRODERMA, PSYCHOLOGICAL AND SOCIAL EFFECTS

psoriasis precipitating factors

INCLUDE TRAUMA, INFECTION (EG TONSILLITIS – CAN CAUSE “GUTTATE” PSORIASIS), DRUGS, STRESS, ALCOHOL

auspitz sign

pinpoint bleeding upon removal of scale in psoriasis

Tx topical

VITAMIN D ANALOGUES, TOPICAL CORTICOSTEROIDS, COAL TAR PREPARATIONS, DITHRANOL, TOPICAL RETINOIDS, KERATOLYTICS AND SCALP PREPARATIONS

Tx phototherapy

UVB AND PHOTOCHEMOTHERAPY I.E. PSORALEN+UVA

Tx oral

METHOTREXATE, RETINOIDS, CICLOSPORIN, MYCOPHENOLATE MOFETIL, FUMARIC ACID ESTERS, BIOLOGICAL AGENTS (E.G. INFLIXIMAB, ETANERCEPT, EFALIZUMAB)

topical tx for mild acne 6 weeks

BENZOYL PEROXIDE AND TOPICAL ANTIBIOTICS (ANTIMICROBIAL PROPERTIES), AND TOPICAL RETINOIDS (COMEDOLYTIC AND ANTI-INFLAMMATORY PROPERTIES)

oral tx for moderate to severe acne

ORAL ANTIBIOTICS OR ANTI-ANDROGENS (IN FEMALES). ORAL RETINOIDS (FOR SEVERE ACNE)

ERYTHEMA, FLUSHING AND PAPULES | RHINOPHYMA (ESPECIALLY MEN)

acne rosacea

AVOIDANCE MEASURES, TOPICAL THERAPIES (EG METRONIDAZOLE GEL), ORAL ANTIBIOTICS (EG TETRACYCLINE ANTIBIOTICS), ORAL ISOTRETINOIN IF RESISTANT

CRUSTED GOLDEN LESIONS

IMPETIGO | TREAT WITH TOPICAL ANTI-BACTERIALS

CELLULITIS – INVOLVING DEEP SUBCUTANEOUS TISSUES – MOSTLY LOWER LIMBS

TREAT WITH ORAL ANTIBIOTICS EG FLUCLOXACILLIN

2-5MM FLESH-COLORED PAPULES WITH CENTRAL UMBILICATION | CLEAR SPONTANEOUSLY WITHIN 6-9 MONTHS

MOLLOSCUM CONTAGIOSUM | POX VIRUS, CHILDREN, CONTACT/TRAUMA

PARVOVIRUS B19 CHILDREN AGED 3-12 FADES SPONTANEOUSLY PREGNANT WOMEN RISK OF FOETAL HYDROPS IN FIRST HALF OF PREGNANCY

ERYTHEMA INFECTIOSUM SLAPPED CHEEK FIFTH DISEASE

OVAL, MINIMALLY ELEVATED, PRURITIC, SCALING PATCHES, PAPULES, AND PLAQUES. TANNISH PINK/SALMON COLOURED IDIOPATHIC (POST-VIRAL?) SELF-LIMITING INFLAMMATORY LESIONS, OCCUR MOST COMMONLY IN YOUNG ADULTS IN THE COOLER MONTHS MOST COMMONLY OVER TRUNK IN A “CHRISTMAS TREE” PATTERN (FOLLOWS SKIN LINES) HERALD PATCH IS INITIAL, LARGE, SINGLE LESION FOLLOWED BY GENERALIZED RASH DAYS TO WEEKS LATER. SELF-LIMITED CONDITION THAT RESOLVES OVER 6-8 WEEKS. MANAGEMENT OF SYMPTOMS: ANTI-HISTAMINES, MOISTURIZERS

PITYRIASIS ROSEA

FEW TO HUNDREDS OF SKIN LESIONS ERUPT WITHIN A 24-HOUR PERIOD HERPES SIMPLEX VIRUS

ERYTHEMA MULTIFORME

FUNGAL SKIN INFECTIONS

DERMATOPHYTES (TINEA/RINGWORM), YEASTS (E.G. CANDIDIASIS, MALASSEZIA), MOULDS (E.G. ASPERGILLUS)

ITCHY, CIRCULAR OR ANNULAR LESIONS WITH A CLEARLY DEFINED, RAISED AND SCALY EDGE

TINEA CORPORIS

FUNGAL SKIN INFECTIONS Dx

KIN SCRAPINGS, HAIR OR NAIL CLIPPINGS (FOR DERMATOPHYTES); SKIN SWABS (FOR YEASTS)

FUNGAL SKIN INFECTIONS Tx

TOPICAL ANTIFUNGAL AGENTS (E.G. TERBINAFINE CREAM) ORAL ANTIFUNGAL AGENTS (E.G. ITRACONAZOLE) FOR SEVERE, WIDESPREAD, OR NAIL INFECTIONS

TINY RED INTENSELY ITCHY BUMPS ON THE LIMBS AND TRUNK

Scabies

Scabies tx

PERMETHRIN X 8 HRS

PINK WHEALS (TRANSIENT), MAY BE ROUND, ANNULAR, OR POLYCYCLIC

ACUTE URTICARIA

ulcer in malleolar area

venous

ulcer in pressure and trauma sites, pretibial, supramalleolar, distal points

arterial

ulcer in pressure sites | soles heels toes metatarsal heads

neuropathic

large shallow irregular ulcer | exudative & granulating base

venous

small sharply defined deep ulcer | necrotic base

arterial

granulating base ulcer +/- callus

neuropathic

leg oedema, haemosiderin, melanin, lipodermatosclerosis, atrophie blanche

venous

cold shiny skin weak PP hair loss

arterial

peripheral neuropathy

neuropathic ulcer

normal ABPI 0.8 - 1

arterial

ABPI under 0.8 | doppler studies and angiography

arterial

ABPI under 0.8 | xray to exclude osteomyelitis

neuropathic

compression bandaging tx for venous but CI in

arterial ulcers

Neuropathic ulcer tx

wound debridement regular repositioning footwear nutrition

Derm Flashcards

(78 cards)