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derm Flashcards

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1
Q

What are the main types of psoriasis?

A 
Guttate
Plaque
Seborrhoeic
Flexural
Erythrodermic
Palmar-plantar pustular
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2
Q

How is psoriasis typically managed first line?

A

Avoid stress, smoking, alcohol.
Emollients
Topical corticosteroid and vitamin D analogue (e.g calcipotriol)

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3
Q

What nail signs are found in psoriasis?

A

Pitting
Beau’s lines
Onchycholysis

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4
Q

What score is used to determine the most appropriate treatment in psoriasis?

A

Psoriasis area and severity index (PASI)

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5
Q

Name two systems for staging melanoma

A

Clarkes level

Breslow thickness

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6
Q

What is the name of scaly spots on sun-damaged skin?

A

Acitinic (solar) keratosis

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7
Q

What is Bowen’s disease?

A

Intraepidermal SCC/ SCC in situ

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8
Q

What causes alopecia areata?

A

Autoimmune

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9
Q

How does alopecia areata present?

A

Patches of hair loss
Non-scarring
Affects young children/adults
Usually regrows

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10
Q

What sign is suggestive of alopecia areata?

A

Exclamation mark hairs

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11
Q

Causes of scarring alopecia

A

Trauma (injury, surgery, radiation)
Infection
Lupus

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12
Q

What is the diagnosis of a young man presenting with frontal hair thinning and receeding of crown?

A

Androgenic alopecia

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13
Q

Which conditions are associated with alopecia areata?

A 
Vitiligo
pernicious anaemia
ITP
diabetes
Addison's
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14
Q

What is a macule?

A

Flat area of altered colour (e.g. freckle)

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15
Q

What is a patch?

A

Large area of altered colour (e.g. port wine stain)

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16
Q

Papule?

A

Solid, raised lesion < 0.5cm in diameter

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17
Q

Nodule?

A

Solid, raised lesion >0.5cm in diameter

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18
Q

Plaque?

A

Palpable scaling lesion > 0.5cm in diameter

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19
Q

Vesicle?

A

Raised, clear fluid filled lesion < 0.5cm in diameter

pustule if contains pus

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20
Q

Bulla?

A

Raised clear fluid filled lesion > 0.5cm in diameter

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21
Q

What is hypertrichosis?

A

Non-androgen dependant pattern of excessive hair growth (e.g in pigmented naevi)

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22
Q

What does koilonychia? (spoon shaped nails suggest)

A

Iron deficiency anaemia

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23
Q

Name the cells found in the skin

A

Keratinocytes
Langerhans cells
Melanocytes
Merkel cells

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24
Q

Name the epidermal layers

A

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basale

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25
Causes of erythema nodosum
Group A strep, primary TB, pregnancy, malignancy, sarcoidosis, IBD, chlamydia, leprosy
26
What are the risk factors for necrotising fasciitis?
DM! Malignancy Abdo surgery
27
What is bullous pemphigoid presentation?
Tense blisters on erythematous base | Preceeded by itchy rash
28
What causes bullous pemphigoid and who does it affect?
caused by autoantibodies | Mainly affects elderly
29
How does pemphigus vulgaris present?
Easily ruptured painful blisters
30
Which age group does pemphigus vulgaris mainly affect?
Middle aged
31
How are venous ulcers treated?
Compression bandages
32
How are arterial ulcers diagnosed?
ABPI <0.8
33
What is the definitive management for arterial ulcers?
Vascular reconstruction
34
What are Wickhams striae?
Lacy white streaks found on oral mucosa in lichen planus
35
How is lichen planus treated?
Potent topical corticosteroids | Topical calcineurin inhibitors (e.g. tacrolimus etc)
36
6Ps of lichen planus?
Papules, polygonal, purple, planar, pruritic, plaques
37
What skin changes are associated with chronic venous insufficiency?
Lipodermatosclerosis Stasis dermatitis Venous ulcer
38
What are the side effects of oral retinoids?
``` Dry skin/lips/eyes Disordered liver function Hypercholesterolaemia Myalgia DEPRESSION TERATOGENICITY ```
39
What test is important before starting oral retinoid?
PREGNANCY TEST | must be on contraception for 1 month before starting
40
Indications for ASOT test (anti-streptococcal antibody)
Rheumatic fever Post-strep glomerulonephritis Scarlet fever Erysipelas
41
What should you test for in an adult suffering badly from molluscum contagiosum?
HIV
42
What does malassezia infection of the skin cause?
Pityriasis versicolour
43
How do you diagnose scabies?
Microscopy of skin scrapings
44
What are the adverse effects of topical steroids?
Cutaneous atrophy Telangectasia Striae Cataracts
45
What is the tx for seborrheic dermatitis?
Topical antifungal cream (ketoconazole) and mild-moderate steroid
46
What condition do you suspect in a middle aged man with multiple itchy nodules worse on the outer aspects of the body?
Nodular prurigo
47
Which self-limiting condition affecting children and young adults is preceded by a herald patch and followed by generalized rash over the torso?
Pityriasis rosea
48
Shiny white, sore, itchy lesions affecting the genital area is likely to be what?
Lichen sclerosis
49
How is lichen sclerosis treated?
Short course potent corticosteroids
50
What condition causes abscesses and scarring affecting apocrine pilosebaceous follicles?
Hidradenitis suppurativa
51
What is the first line tx for acne vulgaris?
Topical retinoid + benzoyl peroxide (keratolytic)
52
Which condition fisrt presents as flushing of face and is then followed by diffuse erythema and papules/pustules?
Rosacea
53
Use of what medication is linked to triggering/exarcerbating rosacea
Steroids
54
What tx can be prescribed for rosacea?
Metronidazole/azelaic acid cream
55
Define erythroderma
Redness of greater than 90% body surface
56
Causes of erythroderma
Eczema, psoriasis, drugs
57
Comps of erythroderma
High output cardiac failure Hypothermia AKI (fluid depletion)
58
What is the most common trigger of erythema multiforme?
HSV
59
What is pyoderma gangrenosum assoc with?
IBD, RA, haematological malignancy, liver disease
60
what is acanthosis nigrans assoc with?
Insulin resistance, obesity. paraneoplastic syndromes
61
Give 3 tx for bowens disease
5-fluorouracil Cryotherapy curretage
62
Name a steroid in each potency
Mild - hydrocortisone Moderate - eumovate Potent - betnovate Very potent - dermovate
63
Systemic side effects of oral steroids
``` (SHIP DOC) Cushings HTN Immunosuppression Psychosis DM Osteoporosis Cataracts ```
64
Define eczema
Chronic, relapsing inflammatory skin condition characterised by itchy, erythematous scaly patches typically affecting the flexor surfaces of children/adults
65
What is the main ix for contact dermatitis?
Patch testing
66
What is RFs associated with acne?
Puberty PCOS Cushings steroid use
67
Types of melanoma
Superficial spreading Nodular Lentigo maligna melanoma Acral
68
How is bullous pemphigoid treated?
Wound dressings | Steroids
69
How is scabies treated?
Topical permethrin
70
Define Steven-Johnson syndrome?
Mucocutaneous necrosis of <10% body surface
71
Define toxic epidermal necrolysis
Mucocutaneous necrosis (>30% body) with systemic symptoms
72
What sign is present in TEN?
Nikolsky sign (sloughing of skin with pressure)
73
Comps of TEN?
dehydration, infection, sepsis, multi-organ failure
74
What organism most commonly causes nec fasc?
Group A haemolytic strep (S.PYOGENES)
75
Causes of systemic itch
``` Renal (CKD) Cholestatic Polycythaemia rubra vera Endocrine (thyroid) Malignant (e.g. HL) ```
76
What are the treatments for actinic keratosis?
Cryotherapy Curretage 5-fluorouracil
77
Which fungus is responsible for seborrheic dermatitis?
Malassezia
78
What are the features of neurofibromatosis type 1?
``` 6 or more café au lait spots Axillary freckling Lisch nodules Neurofibromas Optic glioma LD ```
79
What are the features of tuberous sclerosis?
``` Angiofibromas Ash leaf macules Periungal fibromas Shagreen patches Seizures ```
80
Which drugs cause TEN?
ANTIEPILEPTICS allopurinol NSAIDs
81
How is pityriasis versicolor diagnosis confirmed?
Yellow green fluorescence on wood lamp

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