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Things I don't know, but need to know, for fourth year > Dermatology > Flashcards

Dermatology Flashcards

(75 cards)

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1
Q

Toxic Epidermal Necrolysis - Cause

A

NSAID, Penicillin, Sulphonamides, Allopurinol, Carbamezapine, Phenytoin

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2
Q

Toxic Epidermal Necrolysis - Presentation

A

Systemically Unwell
Nikolsky +ve
Affects mucosa

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3
Q

Toxic Epidermal Necrolysis - Treatment

A

IV Immunoglobulins

Immunosuppresion

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4
Q

At what body coverage is Steven Johnson Syndrome diagnosed?

A

<10%

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5
Q

At what body percentage is TEN diagnosed?

A

> 30%

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6
Q

Primary Management of Extensor Psoriasis

A

Topical Potent Steroid + Topical Vit D for 8 weeks 1x daily
After 4 weeks no improvement -> 4 weeks Vit D 2x daily
Potent Steroid 2x daily or Coal Tar

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7
Q

If the psoriasis is on the face or body how is it treated?

A

Mild or moderate topical steroid 1/2x daily for two weeks

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8
Q

If the patient has scalp psoriasis how is it treated?

A

Potent Topical steroid 1x daily

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9
Q

If initial management for scalp psoriasis hasn’t worked what is second line?

A

Different application method i.e shampoo

+ salicylic acid applied before

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10
Q

Lichen Planus - Signs and Symptoms

A 
Purple
Pruritic
Papular
Polygonal 
Flat
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11
Q

Triggers for lichen planus flairs.

A 
B blockers
Thiazides
Penicillamine
ACEi
Anti malaria's
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12
Q

Seborrhoic Dermatitis - Management

A

Topical Antifungal - Ketoconazole
Steroids - used in short term
If scalp - Head and Shoulders

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13
Q

Rosacea - Treatment

A

Mild - Topical Metronidazole
Severe - Oral Oxytetracyline
Flushing - Topical Brimonidine
Telangectasia - Laser therapy

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14
Q

Behcets

A

Oral + Genital Ulcers + Anterior Uveitis

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15
Q

Erythema Ab Igne

A

Over exposure to infrared radiation

risk of squamous cell carcinoma

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16
Q

First line Abx for animal/human bite

A

Co-Amoxiclav

Doxycycline + Metronidazole

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17
Q

Mildy pruritic, hypo pigmented lesion generally

A

Ptyriasis Versicolour

Topical ketoconazole

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18
Q

Causes of erythema multiform

A

HSV #

Mycoplasma, streptococcus, penicillin, sulph, carbamezapine, allopurinol, NSAIDs, COCP, SLE, Sarcoidosisi

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19
Q 
Abdominal Pain 
Vomting
Motor Neuropathy 
Depression
Hypertension 
Tachychardia
Urine turns RED on standing
A

Acute Intermittent Porphyria

Autosomal Dominant defect inn porphobilinogen deaminase -> reduce harm synthesis

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20
Q

Management of Acute Intermittent Porphyria

A

Avoid Triggers + IV Haem Arginate (Haematin)

IV glucose if unavailable

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21
Q

Pemphigus - general description

A

Nikolsky +ve
Intraepidermal IgG - desmoglein proteins
Affects mucous membranes
Systemic glucocorticoids is mainstay of treatment

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22
Q

Subtypes of Pemphigus and brief description

A

Vulgaris - Desmoglein III, ulceration and pain

Foliaceous -Desmogein I , Milder than vulgaris, no mucous membrane

IgA - Vesicles and erythematous plaques - occurs on trunk

Paraneoplastic - severe, erosive stomatitis, treat underlying cause, usually
haematogenous cancer

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23
Q

Management of Pemphigus

A

Systemic corticosteroid -> recurrence = reducing dose + rituximab
Azathioprine or mycophenolate
Plasma exchange in severe acute

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24
Q

Pemphigoid - general description

A

Nikolsky -ve
No mucous membrane involvement
IgG and compliment deposited subepidermally - along basement membrane

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25
Pemphigoid types
Bullous Pemphigoid Pemphigus Gestationis Mucous Membrane
26
Bullous Pemphigoid
Tense bullae preceded by pruritic plaque No scarring Potent topical steroid -> oral if severe - taper dose 2 weeks after last blister Long term cover - mycophenolate or azathioprine Non responsive - IV immunoglobulin or rituximab
27
Mucous membrane pemphigoid
Scarring is real risk | Blindness and airway compromise
28
Pemphigus Gestationis
Plaques and bullae develop around the umbilicus Topical -> oral steroids Delivery is curative
29
Dermatitis Herpetiformis
``` IgA deposition within the dermis Papules pustules and vesicles Erosions but no scarring Elbows knees buttocks Stop gluten + Dapson to reduce inflammation and blisters ```
30
Linear IgA bullous dermatitis
jewel like IgA deposition along basement membrane Drug induced - stop Vancomycin Antihypertensives NSAIDs Idiopathic - dapsone is given
31
Pityriasis Rosea
Herald spot Widespread with scale rings Resolves over 4-6 weeks rarely needs treatment Oral antihistamines or topical steroid occasionally Severe - oral acyclovir or phototherapy
32
Guttate psoriasis
Preceding URTI strep throat Small red individual spots May need similar treatment to psoriasis
33
Impetigo Management
1. Hydrogen Peroxide 1% 2. Fusidic acid 3. Mupirocin if MRSA 4. Oral flucloxacillin or erythromycin if pen allergic. For widespread or systemically unwell.
34
Impetigo - diagnosis and management
Staph Aureus or Strep Pyogenes Golden crusting Stay of school until 48 hours of abx or lesions have crusted over If antibiotics don't clear swab for sensitivity
35
Scabies managment
Permethrin is first line Malathion lotion second line All household and close contact individuals treated swell Clean all bedding and clothes
36
Scabies in an immunosuppressed patient?
Crusted "norwegian" scabies | Invermectin is first line
37
How long can the itch last post scabies treatment?
4-6 weeks
38
Excision margins in SCC
If lesion under 20mm = 4mm margin | If lesion over 20mm = 6mm margin
39
Describe the effect the breslow thickness has on the revision and wide local excision of the melanoma site.
``` 0-1mm = 1cm border 1-2mm = 1-2cm border 2-4mm = 2-3cm border >4mm = 3cm border ```
40
At what breslow thickness is a lymph node screen advised?
0.8mm
41
Can mimic NF Rapidly growing painful ulcer Linked to autoimmune diseases - Crohns, AS etc or minor trauma
Pyoderma Gangrenosum | Treat with steroids and immunosuppression NEVER surgical debridement Neutrophil mediated
42
Bright red raised lump - overgrowth of blood vessels Can mimic an amelanotic Melanoma Generally post trauma in diabetic etc
Pyogenic Granuloma
43
Management of a dermatophyte fungal nail infection.
Oral terbenafine 6 weeks to 3 months for fingernail 3 - 6 months for toe nail
44
Management of a candida fungal nail
Mild - topical amorolfine | Severe - oral itraconazole 12 weeks
45
Single rapidly growing lesion up to 1-2 cm Spontaneoulsy regresses sloughing of tissue Leaves scar
Smooth dome -> crater with keratin centre Keratoacanthoma - often precursor to SCC Requires excision
46
Black hairy tongue
Brown green or pink - slightly itchy Poor oral hygiene, recent antibiotics, head or neck irradiation, HIV and IVDU Tongue scraping required to rule out Candida NO treatment unless positive for candida
47
Localised well demarcated hair loss Broken exclamation mark hairs at border Linked to autoimmune conditions
Alopecia Areata 50% recover hair within a year 80-90% eventualy Topical steroids may be helpful
48
Cellulitis Management
Clinical Diagnosis Mild - Flucloxacillin or Clarithromycin in Pen allergic ( Erythromycin in pregnant) Severe - Co Amoxiclav Cefuroxime Clindamycin Ceftriaxone
49
When do you admit to hospital in cellulitis?
``` Severe or rapid spread <1yr Facial Cellulitis - unless very mild Frail Immunocompressed Significant Lymphedema ```
50
Purple papule or plaque affecting the skin or mucosa Often ulcerated Respiratory mucosal involvement leads to haemoptysis Hx of immunosuppression related diseases
Kaposi Sarcoma - HIV Human Herpes Virus 8 - Radiotherapy and resection
51
Commonest Melanoma
Superficial Spreading - younger - arms legs chest
52
Other types of less common melanoma
Nodular - 2nd commonest - sun exposed middle aged - lumpy and more aggressive Lentigo maligna - chronic sunexposed - older Acral lentigous - palms soles - darker skin types
53
Management of Tinea
Clinical diagnosis - | Topical Terbanifine -> no improvement skin scraping
54
Nodules + Pustules + Sinus tracks with rope like scars affecting the intertroginous areas. Recurrent furuncles and boils
Hidradenitis Supporative Smoking obesity PCOS and FH all risk factors Axilla is commonest site
55
Management of Hidradentis Suppurotiva
Good hygiene loose clothes weight loss and stop smoking Acute - Steroids (oral or intralesional) or flucloxacillin - Surgical excision and drainage Chronic - Topical clindamycin or oral lymecyline - surgical excision
56
Type 1 hypersensitivity
IgE mast cell Anaphylaxis Atopy Asthma etc
57
Type II Hypersensitivity
IgM or IgG binding to cells | Pernicious anaemia, Rheumatic fever, ITP, Autoimmune Haemolytic anaemia
58
Type III hypersensitivity
Antibody mediated deposition of immune complex | SLE, Post glomerulonephritis, farmers lung, extrinsic allergic alveolitis
59
Type IV Hypersensitivity
Delayed T cell mediated | Contact allergic dermatitis, Graft versus host, TB, MS, Guilian Barre, Chronic Extrinsic allergic alveolitis
60
Type V hypersensitivity
Graves or Myasthenia Gravis
61
Management of hyperhydrosis
Topical Aluminium Chloride Iontophoresis - gentle electrical stimulation Botulinum toxin - axilla transthorasc Sympathectomy
62
Cellulitis near nose or eyes. What antibiotic is required?
Co-Amoxiclav | Amoxicillin + Clavulanic Acid
63
Solitary firm papule which dimples on pinching.
Dermatofibroma
64
Necrotising Ulcerative Gingivitis - Management
Refer to dentist | Meanwhile give Metronidazole oral + Chlorehexidine Mouth wash + analgesia
65
Lichen Sclerosis - Management
Topical steroid + emollient | Tacrolimus if resistant to steroid
66
Management of a lipoma
Generally observed unless... | Uncertain of diagnosis or compressing on other structures - removed
67
When is an USS advised in a suspected lipoma?
``` Ruling out liposarcoma >5cm Increasing in size Pain Deep anatomical location ```
68
Koebners phenomena is common in
Psoriasis - # | Vitiligo
69
Commonest cause of leg cellulitis
Strep Pyogenes
70
Junctional Melanocytic naevi
Flat pigmented
71
Compound melanocytes naevi
Raised pigmented
72
Intradermal Melanocytic naevi
Raised and pale
73
Congenital melanocytic naevi
Present at birth | Large and hairy
74
Dysplastic melanocytic naevi
Atypical can resemble a melanoma
75
Spitz naevi
Develop in children Grow rapidly Pink or red in colour

Things I don't know, but need to know, for fourth year (31 decks)

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