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Y3 GP > Dermatology > Flashcards

Dermatology Flashcards

(92 cards)

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1
Q

What should be asked in a history for a dermatological condition ?

A

Site of onset And any evolution
Duration - acute / chronic
Distribution
Flexor / extensor
Sun exposed area
Affecting mucous membranes
Ask about symptoms - itchy or sore
Aggravating or relieving factors
PMH
Any atopy in the family
Drug history
Travel history
Any current stress

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2
Q

What is the medical term for a small lump ( less than 5mm ) ?

A

Papule

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3
Q

What is the medical term for a larger lump ( 5 - 10 mm ) ?

A

Nodule

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4
Q

What is the medical term for redness ?

A

Erythema

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5
Q

What is the medical term for a small water blister ?

A

Vesicle

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6
Q

What is the medical term for a large water blister ?

A

Bulla

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7
Q

What is the medical term for a pus filled vesicle ?

A

Pustule

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8
Q

What is the medical term for a hairiness ?

A

Hirsutism

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9
Q

What is the medical term for scratch marks ?

A

Excoriations

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10
Q

What is the medical term for stretch marks ?

A

Striae

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11
Q

What is the medical term for itching ?

A

Pruritus

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12
Q

What is a macule ?

A

A non palpable area of discolouration

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13
Q

what is a patch ?

A

Macule larger than 2cm

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14
Q

What is a plaque ?

A

Palpable, flat topped area 1-2cm

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15
Q

What is an ulcer ?

A

Loss of epidermis and dermis

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16
Q

What is lichenification ?

A

Thickening of the skin with exaggerated skin markings

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17
Q

What is cellulitis ?

A

A deep infection of the connective tissue, usually skin and subcutaneous tissues, in which there is obvious oedema.

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18
Q

What are the most commonly causative agents of cellulitis ?

A

Streptococcus pyogenes
Staphylococcus aureus

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19
Q

How does cellulitis present ?

A

Hot
Tender
Redness
Fever
Rigors

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20
Q

What investigations are done when suspecting cellulitis ?

A

FBC
Blood cultures
Swabs of the area

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21
Q

What is the treatment of cellulitis ?

A

Systemic antibiotics for example oral penicillin V plus flucloxacillin

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22
Q

What is erysipelas ?

A

A rapidly spreading streptococcal infection of the skin and subcutaneous tissue characterised by cellulitis and lymphangitis.

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23
Q

What is the most likely cause of erysipelas ?

A

Streptococcus pyogenes

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24
Q

What are some clinical features of erysipelas ?

A

Fever
Tachycardia
Chills
Malaise
Red, hot, tender ( usually red shiny plaque on face )

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25
What investigations are performed when suspecting erysipelas ?
Swab to culture There is also often Leucocytosis and a raised ESR
26
What are some differentials for erysipelas ?
Cellulitis Erysipeloid Necrotising fasciitis
27
What is the management of erysipelas ?
Offer antibiotics - flucloxacillin is first line or clarithromycin or doxycycline
28
What are some complications of erysipelas ?
Arthritis in near by joints Sepsis ( rare ) Endocarditis ( rare )
29
What is impetigo ?
A highly contagious, superficial skin infection caused by staphylococcus aureus or streptococcus pyogenes.
30
What are some clinical features of impetigo ?
Multiple lesions affecting the face or extremities. Honey coloured or golden crusts Itching is common but should be resisted
31
What is the management of impetigo ?
Swab the lesions and culture Topical treatment - topical fusidic acid or mupirocin If systemically ill treat with oral antibiotics such as flucloxacillin
32
What are some complications of impetigo ?
Pneumonia Glomerulonephritis Osteomyelitis
33
What is candidiasis ?
An infection caused by the yeast Candida albicans
34
What is tinea ?
It is a very common superficial fungal skin infection caused by dermatophytes. Usually causes athletes foot, nail infections, tinea corporis.
35
How can a dermatophyte infection be transmitted ?
Direct contact with the infected person or animal Contact with the soil - rare Indirect contact - through objects contaminated with the fungus
36
What is tinea ( a dermatophyte infection ) associated with ?
Hot, humid environments Sweating or maceration of the skin Use of hair greases or oils Occlusive footwear DM
37
What are some clinical features of tinea pedis ?
Affects toe webs, sole or lateral aspect of the foot Itchy Erythematous, soggy scaling
38
What are some clinical features of tinea corporis ?
Itchy erythematous rash Usually on the groin or axillae One or more scaly papules
39
What are the differences between the 2 types of herpes infections ?
Type 1 or HSV I - spread by infected saliva, oral facial lesions Type 2 or HSV II - spread by genital contact, vesicles on the genitalia
40
How does herpes simplex infections present ?
Blisters or sores around the mouth, nose, genitals and buttocks but may occur Lamotrigine anywhere on the skin.
41
What are some investigations to perform when suspecting herpes simplex infection ?
Diagnosis is usually clinical Swab and send for culture
42
What is the management of a herpes simplex infection ?
The infection can be self limiting Oral anti-viral medications include Acyclovir Used to reduce pain, viral shedding and healing time
43
What is molluscum contagiosum ?
A viral skin disease characterised by firm, round, translucent, multiple, dome shaped papules. Is it usually benign.
44
How does molluscum contagiosum spread ?
Direct skin - skin contact
45
What are some clinical features of molluscum contagiosum ?
Pink or white shiny wax-like papules Dome shaped - central pit Mildly itchy Usually on trunk, inner thighs and genitalia
46
What are some differentials for molluscum contagiosum ?
Warts Sebaceous cysts
47
What is the management of molluscum contagiosum ?
No specific treatment is required - usually self limiting Can use cryotherapy or expression of the contents of the pearly core
48
What is shingles ?
An acute, unilateral, self limiting inflammatory disease of cerebral ganglia and the ganglia of posterior nerve roots and peripheral nerves in a segmented distribution caused by the varicella zoster virus.
49
What are the clinical features of the shingles ?
Occurs 1 - 5 days before the onset of the rash Malaise Headache Photophobia Itchy Burning Affects singular dermatomes
50
What are some differentials for shingles ?
HSV Impetigo Candidiasis Contact dermatitis Insect bites
51
What are some complications of shingles ?
Neuralgia Temporary paralysis Neurological complications - encephalitis, hemiparesis, Guillian-Barre syndrome
52
What treatment can be given for shingles ?55
Oral antivirals Analgesics
53
What is chicken pox ?
A highly infective disease predominately of children under the age of 10 caused by the varicella zoster virus
54
How is chicken pox transmitted ?
Direct person to person contact Airborne droplet infection Contact with infected articles of clothing
55
What are some clinical features of chicken pox ?
Incubation 14 - 21 days Macular lesions which develop it not papular or vesicular lesions Mostly affects the face, trunk and sparsely on the limbs Erythema Itchy
56
What are some differentials for chicken pox ?
Herpes simplex Impetigo Contact dermatitis Scabies
57
What treatment options are there for chicken pox ?
Paracetamol Calamine lotion Oral acyclovir can be given for adults
58
What are some complications of chicken pox ?
Pneumonia Cerebellar ataxia Encephalitis Bacterial infection of the lesion
59
What is basal cell carcinoma ?
A locally invasive carcinoma of the basal layer of the epidermis. It almost never metastasises.
60
What are some features of basal cell carcinoma ?
Slow growing locally invasive Malignant
61
What are some clinical features of basal cell carcinoma ?
Usually affects elderly and middle aged people Common sites are in scar tissue or sun damaged skin Small pearly white nodule with visible blood vessels
62
What are some causes of basal cell carcinoma ?
Sun exposure Related to Gorlin’s disease
63
What is the treatment for basal cell carcinoma ?
Surgery - excision Radiotherapy Chemotherapy
64
What is a squamous cell carcinoma ?
A malignant tumour of the epidermis in which the cells, if differentiated, show keratin formation.
65
What are some causes of squamous cell carcinoma ?
Exposure to UV light Chronic exposure to industrial carcinogens Premalignant conditions - bowens disease Immunosuppression
66
What are some differentials for squamous cell carcinoma ?
Basal cell carcinoma Keratocanthoma Malignant melanoma
67
What are some clinical features of squamous cell carcinoma ?
Develop on sun exposed skin Rapidly expanding Painless Ulcerated nodules Cauliflower appearance Metastatic spread may occur via local lymph nodes
68
What is the management of squamous cell carcinoma ?
If it is localised and well differentiated ( producing keratin pearls ) can excise it Poorly differentiated lesions may require the addition of radiotherapy
69
What is melanoma ?
Malignant tumour of the pigment producing cells of the skin - melanocytes. It is not restricted to the skin and can affect the eyes, mucosa, GI tract and Genitourinary tract.
70
What are some risk factors of melanoma ?
UV radio audio exposure Family history History of 3 more severe sun burns Presence of freckles Immunosuppression Blonde or red hair
71
What are some clinical features of melanoma ?
May arise from moles Ulcerated Inflamed Irregular edges Changes in colour Changes in shape Changes in size Itching
72
What are some differentials for melanoma ?
Benign naevi Pigmented basal cell carcinoma Kaposi’s sarcoma
73
What investigations are performed when melanoma is suspected ?
Excision biopsy CXR LFT’S FBC CT scan Sentinel lymph node biopsy
74
What is the management of melanoma ?
Excision biopsy and histological examination Surgery to excise the cancer May need additional radiotherapy or immunotherapy if more advanced.
75
What is the ABCDE guide to checking moles ?
Asymmetry Border - irregular Colour - uneven and different shades of colour Diameter - at least 6mm Evolution - has changed in appearance
76
What is eczema ?
A common and chronic relapsing inflammatory skin disorder characterised by intense pruritis and excoriation.
77
What are some characteristic features of eczema ?
Itch Hot skin Oedema Oozing and weeping Crusting Excoriation Secondary infection
78
What is the management of eczema ?
Emollients - combat dry skin Topical corticosteroids Topical calcineurin inhibitors - Tacrolimus Antibiotcs if infected Antihistamines
79
What is psoriasis ?
A common chronic skin disease characterised by cutaneous inflammation and epidermal hyper proliferation usually over the extensor aspect of the knees and elbows.
80
What causes psoriasis ?
Genetics Infection Stress Trauma Drugs Smoking and alcohol
81
How is a diagnosis of psoriasis made ?
Based on clinical features Rarely a biopsy is needed Scalp lesions and nail lesions
82
How does psoriasis present ?
Raised, erythematous and scaly lesions Red and silvery scales Bleeding Itching Oozing
83
What are the treatment options for psoriasis ?
Corticosteroids Vitamin D analogues Phototherapies
84
What is the referral criteria for psoriasis ?
Diagnosis is uncertain Psoriasis is severe Nail disease Children
85
What is acne vulgaris ?
A common chronic inflammatory disease of the pilosebaceous unit. It is characterised by the obstruction of the pilosebaceous follicle with keratin plugs resulting in comedones, inflammation and pustules.
86
What are some clinical features of acne vulgaris ?
Comedones - blackheads, whiteheads, sandpaper Papules ( inflamed ) Pustules ( contains pus ) Lesions usually present on the forehead, nose and chin. It can also affect the upper chest and back. Scarring can occur
87
What are some treatment options for acne vulgaris ?
Topical retinoid Topical antibiotic + benzoyl peroxide Topical corticosteroids shouldn’t be used
88
When should a referral be made to a dermatologist be made for acne vulgaris ?
Hasn’t responded to 2 completed courses of treatment Acne with scarring Persistent pigmentary changes Psychological harm
89
What is urticaria ?
Vascular reaction of the skin marked by transient appearance of slightly elevated patches and red or pale swellings with severe itching.
90
What are the clinical features of urticaria ?
Rapid change erythematous Itchy Swellings Blotches
91
What investigations should be performed when suspecting urticaria ?
Diagnosis is mainly clinical FBC - Hb, WBC, eosinophils, platelets ESR LFT’s Urinalysis
92
What is the management of urticaria ?
Avoid triggers Antihistamines Antileukotrienes Corticosteroids Adrenaline - acute

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