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4th year passmed > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

What is the commonest infective agent of onychomycosis (fungal nail)?

A

Trichophyton rubrum

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2
Q

What differentials might you give for fungal nail?

A

Psoriasis
Repeated trauma
Lichen planus
Yellow nail syndrome

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3
Q

What is the management of acne?

A
  1. Single topical therapy (topical retinoids, benzoyl peroxide)
  2. Topical combo therapy (+ antibiotic)
  3. Oral abx e.g. tetracyclines
    a) COCP can be used as an alternative in pregnant women
  4. Oral isotretinoin under specialist supervision
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4
Q

When can patients with impetigo return to work?

A

After being on treatment for 48 hours

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5
Q

What is the management of venous ulceration which maximises the likelihood of healing?

A

Compression bandaging

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6
Q

What is the first line management of hyperhidrosis?

A

Aluminium chloride topical

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7
Q

What are the causes of erythema nodosum?

A 
Infection - strep, TB, brucella
Systemic - Sarcoid, IBD, Behcets
Malignancy
Drugs - Penicillin, sulphonamides, COCP
Pregnancy
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8
Q

What is the main complication of actinic keratoses?

A

SCC

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9
Q

Where would you typically find a pyoderma gangrenosum?

A

Lower limb or peristomal

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10
Q

What ar the causes of pyoderma gangrenosum?

A

Idiopathic
IBD
RA, SLE
Myeloproliferation

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11
Q

What is the management of pyoderma gangrenosum?

A
  1. Oral steroids

2. Immunosuppressive therapy

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12
Q

What is a side effect of topical side steroids particularly seen in darker patients?

A

Patchy depigmentation

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13
Q

What are the different steriod potencies and examples of each?

A

Mild - Hydrocortisone
Moderate - Betamethasone/Clobetasone
Potent - Fluticasone
Very potent - Clobetasol (Dermovate)

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14
Q

What conditions is vitiligo associated with?

A 
T1DM
Addison's 
Autoimmune thyroiditis
Pernicious anaemia
Alopecia areata
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15
Q

What is the management of vitiligo?

A

Sun block

Topical steroids if started early

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16
Q

What are the common and important side effects of isoretinoin?

A

Important - Teratogenicity, low mood

Common - Dry eyes, skin, and lips, raised triglycerides

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17
Q

What are the features of acne rosacea?

A

Affect nose, cheeks, forehead
Begins with flushing
Telangiectasia are common
Persistent erythema with papule form later one
Rhinophyma and blepharitis are later signs

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18
Q

What is the management of acne rosacea?

A

Topical metronidazole or PO if more severe disease

High factor suncream

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19
Q

Which drugs might cause worsening of plaque psoriasis?

A 
Beta blockers
Lithium
Antimalarials
NSAIDs
ACEi
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20
Q

What endocrine condition can cause acne vulgaris?

A

PCOS

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21
Q

What disease is dermatitis herpetiformis associated with?

A

Coeliac disease

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22
Q

How would you differentiate between pemphigus vulgaris and bullous pemphigoid?

A

Bullous pemphigoid is restricted to the skin, whereas phemphigus vulgaris also involves the mucosa

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23
Q

Where does acanthuses nigricans typically occur?

A

Axilla, neck, groin (folds)

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24
Q

What is pityriasis versicolor?

A

A superficial cutaneous fungal infection caused by Malassezia furfur

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25
What are the features of pityriasis versicolor?
trunk involvement predominantly with hypo pigmentation, pink our brown patches. Often scaly
26
What are the features of keratoacanthomata?
Volcano or crater like | Initially a smooth dome shaped papule which rapidly grows into a crater filled with keratin
27
What do 'exclamation mark' hairs indicate?
Alopecia areata
28
What is it important to screen for in patients with alopecia aerate?
Autoimmune disease - thyroiditis, diabetes, pernicious anaemia
29
What is the first line management of sevorrheic dermatitis?
Ketoconazole topical
30
When does guttate psoriasis classically present?
After a streptococcal or viral URTI
31
What factors might exacerbate acne rosacea?
Sunlight
32
Is dermatitis herpetiformis itchy?
Yis
33
What is a well recognised side effect of ketoconazole?
Gynaecomastia
34
Which malignancy is assocaited with acanthosis nigricans
GI Adenocarcinoma
35
What are the risk factors for SCC?
``` Sunlight Immunosuppression SMoking Chronic leg ulcers Actinic keratoses ```
36
What are the antibodies targeting in pemphigus vulgaris?
Desmosomes
37
Where are the lesions in HHT/Osler Weber Rendu?
Skin and mucosal membranes
38
What are the diagnostic criteria for HHT?
Epistaxes Telangiectasiae at multiple sites Visceral lesions e/g/ GI telangiectasia or pulmonary nodules FHx
39
What topical agent is commonly prescribed on diagnosis of actinic keratoses?
5-Fluorouracil cream for 2-3 weeks
40
What are the features of lichen planus?
Itchy papular rash on the palms, soles, genitals and flexor surfaces Polygonal rash Koebner phenomenon often seen (new lesions at site of trauma) White lace pattern on buccal mucosa
41
What is the most common cause of hirsutism and what drug is good in this use?
PCOS Dianette - Co-cyprindiol (also a COCP)
42
Peri-orbital and nasolabial scaly rash associated with dandruff =
Seborrhoeic dermatitis
43
What are the causes of erythema multiforme?
HSV - commonest cause Idiopathic Mycoplasma, Strep Drugs - Penicillin, sulphonamides, carbamazepine, NSAIDs, COCP CTDs e.g. SLE Sarcoid Malignany
44
What is the management of lichen planus?
Topical steroids are mainstay | Mayrequire oral steroids/immunosuppression if severe
45
How many skin types are there?
6
46
What is pityriasis rosea?
An acute self limiting viral rash with a Herald Patch on the trunk followed by erythematous, oval scaly patches which follow the lines of Langer producing a fir tree appearance
47
What is the disease course of pityrisaisis rosea?
Rash disappears after 6-12 weeks
48
What are the causes of leukonychia?
Hypoalbuminaemia Fungal disease Lymphoma
49
What is Nikolsky's sign?
Epidermis separates on mild lateral pressure
50
Which drugs are known to cause TEN?
``` Phenytoin Sulphonamides Allopurinol Penicillins Carbamazepine ```
51
How would you differentiate telangiectasia from spider naevi?
Telangiectasia refill from the edges, spider naevi refill from the centre
52
What is leukoplakia and who is it commonly seen in?
White hard spots of the mucous membranes commonly seen in smokers
53
Is leukoplakia serious?
Yes - premalignant
54
What are the systemic causes of pruritus?
``` Liver disease IDA Polycythaemia CKD Lymphoma Thyroid disease ```
55
What are some non liver related causes of spider naevi?
Pregnancy | COCP
56
What are the features of necrobiosis lipodica diabeticorum?
Shiny painless areas of yellow-red skin on the shin of diabetics. Associated with telangiectasia
57
Parkinson's is associated with which skin disease?
Seborrhoeic dermatitis
58
What is the management of chronic plaque psoriasis?
Regular emolients 1. Topical corticosteroids and VitD analogue for 4 weeks 2. If no improvement then up the VitD dose 3. Offercoal tar preparation 4. Short acting dithranol
59
What skin disorders are associated with SLE?
Photosensitive butterfly rash Discoid lupus Alopecia Livedo reticular (net-like)
60
What type of melanoma commonly affects the nail beds?
Acral lentiginous melanoma
61
What is the difference between lichen planus and lichen sclerosis?
Planus= purple pruritic papular polygonal rash on flexor surfaces Sclerosus= itch white spots on old ladies vulvae
62
Where are you most likely to find a keloid scar?
Sternum
63
What is the mainstay of treatment for bullous pemphigoid?
Oral steroids

4th year passmed (28 decks)

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