Dermatology Flashcards
(146 cards)
1
Q
What is the management of extensive fungal nail infection by dermatophytes?
A
- Oral terbinafine
2
Q
How should a child with new-onset purpura be managed?
A
Immediate referral to secondary care to exclude ALL
3
Q
Where are keloid scars most common?
A
Sternum
4
Q
What is the management of athletes foot?
A
- Topical miconazole
- terbinafine
5
Q
What medications exacerbate plaque psoriasis?
A
Beta blockers, lithium, antimalarias, NSAIDS and ACE
6
Q
What should be used for long-term psoriasis?
A
Calcipotriol
7
Q
What is pemphigoid gestationis?
A
Pruritic blistering lesions which in the peri-umbilical region and can then spread to trunk, back buttocks and arms in the 2nd/3rd trimester
8
Q
When does pemphigoid gestationis present?
A
In the second/third pregnancy
9
Q
How is pemphigoid gestationis managed?
A
Oral corticosteroids
10
Q
What can make perioral dermatitis worse?
A
Topical steroids
11
Q
What is the first line management of venous ulcers?
A
Compression bandaging
12
Q
What is a rare side effects of penicllins?
A
Toxic epidermal necrolysis
13
Q
What is the most common malignancy associated with acanthosis nigricans?
A
gastrointestinal adenocarcinoma
14
Q
What are some causes of acanthosis nigricans?
A
- T2DM
- PCOS
- Obesity
- Cushing’s disease
- Acromegaly
- COCP
15
Q
purple, polygonal, pruritic papules suggest what?
A
Lichen planus
16
Q
What is a port wine stain?
A
A vascular birthmark: deep red or purple colour usually over the cheek
17
Q
What is a strawberry naevus?
A
A soft raised vascular swelling which is bright red in colour
18
Q
What is a salmon patch?
A
A flat dull-red area usually on the face and neck, usually in the midline which causes no symptoms
19
Q
What derm feature is associated with Sturge Webber syndrome?
A
Port wine stain
20
Q
What is pityriasis versicolor?
A
A superficial fungal (Malassezia) infection which affects the trunk causing pink/brown patches, sometimes after a suntan
21
Q
What is the management of pityriasis versicolor?
A
Topical antifungal: ketoconazole
22
Q
Salmon patch vs port wine stain?
A
Salmon patch will usually self resolve
23
Q
What is toxic epidermal necrolysis?
A
A emergency scaled skin appearance usually secondary to a drug reaction
24
Q
How does toxic epidermal necrolysis present?
A
- Systemically unwell patient
- Positive Nikolsky sign: epidermis separates with mild lateral pressure
25
What drugs are known to induce toxic epidermal necrolysis?
- Phenytoin
- Allopurinol
- Penicillins
- NSAIDs
- Carbamazepine
26
How is toxic epidermal necrolysis managed?
- Stop trigger
- Supportive care: fluid loss and electrolyte derangements are complications
- IV immunoglobulins are first line
27
What is pityriasis rosea?
An acute self limiting rash which affects younger people
28
How does pityriasis rosea present?
- Herald patch on trunk
- Followed by smaller red macules
- Lethargy
- Christmas tree distribution as on upper parts of arms and legs
29
Bowens vs SCC?
SCC will ulcerate, grow over weeks-months and may bleed
30
What is the management of Bowens?
Topical 5-fluorouracil
31
A rapidly progressing painful rash in children with atopic eczema suggests what?
Eczema herpeticum
32
How is eczema herpeticum managed?
Admission for IV aciclovir with urgent derm and opthal review
33
What are causes of erythema nodosum?
NO cause
Drugs
OCP
Sarcoidosis
UC and Crohns
Microorganisms such as TB, Strep and Chlamydia
34
What is erythema ab igne?
A skin disorder associated with over exposure to infrared radiation: hot water bottles or open fires
35
How should patients with moderate/severe papules in rosacea be managed?
Topical ivermectin and oral doxycycline
36
What is the management of refractory pain in shingles?
Prednisolone
37
What can iron deficiency anaemia cause?
Pruritus
38
What is the management of athletes foot?
- Topical imidazole
- Terbinafine
39
What is a complication of burns?
Curlings ulcers - acute gastric ulcers which develop in response to physiological stress: usually present with vomiting blood
40
What pathogen causes eczema herpeticum?
Herpes simplex 1/2
41
When to use skin patch vs skin prick test?
Skin patch - used for contact dermatitis
Skin prick - used for immediate hypersensitivity reactions e.g. food and resp allergies
42
Skin infection occurring 2-4 weeks after a strep infection?
Guttate psoriasis
43
'tear drop papule on the trunk and limb'
Guttate psoriasis
44
What is livedo reticularis?
- A non-blanching, reticulated rash caused by obstruction of the capillaries
- Can be idiopathic or part of SLE, Ehlers-Danlos
45
non-healing painless ulcer associated with a chronic scar
Squamous cell carcinoma
46
How long will people with shingles be infectious?
Until the vesicles have crusted over - 5-7 days after onset
47
Steroid treatment in psoriasis?
Aim for 4 week break in between courses
48
What is the main reason for using antivirals for shingles?
Reduce post herpetic neuralgia
49
What phenomenon does psoriasis exhibit?
Koebner phenomenon - new skin lesions form at the site of cutaneous injury
50
What is the most important prognostic factor with malignant melanoma?
Depth of the lesion
51
intensely pruritic rash on the palms and soles
pomphlyx eczema
52
What term condition can isoniazid cause?
Pellagra - dermatitis, diarrhoea and dementia
53
How is rosacea managed?
Predominant flushing: topical brimonidine
Mild-moderate papules: topical ivermectin
Moderate-severe papules: tropical ivermictin + oral doxycycline
54
single well-demarcated, erythematous circular patch with a raised edge and central hypopigmentation
tinea corpis
55
Management of severe urticaria?
Short course of oral steroids plus anti-histamine
56
What should be screened for before starting isotretinoin?
Mental health conditions/Pregnany
57
What is a wheal?
Transient, raised lesions due to underlying dermal oedema -> urticaria
58
What does histology of eczema show?
IgE mediated response
- Epidermal acanthosis
- Hyperkeratosis
- Parakeratosis
59
red scaling plaques in sun exposed areas of skin
Discoid lupus
60
Actinic keratosis vs sebhorreic keratosis?
AK - lesions lighter in colour + more in line with the skin, SK - lesions will be much darker + stuck on appearance
61
What can be used for patients with severe childhood eczema?
Wet wrapping
62
Flu-illness, dry cough, target shaped lesions + anaemia
Erythema multiforme caused by Mycoplasma pneumonia
63
Which organisms cause necrotising fasciitis?
Type 1 - mixed
Type 2 - strep pyogenes
64
What are risk factors for malignant melanoma?
- Fair complexion
- FH
- Sunburn
- Sun exposure
65
What are sites where malignant melanoma can occur?
- Choroid of the eye
- CNS
- GI tract
- Neck
66
What are features of BCC?
- Small, pearly white lesion
- Rolled edge
- Central ulcer
- Can be pigmented
67
What surgical technique can be used for BCC?
Mohs micrographic surgery
68
What is the pathophysiology of acne?
Increased sebum production leads to the pilosebaceous follicles becoming blocked and infected
69
Which bacteria is involved with acne?
Propionbacterium acnes
70
What are S/E of isotretinoin?
Dry skin, dry eyes, depression, migraine, muscle aches
71
What is the name for SCC carcinoma in situ?
Bowens
72
What anatomical sites on head and neck give worst prognosis for SCC?
Ear and lip
73
What is the management of lichen sclerosus?
Topical steroids and emollients
74
What does lichen sclerosus increase the risk of
Vulval cancer
75
Most common organism for cellulitis?
Strep pyogenes then staph aureus
76
Incredibly itchy blisters + papules in someone with coeliac?
Dermatitis herpetiformis
77
What classification system is used for patients with cellulitis?
Eron
78
What is the Abx of choice for severe cellulitis?
Co-Amox / Clindamycin
79
Target lesions on back of hands/feet spreading to limbs?
Erythema multiforme
80
What is erythema nodosum?
Painful inflammation of the sub cut fat more common in females
81
Lichen planus vs lichen sclerosus
Planus - can affect inside the vagina, Sclerosus will only affect the external genitals
Planus - purpuric papular lesions, Sclerosus - small, white plaques
82
'saw tooth pattern of epidermal hyperplasia, T-cell infiltration and reduced melanocytes'
Lichen planus
83
Round, pearly papules in crops in children?
Think Molluscum - no treatment needed
84
Erythema multiforme vs pityriasis vericolor?
Pityriasis - white/brown patches with dry scaly skin usually on trunk
Erythema - red, round lesions
85
Papular rash around abdomen/wrist/inner thigh which itches worse at night?
Scabies - treat with Permethrin for all household members
86
Flaky rash on face/scalp/trunk which is not itchy?
Seborrheic Dermatitis
87
Which fungus causes seborrheic dermatitis?
Malassezia furfur
88
What conditions are associated with seborrheic dermatitis?
Parkinsons / HIV
89
What are common complications of seborrheic dermatitis?
Otitis externa / Blepharitis
90
Most common and most aggressive form of melanoma?
Common - superficial spreading
Aggressive - Nodular
91
What is the management of actinic keratoses?
- Avoid sun
- Fluorouracil cream
92
What is erythroderma?
Complex process leading to rapid epidermal cell turnover -> large desquamated area which is red and painful
93
What is the management of erythroderma?
Urgent derm referral with admission to burns unit for emollients, fluids and wet balances
94
What can often cause erythroderma?
Drugs like sulphonylureas, isoniazid and sulphonamides
95
Which antibiotic causes red man syndrome?
Vancomycin
96
Signs of psoriasis on nails?
- Nail pitting
- Oncholysis
- Oil drop sign
97
What sign in psoriasis where pinpoint bleeding occurs when scales are scraped?
Auspitz sign
98
What are the ABCDE of lesions?
Asymmetry
Border
Colour change
Diameter > 6mm
Evolving lesion
99
What are cardinal signs of inflammation?
Dolor
Calor
Rubor
Tumour
Loss of function
100
What autoimmune diseases are associated with dermatitis herpetiformis?
- Coeliac
- Vitiligo
- Addisons
- T1DM
101
What are skin manifestations of liver disease?
- Flushing
- Hyperpigmentation
- Palmar erythema
- Jaundice
- Spider naevi
102
What are nail manifestations of liver disease?
- Clubbing
- Koilonychia
- Leukonychia
103
What is seborrheic keratosis?
Benign warty epidermal growths which occur in older patients - can be removed by cryotherapy/curettage
104
What is folliculitis?
Inflammatory condition of hair follicles caused by Staph aureus
105
Crusty lesion which may bleed easily when bumped or scratched?
SCC
106
What type of hypersensitivity reaction is scabies?
delayed type IV
107
How long can pruritus persist for with scabies?
6 weeks
108
Red or black lump, oozes or bleeds, sun-exposed skin
Nodular melanoma
109
Acute onset of tear-drop scaly papules on trunk and limbs
Guttate psoriasis
110
Afro-Carribean with nodule not on sun exposed area?
Think acral lentiginous melanoma
111
How often should people with scabies be treated?
Twice with treatments one week apart
112
PUVA therapy is associated with what?
SCC
113
Hard swelling near the umbilicus?
Think Sister Mary Joseph nodule - gastric cancer
114
Rash improving with sunlight?
Psoriasis
115
Small lower limb ulcer which develops into deep ulcer following minor trauma?
Think pyoderma gangrenosum - treat with prednisolone
116
What is pyoderma gangrenosum associated with?
- Diabetes
- IBD
- GPA
- Sarcoidosis
- Thyroid disorders
117
widespread raised papules with a central umbilication on his trunk, face, hands, legs and feet
Molluscum contagiosum
118
What can persistent molluscum be a sign of?
Immunocompromise -> HIV testing needed
119
Layers of the skin?
- Epidermis
- Dermis
- Subcut tissue
120
Topical corticosteroids can cause what?
Skin depigmentation in patients with darker skin
121
Bullous pemphigoid vs pemphigus vulgaris?
BP - elderly patient with deep blisters and no mucosal involvement -> treat with topical steroids
PV - middle aged patient with superficial blisters, mucousal involvement -> treat with oral steroids/immunosuppression
122
pruritic wheals?
Urticaria
123
red, scaly rash on the face and scalp which is itchy
Sebhorreic dermatitis
124
What is the most common infection which cause erythema multiforme?
Herpes simplex virus
125
What is vitiligo?
Loss of melanocytes in the skin's epidermis
126
What causes erythroderma?
- Dermatitis
- Psoriasis
- Drug allergies
- Idiopathic
127
What is the management of keratoacanthomas?
Surgical excision
128
purpura, abdominal pain, and arthritis
Henoch-Schonlein Purpura - IgA mediated vasculitis triggered by infection
129
coin-shaped lesions that are well-demarcated, with exudates and crusting
Discoid eczema
130
Steroid makes a rash worse?
Think fungal causes
131
Deep pustular ulcer on leg which is very painful?
Think pyoderma gangrenosum
132
When to do wide local excision vs Mohs micrographic surgery?
Mohs used for lesions where tissue loss should be minimised e.g. face
133
Bullous pemphigoid has antibodies against what?
Epithelial basement membrane
134
Actinic keratosis is a precursor for what?
Squamous cell carcinoma
135
Sebhorreic keratosis is associated with what?
Gastric/Colorectal adenocarcinoma
136
Most common cause of erythroderma?
Skin condition such as psoriasis or eczema
137
Staph scalded skin vs TEN
TEN will have mucosal involvement - usually oral
138
What is the management of scalded skin?
IV Flucloxacillin
139
Withdrawal of steroids can be a trigger for what?
Psoriasis
140
Butterfly rash + ashleef macules + shagreen patch
Tuberous sclerosis
141
Management of molluscum
Watch and wait
142
Blistrs which cover most of the skin following an injury/graze?
Staph scalded skin
143
Skin prick vs patch testing?
Prick - T1 Hypersensitivity reactions
Patch - T4 Hypersensitivity
144
What is the most common type of BCC?
Nodular
145
Round/firm lesion following minor trauma?
Dermatofibroma
146
Hypopigmented skin on face/limbs/face with sensory loss in a traveller?
Leprosy -> treat with rifampicin, dapsone
