Dermatology Flashcards

1
Q

yellow nail syndrome associated with (4)

A

pleural effusions

bronchiectasis

chronic sinus infections

congenital lymphoedema

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2
Q

Causes of Stevens-Johnson syndrome

A

penicillin

sulphonamides

lamotrigine, carbamazepine, phenytoin

allopurinol

NSAIDs

oral contraceptive pill

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3
Q

Treatment of TEN

A
  1. stop precipitating factor
  2. supportive care
  3. Iv ig has been shown to be effective and is now commonly used first-line
  4. immunosuppressive agents (ciclosporin and cyclophosphamide),
  5. plasmapheresis
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4
Q

Treatment of SJS

A

hospital admission is required for supportive treatment

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5
Q

Pemphigus vulgaris is an autoimmune disease caused by antibodies directed against….

A

desmoglein 3, a cadherin-type epithelial cell adhesion molecule

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6
Q

mucosal ( ulceration ) involvement

In Bullous pemphigoid or Pemphigus vulgaris?

A

Pemphigus vulgaris

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7
Q

Pemphigus vulgaris is more common in the ……. population.

A

Ashkenazi Jewish

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8
Q

3 Features of Pemphigus vulgaris

A
  1. mucosal ulceration
  2. skin blistering
  3. acantholysis on biopsy
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9
Q

Treatment of Pemphigus vulgaris

A

steroids are first-line

immunosuppressants

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10
Q

Causes of Onycholysis

A

idiopathic

trauma e.g. Excessive manicuring

infection: especially fungal

skin disease: psoriasis, dermatitis

impaired peripheral circulation e.g. Raynaud’s

hyper- and hypothyroidism

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11
Q

Bullous pemphigoid is secondary to the development of antibodies against …….

A

hemidesmosomal proteins BP180 and BP230

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12
Q

Bullous pemphigoid is more common in

A

elderly patients

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13
Q

Skin biopsy in Bullous pemphigoid

A

immunofluorescence shows IgG and C3 at the dermoepidermal junction

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14
Q

Treatment of Bullous pemphigoid

A

referral to a dermatologist for biopsy and confirmation of diagnosis

oral corticosteroids are the mainstay of treatment

topical corticosteroids, immunosuppressants and antibiotics are also used

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15
Q

Causative organisms of Fungal nail infection (onychomycosis)

A
  1. dermatophytes

account for around 90% of cases

mainly Trichophyton rubrum

  1. yeasts

account for around 5-10% of cases

e.g.Candida

  1. non-dermatophyte moulds
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16
Q

4 Risk factors of Fungal nail infection (onychomycosis)

A

increasing age

diabetes mellitus

psoriasis

repeated nail trauma

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17
Q

Investigation of fungal nail infection

A

nail clippings +/- scrapings of the affected nail

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18
Q

Treatment of fungal nail infection

A
  1. do not need to be treated if it is asymptomatic
  2. dermatophyte or Candida infection is confirmed
    - limited involvement (‰¤50% nail affected, ‰¤ 2 nails affected, more superficial white onychomycosis): topical treatment with amorolfine 5% nail lacquer; 6 months for fingernails and 9 - 12 months for toenails
  • if more extensive involvement due to a dermatophyte infection:oral terbinafineis currently recommended first-line; 6 weeks - 3 months therapy is needed for fingernail infections whilst toenails should be treated for 3 - 6 months
  • if more extensive involvement due to a Candida infection: oral itraconazole is recommended first-line; ‘pulsed’ weekly therapy is recommended
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19
Q

11 Causes of Acanthosis nigricans

A
  1. T2DM
  2. Cushing’s disease
  3. acromegaly
  4. hypothyroidism
  5. polycystic ovarian syndrome
  6. obesity
  7. gastrointestinal cancer
  8. familial
  9. Prader-Willi syndrome
  10. OCP
  11. nicotinic acid
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20
Q

Pathophysiology of Acanthosis nigricans

insulin resistance → hyperinsulinemia → stimulation of ……….. via interaction with insulin-like growth factor receptor-1 (IGFR1)

A

keratinocytes and dermal fibroblast proliferation

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21
Q

small, crusty or scaly, lesions

may be pink, red, brown or the same colour as the skin

typically on sun-exposed areas e.g. temples of head

multiple lesions may be present

Features of

A

Actinic, or solar, keratoses

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22
Q

Managment of Actinic, or solar, keratoses

A

prevention of further risk: e.g. sun avoidance, sun cream

fluorouracil cream: typically a 2 to 3 week course. The skin will become red and inflamed - sometimes topical hydrocortisone is given following fluorouracil to help settle the inflammation

topical diclofenac: may be used for mild AKs. Moderate efficacy but much fewer side-effects

topical imiquimod: trials have shown good efficacy

cryotherapy

curettage and cautery

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23
Q

5 Causes of Scarring alopecia

A

trauma, burns

radiotherapy

lichen planus

tinea capitis

discoid lupus

  • Tom really likes To do scarring alopecia
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24
Q

Causes of Non-scarring alopecia

A

male-pattern baldness

drugs: cytotoxic drugs, carbimazole, heparin, oral contraceptive pill, colchicine

nutritional: iron and zinc deficiency

autoimmune: alopecia areata

telogen effluvium

hair loss following stressful period e.g. surgery

trichotillomania

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25
Q

Management of Basal cell carcinoma

A

surgical removal

curettage

cryotherapy

topical cream: imiquimod, fluorouracil

radiotherapy

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26
Q

Dermatitis herpetiformis caused by deposition of …..

A

IgA in the dermis

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27
Q

Diagnosis of Dermatitis herpetiformis

A

skin biopsy: direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

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28
Q

Treatment of Dermatitis herpetiformis

A

gluten-free diet

dapsone

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29
Q

Erythema ab igne If not treated then patients may go on to develop …..

A

squamous cell skin cancer

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30
Q

Erythema ab igne is a skin disorder caused by over exposure to …..

A

infrared radiation

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31
Q

Causes of erythroderma

A

eczema

psoriasis

drugs e.g. gold

lymphomas, leukaemias

idiopathic

  • Every person goes 2 look inside erythroderma
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32
Q

Erythrodermic psoriasis may be triggered by

A

withdrawal of systemic steroids

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33
Q

Erythrasma is a generally asymptomatic, flat, slightly scaly, pink or brown rash usually found in …..

A

the groin or axillae

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34
Q

Erythrasma is caused by an overgrowth of

A

diphtheroid Corynebacterium minutissimum

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35
Q

Wood’s light reveals a coral-red fluorescence.
Seen in

A

Erythrasma

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36
Q

Treatment of Erythrasma

A

Topical miconazole or antibacterial are usually effective.

Oral erythromycin may be used for more extensive infection

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37
Q

Erythema nodosum usually resolves within …

A

6 weeks

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38
Q

5 main Causes of Erythema nodosum

A
  1. infection

streptococci

tuberculosis

brucellosis

  1. systemic disease

sarcoidosis

inflammatory bowel disease

Behcet’s

  1. malignancy/lymphoma
  2. drugs

penicillins

sulphonamides

combined OCP

  1. pregnancy
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39
Q

Erythema multiforme is a hypersensitivity reaction that is most commonly triggered by ……

A

infections

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40
Q

In Erythema multiforme, the upper limbs are ….

A

more commonly affected than the lower limbs

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41
Q

Causes of erythema multiforme

A
  1. Viruses: HSV , Orf
  2. Bacteria: Mycoplasma,Streptococcus
  3. sarcoidosis
  4. malignancy
  5. connective tissue disease e.g. Systemic lupus erythematosus
  6. drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
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42
Q

The more severe form, erythema multiforme major is associated with

A

mucosal involvement.

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43
Q

Eczema herpeticum is a severe primary infection of the skin by

A

herpes simplex virus1 or 2

And uncommonly Coxsackievirus

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44
Q

Eczema herpeticum, the rash is characterized by

A

rapidly progressing painful rash

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45
Q

monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameterare typically seen in …….

A

Eczema herpeticum

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46
Q

Treatment of Eczema herpeticum

A

Admission
Iv acyclovir

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47
Q

dermatitis artefacta is strongly associated with

A

personality disorder, dissociative disorders and eating disorders

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48
Q

Acrodermatitis enteropathica is a ……. inherited partial defect in intestinal zinc absorption.

A

recessively

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49
Q

acrodermatitis
alopecia

short stature

hypogonadism

hepatosplenomegaly

geophagia (ingesting clay/soil)

cognitive impairment

Features of…

A

Zinc deficiency

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50
Q

Vitiligo is an autoimmune condition which results in the loss of ………. and consequent depigmentation of the skin

A

melanocytes

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51
Q

Vitiligo is associated with

A

type 1 diabetes mellitus

Addison’s disease

autoimmune thyroid disorders

pernicious anaemia

alopecia areata

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52
Q

Management vitiligo

A

sunblock for affected areas of skin

camouflage make-up

topical corticosteroids may reverse the changes if applied early

there may also be a role for topical tacrolimus and phototherapy, although caution needs to be exercised with light-skinned patients

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53
Q

ankle-brachial pressure index (ABPI)
1. Normal value …?
2. Below normal value indicates….?
3. Above the normal value indicates ….?

A
  1. 0.9 - 1.2
  2. indicate arterial disease
  3. indicate arterial disease, in the form of false-negative results secondary to arterial calcification (e.g. In diabetics)
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54
Q

Treatment of Venous ulceration

A
  1. compression bandaging, usually four layer (only treatment shown to be of real benefit)
  2. oral pentoxifylline, a peripheral vasodilator, improves healing rate
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55
Q

immune complex small-vessel vasculitis

A
  1. Henoch-Schonlein purpura
  2. Goodpasture’s syndrome (anti-glomerular basement membrane disease)
  3. cryoglobulinaemic vasculitis
  4. hypocomplementemic urticarial vasculitis (anti-C1q vasculitis)
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56
Q

Systemic mastocytosis results from a neoplastic proliferation of ….

A

mast cells

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57
Q

Features and Systemic mastocytosis

A
  1. urticaria pigmentosa - produces a wheal on rubbing (Darier’s sign)
  2. flushing
  3. abdominal pain
  4. monocytosis on the blood film
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58
Q

Diagnosis of Systemic mastocytosis

A

raised serum tryptase levels

urinary histamine

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59
Q

Causes of Tinea capitis

A

Trichophyton tonsurans (most common causein the UK and the USA)

Microsporum canis acquired from cats or dogs

60
Q

Management of Tinea capitis

A

oral antifungals:

  1. terbinafine for Trichophyton tonsurans infection
  2. griseofulvin for Microsporum infections
  3. Topical ketoconazole shampoo should be given for the first two weeks to reduce transmission
61
Q

Causes of Tinea corporis

A

Trichophyton rubrum and Trichophyton verrucosum(e.g. From contact with cattle)

62
Q

Treatment of Tinea corporis

A

oral fluconazole

63
Q

lesions due to Trichophyton species do not readily fluoresce under …..

A

Wood’s lamp

64
Q

Risk factors of Squamous cell carcinoma of skin

A
  1. excessive exposure to sunlight / psoralen UVA therapy
  2. actinic keratoses and Bowen’s disease
  3. immunosuppression e.g. following renal transplant, HIV
  4. smoking
  5. long-standing leg ulcers (Marjolin’s ulcer)
  6. genetic conditions e.g. xeroderma pigmentosum, oculocutaneous albinism
65
Q

Treatment of Squamous cell carcinoma of skin

A

Surgical excision with 4mm margins if lesion <20mm in diameter.

If tumour >20mm then margins should be 6mm

66
Q

Poor prognosis of Squamous cell carcinoma

A
  1. Poorly differentiated tumours
  2. > 20mm in diameter
  3. > 4mm deep
  4. Immunosupression for whatever reason
67
Q

Necrobiosis lipoidica often associated with

A

surrounding telangiectasia

68
Q

5 Skin disorders associated with diabetes

A
  1. Granuloma annulare
  2. Necrobiosis lipoidica
  3. Neuropathic ulcers
  4. Lipoatrophy
  5. Vitiligo
69
Q

6 Skin disorders associated with tuberculosis

A
  1. lupus vulgaris (accounts for 50% of cases)
  2. erythema nodosum
  3. scarring alopecia
  4. gumma
  5. verrucosa cutis
  6. scrofuloderma
70
Q

What is thecommonest skin disorder found in pregnancy

A

Atopic eruption of pregnancy

71
Q

pruritic blistering lesions

often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms

usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy

A

Pemphigoid gestationis

72
Q

Treatment of Pemphigoid gestationis

A

oral corticosteroids

73
Q

pruritic condition associated with last trimester

lesions often first appear in abdominal striae

A

Polymorphic eruption of pregnancy

74
Q

Tylosis associated with which malignancy

A

Oesophageal cancer

75
Q

Sweet’s syndrome associated with which malignancies?

A

Haematological malignancy e.g. Myelodysplasia - tender, purple plaques

76
Q

Pyoderma gangrenosum associated with which malignancies?

A

Myeloproliferative disorders

77
Q

Necrolytic migratory erythema associated with

A

Glucagonoma

78
Q

Migratory thrombophlebitis associated with

A

Pancreatic cancer

79
Q

Erythema gyratum repens associated with which malignancies

A

Lung cancer

80
Q

Acquired hypertrichosis lanuginosa associated with which malignancies?

A

Gastrointestinal and lung cancer

81
Q

Acquired ichthyosis associated with which malignancies?

A

Lymphoma

82
Q

Sezary syndrome is

A

type of T-cell cutaenous lymphoma

83
Q

Features of Sezary syndrome

A

pruritus

erythroderma typically affecting the palms, soles and face

atypical T cells

lymphadenopathy

hepatosplenomegaly

84
Q

Causes of Livedo reticularis

A
  1. Idiopathic
  2. SLE
  3. polyarteritis nodosa
  4. cryoglobulinaemia
  5. antiphospholipid syndrome
  6. Ehlers-Danlos Syndrome
  7. homocystinuria
85
Q

Nickel is a common cause allergic contact dermatitis and is an example of a type …… hypersensitivity reaction.

A

IV

86
Q

Predisposing factors of Keloid scars

A
  1. people with dark skin
  2. Male young adults, rare in the elderly
  3. sternum ( common site)
87
Q

Koebner phenomenon seen in

A

lichen planus

lichen sclerosus

psoriasis

vitiligo

warts

molluscum contagiosum

  • 2 like people very well & more
88
Q

Mycosis fungoides is a rare form of ….

A

cell lymphoma that affects the skin.

89
Q

Lentigo maligna is a type of ……1……,

typically progresses slowly but may at some stage become invasive causing …….2……

A
  1. melanoma
  2. lentigo maligna melanoma.
90
Q

Management of Hyperhidrosis

A
  1. topical aluminium chloride preparations are first-line. Main side effect is skin irritation
  2. botulinum toxin for axillary symptoms
  3. surgery: e.g. Endoscopic transthoracic sympathectomy. Patients should be made aware of the risk of compensatory sweating
91
Q

Guttate psoriasis may be precipitated by a

A

streptococcal infection2-4 weeks prior to the lesions appearing.

92
Q

Management of Guttate psoriasis

A
  1. most cases resolve spontaneously within 2-3 months
  2. topical agents as per psoriasis
  3. UVB phototherapy
  4. tonsillectomy may be necessary with recurrent episodes
93
Q

hereditary haemorrhagic telangiectasia (HHT) is anautosomal ……condition

A

dominant

94
Q

There are 4 main diagnostic criteria of hereditary haemorrhagic telangiectasia

A
  1. epistaxis : spontaneous, recurrent nosebleeds
  2. telangiectases: multiple at characteristic sites (lips, oral cavity, fingers, nose)
  3. visceral lesions: for example GI telangiectasia , pulmonary arteriovenous malformations , hepatic AVM, cerebral AVM, spinal AVM
  4. family history: a first-degree relative with HHT

If the pt has 2 then they are said to have a possible diagnosis of HHT.

If they meet 3 or more of the criteria they are said to have a definite diagnosis of HHT

95
Q

What is the most common causes of hirsutism

A

Polycystic ovarian syndrome

96
Q

11 Causes of Hirsutism

A
  1. Polycystic ovarian syndrome
  2. congenital adrenal hyperplasia
  3. androgen secreting ovarian tumour
  4. adrenal tumour
  5. androgen therapy
  6. Cushing’s syndrome
  7. obesity
  8. corticosteroids
  9. phenytoin
97
Q

Management of hirsutism

A
  1. weight loss if overweight
  2. cosmetic techniques such as waxing/bleaching
  3. consider using combined oral contraceptive pills such as co-cyprindiol (Dianette) or ethinylestradiol and drospirenone (Yasmin).
    * Co-cyprindiol should not be used long-term due to the increased risk of venous thromboembolism
  4. facial hirsutism: topical eflornithine - contraindicated in pregnancy and breast-feeding
98
Q

Causes of hypertrichosis

A

drugs: minoxidil, ciclosporin, diazoxide

congenital hypertrichosis lanuginosa, congenital hypertrichosis terminalis

porphyria cutanea tarda

anorexia nervosa

99
Q

Impetigo usually caused by

A

either Staphylcoccus aureus or Streptococcus pyogenes

100
Q

Impetigo is common in ….1….., particularly during ……2….. weather.

A
  1. children

2.warm

101
Q

Management of Impetigo

A
  1. hydrogen peroxide 1% cream(for ‘people who are not systemically unwell or at a high risk of complications)
  2. topical antibiotic creams
  3. Extensive disease

oral flucloxacillin

oral erythromycin if penicillin-allergic

102
Q

School exclusion In Impetigo

A

children should be excluded from school until the lesions are crusted and healed or 48 hours after commencing antibiotic treatment

103
Q

Lichenoid drug eruptions - causes

A

gold

quinine

thiazides

104
Q

itchy, papular rash most common on the palms, soles, genitalia and flexor surfaces of arms

rash often polygonal in shape, with a ‘white-lines’ pattern on the surface

oral involvement typically a white-lace pattern on the buccal mucosa

nails: thinning of nail plate, longitudinal ridging

Features of…..?

A

Lichen planus

105
Q

Managment of Lichen planus

A
  1. potent topical steroids are the mainstay of treatment
  2. benzydamine mouthwash or spray is recommended for oral lichen planus
  3. extensive lichen planus may require oral steroids or immunosuppression
106
Q

Lichen sclerosus usually affects ….1… and is more common in .2. …..

A
  1. the genitalia
  2. elderly females
107
Q

Management of Lichen sclerosus

A

topical steroids and emollients

108
Q

Lichen sclerosus increases risk of ….. cancer

A

vulval

109
Q

What is the most aggressive subtypes of melanoma?

A

Nodular melanoma

110
Q

In Molluscum contagiosum, Referral may be necessary in some circumstances:

A
  1. For people who are HIV-positive with extensive lesions urgent referral to a HIV specialist
  2. For people with eyelid-margin or ocular lesions and associated red eye urgent referral to an ophthalmologist
  3. Adults with anogenital lesions should be referred to genito-urinary medicine, for screening for other sexually transmitted infections
111
Q

Which virus is thought to play a role in the aetiology of pityriasis rosea

A

Herpes hominis virus 7 (HHV-7)

112
Q

Pityriasis versicolor is caused by

A

Malassezia furfur

113
Q

Management of Pityriasis versicolor

A

ketoconazole shampoo

if failure to respond to topical treatment then consider alternative diagnoses (e.g. send scrapings to confirm the diagnosis) + oral itraconazole

114
Q

Pompholyx eczema may be precipitated by

A

humidity (e.g. sweating) and high temperatures.

115
Q

Features of Pompholyx

A

pruritic small blisters on the palms and soles

116
Q

Management of Pompholyx

A

cool compresses

emollients

topical steroids

117
Q

Psoriasis is associated with HLA-……..

A

HLA-B13, -B17

118
Q

5 Complications of psoriasis

A

psoriatic arthropathy (around 10%)

increased incidence of metabolic syndrome

increased incidence of cardiovascular disease

increased incidence of venous thromboembolism

psychological distress

119
Q

factors may exacerbate psoriasis

A
  1. Trauma
  2. Alcohol
  3. withdrawal of systemic steroids
  4. drugs:beta blockers,lithium,NSAIDsandACEi, infliximab, antimalarials (chloroquineand hydroxychloroquine).

*Streptococcal infection may trigger guttate psoriasis.

120
Q

Chronic plaque psoriasis management

A

first-line : potent corticosteroid applied once daily plus vitamin D analogueapplied once daily for up to 4 weeks as initial treatment

second-line: if no improvement after 8 weeks then offer:

a vitamin D analogue twice daily

third-line: if no improvement after 8-12 weeks then offer either:

a potent corticosteroid applied twice daily for up to 4 weeks, or

a coal tar preparation applied once or twice daily

short-acting dithranol can also be used

121
Q

adverse effects of Phototherapy

A

skin ageing

squamous cell cancer (not melanoma)

122
Q

Dithranol inhibits…..

adverse effects :

A
  1. DNA synthesis
  2. adverse effects include burning, staining
123
Q

Coal tar inhibits ……..

A

DNA synthesis

124
Q

Seborrhoeic dermatitis is associated with

A

Parkinson’s disease

HIV

125
Q

common complications of seborrhoeic dermatitis

A

Otitis externa and blepharitis

126
Q

Treatment of Seborrhoeic dermatitis

A

Scalp disease management
1. the first-line treatment is ketoconazole 2% shampoo

  1. selenium sulphide and topical corticosteroid may also be useful

Face and body management

  1. topical antifungals: e.g.ketoconazole
  2. topical steroids: best used for short periods
127
Q

Seborrhoeic dermatitis is caused by

A

Malassezia furfur

128
Q

7 Adverse effects of Retinoids

A
  1. teratogenicity
  2. dry skin, eyes and lips/mouth
  3. Low mood
  4. raised triglycerides
  5. hair thinning
  6. photosensitivity
  7. intracranial hypertension:isotretinoin treatment should not be combined with tetracyclines for this reason
129
Q

Mild topical steroids by potency

A
  1. Hydrocortisone 0.5-2.5%
130
Q

Moderate topical steroids by potency

A
  1. Betamethasone 0.025%
  2. Clobetasone 0.05%
131
Q

Potent topical steroids by potency

A
  1. Fluticasone 0.05%
  2. Betamethasone 0.1%
132
Q

Very potent topical steroids by potency

A

Clobetasol 0.05%

133
Q

Features of Rosacea

A

typically affects nose, cheeks and forehead

flushing is often first symptom

telangiectasia are common

later develops into persistent erythema with papules and pustules

rhinophyma

ocular involvement: blepharitis

sunlight may exacerbate symptoms

134
Q

Management of Rosacea

Predominant erythema/flushing

A

Topical brimonidine gel ( alpha adrenergic agonist )

135
Q

Treatment of mild-to-moderate papules and/or pustules due to Rosacea

A

topical ivermectinis first-line

alternatives include: topical metronidazole

136
Q

Treatment of moderate-to-severe papules and/or pustulesdue to Rosacea

A

combination of topical ivermectin + oral doxycycline

137
Q

In Rosacea, Referral should be considered if

A
  1. patients with a rhinophyma
  2. symptoms have not improved with optimal management in primary care
138
Q

Managment of Pyogenic granuloma

A

lesions associated with pregnancy often resolve spontaneously post-partum

other lesions usually persist : Removal methods include
curettage and cauterisation, cryotherapy, excision

139
Q

Causes of Pyogenic granuloma

A

trauma

pregnancy

more common in women and young adults

140
Q

Causes of Pyoderma gangrenosum

A
  1. Idiopathic
  2. IBD
  3. Rheumatological: RA & SLE
  4. Haematological: lymphoma, myeloid leukaemias, monoclonal gammopathy (IgA), myeloproliferative disorders
  5. granulomatosis with polyangiitis
  6. primary biliary cirrhosis
141
Q

Management of Pyoderma gangrenosum

A
  1. oral steroids as first-line treatment
  2. immunosuppressive therapy, for example, ciclosporin and infliximab, have a role in difficult cases
142
Q

Scabies is caused by ……..and is spread by ……..

A

the mite Sarcoptes scabiei

and is spread by prolonged skin contact

143
Q

Management of Scabies

A
  1. permethrin 5% is first-line for 8-12 hours
  2. malathion 0.5% is second-line for 24 hours before washing
  • repeat treatment 7 days later

pruritus persists for up to 4-6 weeks post eradication

  • all household and close physical contacts should be treated at the same time, even if asymptomatic
144
Q

Treatment of Crusted scabies

A

Ivermectin is the treatment of choice and isolation is essential

145
Q

Crusted scabies is seen in patients

A

suppressed immunity, especially HIV.

146
Q

Reticulated, erythematous patches with hyperpigmentation and telangiectasia
Hx of exposure to infrared radiation

?

A

Erythema Ab Igne

147
Q

Describe the rash of eczema herperticum ?

A

Monomorphic punched out erosions ( circular, depressed, ulcerated lesions )