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Dermatology Flashcards

(71 cards)

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1
Q

What is eczema?

A

a chronic atopic condition caused by defects in the skin barriers, leading to inflammation of the skin

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2
Q

Presentation of eczema?

A

dry, red, itchy and sore patches of skin over the flexor surfaces

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3
Q

Mx of eczema?

A

maintenance -> emollients
flares -> thicker emollients, topical steroids, wet wraps
severe flares -> systemic steroids, antibiotics

specialists -> zinc impregnated bandages, topical tacrolimus, phototherapy, methotrexate, azathioprine

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4
Q

Steroid ladder of topical steroids?

A

hydrocortisone 0.5%, 1%, 2.5%
eumovate
betnovate
dermovate

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5
Q

Most common opportunistic bacterial infection in eczema?

A

staph aureus

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6
Q

What is eczema herpeticum?

A

viral skin condition caused by HSV or VZV
usually occurs in patient with pre-existing skin condition that allows the virus to enter the skin

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7
Q

Presentation of eczema herpeticum?

A

patient who suffers with eczema develops a painful, widespread, vesicular rash
systemic symptoms such as fever, lethargy, irritability, reduced oral intake
lymphadenopathy

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8
Q

Mx of eczema herpeticum?

A

clinical diagnosis
viral swabs to confirm
acyclovir (oral or IV)

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9
Q

Complications of eczema herpeticum?

A

life-threatening, particularly in immunocompromised children
bacterial superinfection

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10
Q

DDx for non-blanching rash?

A

meningococcal septicaemia
HSP
ITP
acute leukaemias
HUS
mechanical
traumatic
viral illness

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11
Q

Cause of non-blanching rash?

A

bleeding under the skin
petechiae and purpura

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12
Q

Presentation of acne vulgaris?

A

macules
papules
pustules
comedomes
blackheads
ice pick scars
hypertrophic scars
rolling scars

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13
Q

Mx of acne vulgaris?

A

topical benzoyl peroxide
topical antibiotics
oral antibiotics (lymecycline)
COCP in females
topical retinoids
oral retinoids

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14
Q

Side Effects of isotretinoin?

A

teratogenic
dry skin and lips
photosensitivity
suicidal ideation
SJS and TEN

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15
Q

Examples of viral exanthemas?

A

measles
Scarlet fever (not viral)
rubella
Duke’s disease
Parvovirus B19
roseola infantum

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16
Q

Presentation of measles?

A

fever, coryzal symptoms, conjunctivitis
Koplik spots on buccal mucosa
rash starts on face, behind ears 5 days after fever, and spreads to rest of body
erythema, macular rash

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17
Q

Mx of measles?

A

self-resolving
isolation
notifiable disease
monitor and treat complications

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18
Q

Complications of measles?

A

pneumonia
diarrhoea
dehydration
meningitis
encephalitis
hearing loss
vision loss
death

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19
Q

What causes measles?

A

measles virus

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20
Q

What causes Scarlet fever?

A

Group A Strep (strep pyogenes)

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21
Q

Presentation of Scarlet fever?

A

red-pink, blotchy, macular, ‘sand-paper’ rash starts on trunk and spread outwards
fever
lethargy
flushed face
Strawberry tongue
sore throat
cervical lymphadenopathy

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22
Q

Mx of Scarlet Fever?

A

phenoxymethylpenicillin (penicillin V) for 10 days
notifiable disease
off school for 24hrs after starting antibiotics

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23
Q

Complications of Scarlet Fever?

A

other associated diseases with Strep A
post-streptococcal glomerulonephritis
acute rheumatic fever

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24
Q

What causes rubella?

A

rubella virus

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25
Presentation of rubella?
erythema macular rash starting on face and spreading to rest of the body fever joint pain sore throat cervical lymphadenopathy
26
Mx of rubella?
supportive, self-limiting notifiable avoid pregnant women school exclusion for 5 days after appearance of rash
27
Complications of rubella?
thrombocytopenia encephalitis congenital rubella syndrome to fetus in pregnant women
28
Other names for parvovirus B19?
fifth disease 'slapped-cheek' syndrome erythema infectiosum
29
Presentation of parvovirus B19?
fever coryzal symptoms lethargy diffuse, bright red rash on both cheeks reticular rash on body
30
Mx of parvovirus B19?
self-limiting supportive management no exclusion once rash has formed
31
Complications of parvovirus B19?
occur in immunocompromised, pregnant and haematological conditions aplastic anaemia encephalitis and meningitis pregnancy complications including fetal death hepatitis, myocarditis, nephritis
32
What causes roseola infantum?
human herpes virus 6 and sometimes human herpes virus 7
33
Presentation of roseola infantum?
high fever rash appears after fever settles
34
Complications of roseola infantum?
febrile convulsions
35
What is psoriasis?
chronic autoimmune condition that causes recurrent symptoms of psoriatic skin lesions patches of psoriasis are dry, flaky, scaly, faintly erythematous plaques that commonly form over the extensor surfaces of elbows and knees and on the scalp
36
Types of psoriasis?
plaque psoriasis guttate psoriasis pustular psoriasis erythrodermic psoriasis
37
Key features of psoriasis?
Auspitiz sign (bleeding) Koebner phenomenon (scars) residual pigmentation of skin
38
Mx of psoriasis?
depends on severity of the lesions psychosocial support topical steroids topical vit D analogues topical dithranol tacrolimus (adults only) phototherapy with narrow band UVB light systemic treatment by specialist
39
Psoriasis associations?
nail changes (pitting, onycholysis, thickening, discolouration, ridging) psoriatic arthritis depression and anxiety incr. risk of CVD
40
What is erythema multiforme?
widespread, itchy, erythematous rash that forms characteristic 'target' signs caused by hypersensitivity reaction
41
Causes of erythema multiforme?
hypersensitivity reaction viral infections medications HSV mycoplasma pneumoniae
42
Presentation of erythema multiforme?
widespread, itchy, erythematous rash characteristic 'target' lesions stomatitis mild fever muscle and joint aches headache flu-like symptoms
43
Mx of erythema multiforme?
clinical diagnosis identify underlying cause and treat most of the time resolves spontaneously severe cases -> IV fluids, analgesia and steroids
44
What are urticaria?
aka hives small itchy lumps that appear under the skin may be associated with patchy erythematous rash caused by release of histamine and mast cells
45
Causes of acute urticaria?
allergies contact with chemicals medications viral infections insect bites dermographism
46
Types of chronic urticaria?
chronic idiopathic urticaria chronic inducible urticaria autoimmune urticaria
47
Mx of urticaria?
antihistamines short course of oral steroids for severe flares very severe: anti-leukotrienes omalizumab cyclosporin
48
What is chickenpox?
highly contagious vesicular rash caused by the varicella zoster virus
49
Presentation of chickenpox?
widespread, erythematous, itchy vesicular blistering lesions usually starts on trunk or face and spreads outwards fever itch general fatigue and malaise lesions scab over and then child is no longer contagious
50
Complications of chickenpox?
bacterial superinfection dehydration conjunctival lesions pneumonia encephalitis (ataxia) reactivation as shingles or Ramsay-Hunt
51
Mx of chickenpox?
avoid pregnant women school exclusion until lesions crust over supportive care in children antihistamines and calamine lotion acyclovir in immunocompromised and >14 manage complications
52
What is hand, foot and mouth disease?
blistering lesions over the hand, feet and mouths caused by the Coxsackie A virus
53
Complications of hand, foot and mouth disease?
dehydration bacterial superinfection encephalitis
54
What is molluscum contagiosum?
small, flesh-coloured papules that characteristically have a central dimple caused by the molluscum contagiosum virus, a type of poxvirus
55
Mx of molluscum contagiosum?
simple reassurance and education avoid sharing towels avoid scratching refer to specialist if immunocompromised or if problematic areas: cryotherapy topical potassium hydroxide, benzyl peroxide, tretinoin
56
What is pityriasis rosea?
generalised, self-limiting rash of unknown cause may be cause by HHV 6 or 7 but unknown
57
Presentation of pityriasis rosea?
characteristic herald patch - faint red or pink, scaly oval shape on the torso spreads in a 'Christmas tree' distribution generalised itch low grade pyrexia headache lethargy
58
Mx of pityriasis rosea?
resolves within 3 months non-contagious reassurance itching (emollients, topical steroids or sedating antihistamines)
59
What is seborrheic dermatitis?
inflammatory skin condition that affects the sebaceous glands typically affects scalp, nasolabial folds and eyebrows
60
Presentation of infantile seborrheic dermatitis?
aka cradle cap crusted flaky dry scalp usually resolves by 4 months age, can last up till 12 months
61
Mx of infantile seborrheic dermatitis?
first-line baby oil white petroleum jelly overnight anti-fungal (clotrimazole or miconazole)
62
Mx of seborrheic dermatitis?
scalp - ketoconazole shampoo, topical steroids if doesn't work face and body - topical antifungal (clotrimazole or miconazole), topical steroids
63
What is ringworm?
fungal infection of the skin aka tinea or dermatophytosis
64
Presentation of ringworm?
itchy rash that is erythematous, scaly and well demarcated ring or circular shapes with the edge more defined
65
Mx of ringworm?
anti-fungal creams (clotrimazole, miconazole) anti-fungal shampoo for tinea capitis (ketoconazole) oral anti-fungal nail polish or oral terbinafine in resistant fungal nail infections
66
RFs for nappy rash (contact dermatitis)?
delayed changing of nappies irritant soaps and vigorous cleaning poor absorbent nappies diarrhoea oral antibiotics predispose to candida infection pre-term infants
67
Presentation of nappy rash?
sore, red, inflamed skin in the nappy area skin creases tend to be spared severe cases can lead to erosions and ulcerations
68
Candida > nappy rash features?
rash extending to skin folds larger red macules well demarcated scaly border circular pattern to rash satellite lesions concurrent oral thrush
69
Mx of nappy rash?
switch to highly absorbent nappies change frequently use water or gentle alcohol free soaps ensure nappy area is dry before replacing nappy maximise time not wearing a nappy if superimposed bacterial or fungal infection, treat
70
Complications of nappy rash?
candida infection cellulitis Jacquet's erosive diaper dermatitis perianal pseudo verrucous papules and nodules
71

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