Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GP - General Practice > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is important to elicit in a history in Dermatology?

A

PC:
Nature, site, duration
Evolution/progression
Associated sx, Aggrivating/relieving factors
Contact (change in detergents, clothes, soap etc..)
Events - Stress, illness, travel, sunburn, tanning

Past med/fam hx: Skin disease, atopy (asthma, allergic rhinitis, eczema)

Social: QoL, occupation, hobbies, sport!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 3 diseases most associated with atopy

A

Asthma, eczema, allergic rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When performing an examination, how would you describe a dermatology finding?

A

SSCAAMM
Size + Shape
Colour
Associated secondary changes + Area (distribution)
Morphology + Margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is variegation

A

Multicolour or varied colours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What diameter of skin lesion would concern you? (in terms of cancer)

A

> 6mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

You see a pigmented lesion, how would you describe it?

A

ABCDE
Asymmetry
Border (irregular)
Colour variegation (2 or more colours)
Diameter (>6mm)
Evolving: Change in size, colour, bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define a lesion
Define a Rash

A

Lesion = area of altered skin
Rash = Eruption of lesions (AKA multiple)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define Erythema
Define Purpura

A

Erythema = redness that blanches on pressure
Purpura = Red/purple that does NOT blanch on pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 2 types of Purpura?

A

Petechiae: Small pinpoint macules (1-3mm)
Ecchymosis: Large bruise-like patches (>1cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define Macule
Define Patch

A

Macule = Flat area of altered colour <10mm (e.g. Freckles)
Patch = Large flat area of altered colour >10mm (e.g. Naevus Flammeus or port-wine stain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define Papule
Define Nodule

A

Papule: Solid, raised lesion <5mm e.g. Xanthelasma
Nodule: Solid, raised lesion >5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define Vesicle
Define Pustule
Define Bulla

A

Vesicle: Raised, clear fluid lesion <5mm
Pustule: Pus-containing lesion <5mm
Bulla: Raised clear fluid lesion >5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define Plaque
Give an example

A

Palpable raised scaly lesions
e.g. Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What lesion is Acne. Define it

A

Comedone which is a plug of sebaceous follicle-containing altered sebum, bacteria, cellular debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 2 main layers of the skin

A

Epidermis
Dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a naevus?
Is it typically benign or malignant?
What are the different types of naevi?

A

Naevus = mole = localised malformation of tissue structures
Typically benign

1) Congenital Naevus (birthmark)
2) Intradermal Naevus (birthmark)
3) Junctional Naevus (in junction between epidermis and dermis)
4) Compound Naevus (Group of naevus cells found in each epidermis and dermis)
5) Halo naevus (Mole surrounded by a ring)
6) Atypical naevus (Benign dysplastic mole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Benign skin lesions are common and well-defined. They are typically asymptomatic.
Are they pigmented?
What are Red flags?

A

They may be pigmented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of naevus is most associated with a malignancy? What type of malignancy?

A

Atypical naevus -> Melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of Naevus is this?

A

Congenital Naevus (birthmark)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of Naevus is this?

A

Intradermal Naevus (birthmark). elevated, dome shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What type of Naevus is this?

A

Junctional Naevus (in junction between epidermis and dermis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of Naevus is this?

A

Compound Naevus (Group of naevus cells found in each epidermis and dermis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of Naevus is this?

A

Halo naevus (Mole surrounded by a ring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of Naevus is this?

A

Atypical naevus (Benign dysplastic mole). Risk of Melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is shown in this photo?
Where is it typically found?
What population is more likely to have this?
If you were to examine it, would be hard and firm or soft and mobile?
How would you manage a patient with this?

A

Skin tag
Typically on neck, groin, and skin folds => High BMI patients
Soft and mobile

Management is not necessary as it is harmless. If patient wants it removed, excision, cryothermy, or diathermy may be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the image on the left
What is this?
Where is it found most commonly?
How would you manage this patient?

A

non-erythematous, raised, round lesion with central punctuation. It has a regular border with overlying telangiectasia.

Most commonly found on neck, face, and trunk
Management is not necessary but if the patient wants it removed, then excision.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is shown in these images?
How would you describe these lesions?
Does this have malignant potential?
What is the management of this?

A

This is Seborrheic Keratosis
Darkly pigmented papules/plaques with an irregular, scaly, elevated appearance

No malignant potential

Management not necessary but if needed, surgical excision or cryotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is cryotherapy

A

Any tx that involves the use of freezing temperature to destroy tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is shown in this image?

Describe what you see

If you were to examine this patient. Would this be soft or hard consistency?

How would you manage this patient?

A

Lipoma

Large, dome-shaped subcutaneous lesion with regular border. It has a soft/medium consistency as it is fat

Management is not necessary but if the patient wants it removed, then excision.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a lipoma?

A

Lipomas are benign, slow growing subcutaneous adipose tissue/cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the most common malignancy in dermatology?

A

SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What pre-malignant skin lesions are we concerned about in dermatology?
Which one is associated with sun-induced immunosuppression?

A

Actinic Keratosis
Bowen’s disease (SCC in-situ) - Sun-induced immunosuppresion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe what you see in these images
What is the most likely diagnosis?

Where are these lesions typically found?

How would you manage this patient?

A

Actinic Keratosis: Small erythematous, scaly lesions and rough patches. There are yellow adherent crusts on them as well

These are typically found on sun-exposed skin

Management:
Topical 5FU OD 4/52
3% Diclofenac gel BD 2/52
Cryotherapy
Curettage and Cautery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is 5FU?

A

5-fluorouracil is a cytotoxic chemotherapy medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is diclofenac?

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is curettage?

A

Procedure in which surgeon scrapes off a skin lesion using a sharp blade called a curette

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is Cautery?

A

Procedure that is used to stop bleeding and seal wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe what you see in these images
What is the most likely diagnosis?

Give 1 other feature of this disease not found in the pictures

How would you manage this?

A

Bowen’s disease/SCC in-situ: Large, erythematous, scaly, papules that are typically scattered
May also have ulcerations and bleeding

Management
1) Topical 5FU
2) Cryotherapy
3) Superficial skin surgery
4) Photodynamic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Differentiate between actinic keratosis and Bowen’s disease

A

Actinic keratosis is typically small in size (0.5-2cm) whereas Bowen’s enlarges slowly up to 3cm in size

Bowen’s lesions are also more erythematous and scalier than Actinic karatosis

40
Q

What are the 3 most common types of skin cancer

A

Malignant melanoma (1%)
SCC - Squamous cell carcinoma
BCC - Basal Cell Carcinoma

41
Q

Malignant Melanomas only represent 1% of skin cancers but 80% of skin cancer deaths. How would you describe a lesion suspected on being a melanoma?

What sign is associated with Malignant melanomas? Define it

Give 5 RFs for Malignant melanoma

How would you manage malignant melanoma?

A

ABCDE
Asymmetry
Border (irregular)
Colour variegation (2 or more colours)
Diameter (>6mm)
Evolving: Change in size, colour, bleeding

Ugly Duckling sign: Elevated abnormal lesion, raised compared to surrounding lesion

RFs:
1) UV exposure
2) Skin Type I
3) Increased age
4) Male
5) Immunosuppression
6) Hx of frequent or severe sunburn in childhood
7) Hx of skin cancer
8) Genetic predisposition

Management:
Surgical excision +/- Radiotherapy +/- Chemotherapy if metastasis

42
Q

What is Skin Type I?

A

It is the type of skin that always burns and never tans

43
Q

What is shown in these images?
Describe the lesion (ideal)

A

These pictures are showing squamous cell carcinomas
Hyperkeratotic irregular nodule with central ulceration and scaly appearance

44
Q

UV exposure is one of the main causes of cancer. How does that vary between skin cancers found in the young and older population?

A

Young = Intermittent high intensity UV exposure
Older = Cumulative UV exposure

45
Q

SCC are hyperkeratotic irregular lesions that are associated with a chronic wound/scar. It is the 2nd most common skin cancer and 5% metastasise. How would you manage SCC?

A

Surgical excision +/- radiotherapy

46
Q

What is shown in this image?
Describe the lesion (ideal)

A

Basal cell carcinoma
Nodular with pearly edges, telangiectasia, central ulceration

47
Q

There are several types of BCC, nodular being the most common and characterised by pearly edges, telangiectasia, and central ulceration. BCC rarely metastasises but may still happen. How would you manage a patient with BCC?

A

Cryotherapy
Topical Imiquimod or 5FU
Surgical excision +/- radiotherapy

48
Q

Dermatitis is inflammation of the skin. What are it’s lesions characterised by?

What is it associated with (3)?

How is it classified?

A

Itchy, dry papules on an erythematous base

A/w Asthma, allergic rhinitis, and atopy

Classified as either Endogenous (Atopic dermatitis, Venous eczema) or Exogenous (Contact dermatitis)

49
Q

What is shown in this image? Define the diagnosis

A

Dermatitis on the flexor aspect => characteristic of Atopic dermatitis. It is a chronic inflammatory condition (Atopic) characterised by Itchy, dry papules on an erythematous base (dermatitis)

50
Q

Where does the rash of atopic dermatitis typically occur?

How would you manage Atopic dermatitis?

A

Infants typically on face and extensor surfaces
Children and adults -> Flexor aspect

Management:
1) Emollients
2) Topical Steroids for flareups
3) Tacrolimus
4) Phototherapy by dermatology (for non-responsive cases)

51
Q

What is Tacrolimus?
What is the benefit of using this in the treatment of atopic dermatitis

A

It is a topical immunomodulator to reduce the inflammation or immune response. It is an alternative that does not include steroids as to not subject the patient to long-term steroid use

52
Q

What is shown in this image?

A

Atopic dermatitis (yes again)

53
Q

What is shown in this image?
What is the pathophysiology behind this?

A

Thick, hyperpigmented, scaly skin => Venous eczema

Increased hydrostatic pressure and capillary damage leading to increased permeability and red cell extravasation. These deposits of haem cause the eczematous lesions

54
Q

Venous eczema is represented by thick, hyperpigmented, scaly skin due to increased hydrostatic pressure and capillary damage leading to increased permeability and red cell extravasation. These deposits of haem cause the eczematous lesions.
Where are these lesions typically found?

How would you manage a patient presenting with venous eczema

A

Typically proximal to the media malleolus (shin)

Management:
1) Leg elevation
2) Support stocking
3) Weight reduction
4) Emollients
5) Topical steroids for exacerbations/flareups

55
Q

When prescribing support stockings what should be done prior?

A

Must ensure that the ankle brachial index >0.8

56
Q

When prescribing topical steroids what are your options? State them in increasing order of strength

A

Each step is 5x stronger than the previous
1) Hydrocortisone
2) Clobetasone
3) Betamethasone
4) Clobetasol

57
Q

What would you prescribe first line for a rash causing an itch?

A

Calamine lotion
Not an emollient as it does not have moisturising properties but it is soothing

58
Q

Describe the lesion in the first image.

What is your most likely diagnosis? Give 2 differentials.

What type of dermatitis is this?

If this were to occur acutely? What would be the cause?

A

White yellowish scaly patches/plaques on an erythematous base

Most likely = seborrheic dermatitis
Others include psoriasis and atopic dermatitis

This could either acutely occur in response to Malassezia yeast classifying it as exogenous or it can be endogenous where it is a chronic condition

59
Q

Where does seborrheic dermatitis typically occur?

What is this condition called in paediatrics?

How would you manage this condition?

A

Hairy regions especially in the scalp, eyebrows and face

Cradle cap (baby shampoo)

Management: Ketonazole shampoo +/- cream +/- topical steroids

60
Q

What are the 2 types of dermatitis? Associate each to the images shown.

A

First picture: Irritant dermatitis showing lip licking
Second picture: Allergic dermatitis to the material in contact with the skin

61
Q

Contact dermatitis typically occurs as a result of an irritant or an allergen.
How does Irritant dermatitis occur?
How is it managed?

How does allergic dermatitis occur?
Give an example

A

Irritant dermatitis occurs when chemicals/physical agents damage the skin surface faster than the skin is able to repair itself e.g. Lip lickers in children or in the webs/palms in cleaners

Allergic dermatitis is a Type I hypersensitivity reaction that occurs to materials in contact with the skin such as nickel in earrings or belt buckle

62
Q

What are shown in these images?

What is the image on the right associated with?

A

Guttate psoriasis, associated with tonsillitis

63
Q

Describe the lesion shown in this image

A

Psoriasis: Sharply demarcated pruritic, erythematous/salmon-pink plaques with overlying silvery scale

64
Q

Where is psoriasis typically found?

State 5 RFs for psoriasis

how is psoriasis managed

A

Extensor surfaces (unlike atopic which are typically flexor) => Elbows, knees, nails, and scalp

RFs:
1) Trauma
2) Infection (e.g. tonsillitis for guttate psoriasis)
3) Drugs (beta blockers, antimalarials)
4) Stress
5) Alcohol use

Management:
Mild:
1) vitamin D analogues
2) Corticosteroids
3) Dithranol
Severe: Phototherapy by dermatology
Refractory: Methotrexate or TNF-alpha

65
Q

Dithranol, also called Anthralin is used in the treatment of psoriasis. How does this help in the treatment of psoriasis?

A

Anthralin inhibits keratinocyte hyperproliferation

66
Q

What is shown in this image?

A

Acne

67
Q

What is Acne?
Where is it typically found?

A

Inflammatory disease of the Pilosebaceous Follicle
Found on the face, chest, and back

68
Q

Increased sebum production, abnormal follicle keratinisation, bacterial colonisation, and inflammation.
What bacterium is most associated with acne?

A

Propionibacterium Acne

69
Q

What is the full treatment ladder for acne

A

1) Comedones only => Topical retinoid (Adapalene +/- Benzoyl Peroxide
2) + Papules/pustules => Adapalene or Clindamycin (topical) + Benzoyl peroxide
3) Moderate/severe => Oral Lymecycline + Benzoyl peroxide
4) If female -> COCP
5) Dermatology referral for Isotrenoin (Roaccutane)

70
Q

What must be prescribed alongside Isotretinoin?
What are the side effects of this medication?

A

If female, prescribe COCP as it is teratogenic
Dry skin, reduced mood (increased suicidality)

71
Q

What is Lymecycline?

A

Tetracycline Antibiotic

72
Q

Acne is classified as mild, moderate or severe. Which is shown in this image?

What are the characteristic features of this severity?

How would you manage this patient?

A

Mild acne is characterised by
<30 lesions
Mainly Comedones
*they may have a few papules and pustules

1) Comedones only => Topical retinoid (Adapalene +/- Benzoyl Peroxide
2) + Papules/pustules => Adapalene or Clindamycin (topical) + Benzoyl peroxide

73
Q

Define Comedones
Where are they mostly found?
What are the 2 types?

A

plug of sebaceous follicle-containing altered sebum, bacteria, cellular debris
Mostly found in acne => face, back and chest

Blackheads = open
White heads = closed

74
Q

Acne is classified as mild, moderate or severe. Which is shown in this image?

What are the characteristic features of this severity?

What is your initial management of this patient?

A

Moderate acne
30-125 lesions that include comedones and several inflammatory papules and pustules

Oral Lymecycline + Benzoyl peroxide

75
Q

Acne is classified as mild, moderate or severe. Which is shown in this image?

What are the characteristic features of this severity?

What is your management of this patient?

A

Severe
>125 lesions including comedomes, papules, pustules and ! Multiple nodules with scarring

Moderate/severe => Oral Lymecycline + Benzoyl peroxide
If female -> COCP
Dermatology referral for Isotrenoin (Roaccutane)

76
Q

Acne affects 85% of people aged between 16 and 18. A patient comes and asks you the following questions
Is acne infectious?
Can poor hygiene make acne worse? Should I be washing my face more often then?
Why cant I play with the pimples?
Thank you for these medications, how long will they take to work?

A

No acne is not infectious
It is not associated with poor hygiene. You should not be washing your face more than 2x/day. If you choose to do so, please use a fragrant-free cleanser

Do not play/pop them because that can lead to permanent scarring

It will take 6-8 weeks for any of the treatments to work

77
Q

What are the complications of acne

A

Post-inflammatory hyperpigmentation
Scarring
Deformity
Psychosocial effects

78
Q

Describe what you see
what is the most likely diagnosis?

A

Erythema, flushing, telangiectasia, papules, and pustules on the face especially on the cheeks, nose, and perioral area

Rosacea

79
Q

What is seen in this image?

A

Rhinophyma, a complication of Rosacea

80
Q

What is Rosacea?

It is most common in those aged between 30 and 50. What population group are mostly affected by this?

What are the triggers for rosacea?

Where does rosacea typically appear most?

How is Rosacea treated?

A

It is a chronic inflammatory facial dermatosis characterised by a relapsing remitting pattern typically on the cheek, nose, forehead, and chin

Those with fair skin => northern european countries (Scandinavian)

Triggers:
1) Sun exposure/heat
2) Stress/exercise
3) Alcohol

Management:
1) Avoid triggers
2) Topical Metronidazole gel or Oral Tetracycline (Lymecycline)
3) Referral to dermatoloy esp if complications (Rhinophyma)

81
Q

What is shown in this image?

What is the causative agent?

Is it contagious?

How is it treated?

A

Crusted gold lesion => Impetigo

Staph Aureus or Strep Pyogenes

Yes it is contagious

Topical Fusidic Acid
or Oral Flucloxacilin

82
Q

What is shown in this image? What is your main differential?

What additional features would you note on exam?

What are the major risks with this?

How would you treat this patient

A

Cellulitis characterized by !Ill-defined borders, unilateral swelling, erythema, heat, and tenderness. There may also be pyrexia and features of sepsis

Differential = DVT

Risks: Sepsis, abscess formation, lymphoedema, recurrence

Tx: Raise leg, IV antibiotics, Sepsis workup

83
Q

A 9 year old patient presents to you with this. What is your most likely diagnosis?

What are the characteristic features of this seen along with its progression

how would you manage this patient?

A

Varicella/chicken pox.

Presents as a group of macules -> papules -> vesicles (this picture) on an erythematous base. These will then dry and crust.

Symptomatic management => paracetamol for fever, bed rest, hydration. ! Calamine lotion for the itch

84
Q

What is shown in this image? (diagnosis and description).

Are these painful?

How does this occur?

How is it managed?

A

Shingles: Asymmetrical unilateral vesicular lesions on an erythematous base. They are painful

Reactivation of the Varicella Zoster virus

Managed via Acyclovir + Analgesia

85
Q

Shingles is due to the reactivation of VZ virus. Where does this lie dormant?

A

Remains dormant in the dorsal root ganglion

86
Q

What is shown in this image? (Diagnosis)

What is this diagnosis characterised by?
Is it contagious?

How is it managed if
Localised
Widespread

A

Tinea corpus
Itchy, circular/annular lesion that moves from area to area and person to person => contagious

Managed via topical antifungal - Clotrimazole or Miconazole
If widespread, oral antifungal (Terbinafine)

87
Q

What is shown in this image?

A

Tinea Cruris

88
Q

What is shown in this image?

A

Tinea Pedis

89
Q

a patient presents with this. Give your top 2 differentials

A

Fungal infection of the nails
Onycholisis in psoriasis (or trauma)

90
Q

What is Onycholisis?

A

Detachment of the nail from the nailbed

91
Q

How would you manage fungal infection of the toenails?

What is it associated with?

A

Topical antifungal
Send Nailclippings to lab

Associated with hepatotoxicity => conduct LFTs

92
Q

What is shown in this image? (Diagnosis)
What are other differentials?
How would you treat?

A

Oral candida
ddx: Leukoplakia, Lichen Planus

Topical antifungals (if it doesnt resolve refer to ENT)

93
Q

What is shown in this image?

A

Urticaria => anaphylaxis

94
Q

What is shown in this image?
How would you manage?

A

Angioedema => Anaphylaxis
ABCDE, call for help, IM adrenaline, hydrocortisone, antihistamine (chlorphenamine)

95
Q

A patient presents with this rash.
What type of rash is shown?
What will you do on examination?

A

This is a petechial/purpuric rash
=> Must check if blanching
I will check for Fever, neck stiffness, photophobia

96
Q

A patient presents with this rash. You perform an examination and note that it is non-blanching. The patient also has a fever. What will you do?

A

This is indicative of meningitis
Phone ambulance, Establish IV access to give benzylpenicillin/Cefotaxime.

GP - General Practice (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions