1. topical aluminium chloride 2. iontophoresis 3. botox (licensed for axillary sx only at present) 4. surgery

dermatology Flashcards by S K

pyoderma gangrenosum

what is it?

inflammatory disorder (non-infectious) causing v painful skin ulceration

it is rare

How well did you know this?

Not at all

Perfectly

pyoderma gangrenosum causes:

idiopathic (50%)
IBD (10-15%)
rheumatological
haematological
granulomatosis with polyangiitis
PBC

How well did you know this?

Not at all

Perfectly

pyoderma gangrenosum features: (4)

typically LL
sudden onset
small pustule/ red bump/ blood blister –> painful ulcer
systemic features: fever + myalgia

How well did you know this?

Not at all

Perfectly

Necrobiosis lipoidica diabeticorum

what is it?
associated skin sign?

shiny, painless areas of yellow/red skin typically on the shin of diabetics

associated with telangiectasia

How well did you know this?

Not at all

Perfectly

erythema nodosum features (4)

inflammation of subcutaneous fat
–> tender, erythematous, nodular lesions
usually occurs over shins,
resolves within 6 weeks
lesions heal without scarring

How well did you know this?

Not at all

Perfectly

erythema nodosum causes

infection
streptococci
tuberculosis
brucellosis
systemic disease
sarcoidosis
inflammatory bowel disease
Behcet’s
malignancy/lymphoma
drugs
penicillins
sulphonamides
combined oral contraceptive pill
pregnancy

How well did you know this?

Not at all

Perfectly

pretibial myxoedema

how does it look?
associated condition?

shiny, orange peel skin

Grave’s disease

How well did you know this?

Not at all

Perfectly

sedating anti-histamines
i. example:
ii. other SE

i. chlorphenamine
ii. anti-muscarinic - dry mouth, urinary retention, blurred vision, constipation

How well did you know this?

Not at all

Perfectly

non-sedating anti-histamines examples:

loratadine
cetirizine (but this is more sedating than other non-sedating ones xo)

How well did you know this?

Not at all

Perfectly

erythema multiforme
what is it?

hypersensitivity reaction most commonly triggered by infections

How well did you know this?

Not at all

Perfectly

erythema multiforme features

target lesions
initially on the back of the hands / feet then torso
UL>LL
sometimes mild itch

mucosal involvement in severe form

How well did you know this?

Not at all

Perfectly

erythema multiforme causes

viruses: HSV (most common cause
idiopathic
bacteria: Mycoplasma, Streptococcus
drugs
connective tissue disease e.g. Systemic lupus erythematosus
sarcoidosis
malignancy

How well did you know this?

Not at all

Perfectly

drug causes of erythema multiforme

penicillin
sulphonamides, carbamazepine
allopurinol
NSAIDs
COCP
nevirapine

How well did you know this?

Not at all

Perfectly

lichen planus features:

4Ps
papules
Purple
Pruritic
Polygonal

on flexor surface
Wickham’s striae (white lines pattern)
often + oral involvement (white-lace pattern on buccal mucosa)

nails:
thinning of nail plate
longitudinal ridging

How well did you know this?

Not at all

Perfectly

lichenoid drug eruption causes:

gold
quinine
thiazides

How well did you know this?

Not at all

Perfectly

lichen planus mgt

potent topical steroids
benzydamine mouthwash or spray if oral lichen planus
oral steroids or immunosuppression if extensive

How well did you know this?

Not at all

Perfectly

hyperhydrosis mgt

topical aluminium chloride
iontophoresis
botox (licensed for axillary sx only at present)
surgery

How well did you know this?

Not at all

Perfectly

keloid scar mgt:

intra-lesional steroids e.g. triamcinolone
surgical excision if large

How well did you know this?

Not at all

Perfectly

where do keloid scars most commonly occur

sternum > shoulder > neck > face > extensor surfaces of limbs > trunk

How well did you know this?

Not at all

Perfectly

exacerbating factors for psoriasis

trauma
alcohol
drugs:
- BBs
- lithium
- antimalarials
- NSAIDS
- ACEi
- infliximab

streptococcal infections (trigger GUTTATE psoriasis)

How well did you know this?

Not at all

Perfectly

shingles rx within how long of onset of rash

Study These Flashcards

72hrs

pityriasis vesicolor
what is it ?

Study These Flashcards

superficial cutaneous fungal condition associated with malassezia furfur

pityriasis vesicolor
predisposing factors

Study These Flashcards

occurs in healthy individuals
immunosuppression
malnutrition
Cushing’s

pityriasis vesicolor
mgt

Study These Flashcards

ketoconazole

if does ntp resolve send skin scrapings and consider itraconazole

shingles most commonly affected dermatomes

T1-L2

guttate psoriasis features:

recent hx strep throat "tear drop" scaly papules on trunk & limbs resolved in 2-3 months, mgt like psoriasis

SJS causes: (8)

penicillin sulphonamides lamotrigine, carbamazepine, phenytoin allopurinol NSAIDs oral contraceptive pill

SJS features (5)

maculopapular rash with target lesions --> may develop into vesicles or bullae Nikolsky sign +ve - (blisters and erosions appear when the skin is rubbed gently) mucosal involvement systemic symptoms: fever, arthralgia

toxic epidernal necrolysis features:

systemically unwell e.g. pyrexia, tachycardic positive Nikolsky's sign: the epidermis separates with mild lateral pressure

drug precipitants of TEN (toxic epidermal necrolysis (6)

phenytoin sulphonamides allopurinol penicillins carbamazepine NSAID

TEN mgt

stop precipitant supportive care ivIg sometimes: immunosuppressive agents (ciclosporin and cyclophosphamide), plasmapheresis

impetigo mgt:

hydrogen peroxide 1% cream if well topical abx - fusidic acid - topical muciporin if fusidic acid resistance suspected extensive disease: - PO fluclox - PO erythromycin if penicillin allergy

school exclusion in impetigo:

until: - lesions crusted over OR - 48hrs from onset of rx

vitiligo associated conditions: (5)

type 1 diabetes mellitus Addison's disease autoimmune thyroid disorders pernicious anaemia alopecia areata

chronic plaque psoriasis mgt

emollients 1. potent topical steroids + vitD analogue OD (apply separately, for 4 weeks) if no improvements in 8 weeks 2. vitamin D analogue BD if no improvement in 8-12 weeks 3. potent topical steroid BD OR coal tar OD can also use short acting dithranol

chronic plaque psoriasis mgt in secondary care:

phototherapy systemic therapy: - methotrexate - ciclosporin - systemic retinoids - biological agents: infliximab, etanercept and adalimumab ustekinumab (IL-12 and IL-23 blocker) is showing promise in early trials

scalp psoriasis mgt:

OD potent topical steroids for 4 weeks if no improvement try different formulation

face/ flexural/ genital psoriasis mgt

mild/ moderate potency steroids OD/ BD FOR MAX 2 WEEKS

vitamin D analogues examples:

calcipotriol (Dovonex) calcitriol tacalcitol (can be used LT)

seborrhoeic dermatitis what is it?

inflammatory reaction related to a proliferation of a normal skin inhabitant, a fungus called Malassezia furfur

seborrhoeic dermatitis features:

eczematous lesions in sedum rich areas -(nasolabial folds, periorbital, auricular) otitis externa blepharitis

seborrhoeic dermatitis mgt:

ketokonazole (topical anti-fungal) short term: topical: steroids

pompholyx eczema

affects hands + feet - blisters - itch ++

pompholyx eczema mgt

cooling emollients topical steroids

scabies mgt

1. permethrin 5% is first-line 2. malathion 0.5% is second-line pruritus persists for up to 4-6 weeks post eradication

crusted (Norwegian) scabies

ivermectin

fungal nail infection mgt

1. amorolfine nail lacquer 2. PO terbinafine PO itraconozole if due to candida

eczema herpeticum i. causative organism ii. mgt

i. HSV 1 (rarely coxsackie A16) ii. iv aciclovir (steroids make it worse)

acne rosacea mgt:

SPF/ concealer if predominant erythema/ flushing: - brimodine gel / PO propanolol papules/ pustules 1. topical ivermectin 2. topical azelic acid 3. topical metronidazole 4. topical ivermectin + PO doxycycline ^^ PO retinoids if this fails

mild- mod acne mgt

combination of any 2 of the following: topical benzoyl peroxide topical abx (clindaymycin) topical retinoids (tretinoin/ adapalene)

acne rosacea refer to secondary care if:

sx not improved with optimal primary care mgt rhinophyma

dermatology Flashcards

(51 cards)