Dermatology 2 Flashcards by H JP

Chronic condition affecting the head of the penis
Middle aged/ elderly men
Uncircumcised
Erythematous, well demarcated shiny patches

Mx (3)

Zoon’s balanitis

Circumcision
CO2 laser therapy and topical steroids

How well did you know this?

Not at all

Perfectly

Acrodermatitis - red crusted lesions in the acral distribution (distal limbs), periorifical and perianal

Alopecia
Short stature
Hypogonadism
Hepatosplenomegaly
Cognitive impairment
= which condition?

Zinc deficiency

How well did you know this?

Not at all

Perfectly

Associated conditions with vitiligo (5)

Mx (3)

T1DM
Addison’s
Autoimmune thyroid disease
Pernicious anaemia
Alopecia areata

Sunblock
Camouflage make up
Topical steroids

How well did you know this?

Not at all

Perfectly

Name two large vessel vasculitis

Medium vessel (2)

Small vessel (4)

Temporal arteritis
Takyasu’s

Polyarteritis nodosa
Kawasaki

Granulomatosis with polyangitis
Churg Strauss
Henoch-Schonlein purpura
Goodpasture’s

How well did you know this?

Not at all

Perfectly

Who is the shingles vaccine offered to?

All patients age 70-79

How well did you know this?

Not at all

Perfectly

Name six drugs known to induce TEN

Phenytoin
Sulphonamides
Allopurinol
Penicillin
Carbamezapine
NSAIDs

IVIG

How well did you know this?

Not at all

Perfectly

What it tinea capitis?
If untreated can lead to a?

Mx (2)

Scalp ringworm
Kerion - raised, pustular, spongy/ boggy mass

Mx PO terbinafine + topical ketoconazole shampoo for first 2 weeks

How well did you know this?

Not at all

Perfectly

What is tinea corpororis?
Mx (1)

Fungal infection on trunk, legs or arms
Mx PO fluconazole

How well did you know this?

Not at all

Perfectly

SJS characteristic lesion

Target lesions, can develop into vesicles/ bullae with mucosal involvement

How well did you know this?

Not at all

Perfectly

SCC RF (4)

Smoking
Sun exposure
Bowen’s disease
Immunosuppression

How well did you know this?

Not at all

Perfectly

Difference between spider naevi and telangiectasia

Spider naevi fill from the centre
Telangiectasia fill from the edge

How well did you know this?

Not at all

Perfectly

Difference between a vesicle and a bullae

<5mm = vesicle fluid filled
>5mm = bullae fluid filled

How well did you know this?

Not at all

Perfectly

Malar rash is seen in?
What area is spared?

SLE
Nasolabial sparing

How well did you know this?

Not at all

Perfectly

Name four skin manifestations of SLE (4)

Malar rash
Discoid lupus
Alopecia
Livedo reticularis

How well did you know this?

Not at all

Perfectly

Pruritic condition associated with last trimester
Lesions often appearing first in abdominal striae
=
Mx

Polymorphic eruption of pregnancy
Emollients, topical and PO steroids

How well did you know this?

Not at all

Perfectly

Mx atopic eruption of pregnancy

Nil

How well did you know this?

Not at all

Perfectly

Pruritic blistering lesions often developing in peri-umbilical region, spreading to trunk, back, buttocks and arms
Usually presents in 2nd and 3rd trimester
Rarely seen in first pregnancy
=
Mx

Pemphigoid gestationis
Mx PO steroids

How well did you know this?

Not at all

Perfectly

Shiny, painless areas of yellow/red/brown skin typically on the shin - seen in diabetics
Often with surrounding telangiectasia

Necrobiosis lipoidica

How well did you know this?

Not at all

Perfectly

Name four common skin disorders associated with diabetes

Necrobiosis lipoidica
Vitiligo
Neuropathic ulcers
Granuloma annulare

How well did you know this?

Not at all

Perfectly

May be acquired or congenital
Describes a thickening of the skin of the palms and soles
Acquired causes include reactive arthritis
=

Keratoderma

How well did you know this?

Not at all

Perfectly

Name four conditions that can cause keratoderma

Psoriasis
Dermatitis
Reactive arthritis
SLE

How well did you know this?

Not at all

Perfectly

Affects people who sweat excessively
Patients may complain of damp and excessively smelly feet
Usually caused by Corynebacterium
Heel and forefoot may become white with clusters of punched-out pits
=

Pitted keratolysis

How well did you know this?

Not at all

Perfectly

Crops of sterile pustules affecting the palms and soles
The skin is thickened, red. Scaly and may crack
More common in smokers
=

Palmoplantas pustulosis

How well did you know this?

Not at all

Perfectly

Affects children. More common in atopic patients with a history of eczema
Soles become shiny and hard. Cracks may develop causing pain
Worse during the summer
=

Juvenile plantar dermatosis

How well did you know this?

Not at all

Perfectly

Shingles How long are they infectious for? How do you reduce the risk of spread

Until the vesicles have crusted over Usually 5-7 days following onset Covering lesions reduces the risk

Analgesia for shingles (3)

Paracetamol NSAIDs Amitriptyline

When do you give antivirals for shingles?

Within 72 hours Unless <50yo with mild truncal rash with mild pain

Shiny orange peel skin

Pretibial myxoedema

Shin lesions: Initially small red papule later deep, red, necrotic ulcers with a violaceous border

Pyoderma gangrenosum

Mx seborrhoeic dermatitis (2)

1. Head & Shoulders & Neutrogena T/Gel (Both contain zinc) 2. topical ketoconazole

Scabies mx (2) Who should be treated?

permethrin 5% is first-line (8-12 hours) malathion 0.5% is second-line (24 hours) Repeat 7/7 later all household and close physical contacts should be treated at the same time, even if asymptomatic

Mx crusted scabies

Ivermectin

pink and blotchy, and commonly found on the forehead, eyelids and nape of the neck Vascular birthmark = Course of rash

Salmon patch AKA stork mark Fades over a few months

typically affects nose, cheeks and forehead flushing is often first symptom telangiectasia are common later develops into persistent erythema with papules and pustules rhinophyma = Mx (3)

Rosacea Mx Topical metronidazole Topical brimonidine if predominant flushing PO oxytetracycline

Adverse effects of retinoids (8)

1. Teratogenecity 2. Depression 3. Hair thinning 4. Dry skin/eyes/mouth/lips 5. Raised triglyc 6. Nose bleeds 7. Intracranial HTN 8. Photosensitivity

Causes of pyogenic granuloma (2)

Trauma Pregnancy Mx pregnancy - resolve spontaneously, otherwise currettage

most common sites are head/neck, upper trunk and hands. Lesions in the oral mucosa are common in pregnancy initially small red/brown spot rapidly progress within days to weeks forming raised, red/brown lesions which are often spherical in shape the lesions may bleed profusely or ulcerate =

Pyogenic granuloma

Causes of pyoderma gangrenosum (6) Mx

IBD RA SLE Idiopathic 50% Lymphomas and leukemias PO steroids

Purpura is usually caused by

Low platelets (ITP)

Pruritus particularly after warm bath 'Ruddy complexion' Gout Peptic ulcer disease =

Polycythaemia

most commonly affects trunk patches may be hypopigmented, pink or brown. May be more noticeable following a suntan scale is common mild pruritus = Mx

Pityriasis versicolor Mx topical ketoconazole

What is pompholyx? Precipitated by? (2)

Type of eczema affecting the hands and feet Sweating and high temperatures

small blisters on the palms and soles pruritic often intensely itchy sometimes burning sensation once blisters burst skin may become dry and crack = Mx (3)

Pompholyx Cool compress Emollients Topical steroids

classically presents with photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands (most common feature) hypertrichosis hyperpigmentation = Mx (2)

Porphyria cutenea tarda Mx chloroquine, venesection

Name three factors that may exacerbate psoriasis

Trauma Alcohol Withdrawal of steroids

Name four drugs that can exacerbate psoriasis

BB Lithium Antimalarials NSAIDs

What can trigger guttate psoriasis?

Strep infection

Psoriasis Mx All patient should use? 1st line treatment (2) Length of time If no improvement over what time period? 2nd line If no improvement after further 8-12 weeks 3rd line (2) 4th line

Regular emmolients 1. Potent steroids OD + vit D analogue OD - 4 weeks If no improvement after 8 weeks 2. Vitamin D analogue BD If no improvement after 8-12 weeks 3. Top steroid BD - 4 weeks OR Coal tar prep OD/BD 4. Dithranol

Secondary care rx of psoriasis (3)

1. Phototherapy 2. PO MTX 3. Ciclosporin

Mx scalp psoriasis Mx face/flexural/ genital psoriasis

Top potent steroids OD 4 weeks Mil to mod OD for 2 weeks

How long should you use potent steroids for? Very potent steroids? Break time?

No longer than 8 weeks Very potent for no longer than 4 weeks Try and have a break of at least 4 weeks between each treatment

Two examples of vitamin D analogues Maximum weekly amount for adults in grams

Calcipotriol Calcitriol 100g

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 (Wickham's striae) Koebner phenomenon may be seen (new skin lesions appearing at the site of trauma) oral involvement in around 50% of patients: typically a white-lace pattern on the buccal mucosa nails: thinning of nail plate, longitudinal ridging Mx (2)

Lichen planus Mx topical steroids, denzydamine mouthwash if oral

Lichen planus can be caused by which drugs (3)

Gold Quinine Thiazides

Presentation is usually in boys aged between 5-14 years Appears following sun exposure Itchy red bumps turning into blisters and crusts on light exposed parts of the ears Occurs in spring usually = Mx (3)

Juvenile spring eruption Sunscreen, emollients, antihistamines

'golden', crusted skin lesions typically found around the mouth very contagious = Caused by what bacteria? Mx (3) School

Impetigo Staph Aur or strep pyogenes Mx Hydrogen peroxide 1% cream Topical fusidic acid or mupirocin PO fluclox/ erythro if pen allergic School exclusion until lesions are crusted and healed or 48 hours after starting abx treatment

Hyperhydrosis mx (3)

Topical aluminium chloride preparations Iontophoresis Botulinium toxin

Hirsutism Assessment/ scoring system name What score indicates moderate or severe

Ferriman-Gallwey >15

It is characterized by the development of inflammatory nodules, pustules, sinus tracts, and scars in intertriginous areas. It should be suspected in pubertal or post-pubertal patients who have a diagnosis of recurrent furuncles or boils, especially in intertriginous areas. =

Hidradenitis suppurativa

Hidradenitis suppurativa RF (5) Mx (2)

FH Smoking Obesity T2DM PCOS Mx 1. Steroids 2. Fluclox

What is Osler Weber Rendu syndrome (alternative name)

Hereditary haemorrhagic telangiectasia

HHT - Hereditary haemorrhagic telangiectasia Diagnostic criteria

3 or more of: Epistaxis Telangiectases (lips, oral cavity, fingers, nose) Visceral lesions e.g GI telang with or without bleeding, AVM FH

Dermatology 2 Flashcards

(62 cards)