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MRCP > Dermatology 2 > Flashcards

Dermatology 2 Flashcards

1
Q

complications associated with acne rosacea?

A

rhinophyma,

ocular: blepharitis

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2
Q

management of acne rosacea with limited number of pustules/ papules, no plaques?

A

topical metronidazole

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3
Q

management of acne rosacea with predominant flushing but limited telangiectasia?

A

consider topical brominidine gel

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4
Q

management of severe acne rosacea?

A

systemic antibiotics e.g oxytetracycline

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5
Q

management of acne rosacea with prominent telangiectasia?

A

laser therapy

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6
Q

management of SCC <20mm in diameter?

A

excision with 4mm margins

*mohs micrographic surgery may be used in high risk patients and in cosmetically impt sites

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7
Q

management of SCC >20mm in diameter?

A

excision with 6mm margins

*mohs micrographic surgery may be used in high risk patients and in cosmetically impt sites

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8
Q

Good prognostic factors of SCC?

A
  • well differentiated
  • <20mm diameter
  • <2mm deep
  • no associated diseases
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9
Q

Poor prognostic factors of SCC?

A
  • poorly differentiated
  • > 20mm diameter
  • > 4mm deep
  • immunosuppression
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10
Q

what bacteria is implicated in acne vulgaris pathology?

A

Anaerobic bacteria: Propionibacterium acnes

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11
Q

What may cause obstruction of the pilosebaceous follicle leading to acne vulgaris?

A

follicular epidermal hyper proliferation -> keratin plug

-> obstruction of pilosebaceous follicle

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12
Q

Patient on TPN + perioriicial dermatitis, alopecia, acrodermatitis?

A

Zinc deficiency

- TPN patients do not receive zinc

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13
Q

what antibiotic predisposes to pellagra?

A

isoniazid

  • isoniazid inhibits the conversion of tryptophan -> niacin
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14
Q

what drugs may cause lichen planus?

A
  • gold
  • quinine
  • thiazides
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15
Q

1st line management of scabies?

A

permethrin 5%

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16
Q

management of crusted scabies?

A

Ivermectin

  • crusted skin will be teeming with hundreds of thousands of organisms
  • seen in pts with suppressed immunity, esp HIV
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17
Q

management of crusted scabies?

A

Ivermectin

  • crusted skin will be teeming with hundreds of thousands of organisms
  • seen in pts with suppressed immunity, esp HIV
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18
Q

Erythema nodosum with no other past medical history, what is a useful investigation?

A

CXR- can help exclude sarcoidosis, TB

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19
Q

shiny orange peel skin over shins?

A

pretibial myxoedema

  • seen in Graves disease
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20
Q

initially small red papule, -> later deep, red, necrotic ulcers with a violaceous border on shins

A

pyoderma gangrenous

  • idiopathic in 50%, IBD, myeloproliferative disease, connective tissue diseases
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21
Q

shiny, painless areas of yellow/red skin typically on the shin of diabetics
- often assoc w telangiectasia

A

Necrobiosis lipoidica diabeticorum

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22
Q

acanthosis nigricans assoc w which kind of GI cancer?

A

gastric adenocarcinoma

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23
Q

management of lichen sclerosus?

A

topical steroids, emollients.

  • If atypical features present, biopsy.
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24
Q

causes of scarring alopecia?

A
  • trauma, burns
  • radiotherapy
  • lichen planus
  • discoid lupus
  • tinea wapitis
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25
Q

drugs causing non scarring alopecia?

A

cytotoxic drugs, carbimazole, heparin, COCP, colchicine

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26
Q

what nutritional deficiencies may cause non scarring alopecia?

A

iron, zinc deficiency

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27
Q

extensive umbilicated lesions in HIV?

A

molluscum contagiosa

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28
Q

extensive umbilicated lesions in HIV?

A

molluscum contagiosum

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29
Q

what is systemic mastocytosis?

A

neoplastic proliferation of mast cells

30
Q

features of systemic mastocytosis?

A
  • urticaria pigmentosa - produces a wheal on rubbing (Darier’s sign)
  • flushing
  • abdominal pain
  • monocytosis on the blood film
31
Q

diagnosis of systemic mastocytosis?

A

raised serum tryptase,

high urinary histamine

32
Q

Darier’s sign?

A

systemic mastocytosis

- produces a wheal on rubbing

33
Q

1st line management of chronic plaque psoriasis?

A

topical potent steroid + vit D analogue

  • should be applied separately, ie. one in the morning, and the other in the evening
34
Q

2nd line management of chronic plaque psoriasis (if no improvement of 8 wks of 1st line treatment)?

A

Vit D analogue BD

35
Q

Management of scalp psoriasis?

A

potent topical steroids OD for 4 wks

36
Q

Management of face, flexural, genital psoriasis?

A

mild/ mod potency topical steroids for max of 2 wks

37
Q

1st line management of dermatophyte nail infection

A

oral terbinafine (itraconazole as alternative)

  • 1.5- 3 mo for fingernails
  • 3- 6 mo for toenails
38
Q

management of candida nail infection?

A

mild- topical anti fungal (amorolfine)
severe- oral itraconazole

fingernails - 6 mo
toenails - 9-12 mo

39
Q

causes of Stevens Johnsons syndrome?

A

penicillin, sulphonamides

  • anti-epileptics: lamotrigine, carbamazepine, phenytoin
  • allopurinol
  • NSAIDs
  • OCP
40
Q

Pigmentation of nail bed affecting proximal nail fold (Hutchinson’s sign)?

A

Acral lentiginous melanoma

41
Q

what malignancy is associated with Necrolytic migratory erythema?

A

glucagonoma

42
Q

pemphigus vulgaris: antibodies directed against?

A

desmoglein -3

43
Q

1st line management of pyoderma gangrenosum?

A

oral steroids

44
Q

pemphigoid: antibodies directed against?

A

hemidesmosomal proteins BP180 and BP230

45
Q

monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter

A

eczema herpeticum

46
Q

what may precipitate pompholyx eczema?

A

humidity e.g. sweating, high temps

47
Q

conditions associated with seborrhoeic dermatitis?

A

HIV, Parkinson’s disease

48
Q

1st line treatment of Toxic Epidermal necrolysis?

A

IVIG

49
Q

erythema nodosum: usually heals within?

A

6 wks

50
Q

drugs known to exacerbate psoriasis?

A
  • beta blockers,
  • lithium,
  • antimalarials (chloroquine and hydroxychloroquine),
  • NSAIDs and ACE inhibitors,
  • infliximab
51
Q

what virus is associated with pityriasis rosea?

A

HHV-7

52
Q

photosensitive rash on face/ hands + hypertrichosis + hyperpigmentation?

A

porphyria cutanea tarda

53
Q

management of porphyria cutanea tarda?

A
  • chloroquine

- venesection: preferred if iron ferritin is above 600 ng/ml

54
Q

asymptomatic, flat, slightly scaly, pink or brown rash usually found in the groin or axillae

A

erythrasma

  • caused by overgrowth of the diphtheroid Corynebacterium minutissimum
55
Q

examination of erythrasma?

A

Wood’s light: coral-red fluorescence

56
Q

management of erythrasma?

A

topical miconazole, or antibacterial.

if extensive infection: oral erythromycin

57
Q

what bacteria is isolated in erythrasma?

A

Corynebacterium minutissimum

58
Q

management of early keloids?

A

intra lesions steroids e.g. triamcinolone

59
Q

most common sites for keloid scars?

A

in decreasing frequency:

  1. sternum
  2. shoulder
  3. neck
60
Q

management of facial hirsutism not responding to cocp?

A

topical eflornithine

  • CI in preg/ breastfeeding
61
Q

papular lesions that are often slightly hyperpigmented and depressed centrally
+ typically on hands / feet, extensor surfaces

A

granuloma annulare

  • assoc DM
62
Q

drug causes of hypertrichosis?

A

minoxidil, ciclosporin, diazoxide

63
Q

most common cause of tinea capitis in the UK?

A

Trichophyton tonsurans

64
Q

which tetracycline is less used due to possibility of irreversible skin pigmentation?

A

minocycline

65
Q

erythema ab igne increases risk of…?

A

SCC

66
Q

moderate potency topical steroids?

A

betametasone valerate 0.025% (Betnovate RD)

clobetasone butyrate 0.05% (Eumovate)

67
Q

potent topical steroids?

A 
Betnovate= Betametasone valerate 0.1%,
Cutivate = fluticasone propionate 0.05%
68
Q

very potent topical steroids?

A

Dermovate = clobetasol propionate 0.05%

69
Q

management that can help accelerate the clearance of guttate psoriasis?

A

UVB phototherapy

70
Q

Management of dermatitis herpetiformis?

A

Gluten free diet

Dapsone topical

71
Q

2nd line mx of dermatitis herpetiformis after treatment w gluten free diet +|- dapsone?

A

Sulfapyridine

72
Q

Diagnostic criteria for NF1?

A
  • at least 6 cafe au last spots/ hyperpigmented macules (at least 15mm in adults, 5mm in <10yos)
  • axillary or inguinal freckles
  • two or more typical neurofibromas or 1 plexiform neurofibroma
  • optic nerve glioma
  • 2 or more iris hamartomas (Lisch nodules seen on slit lamp)
  • sphenoid dysplasia or typical long bone abnormalities such as arthorsis

MRCP (21 decks)

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