Flashcards in Dermatology Deck (52):
When might you see lichenified skin?
As a result of chronic itching of eczema
What is the ABCDE for taking a history of a skin lesion?
A - asymmetry
B - border irregularity
C - colour variation
D - diameter
E - evolution over time
What is a macule?
A flat area of altered skin colour (impalpable)
What is a papule?
An elevated, palpable skin lesion
What is a nodule?
An elevated, palpable skin lesions >5mm
What is a vesicle?
A fluid-filled blister
Palpable purpura are characteristic of what group of conditions?
How does tinea corporis typically present?
Scaly, annular lesions on the body that are itchy & have an area of central clearing
What is the management of tinea?
-Topical agent, eg/ imidazole or terbinafine creams
-Oral griseofulvin for extensive infections
-Tinea of the scalp needs prolonged treatment with oral antifungals
What are some specific treatments of molluscum contagiosum?
-Topical irritants - eg/ salicylic acid
Which pathogen usually causes folliculitis?
Which pathogen usually causes impetigo?
What is the treatment of impetigo?
Anti-staph antibiotics: flucloxacillin or cephalexin
Which organism commonly causes cellulitis?
Grp A Streptococcus
What are 3 features of eczema on history?
-Located in flexures
-Worse in winter
-Pt may also have asthma & hayfever
-Family Hx of eczema
What are some of the triggers of eczema?
-Stress & anxiety
-Genetic predisposition (Filaggrin mutation)
What does discoid eczema look like?
Annular disc-like patches of eczema (mimics psoriasis & tinea)
What is asteatotic eczema?
Eczema that is worst on the front of the legs of elderly patients, and flares up in winter
What is pompholyx?
Vesicular hand & foot eczema
What is the treatment of diffuse erythrodermic eczema?
Intense topicals & systemic immunosuppression
What is eczema herpeticum & how is it treated?
Secondary infection of eczematous skin with HSV virus. Tx: systemic antiviral treatment + opthalmology assessment if eye involvement
What are the lifestyle modifications for atopic eczema?
-Warm, not hot showers
What are specific eczema treatments?
-Non-steroid anti-inflammatory creams (eg/ pimecrolimus)
-Treat suspected infections with antibiotics
-Phototherapy with UVB
What are 3 features of eczema on examination?
-Erythematous, ill-defined scaly patches
-Rash in flexural areas
-Lichenified skin in chronic eczema
What are 3 features of psoriasis on history?
-Mostly on extensor surfaces
-Better with UV exposure
What are 3 features of psoriasis on examination?
-On extensor surfaces
-Well demarcated plaques
-Very erythematous/salmon pink
How does flexural & genital psoriasis differ from typical psoriasis?
Flexural & genital psoriasis is less scaly, and has a 'glazed' appearance (often confused with tinea)
What is post-streptococcal guttate psoriasis?
Occurs 1-2 weeks after Strep infection - sudden onset of small plaque psoriasis
What are the treatment options for psoriasis?
-Topical - steroids, tars, calcipotriol, dithranol, emollients
-Phototherapy - narrowband UVB treatment
-Systemic - oral acitretin, methotrexate, cyclosporin A, biologic agents
What are the 4 components of acne?
1. Abnormal keratinization of sebaceous duct
2. Colonization with bacteria
3. Increase in androgen levels leading to increased sebum production
What are the topical treatments for acne?
Keratolytics, comedolytics, anti-bacterials
What are some systemic treatments for acne?
Antibiotics (doxycycline, minocycline), anti-androgenic OCP (females), systemic retionoids (isotretinoin)
How long is the treatment course of systemic isotretinoin for acne?
6-12 months (specialist use only)
What are some of the adverse effects of systemic isotretinoin?
Teratogenic, dryness, photosensitivity, controversial association with depression
What are some triggers of vascular rosacea?
Sunlight, alcohol, hot foods, spicy foods, emotion, heat, topical steroids
What are some clinical features of rabies?
-Spares face & head in adults
-Intensely itchy rash, starting on hands & feet
-Itch is worse at night
-Spreads to genital areas, generalised body rash
-Incubation period 4-6 weeks
What are the general management considerations for scabies?
-Treat all close contacts
-Treat index case at diagnosis & again at 1 week
-Post-scabetic itch can take weeks to settle
What is the topical treatment of scabies?
-5% permethrin cream from neck down
Which is the most commonly diagnosed skin cancer?
What are the 2 precursor lesions to SCC?
-Solar (actinic) keratosis
-Bowen's disease (SCC in situ)
What is the typical description of an SCC?
Erythematous, hyperkeratotic papule or nodule that may bleed or ulcerate & may be tender
What is the typical description of a BCC?
Pearly nodules often containing prominent, dilated subepidermal blood vessels (telangiectasias), may bleed
Which non-pigmentous skin cancer is more likely to metastasize?
How are solar keratoses described?
Erythematous, scaly lesions commonly found on the dorsum of hands
What is the treatment of solar keratoses?
What are some features of Bowen's disease?
-Full thickness epidermal dysplasia, with no invasion
-Commonly seen in lower limbs
-Risk of malignant transformation to SCC is 3-5%
-Often asymptomatic, but can be itchy, painful or may bleed
What is a benign junctional naevus?
A naevus located at the epidermal side of the dermo-epidermal junction
What is a benign compound naevus?
A naevus located in the epidermis & the dermis
What is a benign intradermal naevus?
An intradermal naevus - usually pale in colour
What are some features of a benign mole?
-Does not change with time
Name 4 risk factors for melanoma.
-Multiple dysplastic naevi (>5)
-Past history of melanoma
-History of blistering sunburn
-Type 1 skin