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Flashcards in Dermatology Deck (216)
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1

What is necrotizing fasciitis?

A fulminant, rapidly spreading infection with widespread tissue destruction through all tissues and planes

2

What is the mortality like for necrotising fasciitis?

Very high

3

What is type 1 necrotizing fasciitis caused by?

aerobic and anaerobic bacteria, seen post surgery or in diabetics

4

What is type 2 necrotizing fasciitis caused by?

group A streptococci (GAS), arising spontaneously

5

What are the symptoms of necrotizing fasciitis?

severe pain at site of initial infection with tissue necrosis
spreading infection across all planes
spreading erythema, pain and crepitus
fever, toxicity and pain

6

What do investigations show in necrotizing fasciitis?

increased CRP, ESR, WCC

7

What is the treatment for necrotizing fasciitis?

antibiotics (2 = benzylpenicillin and clindamycin, 1 = broad spectrum), surgical exploration, amputation

8

What is cellulitis?

infection of the deep subcutaneous layer

9

What are the symptoms of cellulitis?

hot and tender area, blisters, low grade fever, lymphedema, poorly demarcated margins

10

Where about does cellulitis affect and then spread to?

Starts in the lower leg and spreads upwards

11

How does the skin appear in erysipelas?

larger area with erythematous and sharply demarcated from normal skin

12

What causes cellulitis?

beta-haemolytic streptococcus, staphylococcus or MRSA

13

Investigations for cellulitis?

swab of toes, antistreptolysin O titre (ASOT) and antiDNAse B titre (ADB)

14

What is erysipelas?

a more superficial infection of cellulitis, often of the face, has a well demarcated edge

15

What is the treatment of cellulitis?

phenoxymethylpenicillin and flucloxacillin (IV or oral depending on how widespread), treat underlying cause, low dose antibiotic prophylaxis if recurrent to prevent further lymphatic damage

16

What is vasculitis?

Inflammatory disorder of blood vessels causing endothelial damage

17

What are the symptoms of vasculitis?

haemorrhagic papules, pustules, nodules, plaques that can erode and ulcerate, don't blanch from glass slide, fixed livedo reticularis pattern, pyrexia and arthralgia

18

What is leucocytoclastic vasculitis?

the most common cutaneous vasculitis affecting the small vessels

19

how does leucocytoclastic vasculitis usually appear?

on lower legs as a symmetrical palpable purpura

20

What is the treatment of vasculitis?

can resolve spontaneously, analgesia, support stockings, dapsone, prednisolone

21

What is the cause of leucocytoclastic vasculitis?

drugs, infection, inflammatory disease, malignant disease, idopathic

22

What causes pressure sores?

elderly, immobile, unconscious, paralysed from skin ischemia, sustained pressure over bony prominence

23

What are the four grades of pressure sores?

1 - non blanchable erythema of intact skin
2 - partial thickness skin loss of epidermis/dermis
3 - full thickness skin loss involving subcutaneous tissue, not fascia
4 - full thickness skin loss involving muscle, bone, tendons and joint capsule

24

What is the risk assessment scale called for pressure sores?

Norton scale and waterlow pressure sore risk assessment

25

What is the treatment for pressure sores?

bed rest, pillows, air filled cushions, pressure relieving mattress, regular turning, adequate nutrition, non irritant occlusive moist dressings, analgesics, plastic surgery, treat underling cause

26

What is eczema?

superficial skin inflammation with vesicles, redness, oedema, oozing, scaling and pruritis

27

What is the cause of eczema?

Atopy - initial selective activation of Th2 type CD4 lymphocytes in the skin which drive the inflammatory process

28

How common is eczema and who is most likely to have it?

In 5% of the population
10-20% of children
Genetic disease
More likely if atopic
20-30% chance of passing onto child

29

What are some exacerbating factors of eczema?

dust mites, food allergies, pets, teething, strong detergents, chemicals, woollen clothes, lack of infection in infancy

30

What are the clinical features of eczema?

itchy erythematous scaly patches in flexures, hyper or hypo pigmented skin, blisters if herpes infection, can be punched out lesions (eczema berpeticum)