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Year 2 MBChB > Dermatology > Flashcards

Dermatology Flashcards

(117 cards)

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1
Q

What is vitiligo?

A

Autoimmune condition resulting in the loss of melanocytes, and depigmentation of the skin

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2
Q

What conditions are associated with vitiligo?

A

T1DM
Alopecia
Addisons
Anaemia

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3
Q

What are the features of vitiligo?

A

Well demarcated plaques of depigmented skin

Peripheries most affected

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4
Q

What is the management of vitiligo?

A

Sun block
Make up
Cannot be reversed

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5
Q

What is impetigo?

A

Superficial bacterial skin infection

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6
Q

What is impetigo usually caused by?

A

Staph aureus

Strep pyogenes

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7
Q

What are the features of impetigo?

A

Golden crusted skin lesions, usually around mouth

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8
Q

What is the management of impetigo?

A

Localised: topical fusidic acid/retapamulin
Extensive: oral flucloxacillin

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9
Q

What is acne rosacea?

A

Chronic skin disease of unknown aetiology

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10
Q

What is the presentation of acne rosacea?

A

Flushing
Rhinophyma
Telangiectasia
Persistent erythema + pustules

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11
Q

What is the management of acne rosacea?

A

Topical metronidazole
Oxytetracycline
Laser therapy for telangiectasia

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12
Q

What is acne vulgaris

A

Condition characterised by obstruction of pilosebaceous follicles with keratin plugs

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13
Q

What are the features of mild acne vulgaris?

A

Open and closed comedones

Sparse inflammatory lesions

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14
Q

What are the features of moderate acne vagaries?

A

Widespread non-inflamm lesions and numerous papules and pustules

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15
Q

What are the features of severe acne vulgaris?

A

Extensive inflamm lesions

may include nodules, pitting, and scarring

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16
Q

What is the management of acne vulgaris?

A

Topical retinoids
Topical abx + retinoids
oral oxytetracycline
Oral isotretinoin

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17
Q

What organism mainly causes fungal nail infections?

A

Trichophyton rubrum

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18
Q

What are the features of fungal nail infections?

A

Unsightly nails; thickened, rough, opaque

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19
Q

What investigations are done in fungal nail infections?

A

Nail clippings/scrapings

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20
Q

What is the management of a fungal nail infection caused by dermatophytes?

A

Oral terbinafine/itraconazole for 3-6m

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21
Q

What is the management of a fungal nail infection caused by candida?

A

Topical antifungals

Oral itraconazole for 12 weeks

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22
Q

What is dermatitis herpetiformis?

A

Autoimmune blistering skin disorder

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23
Q

What disease is dermatitis herpetiformis associated with?

A

Coeliac disease

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24
Q

What is dermatitis herpetiformis caused by?

A

IgA deposition in the dermis

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25
What are the features of dermatitis herpetiformis?
Itchy vesicular skin lesions on extensor surfaces
26
How is dermatitis herpetiformis investigated?
Skinn biopsy - direct immunofluorescence
27
What is the management of dermatitis herpetiformis?
Gluten free diet | Dapsone
28
What may guttate psoriasis be preceded by?
Strep infection - 2-4 weeks
29
What are the features of guttate psoriasis?
Tear drop papules on trunk and limbs
30
What is the management of guttate psoriasis?
Resolves 2-3m Emollients + steroid creams UVB phototherapy
31
What is erythema nodosum?
Symmetrical erythematous tender nodules
32
What is pretibial myxoedema seen in?
Graves disease
33
What is pretibial myxoedema?
Shiny orange peel skin
34
What is pyoderma gangrenosym?
Small red papule that developed into deep red necrotic ulcer with volaceous border
35
What are some causes of shin lesions?
Strep infection Sarcoid IBD
36
What is necrobiosis lipoidica diabeticorum?
Shiny, painless yellow/red skin in diabetics
37
What is alopecia areata?
Autoimmune condition leading to localised well demarcated patches of hair loss
38
What is cellulitis?
Infection of subcut tissues
39
What organism commonly causes cellulitis?
Strep pyogenes
40
What is the presentation of cellulitis?
Erythematous skin Oedema Pain Reduced mobility
41
What does erythematous tracking mean?
Spread to lymph
42
What is the management of cellulitis?
Benzyl penicillin Flucloxacillin Paracetamol Demarcation to assess spread
43
What is the presentation of henoch-schonlein purpura?
Erythematous and purpuric papules on buttocks and lower limbs (extensor surfaces) Polyarthritis
44
What is the management of henoch-schonlein purpura?
Analgesia for arthralgia | Self-limiting
45
What is a keratoacanthoma?
Benign epithelial tumour
46
What is the presentation of keratoacanthoma?
Solitary nodule with central keratin (may be horny)
47
What is the management of a keratoacanthoma?
Refer under 2 week rule Complete excision Sun protection advice
48
What are some drug causes of urticaria?
Aspirin Penicillins NSAIDs Opiates
49
What is the presentation of lichen planus?
Itchy papular rash most common on palms and soles White lace pattern Polygonal Oral involvement in 50%
50
What is porphyria cutanea tarda caused by?
Defect in uroporphyrinogen decarboxylase Alcohol Hep C
51
How does porphyria cutanea tarda present?
``` Photosensitive rash - face and dorsum of hands Blistering Skin fragility Excessive hair growth Hyperpigmentation ```
52
How is porphyria cutanea tarda investigate?
Pink fluorescence of urine under Woods lamp
53
How is porphyria cutanea tarda managed?
Chloroquinine | Venesection
54
What gene is most important in eczema?
Filaggrin
55
What are chronic changes in atopic eczema?
Excoriation Lichenification Secondary infection
56
What type of hypersensitivity reaction of contact allergic dermatitis?
Type IV (T lymphocytes)
57
What is bullous pemphigoid?
Autoimmune condition | Antibodies against hemidesmosal proteins leading to sub epidermal blistering
58
How does bullous pemphigoid present?
Itchy, tense blisters around flexures Heal without scarring Mouth usually spared
59
How is bullous pemphigoid investigated?
Immunofluorescence: IgG & C3 at DEJ
60
What is the management of bullous pemphigoid?
Corticosteroids PO Topical corticosteroids Immunoscupression Abx
61
What is the commonest cause of erythema multiforme?
HSV
62
What is the major form of erythema multiforme?
SJS - mucosal involvement
63
How does erythema multiforme present?
Target lesions upper limbs affected more than lower mild pruritus
64
What is the management of erythema multiforme?
Withdraw drug Treat infection Analgesia Local skin care
65
How does pemphigus vulgaris present?
Flaccid blisters Pain Do scar Oral cavity affected
66
How is pemphigus managed?
Steroids | Immunosupression
67
What T cells are key in psoriasis?
TH2 & TH17
68
What are some skin signs of diabetes?
Ulcers, xanthomata, necrobiosis lipoidica, acanthuses nigricans
69
What is erysipelas usually caused by?
Strep
70
What are thyroid hormones actions in the skin?
Promotes fibroblasts, regulates epidermal differentiation, skin perfusion + hair
71
What are the skin features in SLE?
Butterfly rash, photosensitivity
72
What is the morphology of erythema multiforme?
Target lesions
73
What is SJS?
Variant of erythema multiforme with blistering and marked mucosal involvement
74
What skin disorders are associated with HIV?
Kaposki's sarcoma, seborrhoea eczema, infections
75
What are the features of a BCC?
Raised, pearly edge, telangiectasia, central ulceration
76
What are the surgical treatments for a BCC?
Standard excision, Mohs surgery
77
What are the non-surgical treatments for a BCC?
Imiquimod, PDT, cryotherapy
78
What are SSC pre-cursors?
AK and Bowen's
79
What is Bowen's disease?
Intra-epidermal SCC
80
What is AK?
Hyperkeratotic areas on sun-exposed sites
81
What is the most common skin cancer post-transplant?
SCC
82
Which type of malignant melanoma occurs on palms/soles mainly?
Acral lentiginous
83
What are the phases of melanomas?
Radial growth --> vertical growth
84
Which phase of melanoma growth can metastasise?
Vertical growth phase
85
Which type of growth do nodular melanomas exhibit?
Vertical growth from the outset
86
What is Breslow thickness?
Measures from the granular layer of epidermis to the deepest tumour cell
87
What is Breslow thickness used for?
Determining prognosis
88
What is urticaria?
A transient eruption of erythematous and oedematous swellings of the dermis, usually associated with itching
89
What is angio-oedema?
Transient swellings in the pepper dermal, subcut and submucosal tissues
90
What do antihistamines do?
Reversible competitive inhibitors of histamine binding to histamine receptors
91
What drug is given in anaphylaxis and how much?
IM adrenaline 1mL of 1:1000
92
Which nerve fibres transmit itch?
Unmyelinated C fibres
93
What is the major gene locus in psoriasis?
6p21.3 (PSORS 1)
94
Which HLA antigen causes a 10-fold increased risk of psoriasis?
HLA-Cw6
95
What is the pathogenesis of psoriasis?
Hyperproliferation of epidermal cells - faster epidermal turnover time
96
What is the normal epidermal turnover time?
25 days
97
What are histological features of psoriasis?
Parakeratotic stratum corneum, absence of granular layer, expanded prickle cell layer
98
What is Auspitz' sign?
Removing scale reveals pinpoint bleeding
99
What are the features of chronic plaque psoriasis?
erythematous scaly plaques on extensor surfaces (silvery scale)
100
What is Koebner phenomenon?
Psoriasis develops in sites of trauma (scratching, burns)
101
Who does guttate psoriasis affect?
Young patients (15-25 years)
102
What are the features of guttate psoriasis?
Raindrop psoriatic lesions on the trunk 7-10 days after strep throat
103
What is the management of guttate psoriasis?
Nil, emollients, topical tar, phototherapy
104
What is the management of scalp psoriasis?
Olive oil, tar shampoos, coconut oil
105
What are the blood changes in pustular psoriasis?
Hypoalbuniaemia, hypocalcaemia and leucocytosis
106
What are psoriatic nail changes?
nail pitting, oncholysis, 'oil drop' lesions
107
What is the treatment of psoriasis (increasing in severity)?
Topical (emollients, tar, vit D analogues, topical steroids), phototherapy, oral treatments
108
What does coal tar do in psoriasis?
Reduces DNA synthesis and epidermal proliferation
109
What should you never use on generalised psoriasis?
Potent topical steroids
110
Why should you never use potent topical steroids on generalised psoriasis?
Risk of rebound flare up
111
What is furunculosis?
Acute deep infection of the hair follicles
112
What is staphylococcal scalded skin syndrome?
Epidermolytic exotoxin produced by staph causes splitting between desmosomes in granular layer
113
What is the management of bacterial skin infections?
Swab, fusidic acid, oral abx if extensive
114
What is the management of SSSS/facial erysipelas?
IV antibiotics
115
What is the management of viral warts?
Salicylic acid (at least three months therapy), cryotherapy
116
How are fungal infections investigated?
Skin scrapings, Woods lamp, biopsy with PAS stain
117
What is the management of fungal infections?
Topical antifungals, oral if tinea ungium or capitis

Year 2 MBChB (8 decks)

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