Dermatology Flashcards
(19 cards)
35y f 👗+ facial butterfly rash + (symmetrical) joint pains in the knees &elbow + multiple painful mouth ulcer + discoid rash ( scaly ,erythmatous , well demarcated at sun exposed area )+ photosensitivity🌝+ Raynaud phenomenon🌬+ fibrosis alveolitis + glomerulonephrits .
Dx😃
Invest 🤔
SLE (systemic lupus erythematous )
Invest:
#FBC{normocytic normochromic anemia } &ESR {increased}
#AutoABs
* ANA (not specific present in other auto immune diz )
*anti-dsDNA (highly specificity)
*anti-smith (most specific )
*anti-histone ( drug induced lupus )
*RF (20% +ve )
* complement C3,C4 low during active phase dt consumption.
19y F 👗+itchy well demarcated bright red elevated lesions over extensor surface of her bady (plaques ) + dry itchy scalp+nail changes( pitting & onycholysis) +lesions comes & goes +ve FHx.
Dx?
Psoriasis
Red raised (itchy) rash after playing football + past history of asthma Most appropriate management? 🙈
Urticaria 😡 #Oral chlorpheniramine
Hoarseness of voice + wheezy chest + dysnea + stridor + swelling of the tongue &cheek
Most appropriate ttt?
Adrenaline IM
Anaphylactic shock 😲😱
Severe itching after insect bit
Oral antihistamine
{ 🇦🇱 itching without $&$ of anaphylaxis) >manage with oral antihistamine
*1st generation &sedative chlorpheniramine
*2nd generation &non sedative : oral citirazine
Itching wheals of all sizes after viral infection +comes &goes 🤔dx?
Urticaria
Note : chrophenamine most safe in pregnancy
Dry skin scaly itchy rash +hx of asthma + +ve FHX
Ttt?
Eczema
1st apply emollient cream (faster absorption)
2nd apply steroid pint.
Case1 :CHF on meds ( hydralazine)
Case 2 : TB &on meds(isoniazid)
Drug induced lupus
Invest: anti-histone
Hx travel to India + elevated patches on both shins -may on arm or thigh -tender erythematous nodular lesions
Erythema nodosum India(think of TB ) Causes : TB IBD Sarcoidosis Penicillin
Tender necrotizing genralized rash with necrotic base sparing oral mucosa & genital area .{think of Steven Johnson $😱} after AB for pneumonia
Or may be just itchy skin rach
Erythema multi form Causes: mycoplasma Penicillin Amoxicillin Note :both hx of antibiotic &spot dx differentiate it from allergy)
Hx of camping + insect bite + tender skin lesion
Erythema chronicum
Cause:Lyme diz
Hx of RF (Rheumatic fever ) + raised non-tender rings on inner surfaces of limbs
Erythema marginatum
Firm red rash on the cheeks 《slapped cheeks $》 lasted for 2 days
Erythema infectiousm (5th diz) Cause :parvovirus B19
Elderly sit close fo an apen fire (Chronic exposure to infrared radiation in the form of heat )
Erythema Ab lgne
Itchy scaly rash over her wrist with fine white streaks overlying the lesions &flexor surfaces + lacy white pattern on buccal mucosa + ridges on nails
Lichen planus Re: 4 P Purple Pruritic Papular Polygonal rash
Pearly white umbilicated ulcer (solitary ,shiny ,red,nodule with central depression with rolled or inverted edges )on nose for months +hx of exposure to UV (sum_exposed area )
Basel cell carcinoma
Note: ulcer presenting above neck in plab mostly BCC
Red papules &pastules on the nose, forehead , cheeks + flushing after alcohol or spicy food + telangiectasia +rhinophyma (nose disfigurement)
Ance rosacea
To be sure form dx this erytjema shouls lasted for 3 months at least
Cellulitis ttt
Caused by: Strept or staph
Ttt:flucloxacillin
4y child with painful honey coloured crusted lesion on her face &neck mostly localized around her mouth ,hot to touch +otherwise well
Impetigo Ttt: *1st topical fusidic acid *2nd if MRSA :topical mupirocin *Systemic AB: flucloxacillin If resistant go for clarithromycin or erythromycin
