Dermatology Flashcards by Mike Hurley

Nodular BCC

Pearly nodule

May have central ulceration

Blood vessels across surface

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Superficial BCC

Younger, upper trunk, shoulders
Slightly scaly, irregular plaque
Multiple microerosions

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Actinic keratosis (Also: solar keratosis)

Flat or thickened papule or plaque
white/yellow, scaly, warty or horny surface
skin colour, red or pigmented
tender or asymptomatic

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Actinic cheilitis

Diffuse or patchy dryness and variable
thickening of lower lip

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Grover disease (Transient acantholytic dermatosis/sweat rash)

Most common in men >50
Sometimes follows sweating, heat stress

Frequently itchy, may be asymptomatic
Red crusted papules on central back/mid-chest

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Intramammary Paget disease (also called Paget disease of the nipple)

Uncommon skin cancer characterised by a chronic
eczema-like rash of the nipple and
adjacent areolar skin.
Associated with underlying breast cancer

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Extramammary Paget disease

Uncommon skin cancer characterised by
chronic eczema-like rash of anogenital regions of
men and women most commonly occurs in the vulva
of women aged between 50-60 years
mild to intense itching

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Chondrodermatitis nodularis helicis (Winkler disease)

Tender lump in cartilaginous portion of ear

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Lichen simplex chronicus

Itch due to another condition results in repetitive scratching and rubbing

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Asteatotic eczema (‘lack of oil’)

Crazy-paving appearance

Diamond-shaped plates of skin are separated from each other by red bands forming a network.

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Pompholyx

A form of hand/foot eczema characterised by vesicles or bullae (blisters). 
In many cases it appears to be related to sweating, as flares often occur during hot weather, humid conditions, or following emotional upset. 
Can cause intense itch/burning/nail pitting and ridges. 
Address hyperhydrosis (absorbent socks, antiperspirants), c/s

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Exfoliative keratolysis/keratolysis exfoliativa

Focal peeling of the palms and less often the soles.

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Nodular prurigo/Prurigo nodularis

Very itchy firm lumps

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Keratosis pilaris

Outer aspect of both upper arms.

Also occur on the thighs, buttocks, cheeks, and less often on the forearms and upper back

Not itchy

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Pityriasis alba

It often presents following sun exposure,
Lesions 0.5 – 5cm can be scaly

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Erythrodermic psoriasis. (1/3 of erythroderma)

Red dry skin all over the body.
Occurs in setting of worsening or unstable psoriasis.

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Pityriasis rosea

Characterised by an initial single larger patch followed by similar, smaller oval red patches that are located
Mainly on the chest and back

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Lichen planus

Symptoms can range from none (uncommon) to intense itch

Papules and polygonal plaques are shiny, flat-topped and firm on palpation

Most often front of the wrists, lower back, and ankles.

New papules and plaques often have a purple or violet hue

Plaques are crossed by fine white lines
called ………… striae.

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Lichen sclerosis

Genital & perianal areas.
White crinkled or thickened patches of skin that have a tendency to scar

Can be extremely itchy and/or sore

The clitoris may be buried (phimosis).

The labia minora resorb/shrink.

The entrance to the vagina tightens

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Impetigo

Characterised by pustules and honey-
coloured crusted erosions

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Pityriasis versicolor (also tinea versicolor)

Trunk, neck, and/or arms. The patches may be coppery brown, paler than surrounding skin, or pink.

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Kerion

Most often on scalp (tinea capitis)

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Hidradenitis suppurativa

Affects apocrine gland-bearing skin in the axillae, in the groin, and under the breasts.
It is characterised by recurrent boil-like nodules and abscesses that culminate in pus-like discharge, difficult-to-heal open wounds (sinuses) and scarring

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Erythema nodosum

Red lumps on shins, around knees or ankles, ranging in size from cherry to grapefruit.
Hot & painful. May be associated with a number of causes incl: throat infections, sarcoidosis, TB, pregnancy, OCP, NSAIDs & inflammatory bowel disease

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Henoch-Schonlein purpura

Often preceded by URTI. Tetrad of signs: rash, arthritis, abdo pain, kidney impairment. Red spots or bumps become palpable purpura - buttocks, lower legs, elbows, knees

Cutaneous larva migrans

Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that have been contaminated with animal faeces Larvae migrate under the skin's surface and cause itchy red lines or tracks

Bullous pemphigoid

People \>50yrs, rarer in younger people Severe itch & large bullae

Dermatitis herpetiformis

Symmetrically distributed lesions most commonly on scalp, shoulders, buttocks, elbows and knees. Extremely itchy papules and vesicles on normal or reddened skin May be associated gastrointestinal symptoms

Polymorphous light eruption

Occurs in Northern Europeans holidaying in the Mediterranean The arms, the back of the hands, the V of the neck, the chest and lower legs/feet may be affected, but the face is usually spared Crops of 2–5 mm pink or red papules Persists for several days, and often longer if the affected skin is exposed to more sunlight Burning sensation or itch

Telogen effluvium

temporary hair loss due to shedding of resting hair after some shock to the system (illness, surgery, weight loss..)

Digital myxoid pseudocyst

Arises from degeneration in the connective tissue on the top of the last segment of the finger

Toxic erythema of the newborn (erythema toxicum neonatorum)

Often begins on the face and spreads to affect the trunk and limbs. Otherwise well infant

Tuberous sclerosis

Hamartomas in many organs, but particularly the skin, brain, eye, kidney and heart. Skin lesions, epileptic seizures and developmental delay/behavioural problems are the main features of this condition

Pyoderma gangrenosum

A rapidly enlarging, very painful ulcer Associations with rheumatoid arthritis, IBD, leukaemia and monoclonal gammopathy

Chillblains

Itchy and/or tender red or purple bumps that occur as a reaction to cold.

Orf

Occurs in sheep farmers, shearers, butchers Small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. 2cm -5cm diameter Often tender Generally solitary or few in number. Most commonly on the fingers, hands or forearms but can appear on the face

Milker's nodule

Dairy farmers or vets who examine the mouths of animals Small, red, raised, flat-topped spots develop. Within a week they appear as red-blue, firm, slightly tender blisters or nodules (lumps), usually between 2 and 5 in number Usually on the hands, particularly the fingers, but occasionally the face The top of the nodules often develops a greyish skin and a small crust

Guttate psoriasis

A shower of red, scaly tear drops on the trunk and upper arms and thighs. The rash comes on very quickly, usually within a couple of days, and may follow a streptococcal infection of the throat

Keratoacanthoma

Erupts in sun damaged skin, solid core filled with keratin.

Molluscum contagiosum

There are several ways it can spread. Direct skin-to-skin contact Indirect contact via shared towels or other items Auto-inoculation into another site by scratching or shaving Sexual transmission in adults The papules may persist for up to 2 years or longer. In children, about half of cases have cleared by 12 months, and two-thirds by 18 months, with or without treatment.

Dermatofibroma (cutaneous fibrous histiocytoma)

Benign fibrous nodule that most often arises on the skin of the lower legs.

Periorificial dermatitis

Groups of itchy or tender small red papules around eyes, nostrils, mouth. Mainly adult women, often using inhaled or topical c/s, can also be induced by cosmetic creams, sunscreen, OCP.

Allergic contact dermatitis

Itchy reaction to material, arises hours after contact eg Nickel, preservatives, rubber, dye, adhesives. Affected skin may be red and itchy, swollen and blistered, or dry and bumpy Confined to the site of contact

Irritant contact dermatitis

Due to irritants - water, saliva (children), soaps, detergents, solvents, acids, alkalis, and friction Most often affecting cleaners, hairdressers and food handlers. Well demarcated red patch with a glazed surface, but there may be swelling, blistering and scaling of the damaged area

Chickenpox

Itchy red papules progressing to vesicles on the stomach, back and face, and then spreading to other parts of the body. Blisters can also arise inside the mouth Pruritic Additional symptoms such as high fever, headache, cold-like symptoms, vomiting and diarrhoea

Seborrhoeic dermatitis

Affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk. Salmon-pink, thin, scaly, and ill defined plaques in skin fold on both sides of the face. Petal or ring shaped flaky patches on hair line and on anterior chest. Associated blepharitis

Rosacea

Chronic facial rash usually affecting 30-60yo. Red papules and sometimes pustules on the nose, forehead, cheeks and chin Symptoms include frequent flushing, red face due to redness and telangiectasia aggravated by sun, alcohol, hot or spicy food, Worse with corticosteroids Associated blepharitis

Erythema infectiosum

Mild fever and headache at first then rash a few days later with firm red cheeks (feel burning hot) - lasts 2 to 4 days, followed by a pink lace-like rash on the limbs and sometimes the trunk Rash can persist for up to six weeks at least intermittently

Roseola infantum (exanthem subitum)

Children 6 months - 3 years High fever lasting for 3-5 days, sore throat runny nose, cough, irritability and tiredness As the fever subsides a rash (exanthem) may appear on the face and body Small rose-pink or red raised spots (2–5 mm in diameter) that blanch Mainly affects trunk and rarely spreads to involve neck, face, arms and legs May fade within a few hours or persist for as long as 2 days

Rubella

Slight fever, sore throat, runny nose and malaise (may occur prior to appearance of rash) Characterised by rash, retroauricular, occipital and posterior cervical lymph nodes and fever Rash Begins on the face and spreads to the neck, trunk and extremities Pink or light red spots about 2–3 mm in size. Lasts up to 5 days (average is 3 days). May or may not be itchy

Measles

Cough, coryza, conjunctivitis. Koplik spots on oral mucosa. A red blotchy non itchy rash appears on the face and behind on the ears by the third day of the illness, spreads to the trunk, and becomes more generalised over the next few days.

Hand foot and mouth disease

Mild fever, sore throat and loss of appetite. Malaise, swollen lymph glands, and mild diarrhoea may be present. Lesions on the dorsal and palmar surfaces of the hands and feet. Small vesicles and ulcers in and around the mouth, palate, and pharynx - painful Red macules and papules

Erythema multiforme

triggered by viral infections (usu HSV - cold sores), also M.pneumoniae. Typical target lesions. The lesions are first seen on the backs of hands and/or tops of feet, and then spread along the limbs towards the trunk. Dark red centre, pale pink ring (oedema), outermost bright red ring. Typical lesions may be few in number. Kobner phenomenon.

Stevens-Johnson syndrome/Toxic Epidermal Necrolysis

Flu-like prodrome followed by abrupt onset of a tender/painful red skin rash. Blisters then merge to form sheets of skin detachment, exposing red, oozing dermis. Nikolsky sign. Mucosal involvement is prominent and severe.

Staphylococcal Scalded Skin Syndrome

Young children (neonates), usu \<5yo. starts with fever, irritability and widespread redness of the skin. Within 24-48 hours fluid-filled blisters form. These rupture easily, leaving an area that looks like a burn or scald Nikolsky sign (gentle strokes result in exfoliation)

Melasma/Chloasma

blotchy, brownish facial pigmentation. RF: Sun exposure, pregnancy, hormone treatments, medications, hypothyroidism

Granuloma Annulare

May be associated with autoimmune thyroiditis, diabetes, hyperlipidaemia, HIV, lymphoma Usually affects the fingers or the backs of both hands, but is also common on top of the foot or ankle, and over one or both elbows. Centre of each ring is often a little depressed Plaques tend to slowly change shape, size and position

Necrobiosis lipoidica

Can affect insulin dependent diabetics, although it may occur in non-diabetic subjects as well. One or more tender yellowish brown patches develop slowly on the lower legs over several months Centre of the patch becomes shiny, pale, thinned, with telangiectasia

Blue naevus

Halo naevus

Scarlet fever

It affects people who have recently had a sore throat (strep throat) or school sores (impetigo). Sudden fever associated with sore throat, cervical lymphadenopathy, headache, nausea, vomiting, loss of appetite, swollen and red tongue, abdominal pain, body aches, and malaise. Characteristic rash appears 12–48 hours after the start of the fever. The rash usually starts below the ears, neck, chest, armpits and groin before spreading to the rest of the body over 24 hours Rash looks like sunburn with goose pimples with rough sandpaper-like feel. Pastia lines (ruptured capillaries in body folds) Peeling occurs as rash fades

Rheumatic fever

A complication of scarlet fever. ARF generally develops several weeks after an episode of streptococcal pharyngitis; sometimes after impetigo. Fever Arthralgia Raised ESR \> 30 or CRP \> 30 ECG prolonged PR interval migratory polyarthritis (knees ankles, elbows and wrists) carditis, Sydenham chorea Annular erythema subcutaneous nodules (uncommon)

Pyogenic granuloma

Shiny red mass with a raspberry-like or raw minced meat appearance Rapidly increase in sizeover a period of a few days to weeks to anywhere between 2mm and 2cm in diameter

Dermatology Flashcards

(63 cards)