Dermatology Flashcards
(89 cards)
1
Q
What skin condition can steroids lead to
A
Acne
2
Q
What skin condition can immunosuppression lead to
A
Skin cancer
3
Q
What is tinea corporis
A
Ringworm - a fungal skin infection
4
Q
What does tinea corporis look like
A
An oval ring of scaly red patches that form a ring around an area of central sparing
5
Q
Which number T helper cell is involved in a) Eczema b) Psoriasis
A
Eczema - Th2
Psoriasis - Th1
6
Q
What structure can you use when describing skin lesions
A
Distribution Type of lesion Shape Edge Colour Secondary features
7
Q
Ways you can describe the distribution of skin lesion/rash
A
Central/distal Symmetrical/asymmetrical Flexor, extensor, truncal, palmar, plantar Localised/generalised Dermatomal Follicular Photosensitive/exposed
8
Q
Ways you can describe the type of skin lesion
A
Macule Papule Vesicle Pustule Patch Plaque Nodule Bullae Erosion
9
Q
What is a macule defined as
A
A flat lesion <0.5cm
10
Q
What is the size limit for papules, vesicles, pustules
A
<0.5cm
11
Q
What is a patch defined as
A
A flat lesion >0.5cm
12
Q
What is a plaque defined as
A
A flat lesion >1cm and palpable
13
Q
What would you call a raised lesion >0.5cm
A
Nodule
14
Q
What would you call a raised lesion >0.5cm and filled with fluid
A
Bullae
15
Q
Ways you can describe the shape of a skin lesion
A
Circular Linear Annular (ring, target) Irregular Reticulated (like a net) Discoid
16
Q
Ways you can describe the edge of a skin lesion
A
Well demarcated
Ill defined
Raised/flat
Confluent
17
Q
Ways you can describe the colour of a skin lesion
A
Erythematous
Pigmented/hypopigmented
Purpuric/violaceous
Black/brown/tan
18
Q
Some of the secondary features that may be associated with a skin lesion/rash
A
Crust Scale Keratosis Lichenification Erosion Excoriation Fissure Ulceration Desquamation (peeling) Exudate Verrucous/warty Dry
19
Q
What are the two main types of exogenous eczema
A
Irritant/allergic contact
Photosensitive/photoallergic
20
Q
What are the 7 types of endogenous eczema
A
Atopic Seborrhoeic Asteatotic Discoid Pityriasis alba Pompholyx Varicose
21
Q
Classic description of the rash of atopic eczema
A
Papules and vesicles with an erythematous base over the flexor surfaces
22
Q
Classic description of the rash associated with seborrhoeic dermatitis/eczema
A
Greasy/scaly erythematous rash around the nose/ears/scalp
23
Q
Classic description of asteatotic eczema/dermatitis
A
Cracked dry skin on lower limbs
24
Q
Classic description of pityriasis alba
A
Pink scaly patches that later leave hypopigmented areas of skin
25
Classic description of pompholyx eczema/dermatitis
Itchy blisters/vesicles on lateral aspects of fingers and toes. It's an acute presentation of eczema
26
What is lichenification
Increased skin markings - seen in chronic eczema
27
Classic description of wheals
Transient, circumscribed, elevated papules or plaques with erythematous borders and pale centres
28
Features of infected eczema
```
Weeping
Pustules
Crust
Not improving with normal treatment
Rapidly worsening
Fever
Malaise
```
29
Complications of untreated eczema herpeticum
Hepatitis
Encephalitis
Pneumonitis
30
Features of eczema herpeticum
Rapidly worsening painful areas of clustered blisters. Punched out uniform erosions (circular, depressed, ulcerated), may become confluent areas of erosion with crusting
Systemic fever, lethargy, distress
31
Which virus causes eczema herpeticum
Herpes simplex 1
32
A combined steroid + antibiotic cream used for localised skin infections
Fucidin
33
What class of topical treatments reduce T cell response
Topical calcineurin inhibitors e.g. Tacrolimus
34
Underlying pathological process that causes psoriasis
Epithelial turnover is accelerated - 3-4 days rather than weeks. Also inflammatory and autoimmune aspects.
35
What are the differences between type 1 and type 2 psoriasis
Type 1;
75%
Presents <40 years old
HLA-CW6 gene associated
Type 2;
25%
Presents age 55-60
No gene association
36
A child who has one parent with psoriasis has what chance of having it themselves
1 in 4
37
Which type of psoriasis often happens after a strep throat infection
Guttate psorasis
38
What is erythrodermic psoriasis
A psoriasis flare than covers 90% of the body surface, become hypotensive and need admission
39
What is generalised pustular psoriasis
A flare of psoriasis with red/hot/painful pustules that develop within plaques. Usually as a result of steroid withdrawal. Needs emergency admission.
40
How does alcohol affect psoriasis
Makes it worse/less responsive to treatment
41
Medications that can trigger psoriasis
```
Antimalarials
NSAIDs
Non-selective beta blockers
Lithium
Terbinafine (oral anti-fungal)
```
42
Nail changes associated with psoriasis
Pitting
Onycholysis
Periungal erythema
Subungal hyperkeratosis
43
What is Auspitz's sign
The appearance of punctate bleeding spots when psoriasis scales are scraped off
44
Criteria for referral of psoriasis to dermatology
```
Erythroderma
>20% body area involved (extensive)
Severe disabling psorasis
Failure to respond to topical treatments
Unstable/rapidly extending psoriasis
```
45
What score/tool is used as an objective measure of psoriasis severity
PASI - Psoriasis area severity index
46
What score/questionnaire is used to subjectively measure the severity of skin diseases
DLQI - Dermatology life quality index
47
What score is used to screen for psoriatic arthritis
PEST score
48
How do light therapies work for psoriasis
Slow keratinocyte growth
49
Underlying patho of acne vulgaris
Blockage and inflammation of the pilosebaceous unit
Keratinisation and plugging of the follicle leads to build up of sebum from the sebaceous gland which causes inflammation
50
Which bacteria plays a role in acne
Propionbacterium acnes
51
Which hormones plays a role in acne
Androgens
52
What do you call the non-inflammatory lesions seen in acne
Comedones - open (black heads) or closed (white heads)
53
What do you call the inflammatory lesions seen in acne
Papules
Pustules
Nodules
54
What scale is used to assess the psychosocial effects of acne
APSEA scale
55
What scoring system is used to assess the clinical severity of acne
Leeds scoring system
56
Indications for oral retinoids (Isotretinoin) in acne
```
Moderate and not responding to treatment or relapsing
Severe acne
Scarring
Unusual form of it
Psychological impact
```
57
Topical retinoids are particularly good at treating which aspect of acne?
Comedones
58
In general, how long to acne treatments take to work
8 weeks - 3 months. So follow up usually 8-12 weeks after each treatment initiation
59
What is acne fulminans/acne maligna
A a rare skin disorder presenting as an acute, painful, ulcerating, and hemorrhagic clinical form of acne. It may or may not be associated with systemic symptoms such as fever and polyarthritis. Acne fulminans also may cause bone lesions and laboratory abnormalities.
60
What is acne conglobata
A highly inflammatory disease presenting with comedones, nodules, abscesses, and draining sinus tracts.
61
Is basal cell or squamous cell carcinoma more common
BCC
62
Risk factors for BCC and SCC
Chronic UV exposure
Fitzpatrick skin type 1 + 2
Immunosuppression
Previous SCC
63
Which syndrome is strongly associated with developing basal cell carcinomas
Gorlin syndrome (naevoid basal cell carcinoma syndrome)
64
Risk factors for SCC specifically
Smoking
Chronic ulcers
Xeroderma pigmentosum
65
What is the name of the system used to describe skin types
Fitzpatrick
66
Describe Fitzpatrick skin type I
Always burns, never tans
Pale white skin
Ginger/blonde hair
Blue/hazel eyes
67
Describe Fitzpatrick skin type II
Usually burns, tans poorly
Fair skin
Blue eyes
68
Describe Fitzpatrick skin type III
Burn turns into tan
| Darker white skin
69
Describe Fitzpatrick skin type IV
Tans easily, burns minimally
| Light brown skin
70
Describe Fitzpatrick skin type V
Tans dark brown, rarely burns
| Brown skin
71
Describe Fitzpatrick skin type VI
Always tans dark, never burns
| Dark brown/black skin
72
Typical description of SCC
Fast growing, hardened nodular lesion with crusted/hyperkeratotic surface. May ulcerate and may be painful
73
Typical description of BCC
Slow growing, pearly translucent nodule with telangiectasia
74
What is Bowen's disease
Squamous cell carcinoma in situ
75
High risk features of primary SCC that would need MDT discussion
Location - ear, lip, eyelid, nose, scale
Size - >20mm wide, >4mm deep, invading below dermis
Immunosuppression
Recurrent
76
Advice regarding sun protection for patients with skin cancer history
UVA+UVB protection, SPF 30+, star rating 3/4 (UVA protection), apply 30 mins before then every 2hrs, don’t rub it in just apply a film, wear a hat and appropriate clothing, stay in shade 11am-3pm
77
Treatment options for BCC
```
Leaving them (if elderly)
Imiquimod cream
Photodynamic therapy
Radiotherapy
Surgical excision
```
78
Describe a junctional naevus
Brown + Flat
| Melanocytes are are the dermo-epidermal junction
79
Technical name for a mole
Melanocytic naevus
80
Describe an intradermal naevus
Skin coloured + Raised
| Melanocytes are in the dermis
81
Describe an intermediate naevus
Centre is raised and skin coloured but edge is flat and brown
82
Describe a compound naevus
Brown + Raised
| Melanocytes in the dermo-epidermal junction and dermis
83
What are the 3 main types of skin cancer
BCC
SCC
Melanoma
84
Is assessing for skin cancer mets what do you examine for
Lymphadenopathy
| Hepatosplenomegaly
85
What scale is used to stage/assess prognosis of melanomas
Breslow thickness scale
86
How long does pruritus need to be present for to class as chronic
>6 weeks
87
What is pruritus
Itch without rash
88
What is prurigo
Intensely itchy papules and nodules
89
Non-dermatological causes of widespread itch
```
Post-herpetic neuropathy
OCD, anxiety
Hyperthyroidism
DM
CKD causing hyperparathyroidism and uraemia
Cholestasis
Hodgkins leukaemia
Dermatomyositis
Scleroderma
Medication
```
