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Year 4 > Dermatology > Flashcards

Dermatology Flashcards

(78 cards)

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1
Q

How is UV involved in carcinogenesis?

A 
UVB = causes direct DNA damage 
UVA = produces oxidative damage
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2
Q

p53 mutation is associated with what (3)

A

Actinic keratoses
Carcinoma in situ (Bowens)
SCC

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3
Q

SSC is associated with (2)

A

Precursor lesions

Transplant patients

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4
Q

What virus is SSC associated with?

A

HPV

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5
Q

What virus is Kaposi’s sarcoma associated with?

A

HHV 8

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6
Q

Types of BCC

A

Nodular
Superficial
Infiltrative

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7
Q

Common appearances of BCC

A

Raised, pearly edge
Telangiectasia
Central ulceration

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8
Q

What is Moh’s surgery?

A

Excision and examination with pathology then going back in for revision surgery
Often used when margins aren’t clear e.g. nasal lesions

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9
Q

Pathology of actinic keratoses

A

Dysplastic keratinocytes

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10
Q

Pathology of Bowen’s disease

Common site

A

Full thickness dysplasia

Lower leg

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11
Q

Types of melanoma (4)

A

Superficial spreading
Lentigo maligna
Nodular
Acral lentiginous

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12
Q

Presentation of superficial spreading melanoma

A

Lower limbs

Associated with intermittent high UV

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13
Q

Presentation of lentigo maligna melanoma

A

Face

Associated with cumulative UV exposure

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14
Q

Presentation of nodular melanoma

A

Trunk

Associated with intermittent high UV

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15
Q

Presentation of acral lentiginous melanoma

A

Common on the palms, soles and nails

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16
Q

Growth phase - which type of melanoma STARTS with a vertical growth phase?

A

Nodular

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17
Q

Breslow thickness =

A

Measures the deepest tumour cell from the granular dermis

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18
Q

Sturge Weber Syndrome is associated with

A

Port Wine Stains

= usually seen in the CN V1 distribution, stain associated with ipsilateral vascular malformation

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19
Q

Presentation of Strawberry Naevus

A

= benign soft tissue tumour
Usually a single lesion presenting in the first month of life, often the head and the neck
Complications: peri-ocular lesions can affect vision, large tumours can cause airway obstruction

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20
Q

What can a strawberry naevus indicate?

A

Underlying defect e.g. spina bifida

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21
Q

Cafe au lait macules (CALMs) are associated with…

A

Neurofibromatosis Type I

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22
Q

Skin features in neurofibromatosis type I (3)

A

CALMs
Neurofibromas
Axillary/inguinal freckling

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23
Q

Ash leaf macules are associated with…

A

Tuberous sclerosis

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24
Q

Skin and nail features in tuberous sclerosis (4)

A

CALMs
Facial angiofibromas
Periungal fibromas
Shagreen patch

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25
Histological findings in Psoriasis
Thickened parakeratotic corneal layer Munro microabscesses Abscence of granular layer
26
Auspitz's sign =
removing scale reveals pin point bleeding
27
Presentation of guttate psoriasis
Associated with streptococcal sore throat | See multiple small lesions on the trunk
28
Presentation of erythrodermic psoriasis | Management
>90% of the skin surface is red, usually occurs in patients with known or deteriorating psoriasis Mx: need fluid balance, rest, emollients and systemic immunosuppressants
29
Example of Vitamin D analogue
Calcipotriol e.g. dovobet
30
Pathogenesis of Acne (4)
Increased sebum production Poral occlusion Dermal inflammation Bacterial colonisation (p. acnes)
31
Management of Acne Vulgaris
1. Topical treatments 2. Oral AB e.g. doxycycline or erythromycin 3. Isotretinoin Can try OCP in women
32
Management of Acne Rosacea
Avoidance of dietary triggers Topical metronidazole May consider oral antibiotics
33
Presentation of atopic eczema | Infants VS Children
Infancy - extensor surfaces, face, nappy region often spared Children - flexor pattern
34
Example of a mild steroid
Hydrocortisone 1%
35
Example of moderate steroid
Clobetasone butyrate 0.5%
36
Example of potent steroid
Betamethasone valerate 0.1%
37
Example of very potent steroid
Clobetasol proprionate 0.05%
38
Other topical steroid sparing agents used in eczema
Calcineurin inhibitor | e.g. Tacrolimus
39
Management of eczema herpeticum
Oral aciclovir | Urgent referral
40
Causes of acanthosis nigricans
Diabetes/insulin resistance Obesity GI/GU cancer
41
Mycosis fungoides =
Cutaneous T-cell lymphoma | Starts as a patch, if progresses can become a plaque and then an overt tumour
42
Associations with erythema nodosum (5)
``` URTI/streptococcus Oral contraceptive pill Inflammatory bowel disease Sarcoidosis Penicillins ```
43
Management of seborrheic dermatitis
Ketoconazole 2% cream | +/- mild topical steroid
44
Variable pigmentation differential
Vitiligo | Pityriasis versicolour
45
Management of itch in CKD
UVB can be useful
46
Presentation of polymorphic light eruption
= itchy spotty rash brought on by the sun | Settles when out of the sun
47
ABPI indicating vascular disease
<0.8
48
ABPI indicating calcification
>1.3
49
Management of Bowen's disease
5-FU topical
50
Investigation of choice for dermatitis herpetiformis
Diagnostic biopsy with immunofluorescence
51
Presentation of pityriasis rosea
Associated with viral infection | Often starts as a larger 'herald' lesion which then fades before smaller more widespread lesions appear on the trunk
52
Management of lichen planus
Emollient | Strong steroid
53
Complication of impetigo
Blistering producing bullous impetigo | Can result in staphylococcus scalded skin syndrome
54
Management of impetigo (1st line)
Topical fusidic acid
55
Management of neglected/difficult to excise BCC
Radiotherapy
56
What is a partial thickness loss of skin called?
Erosion
57
What is a full thickness loss of skin called?
Ulceration
58
What is a keratoacanthoma?
Appears like an SCC, developing very rapidly, but will almost completely resolve
59
Association with erythema multiforme (2)
Herpes simplex | Mycoplasma
60
Skin signs of lymphoma (2)
Erythroderma | Ichthyosis
61
Findings in bullous pemphigoid
Linear IgG and complement on the basement membrane
62
Pathogenesis in pemphigus vulgaris
Antibodies formed against desmoglein 3
63
Management of pemphigus vulgaris
Cyclophosphamide 500mg IV every 4 weeks | High dose dexamethasone
64
Findings in dermatitis herpetiformis
Granular deposits of dermal papillary IgA
65
Management of anaphylaxis
IM Adrenaline (1:1000) High concentration O2 IV Anti-Histamine 200mg IV hydrocortisone
66
Where are melanocytes found?
Dermo-epidermal junction
67
Management of lentingo melanoma
Iquimod | Watchful waiting
68
Difference in location of salmon patches VS port wine stain
Salmon patches are usually central
69
Presentation of frontal fibrosing alopecia
Affects the front of the forehead, produces a shiny clear cut line Sometimes get involvement of the eyebrows
70
What is 'dress'? What is it associated with? Potential complications?
A drug related rash with eosinophilia Associations = carbamazepine, lamotrigine, co-trimoxazole Complications = liver necrosis, lymphadenopathy, pericardial effusion
71
Nikolsky's Sign
= press on the blister and it will spread laterally
72
How is erythema multiforme classified? | Differences between?
Major and minor | Major is associated with mucosal involvement
73
Examples of sedating antihistamines (2) | Use of sedating anti-histamine
Chlorphenamine Hydroxyzine Useful for itch (non-sedating won't have an effect)
74
Presentation of pyoderma gangrenosum
Seen as an initial red papule which becomes a necrotic ulcer Can be associated with IBD or connective tissue disease
75
Pityriasis versicolour - Cause - Worsened by...
= fungal | Made worse by the sun
76
Pyoderma gangrenosum - Presentation - Association
= starts as a red papule > open ulceration | Association: rheumatoid arthritis, ulcerative colitis, vasculitis
77
Management of rosacea
ORAL antibiotics
78
Management of dermatitis herpetiformis
Dapsone | = antibiotic

Year 4 (27 decks)

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