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Year 4: Special Senses > Dermatology > Flashcards

Flashcards in Dermatology Deck (115)
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1

Describe how a patient with urticaria would present.

Itchy wheals

2

Describe the causes of urticaria.

- Idiopathic

- Food (e.g. nuts, sesame seeds, shellfish, dairy
products)

- Drugs (e.g. penicillin, contrast media, non-steroidal anti-
inflammatory drugs (NSAIDs), morphine, angiotensin-converting
enzyme inhibitors (ACE-i))

- Insect bites

- Contact (e.g. latex)

- Viral or
parasitic infections

- Autoimmune

- Hereditary

3

Describe how you would manage a patient with urticaria.

- Antihistamines

- Corticosteroids is severe

4

Describe the potential complications of urticaria.

Normally uncomplicated

5

Describe the pathophysiology behind urticaria.

It is due to a local increase in permeability of capillaries and small venules.

A large number of inflammatory mediators (including prostaglandins, leukotrienes, and chemotactic factors) play a role but histamine derived from skin mast cells appears to be the major mediator.

6

Describe how a patient with angioedema would present.

Swelling of tongue and lips

7

Describe the causes of angioedema.

- Idiopathic

- Food (e.g. nuts, sesame seeds, shellfish, dairy
products)

- Drugs (e.g. penicillin, contrast media, non-steroidal anti-
inflammatory drugs (NSAIDs), morphine, angiotensin-converting
enzyme inhibitors (ACE-i))

- Insect bites

- Contact (e.g. latex)

- Viral or
parasitic infections

- Autoimmune

- Hereditary

8

Describe how you would manage a patient with angioedema.

Corticosteroids

9

Describe the pathophysiology behind angioedema.

Deeper swelling involving the dermis and subcutaneous tissues

10

Describe the potential complications of angioedema.

- Asphyxia (unconsciousness)

- Cardiac arrest

- Death

11

Describe how a patient with anaphylaxis would present.

- Bronchospasm

- Facial and laryngeal oedema

- Hypotension

(NOTE: can present initially
with urticaria and angioedema)

12

Describe the causes of anaphylaxis.

- Idiopathic

- Food (e.g. nuts, sesame seeds, shellfish, dairy
products)

- Drugs (e.g. penicillin, contrast media, non-steroidal anti-
inflammatory drugs (NSAIDs), morphine, angiotensin-converting
enzyme inhibitors (ACE-i))

- Insect bites

- Contact (e.g. latex)

- Viral or
parasitic infections

- Autoimmune

- Hereditary

13

Describe how you would manage a patient with anaphylaxis.

- Adrenaline

- Corticosteroids

- Antihistamine

14

Describe the potential complications of anaphylaxis.

- Asphyxia (unconsciousness)

- Cardiac arrest

- Death

15

Describe how a patient with erythema nodosum would present.

- Discrete tender nodules which may become confluent

- The shins are the most common site

16

Describe the causes of erythema nodosum.

- Group A beta-haemolytic streptococcus

- Primary tuberculosis

- Pregnancy

- Malignancy

- Sarcoidosis

- Inflammatory bowel disease (IBD)

- Chlamydia

- Leprosy

17

Describe how you would manage a patient with erythema nodosum.

- Reassurance and patient education

- Lesions continue to appear for 1-2 weeks and leave bruise-like discolouration as they resolve

- Lesions do not ulcerate and resolve without atrophy or scarring

18

Describe the pathophysiology behind erythema nodosum.

A hypersensitivity response to a variety of stimuli

19

Describe how a patient with erythema multiforme would present.

Mucosal involvement is absent or limited to only one mucosal surface

20

Describe the pathophysiology behind erythema multiforme.

Acute self- limiting inflammatory condition with herpes simplex virus being the main precipitating factor

21

Describe the causes of erythema multiforme.

- Often unknown

- Herpes simplex virus

- Drugs

22

Describe how you would manage a patient with erythema multiforme.

- Early recognition and call for help

23

Describe how a patient with Stevens-Johnson syndrome would present.

Mucocutaneous necrosis with at least two mucosal sites involved.

Skin involvement may be limited or extensive.

24

What can be seen on the histopathology of a patient with Stevens-Johnson syndrome?

Epithelial necrosis with few inflammatory cells

25

Describe the pathophysiology behind toxic epidermal necrosis.

Usually drug-induced

26

Describe how a patient with toxic epidermal necrosis would present.

Extensive skin and mucosal necrosis accompanied by systemic toxicity

27

What can be seen on the histopathology of a patient with toxic epidermal necrosis?

Full thickness epidermal necrosis with sub-epidermal detachment

28

What are the morality rates of Stevens-Johnson syndrome?

5-12%

29

What are the morality rates of toxic epidermal necrosis?

>30%

30

Why do patients with Stevens-Johnson syndrome or toxic epidermal necrosis often die?

- Sepsis

- Electrolyte imbalance

- Multi-system organ failure