Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3B > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Eczema pathophysiology

A

Atopic dermatitis
Relapsing and remitting

IgE + Eosinophils

Defect in skin barrier

  • pH ^
  • Protease ^
  • Fillagrin ^

Defect in immune system

  • IL4, 5, 13 ^
  • Th2 mediated response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Eczema aetiology

A

Atopy
Family history
Smoke exposure
Hygiene hypothesis

Triggers

  • House dust mites
  • Heat
  • Infection
  • Stress
  • Sweat
  • Soaps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Eczema clinical features

A

Adults - Flexures
Children - Face and extensors

Criteria - Itchy skin + 3 of…

  • Dry skin
  • Active flexure involvement
  • Flexure involvement in past year
  • History of atopy
  • Onset < 2 years

Other features

  • Scaly
  • Dry
  • Erythematous
  • Hyperpigmentation
  • Lichenification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Eczema management

A

Avoid triggers

Emollients

Mild/moderate TCS (Hydrocortisone) ± TCI (Tacrolimus)
Moderate/potent TCS (Betamethasone) ± TCI (Tacrolimus)

Systemic immunosuppressant - Ciclosporin

Phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Eczema prognosis and complications

A

Prognostic markers associated with severe disease

  • Onset 3-6 months
  • Severe disease in childhood
  • Atopy
  • Small family size
  • High serum IgE

Complications

  • Infection - Staph A - Topical Fusidic acid
  • Psychological

Infection with HSV - Eczema herpeticum

  • Emergency
  • Give Acyclovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contact dermatitis

A

Irritant - Non-allergic

  • Due to weak acids/alkalis - Detergents or cement
  • Hands - Erythema

Allergic - Type 4 hypersensitivity

  • Head after dye - Acute weeping eczema
  • Affects margins of hairline

Topical treatment - Potent steroid - Betamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Psoriasis aetiology

A

Keratinocyte proliferation
Parakeratosis

Plaque - Most common

  • Well demarcated
  • Red scaly patches
  • Extensor surfaces, sacrum, scalp
  • Auspitz sign - Bleeding on scale removal

Flexure

  • Older females
  • Smooth skin

Seborrhoeic - Nasolabial / Retroauricular

Guttate - Younger patients

  • Transient psoriatic rash
  • Triggered by Strep P
  • Multiple red lesions - “Teardrops”

Pustular

  • Palms and soles
  • Yellow/brown lesions

Erythrodermic - Total body redness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Psoriasis exacerbating factors

A

Trauma
Alcohol
Infection
Stress

Drugs

  • BB
  • ACE-I
  • NSAIDs
  • Lithium
  • Anti-malarial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Psoriasis management

A

Avoid triggers

Emollients

TCS - Hydrocortisone OD
Topical vitamin D analogue - Calcipotriol OD
No response - Change to BD

Coal tar preparation
Phototherapy

Methotrexate
Ciclosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Psoriasis other features and complications

A

Nails

  • Pitting
  • Beau lines
  • Onycholysis

Arthritis

Psychological

VTE / CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acne vulgaris pathophysiology

A

Inflammation of pilosebaceous follicle

  1. Androgen excess - PCOS, puberty, Cushing’s
  2. Increased sebum production
  3. Comedone formation
  4. Comedone infected by propionibacterium acnes
  5. Inflammation = Acne

Papules
Nodules
Cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acne management

A

Topical retinoid - Tretinoin
Oral retinoid - Isotretinoin

Benzoyl peroxide
Salicylic acid

Topical abx - Clindamycin
Oral abx - Tetracycline

COCP

Not affected by diet!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acne complications + Isotretinoin side effects

A

Psychological
Scarring / Hyperpigmentation

Acne fulminans

  • Systemic upset
  • Admit
  • Responds to oral steroids

Isotretinoin side effects

  • Depression
  • Dry eyes / skin
  • Teratogenic
  • Abnormal LFTs
  • Hypercholesterolaemia
  • Myalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Seborrhoeic dermatitis aetiology

A

Chronic dermatitis
Inflammatory reaction
Proliferation of normal skin inhabitant

Fungus - Malassezia furfur

Associated conditions

  • HIV / AIDS
  • Parkinson’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Seborrhoeic dermatitis clinical features

A

Scaling - Red, itchy, greasy skin

Nasolabial folds
Peri-auricular
Peri-orbital
Scalp - Dandruff
Chest
Otitis externa
Blepharitis

Children - Cradle cap

  • Face
  • Nappy areas
  • Flexors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Seborrhoeic dermatitis management

A

Scalp - OTC preparations

  • Zinc pyrithione - Head & Shoulders
  • Tar - Neutrogena T-Gel

Face and body

  • Topical Ketoconazole
  • Topical corticosteroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

BCC aetiology

A

Malignant proliferation of epithelial keratinocytes

  • Slow growth
  • Local invasion
  • Metastases are rare

Risk factors

  • Sunlight / UV
  • Age
  • Male
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BCC clinical features / investigations / management

A

Clinical features - Pearly flesh coloured papule

  • Telangiectasia
  • Ulceration - Central crater
  • Sun-exposed sites - Head and neck

Investigations - Biopsy

Management

  • Surgical removal
  • Curettage
  • Cryotherapy
  • Topical cream - Imiquimod
  • Mohs micrography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SCC aetiology and clinical features

A

Malignant proliferation of epithelial keratinocytes and skin appendages

Risk factors

  • Smoking
  • Actinic keratosis - Pre-malignant state
  • Bowen’s disease
  • Sunlight / UV exposure
  • Immunosuppression

Clinical features - Common on the lip in smokers

  • Ulceration and bleeding
  • Crusty and scaly
  • Ill-defined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SCC investigations / management / prognosis

A

Investigations - Biopsy

SCC in situ - Bowen’s disease

  • Cryotherapy
  • Topical chemotherapy - Imiquimod

Invasive
< 2cm - Surgical excision
> 2cm - Mohs microscopic surgery

Metastatic - Surgery ± Chemo/Radio

Prognosis - 2-5% metastasise

  • Lymph nodes
  • Liver
  • Brain
  • Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Malignant melanoma aetiology

A

Malignant proliferation of melanocytes

UV exposure
Family history
Immunosuppression

22
Q

Malignant melanoma types

A

Superficial spreading - Growing mole

  • 70% of cases
  • Arms, legs, back, chest
  • Young people

Nodular - Red or black lump - Bleeds or oozes

  • Second most common
  • Sun-exposed skin
  • Middle aged people

Lentigo maligna - Growing mole

  • Less common
  • Sun-exposed skin
  • Older people

Acral lentiginous - Subungal pigmentation + Hutchinson’s sign

  • Rare
  • Nails, palms, soles
  • African-Americans
  • Asians
23
Q

Malignant melanoma diagnostic features

A

Major criteria

  • Change in size
  • Change in shape
  • Change in colour

Minor criteria

  • Diameter > 7mm
  • Inflammation
  • Oozing or bleeding
  • Altered sensation
24
Q

Malignant melanoma investigations / management / prognosis / complications

A

Investigations - ABCDE ± CT staging

  • Asymmetry
  • Bored
  • Colour
  • Diameter
  • Evolving

Management - Wide local excision ± Chemo/Radio

Prognostic factor - Breslow’s thickness

Complications - Mets

25
Q

Bullous pemphigoid aetiology and clinical features

A

Autoimmune
Antibodies against hemidesmosomal proteins
Dermis and epidermis become separated

Clinical features - Itchy tense blisters

  • Painless
  • Trunk and limb involvement
  • Flexures
  • Heal without scarring
  • No mucosal involvement - Mouth spared
  • Nikolsky -ve
26
Q

Bullous pemphigoid investigations and management

A

Investigations - Skin biopsy + Immunofluorescence
- IgG and C3 at dermo-epidermal junction

Management

  • Oral CS - Pred
  • Topical TCI - Tacro
  • Topical CS - Clobetasol
  • Antihistamine - Hydroxyzine
  • Immunosuppressant - Ciclosporin
27
Q

Pemphigus vulgaris

A

Autoimmune
Antibodies against desmoglein-3
Separation within epidermis layer

Clinical features - Erythematous blisters

  • Painful
  • Not itchy
  • Mucosal involvement
  • Nikolsky +ve

Investigations - Skin biopsy + Immunofluorescence

Management

  • Oral CS - Pred
  • Immunomodulator - Mycophenolate
28
Q

Lichen planus aetiology and clinical features

A

Chronic inflammatory dermatosis
Most likely AI
Keratinocyte apoptosis

Clinical features - All the P’s

  • Pruritus
  • Purple
  • Papule
  • Polygonal + White lines = Wickham’s striae
  • Plaque
  • Palms, soles, genetalia, flexor surfaces

Koebner phenomenon - New lesions at site of trauma

Oral involvement - White lace pattern

29
Q

Lichen planus drug eruptions / management

A

Gold
Quinine
Thiazides

Topical CS - Clobetasol
Oral CS - Pred

Antihistamine - Chlorphenamine

30
Q

Acne rosacea

A

Risk factors / triggers

  • Fair skin
  • Extreme temperatures - Hot baths / showers
  • Sunlight
  • Emotional stress
  • Hot drinks
  • Alcohol

Clinical features

  • Facial flushing - Cheeks, nose, forehead
  • Telangiectasia
  • Later develops into persistent erythema + Papules / pustules
  • Rhinophyma
  • Orbital blepharitis

Management

  • Topical abx - Met
  • Oral abx - Doxy
  • Telangiectasia - Laser therapy
  • Avoid triggers - Daily sunscreen
31
Q

Cellulitis aetiology and clinical features

A

Acute infection of skin an subcutaneous tissue

Staph A
Strep pyogenes

Risk factors

  • Immunocompromise
  • Poor healing - Diet, smoking, DM

Clinical features - Red, hot, painful, swollen
- Systemic upset - Fever?

Orbital features

  • Ophthalmoplegia
  • Exophthalmos
  • Painful movements
  • Visual disturbances
32
Q

Cellulitis investigations / classification / management / complications

A

Investigations - Clinical diagnosis

  • Swab area
  • Septic screen?
  • D-dimer - Rule out DVT?

Eron classification

  1. No systemic upset + No uncontrolled comorbs
  2. No systemic upset + Comorbs
  3. Systemic upset + Unstable comorbs
  4. Sepsis + Severe infection (E.g. nec fasc)

Management - Fluclox

Complications

  • Sepsis
  • Osteomyelitis
33
Q

Scabies aetiology and clinical features

A

Mite - Sarcoptes scabiei

Transmission

  • Prolonged skin contact
  • Bedsheets

Children and young adults

Widespread pruritus - Worse at night

  • Abdomen
  • Forearms
  • Hands - Between fingers

Linear burrows

  • Interdigital webs
  • Flexor aspect of wrist
34
Q

Scabies investigations / management

A

Clinical diagnosis

Permethrin x2
Wash all clothes and bedding

Treat all household contacts

Pruritus may last 4-6 weeks post-eradication

35
Q

Molluscum contagiosum

A

Viral

  • Close contact
  • Shared towels

Clinical features - Children ± Atopic eczema

  • Smooth pearly white papule
  • Central dimple
  • Up to 5mm
  • Everywhere except palms and soles
  • Extremely itchy

Management - Self-limiting
- Squeeze after a bath

36
Q

Impetigo

A

Staph aureus - Incubation period 4-10 days

  • Direct contact
  • Toys / equipment
  • Clothing

Clinical features - Gold crusted lesions

  • Face and mouth
  • Flexures
  • Limbs

Investigations - Swab ± MC&S

Management

  • Topical hydrogen peroxide
  • Topical abx - Fusidic acid
  • Oral abx - Fluclox
  • School exclusion - 48 hours after treatment initiated
37
Q

Scalded skin syndrome

A

Staph A - Epidermidis toxin

Clinical features

  • Red painful skin
  • Nikolsky sign +ve

Management - IV fluids
+ Fluclox

38
Q

Necrotising fasciitis aetiology

A
  1. Mixed anaerobes and aerobes
    - Most common
    - Occurs post-surgery in DM
  2. Strep pyogenes

Risk factors

  • DM - SGLT-2 inhibitors
  • VZV
  • Surgery / Trauma - Abdo surgery
  • Non-traumatic skin lesions
  • IVDU
  • Immunsuppression
39
Q

Necrotising fasciitis clinical features / management / prognosis

A

Perineum most commonly affected - Fournier’s gangrene
Severe pain - Out of keeping with wound size/appearance
Haemorrhagic bullae
Subcutaneous emphysema
Signs of sepsis - Fever, tachy, etc.

Management

  • Surgical debridement
  • IV broad spec abx - Vanc + Taz

Prognosis - Mortality is 20%

40
Q

Seborrhoeic keratosis

A

Benign epidermal skin lesions

Clinical features - Elderly + UV exposure

  • Light brown/black
  • Stuck-on appearance
  • Keratotic plugs on surface

Management

  • Reassurance
  • Cryotherapy/curettage if bothersome
41
Q

Erythema nodosum

A

Inflammation of subcutaneous fat
Hypersensitivity reaction

Aetiology - NODOSUM

  • No - Idiopathic
  • Drugs - Penicillin / Sulphonamides
  • OCP / Pregnancy
  • Sarcoidosis / TB
  • UC / Crohn’s
  • Microbiology - Strep

Clinical features - Shins!

  • Painful red lesions
  • Heal without scarring

Management - Treat cause
- Resolve within 6 weeks

42
Q

Pyoderma gangrenosum

A

Aetiology

  • UC / Crohn’s
  • RA / SLE
  • Lymphoma / Leukaemia
  • PBC

Clinical features

  • Lower limb
  • Small red papule
  • Becomes ulcerated
  • Systemic symptoms - Fever?

Management

  • Oral CS - Pred
  • Immunosuppressant - Ciclosporin
43
Q

Erythroderma

A

Any rash > 95% skin coverage

Aetiology

  • Eczema
  • Psoriasis
  • Drugs - Gold
  • Lymphoma
  • Leukaemia

Management - IV fluids

  • Wet wraps and emollients
  • Treat cause

Complications

  • High output cardiac failure
  • Electrolyte imbalance
  • Dehydration
  • Hypothermia
  • Hypoglycaemia
44
Q

Erythema multiforme

A

Type 4 hypersensitivity

Aetiology - Triggered by infection - HSV

Clinical features

  • Target lesions
  • Backs of hands and feet - Spreads to torso
  • Upper limbs more commonly affected
  • Haemorrhagic lips

Management - Treat cause

45
Q

Venous ulcers aetiology

A

Incompetent valves + Chronic venous insufficiency
Stasis of blood flow - Blood flows into superficial veins
= Oedema + Eczema + Varicose veins

Age
Smoking
Family history
Orthostatic compression

46
Q

Venous ulcers clinical features

A 
Lateral and medial malleolus - Posterior calf
Edge - Shallow, sloping, irregular
Base - Slough, granulation, moist
Painless 
Bleeding
47
Q

Venous ulcers investigations and management

A

ABPI - Assess for poor arterial flow - Could affect wound healing
Swab + MC&S
HbA1c

Management

  • Debridement ± Abx (Fluclox)
  • Compression bandaging - 4 layers
  • Pentoxifylline
48
Q

Arterial ulcers aetiology and clinical features

A

CVD
PAD
Smoking
DM

Presentation - Dorsal foot, toe, heel

  • Punched out
  • Well demarcated
  • Base - Grey granulation
  • Painful
  • Do not bleed on probing
  • Cold with no palpable pulses
49
Q

Arterial ulcers investigations and management

A

Pedal pulses
ABPI < 0.8
Colour doppler ± Angiography

Management

  • Smoking cessation
  • Revascularisation surgery

CV risk management

  • Statin
  • ACE-I
  • Aspirin
  • Clopidogrel
50
Q

Neuropathic ulcers

A

Aetiology - Pressure

Clinical features

  • Plantar surface of hallux and MTPJ
  • Punched out and deep
  • Bleeds on probing
  • Painless
  • Absent local sensation

Management - Cushioned shoes to reduce callous formation

3B (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions