Dermatology Formative Flashcards Preview

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Flashcards in Dermatology Formative Deck (79):
1

Gel

Thickened aqueous solution
-semi-solid, containing high

2

Lotion

Liquid formulation
Suspension of medication in water/alcohol/other liquid

3

Pastes

Semi-solids, stiff, greasy, difficult to apply, often used in cooling, drying, soothing bandages
-contain finely powdered material

4

Ointment

Semi-sold grease/oil, no preservative, less cosmetically attractive, greasy

5

Cream

Semisolid emulsion of oil in water, contains preservative, cosmetically acceptable, non greasy

6

Examination for herpes simplex

Blister fluid: electron microscopy, viral culture and PCR

7

Usual cause of cellulitis?

beta haemolytic streptococcus

8

Diagnosis of cellulitis?

Serologically (so do a blood test and look for antibodies)

9

Treatment for cellulitis?

Phenoxymethylpenicillin (or erythromycin) and flucloxacillin

10

Investigation for scabies?

Skin scrapings for microscopy

11

Investigation for ring worm?

Skin scraping for microscopy and culture, and woods light

12

Investigation for impetigo?

Swab of lesion sent in bacterial container for microscopy and culture

13

Atrophy

Thinning of the skin

14

Crusted

Dried serum or exudate on the skin

15

Scaly

Visible flaking and shredding of surface skin

16

Erosion

Partial epidermal loss
(denuded area of skin)

17

Weal

Itchy raised "nettle rash" like swelling due to dermal oedema

18

Large, flat-topped elevated, palpable lesion

Plaque

19

Organism causing boils?

Usually staph aureus

20

Treatment for boils?

Erythromycin (occasionally incision and drainage)

21

Organsim causing pitted keratolysis?

Corynebacterium
-frequently involves the soles of the forefoot and appears as numerous punched out circular lesions

22

Chronic lesions of lupus vulgaris are at high risk of developing what?

High risk of developing squamous cell carcinoma

23

How are warts spread?

Warts are spread by direct contact, they are also associated with trauma

24

Common cutaneous infection of childhood caused by pox virus. Lesions are multiple small (1-3mm) translucent papules which often look like fluid filled vesicles but are infact solid. Individual lesions may have a central depression called a punctum. They exhibit the Kobner phenomenon. They occur at any body site including the genitalia

Molluscum contagiosum
-rarely require treatment as they spontaneously resolve

25

Disease of sheep and goats
-caused by pox virus
-1-2 cm reddish papules with a surrounding erythema which usually becomes pustular

Orf
-lesions resolve spontaneously after 4-6 weeks
-Occasionally, orf is complicated by erythema multiforme

26

What can complicate orf?

Erythema multiforme can complicate orf

27

Asymmetrical scaly patches which show central clearing and an advancing scaly, raised edge

Tinea corporis
-central clearing is not a universal feature and it is recommended that all asymmetrical scaly lesions should be scraped for fungus
-Ring worm of the face often arises after the use of topical steroids

28

When does ringworm of the face often arise?

Ringworm of the face often arises after the use of topical steroids

29

The skin in the toe clefts looks white, macerated and fissured

Tinea pedis (athletes foot)

30

How is scalp ringworm spread?

Scalp ringworm is spread by close contact and may also be spread indirectly by hairdressers

31

Clotrimazole, miconazole, terbinafine

Anti-fungals (e.g. for ringworm)

32

Intensely itchy rash caused by the mite sarcoptes scabiei
It presents clinically with itchy red papules (or occasionally vesicles and pustules) which can occur anywhere in the skin but rarely on the face
-especially web spaces between fingers and toes
-palms and soles
-around wrists and axillae
-male genitalia
-around nipples and umbilicus

Scabies

33

Treatment for scabies

Permethrin 5% (tobical sabicide)
-applied and washed off after ten hours

34

Enhance rehydration of epidermis
-For all dry/scaly conditions esp. eczema

Emollients

35

How much emollient do you need to prescribe weekly?

Prescribe 250-500g weekly

36

Vasoconstrictive
Anti-inflammatory
Anti-proliferative

Topical cortico-steroids

37

Hydrocortisone 1%

Mild

38

Clobetasone Butyrate 0.5%

Moderate

39

Modrasone

Moderate

40

Elocon

Potent

41

Betamethasone valerate 0.1%

Potent

42

Clobetasol proprionate 0.05%

Very potent

43

Use of topical steroids

Eczema (dermatitis)
Psoriasis
Other non-infective inflammatory dermatoses e.g. lichen planus
Keloid scars (usually intralesional)

44

Quantity of topical steroid needed for whole body application?

20-30g

45

Quantity of steroid in 1 fingertip unit?
And how much does this cover?

1/2g
Covers 2 hand areas

46

Topical steroid side effects?

Thinning of skin, purpura, stretch marks
Perioral dermatitis
Fixed telangectasia
Steroid rosacea

47

May worsen or mask infections
Systemic absorption
Tachyphylaxis : decrease in response to anti-inflammatory effects
Rebound flare of disease (esp. psoriasis)

Topical steroid

48

Povidone iodine
Chlorhexidine
Triclosan
Hydrogen peroxide

Antiseptics
(have bacteriostatic/ bactericidal effects)

49

Anti-septic you could use in acute exudative eczema or pompholyx?

Potassium permanganate rinse/soak/bath

50

Topical antibiotics for acne?

Clindamycin, erythromycin, tetracycline

51

Topical antibiotics for rosacea?

Metronidazole

52

Topical antibiotics for impetigo?

Mupirocin, fusidic acid

53

Type of anti-viral required for eczema herpeticum?

Oral anti-viral needed for eczema herpeticum

54

Type of medication needed for candidi and pityrasis vesicolour?

Anti-yeast

55

Medication needed for dermatophytes (ringworm)

Anti-fungal

56

Menthol
Capsaicin
Camphor/phenol
Crotamiton

Anti-pruritics
-Menthol is added to calamine and other lotions/creams to impart cooling senstation
Capsaicin is from red chilli peppers --> depletes substance P at nerve endings and reduces neurotransmission, effect gradually builds
Camphor/phenol --> for pruritis ani

57

When might you use camphor/phenol?

For pruritis ani

58

This is from red chilli peppers, depletes substance P at nerve endings and reduces neurotransmission, effect gradually build

Capsaicin

59

Give an example of a keratolytic

Salicylic acid
10-40%

60

Used to soften keratin:
Viral warts
Hyperkeratotic eczema & psoriasis
Corns and calluses
To remove keratin plaques in scalp

Keratolytics
e.g. salicylic acid 10-40%

61

What is podophyllin used for?

Genital warts

62

Treatment of warts?

Keratolytics e.g.Salicylic acid
Formaldehyde
Glutaraldehyde
Silver nitrate
Cryotherapy (usually liquid nitrogen)
Podophyllin (genital warts)

63

Topical psoriasis treatment?

Emollients and choice of:
Coal tar
Vitamin D analogue
Keratolytic
Topical steroid
Dithranol

64

Pros and cons of vitamin D analogues?

Clean, no smell
Easy to apply
BUT can be irritant
Use limited to ?100g weekly

65

Side effects of dithranol

Difficult to use and irritant and stains normal skin
"dithranol staining and burning"

66

Treatments for scalp psoriasis

Greasy ointments to soften scale
Tar shampoo
Steroids in alcohol base
Vitamin D analogues

67

Psoriasis in axilla

Topical steroids for face, flexures and groin/genitals

68

Imidazoquinoline amine
Immune response modulator
Enhances innate & cell-mediated immunity
Anti-viral, anti-tumour effects

Imiquimod

69

Tacrolimus, pimecrolimus

Calcineurin inhibitors
-suppress lymphocyte activation
-topical treatment of atopic eczema, especially face, children

70

When would you use calcinuerin inhibitors?

Topical treatment of atopic eczema, especially face, children
-does not cause cutaneous atrophy
-may cause burning sensation on application(?risk of cutaneous infections ?? risk of skin cancer?)

71

Side effects of topical therapies?

Burning or irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity

72

UVA and UVB, which is responsible for direct/indirect DNA damage

UVA: indirect damage
UVB: direct damage

73

Being female and having malignant melanoma?

Improve the prognosis

74

Adverse prognostic factors for malignant melanoma

Vascular invasion
Nodular subtype
Ulceration

75

Where do you get arterial ulcers?

Foot/mid shin

76

Where do you get venous ulcers?

Medial or lateral malleolus

77

What is the breslow thickness?

Depth from the granular layer of the epidermis to the deepest melanoma cell

78

Cutaneous horn

Made of keratin
-most common lesions are seborrhoeic keratoses

79

Where do dermatofibromas commonly develop?

Lower legs