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Dermatology Formative Flashcards

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1
Q

Gel

A

Thickened aqueous solution

-semi-solid, containing high

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2
Q

Lotion

A

Liquid formulation

Suspension of medication in water/alcohol/other liquid

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3
Q

Pastes

A

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

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4
Q

Ointment

A

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

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5
Q

Cream

A

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

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6
Q

Examination for herpes simplex

A

Blister fluid: electron microscopy, viral culture and PCR

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7
Q

Usual cause of cellulitis?

A

beta haemolytic streptococcus

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8
Q

Diagnosis of cellulitis?

A

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

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9
Q

Treatment for cellulitis?

A

Phenoxymethylpenicillin (or erythromycin) and flucloxacillin

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10
Q

Investigation for scabies?

A

Skin scrapings for microscopy

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11
Q

Investigation for ring worm?

A

Skin scraping for microscopy and culture, and woods light

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12
Q

Investigation for impetigo?

A

Swab of lesion sent in bacterial container for microscopy and culture

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13
Q

Atrophy

A

Thinning of the skin

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14
Q

Crusted

A

Dried serum or exudate on the skin

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15
Q

Scaly

A

Visible flaking and shredding of surface skin

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16
Q

Erosion

A

Partial epidermal loss

denuded area of skin

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17
Q

Weal

A

Itchy raised “nettle rash” like swelling due to dermal oedema

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18
Q

Large, flat-topped elevated, palpable lesion

A

Plaque

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19
Q

Organism causing boils?

A

Usually staph aureus

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20
Q

Treatment for boils?

A

Erythromycin (occasionally incision and drainage)

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21
Q

Organsim causing pitted keratolysis?

A

Corynebacterium

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

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22
Q

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

A

High risk of developing squamous cell carcinoma

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23
Q

How are warts spread?

A

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

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24
Q

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

A

Molluscum contagiosum

-rarely require treatment as they spontaneously resolve

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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

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