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Rapid Reference - Dermatology > Limbs > Flashcards

Limbs Flashcards

1
Q

What sites are commonly affected by atopic eczema

A

Antecubital fossa
popliteal fossa
face
hands

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2
Q

What sites are commonly affected by psoriasis

A

Elbows
knees
trunk
scalp

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3
Q

What causes folliculitis

A

infection of hair follicles by staph aureus

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4
Q

What does tinea corporis signify

A

a fungal infection with the characteristic annular appearance of “ringworm”

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5
Q

Where does Lichen plans often involve

A

the wrists

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6
Q

What is Bowen’s disease

A

in-situ squamous cell carcinoma

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7
Q

Where is Bowen’s disease typically found

A

On the shins of elderly ladies

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8
Q

Where is the most common site for malignant melanoma to appear

A

Lower leg

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9
Q

What is atopic eczema

A

A remitting itchy inflammatory dermatitis, often associated with a personal history of asthma or allergic rhinitis

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10
Q

What are the most common clinical signs of atopic eczema

A

Scratching or rubbing especially at night

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11
Q

What general advice can you give to a patient with a new diagnosis of eczema

A

General measures: loose cotton clothing and avoid wool and excessive heat.
Keep nails short
Career advice: avoid wet work jobs e.g. nursing, hairdressing and cleaning

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12
Q

What emollients are used for eczema

A

Moisturisers such as aqueous cream
E45
Diprobase

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13
Q

How do emollients work in eczema

A

They re-establish the surface lipid layer and enhance rehydration of the epidermis
The desire to scratch is also reduced

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14
Q

What does the choice of emollient come down to

A

the patients choice - whether t is greasy or tolerable - often patients need to try different products to see what they prefer

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15
Q

What is the rule about topical steroids and eczema

A

prescribe the least potent strength steroid that is effective

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16
Q

How often should topical steroids be applied

A

Usually twice a day

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17
Q

What is the wet wrap technique

A

wetted tubifast dressings, applied over a topical steroid or emollient for a short time in exudative eczema

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18
Q

What are some third line treatments for patients with eczema

A

PUVA
UVB light
immunosuppressive drugs

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19
Q

What is folliculitis

A

an acute pustular infection of multiple hair follicles often on the legs due to staph aureus

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20
Q

What are the clinical features of folliculitis

A

follicular pustules in hair-bearing areas often in areas that are shaven

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21
Q

What is the treatment for folliculitis

A

Acute Staphylococcal infections - antibiotics both systemic and topical
Chronic and recurrent - topical antibiotic , regular showering

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22
Q

What is a more common name of urticaria

A

hives

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23
Q

What is urticaria

A

a common eruption characterised by transient usually pruritic, wheals due to acute dermal oedema from extravascular leakage of playma

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24
Q

What are the clinical features of chronic urticaria

A

itchy, pink wheals,

round or annular papule or plaques

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25
Q

What might cause a sudden onset of urticaria

A

IgE mediated reaction from an allergen such as eggs, fish, peanuts, latex or a drug

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26
Q

What is characteristic of cholinergic urticaria

A

small intensely itchy papule that appear in response to sweating, induced by heat, exercise, emotion or spicy food

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27
Q

What is the treatment for urticaria

A

Avoid exacerbating factors
histamine type 1 receptor blockers
Adrenaline in anaphylactic shock
Diet: salicylates in food aggregate chronic urticaria

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28
Q

Where does Tinea corporis occur

A

limbs and trunk

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29
Q

where does tinea pedis occur

A

feet

30
Q

what are the clinical features of tinea corporis

A

single or multiple plaques with scaling and erythema especially at the edges

31
Q

What are general measures in the treatment of fungal infections

A

humid and sweaty conditions e.g. occlusive footwear

Dusting pwder may help to keep the feet or body folds drug

32
Q

What is the topical treatment for fungal infection

A

Clotrimazole (canesten) for 3-6 weeks

33
Q

What systemic therapy may be required for fungal infection

A

Oral anitfungals

34
Q

What is lichen plans

A

a relatively common pruritic papular dermatosis

35
Q

What does lichen plans involve

A

flexor surfaces,
mucous membrane
genitalia

36
Q

Describe the clinical appearance of lichen plans

A

Symmetrical on limbs especially wrists
very itchy
flat topped polygonal papule

37
Q

What is the therapy for Lichen plans

A

usually self-limiting

moderate to high potency topical steroids usually produce symptomatic improvement

38
Q

What is discoid eczema

A

Eczema of an unknown aetiology characterised by coin shaped lesions on the limbs

39
Q

What is the treatment of discoid eczema

A

Moderately potent or potent topical steroid

40
Q

What causes venous eczema

A

incompetence of the deep perforating veins increases the hydrostatic pressure in the dermal capillaries

41
Q

Venous eczema always affects children. True or false

A

False - usually middle aged or elderly

42
Q

What is the usual treatment for venous eczema

A

Emollient alone or with a mild or moderatley potent steroid ointment

43
Q

Who is affected by leg ulcers more commonly. Men or women

A

Women (twice)

44
Q

What are the majority of leg ulcers

A

Venous

45
Q

What is venous disease predisposed to by

A

obesity and thrombosis

46
Q

What are some skin changes seen in a venous disease/ ulcer

A

Brown haemosiderin deposits from extravasated red cells
Telangectasia and white lacy scars occur at the ankle
Eczema

47
Q

Where do venous ulcers usually arise

A

Medial malleolus

48
Q

Initially, venous ulcers are exudative. True or false

A

True

49
Q

When are systemic antibiotics indicated for leg ulcers

A

When there is a purulent discharge
rapidly advancing ulcer edge
cellulitis
septicaemia

50
Q

Describe the appearance of an arterial ulcer

A

deep
painful
gangrenous
located on the foot or mid-shin

51
Q

What are the general measures for treating a venous ulcer

A

walking
dieting for obese
analgesia

52
Q

What do compression bandages do

A

reduce oedema

promote venous return

53
Q

How long are compression bandages left on for

A

2-7 days

54
Q

What makes up a 4 layer bandage

A

orthopaedic wool
standard crepe
Elset elasticated bandage
elasticated cohesive bandage

55
Q

What is cellulitis

A

An infection of the subcutaneous tissues often due to streptococci

56
Q

What are the cardinal features of cellulitis

A 
swelling
redness
local pain
systemic upset
fever
57
Q

What is the treatment for cellulitis

A

Phenoxymethylpenicillin (500mg x4/day) with flucloxacillin (250mg x4/day)

58
Q

What is dermatofibromas

A

Common dermal nodules that are usually asymptomatic

59
Q

What do dermatofibromas represent

A

reaction pattern to an insect bite or other trauma

60
Q

Where do dermatofibromas usually occur

A

lower legs

61
Q

Describe the appearance of a dermatofibroma

A

Firm
dermal nodules (5-10mm)
may be pigmented
enlarge slowly if at all

62
Q

Previous exposure to what predisposes to Bowen’s disease

A

Arsenicals

63
Q

What are the clinical features of Bowen’s disease

A

pink or lightly pigmented scaly plaques

64
Q

Transformation of Bowen’s disease into squamous cell carcinoma is infrequent. True or false

A

True

65
Q

What is malignant melanoma

A

a malignant tumour of melanocytes usually arising in the epidermis

66
Q

What clinical signs or symptoms suggest malignant melanoma

A

Size: recent increase
Shape: irregular
Colour: variation, darker or lighter Inflammation: may be at the edge
Itch

67
Q

How is locall invasion of a malignant melon assessed

A

Breslow method - measures the distance between the granular ell layer to the deepest identifiable malignant cell in the dermis

68
Q

What are the four main types of malignant melanoma

A

superficial spreading malignant melanoma
Lentigo malignant melanoma
Acral lentiginous malignant melanoma
Nodular malignant melanoma

69
Q

What is the primary treatment for malignant melanoma

A

Surgical excision

70
Q

What might be necessary to close the defect

A

A skin graft

71
Q

If a tumour is more than 1mm thickness how much clearance is required

A

1-2cm

72
Q

1cm If a tumour is 1mm or less, what is the required clearance margin

A

1cm

Rapid Reference - Dermatology (4 decks)

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