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Other derm conditions Flashcards

(55 cards)

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1
Q

Urticaria treatment

A
  • H1 and H2 blockers (antihistamines) e.g. fexofenadine, benadryl, hydroxyzine, ranitidine
  • Steroids
  • Prednisolone
  • Consider Epinephrine if airway compromise
  • Continue treatment for 5 days
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2
Q

Vitiligo presentation

A

Associated to other autoimmune disease
Familial history
Starts in teens / 20s usually

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3
Q

Vitiligo management

A
  • Topical steroids
  • Topical tacrolimus (unlicenced)
  • Ultraviolet light therapy
  • Also:
  • Sunscreens / Burn Prevention
  • Cosmetic cover up
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4
Q

What is Hidradenitis supperativa

A

Inflammatory disease – chronic, severe, scarring in apocrine gland follicles

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5
Q

Hidradenitis supperativa presentation

A

Painful, red inflamed nodule/abscess; purulent drainage; double comedones – form fistulae
Presents after puberty
More common in females
Axillae, groin, breast, buttocks, perineum
RF
Obesity
DM
predisposition to acne

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6
Q

Melasma aetiology?

A
  • Sunlight exposure
  • Contraceptives
  • Pregnancy
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7
Q

Melasma presentation

A

Patches of bilateral, macular areas of hyperpigmentation in sun exposed
areas, usually with irregular borders; most common on face

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8
Q

Melasma Tx

A
  • Opaque sunblock or avoid sun exposure
  • Topical hydroquinone (lightening agent)
  • Tretinoin
  • Pregnancy cases may resolve in several months
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9
Q

What are lipomas?

A

Benign tumour of subcutaneous fat cells

Soft, rounded, mobile, non-tender nodules, average 3-5cm

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10
Q

Lipoma Tx

A

Excision if large or symptomatic

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11
Q

Treatment for epithelial/sebaceous cysts?

A

Abx if inflamed

Excision: entire cyst wall or
may regenerate

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12
Q

What is Decubitus
ulcers and what is it caused by?

A

Pressure sores - Persistently red, broken skin, often extending to underlying structures

Caused by pressure/friction usually over bony prominences

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13
Q

Decubitus ulcers treatment

A
  • Repositioning and pressure support products
  • Wound management dressings
  • Pain relief
  • Infection control
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14
Q

Acanthosis Nigricans presentation?

A

Appearance
* Dark, thick, velvety skin in body folds and creases
* Skin often looks “dirty”
* Affects areas such as axillae, groin and neck

Associated with:
* Obesity
* Diabetes
* Endocrine disorder
* GI Tumors

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15
Q

Treatment of acanthosis nigricans?

A
  • Ammonium Lactate 12% prn to
    soften skin
  • Aqua glycolic acid (Aqua Glycolic
    body lotion) bd
  • Treat underlying cause
  • Surgery if GI tumor
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16
Q

What is Bullous conditions: Pemphigoid?

A

Autoimmune disorder - Erythematous, papular or urticarial bullae in inflammatory plaques; often in flexural areas

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17
Q

Diagnosis of Bullous conditions: Pemphigoid? (Ix)

A

immunofluorescence

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18
Q

Management of Bullous conditions: Pemphigoid?

A

Topical or systemic steroids
+/- immunosuppressants

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19
Q

Seborrhoeic neoplasia presentation?

A
  • Inherited familial tendency
  • Usually over age 30
  • males >females
  • More likely in face, trunk, arms (sun-exposed areas)
  • “Stuck to the skin” surface appearance
  • Brownish papule with a greasy, warty appearance
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20
Q

Seborrhoeic neoplasia Tx?

A

*Cryosurgery
* Curettage
* Routine skin exams to watch for melanoma

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21
Q

What is Basal Cell
Carcinoma

A

RODENT ULCER - Malignant tumor originating from the basal cells of the epidermis

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22
Q

Basal cell carcinoma presentation?

A
  • More common in fair-skinned blondes and redheads
  • Begins small, smooth surfaced, well defined nodule
  • Colour pink to red
  • “Pearly” or rolled translucent border
  • Telangiectatic vessels
  • varying degrees of melanin pigments
  • As nodule enlarges, central ulceration and crusting occurs
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23
Q

Risk factors of basal cell carcinoma?

Study These Flashcards
A
  • Chronic sun exposure
  • Light complexion
  • Tendency to sunburn
24
Q

Diagnosis of basal cell carcinoma?

Study These Flashcards
A

Biopsy mandatory to confirm
diagnosis

25
Tx of basal cell carcinoma?
* Curettage * Excision * Cryosurgery * Mohs surgery * Radiation
26
Squamous Cell Carcinoma presentation?
* More common in fair-skinned blondes and redheads and living in sunny places * Slowly evolving isolated keratotic papule or plaque - Highly Differentiated – keratinised on surface and firm to palpation - Poorly Differentiated – no keratinisation, fleshy, granulomatous, soft on palpation
27
Risk factors of squamous cell carcinoma?
* Chronic sun exposure * Light complexion / easy burning * HPV
28
Diagnosis of squamous cell carcinoma?
Biopsy mandatory to confirm diagnosis
29
Tx of squamous cell carcinoma
* Excision * Mohs surgery * Radiation (if no other choice)
30
Melanoma RFs?
* Chronic sun exposure * Light complexion * Tendency to sunburn * Family hx * One bad sunburn ↑ risk
31
Melanoma diagnosis?
Biopsy
32
Melanoma management?
* 2 week referral * Total excision, with margins to be determined * Possibly interferon α * Chemotherapy and immunotherapy for metastatic disease (previously <5% 5 year survival)
33
What is the ABCDE approach for dermal neoplasia?
Asymmetry Border irregularity Colour variation Diameter larger than 6 mm Evolving or changing
34
What is Dyshidrosis?
Type of ezcema with itchy, erythmatous eruptions on hands/toes
35
Dyshidrosis management?
Topical steroids, Burrow’s solution (10% aluminium acetate dilution)
36
Cause of Lichen Simplex Chronicus
Repetitive rubbing and scratching
37
Managment of licen simplex chronicus?
* Must stop itch-scratch-itch cycle * Occlusive dressings nocte * Topical steroids * Sedative antihistamine
38
What is exanthem?
Wide spread rash
39
Presentation of exanthem?
Associated with systemic symptoms * Fever * Malaise * Headache Usually caused by virus, but may be drug reaction
40
What is Varicella-zoster virus and its presentation?
Shingles - reactivation due to ↓ immune function, illness, fatigue or stress) - painful, unilateral grouped vesicular rash, in dermatomal pattern - does not cross midline
41
Shingles treatment?
Anti-virals if within 72 hours onset of rash * Aciclovir 800 mg po 5 times per day x 7d Pain control * Opiates * Anticonvulsants * Tramadol * ? steroids
42
Herpes opthalmicus management?
EMERGENCY - needs opthalmologist referral (vesicles on tip of nose)
43
What is Post-herpetic neuralgia?
Persistence of pain in area previously affected by herpes zoster for more than 3 months after the resolution of the rash
44
Presentation of post herpetic neuralgia?
Occurs for more than 3 months after resolved shingles * “Electrical shock” pain * Deep, severe itching * Hypersensitive skin – some people don’t want to wear clothing over the affected area
45
Tx of post herpetic neuralgia?
anticonvulsants or topical analgesia
46
Acne vulgaris treatment
* First line: good skin hygiene + topical benzoyl peroxide, topical antibiotics or topical retinoids * Second line: oral antibiotics on a daily basis / oral contraceptive pills for female patients * Third line: oral isotretinoin (aka “Roaccutane”) - Consultant only as potentially severe side effects including depression / suicidality and known teratogen
47
Rosacea presentation?
*Age: 30 – 50 y/o * Gender: Females > Males * Worse with alcohol exposure * “Flushing” or “heat on the face” * Associated with ocular complications (conjunctivitis, styes, chalazia)
48
Rosacea Tx
* First line: daily topical antibiotics, most often metronidazole * Second line: oral antibiotics daily (tetracycline, lymecycline, doxycycline) * Last resort: Isotretinoin * Reduction or elimination of alcohol or hot beverages
49
What is folliculitis and what is it caused by?
* Pustular infection (itchy, clustered and red) of hair follicles, usually caused by S. aureus * EXCEPT – hot tub folliculitis – pseudomonas
50
Management of folliculitis?
* Topical antiseptic wash e.g. chlorhexidine * Oral abx, usually flucloxacillin (if pseudomonas: ciprofloxacin)
51
What is Onychomycosis
fungal infection of nails
52
Dx and Tx of Onychomycosis
Dx: clippings – microscopy 2/52; culture 6-8/52 * Dx CANNOT be made clinically! Tx based on pathogen (get baseline LFTs) * Terbinafine or Itraconazole (candidal infections)
53
What is Paronychia?
Acute infection, usually S. aureus
54
Causative organism of paronychia?
Erythematous, painful, throbbing, swollen lateral or proximal nail fold; +/- purulence/abscess
55
Managment of paronychia?
* Warm soaks * Flucloxicillin * Release purulence if possible (consider I&D)

Dermatology (5 decks)

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