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Yr 4 and 5 dermatology > passmed > Flashcards

passmed Flashcards

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1
Q

acanthosis nigricans assoicated with what malignancy

A

gastric adenocarcinoma

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2
Q

what is the koebner phenomenan

A

The Koebner phenomenon describes the worsening or development of skin lesions at the sites of injury.
psoriasis
vitiligo
warts
lichen planus
lichen sclerosus
molluscum contagiosum

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3
Q

what skin condition follows langers lines in distribution

A

ptyrias rosacea

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4
Q

difference between dermoid cyst and dermoid tumour

A

Dermoid cysts are embryological remnants and may be lined by hair and squamous epithelium, located in the midline and may be linked to deeper structures resulting in a dumbbell shape to the lesion. excision

Desmoid tumours develop in ligaments and tendons. consist of fibroblast dense lesions (resembling scar tissue). They should be managed in a similar manner to soft tissue sarcomas.

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5
Q

Tinea is a term given to dermatophyte fungal infections. Three main types of infection are described depending on what part of the body is infected
what are they

A

tinea capitis - scalp
tinea corporis - trunk, legs or arms
tinea pedis - feet

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6
Q

Chondrodermatitis nodularis helicis is usually painful, what is it

A

Chondrodermatitis nodularis chronica helicis (CNH) is a benign inflammatory condition that affects the skin and cartilage of the pinna.

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7
Q

renal transplant linekd to what skin cancer

A

SCC
secondary to immunosuppresion

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8
Q

guttate psoriaisi forms after what type of infection

A

strep

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9
Q

how does Calcipotriol work

A

is a vitamin D analogue that reduces epidermal proliferation therefore reducing the scale and thickness of psoriatic plaques, but not the associated erythema.

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10
Q

when should IV fluids be given for burns

A

‘In adults, IV fluids should be given in second or third degree burns that cover 15% body surface area or more. In children, IV fluids are recommended when burns cover 10% body surface area.’

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11
Q

shingles treat with what

and why

A

oral antiviral within 72hours

prevent the incidence of post-herpetic neuralgia

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12
Q

severe uticaria tx

A

Severe urticaria - A short course of an oral corticosteroid may required in addition to a non-sedating antihistamine

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13
Q

acne refeeral to derm

A

scarring

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14
Q

Dermatitis herpetiformis key sx

A

very ithcy - cna be on stomach elbows, below knees

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15
Q

pityriasis versicolor tx

A

ketoconazole shampoo thenr oral fungal
hypopigmented patches

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16
Q

difference between vitiligo and pityriasis versicolor

A

Pityriasis versicolour is a fungal infection that characteristically causes light patches on the trunk which can be mildly pruritic. It affects many groups including the healthy, the immunocompromised and physically active individuals. Vitiligo would typically present with a more symmetrical pattern. The other options present with different looking lesions.

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17
Q

A non-healing painless ulcer associated with a chronic scar potentially post burn is indicative of

A

SCC - marjolin

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18
Q

eczema herpticum

A

refer
commonly after trialled treat for eczema
face

On examination, monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter are typically seen.

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19
Q

features of subhorrbeic dermatitis

A

eczematous lesions on the sebum-rich areas: scalp (may cause dandruff), periorbital, auricular and nasolabial folds
otitis externa and blepharitis may develop

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20
Q

‘dimple’ sign is described in the brief. This is when a lesion dimples when it is pinched. This sign is typically associated with

A

dermatofibroma

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21
Q

2nd line for rosacea after topical abx already used

A

Oral doxycycline + topical ivermectin

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22
Q

what is hyperhidrosis

A

Hyperhidrosis describes the excessive production of sweat.

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23
Q

A 15-year-old girl comes to see you as she has noticed that her hands become very sweaty. She says that this can become quite awkward in social situations for example if she has to shake hands with someone. She is also worried about how this may affect her upcoming GCSE exams.

Which one of the following is most suitable for first line management of this condition?
huperhidrosis

A

topical aluminium chloride preparations are first-line. Main side effect is skin irritation

other options

iontophoresis: particularly useful for patients with palmar, plantar and axillary hyperhidrosis
botulinum toxin: currently licensed for axillary symptoms
surgery: e.g. Endoscopic transthoracic sympathectomy. Patients should be made aware of the risk of compensatory sweating

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24
Q

side effect of aluminium chloride

A

skin irritation

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25
onychomycosis tx
nail fungus casused by dermatophytes Oral terbinafine
26
A 63-year-old man presents to his general practitioner with a three-week history of an itchy rash over the face and upper chest. His only past medical history is HIV for which he is poorly compliant with his anti-retroviral medications. On examination, areas of erythema over the eyebrows, nasolabial folds, and upper chest are noted. Excoriations surrounding the rash are present. What is the most appropriate initial treatment?
seborrhoeic dermatitis topical keto
27
A 43-year-old female presents to her general practice with multiple red lesions on her hands. She reports that these have developed over the past 24 hours, are slightly itchy but not painful. There is no involvement of the mucous membranes. Clinical examination reveals: what durg
co-amoxiclav
28
erythema multiform commonyl seen where
target lesions initially seen on the back of the hands / feet before spreading to the torso upper limbs are more commonly affected than the lower limbs pruritus is occasionally seen and is usually mild
29
target lesions, seen on hands and feet later spread to torso what causes
viruses: herpes simplex virus (the most common cause), Orf* idiopathic bacteria: Mycoplasma, Streptococcus drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine connective tissue disease e.g. Systemic lupus erythematosus sarcoidosis malignancy
30
difference between bullous pempigoid and pemphigus vulgaris
Blisters/bullae no mucosal involvement (in exams at least*): bullous pemphigoid mucosal involvement: pemphigus vulgaris
31
complciations of erythroderma
Inpatient treatment for erythroderma must be monitored for complications like dehydration, infection and high-output heart failure
32
what is erthroderma and what are the causes
Erythroderma is a term used when more than 95% of the skin is involved in a rash of any kind. Causes of erythroderma eczema psoriasis drugs e.g. gold lymphomas, leukaemias idiopathic
33
what is a keratocanthoma
Keratoacanthoma is a dome-shaped lump or tumor that grows on your skin. older males with a history of chronic sun exposure.
34
pneumonic for things that cause nodosum
NO – idiopathic D – drugs (penicillin sulphonamides) O – oral contraceptive/pregnancy S – sarcoidosis/TB U – ulcerative colitis/Crohn's disease/Behçet's disease M – microbiology (streptococcus, mycoplasma, EBV and more)
35
in acne can you antibiotics as a monotherapy
Acne vulgaris: topical or oral antibiotics should not be used as monotherapy
36
An itchy rash affecting the face and scalp distribution is commonly caused by
Seborrhoeic dermatitis is a common, chronic, or relapsing form of dermatitis that mainly affects the sebaceous gland-rich regions of the scalp, face, and trunk.
37
violaceous papules on the flexor aspects of her wrists
lichen planus
38
what 3 drugs cause lichenoid drug eruptions
gold quinine thiazides
39
difference betwen lichen planus and lichen sclerosus
planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham's striae over surface. Oral involvement common sclerosus: itchy white spots typically seen on the vulva of elderly women
40
tx lichen planus mainstay mouth extensive
potent topical steroids are the mainstay of treatment benzydamine mouthwash or spray is recommended for oral lichen planus extensive lichen planus may require oral steroids or immunosuppression
41
parkinsons associated with what skin conditon
sebhorrheic dermaitits
42
what skin reaction presetns like lupus
rosacea
43
what is urticara
Urticaria describes a local or generalised superficial swelling of the skin. The most common cause of urticaria is allergy although non-allergic causes are seen. pale, pink raised skin. Variously described as 'hives', 'wheals', 'nettle rash' pruritic
44
1st line treatment for uticara and then what do we also given for severe or resistant episodes
non-sedating antihistamines are first-line prednisolone is used for severe or resistant episodes
45
7 features of rosacea ( basically adult acne)
typically affects nose cheeks and forehead flushing telangiectasia persistent erythema with papules and pustules rhinophyma - skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous. blepharitis sunlight exacerbates it
46
in rosacea if you have persistant flushing what can you do
topical brimonidine - alpha adrenergic agonist - reduces redness within 30 minutes reaction peak action at around 3-6hours
47
mild to moderate papules or pustules in acne rosacea
topical ivermectin
48
moderate to severe papules/pustules acne rosacaea
combo of topical ivermectin and oral doxy
49
when do consider referral for acne rosacea and what happens
primary care hasnt resolved it laser therapy - if prominenet telangiectasia pts with rhunophyma
50
The parents of an 8-year-old girl have noticed a small growth on the sole of her foot for the last 3 months that has become painful. On examination, there is a small, firm, hyperkeratotic growth with tiny overlying black dots.tx
This child has a plantar wart, also known as a verruca. The tiny black dots are caused by thrombosed capillaries. They often self-resolve, but if treatment is desired, topical salicylic acid (15–50%) applied daily for up to 12 weeks can be tried.
51
A 76-year-old man has a longstanding patch of rough, itchy skin on his scalp which has not changed in size. On examination, there is a 1cm area of erythema and some scaling which is rough in texture, with evidence of surrounding sun damage. There is no ulceration or bleeding. condtion adn tx
This man likely has an actinic keratosis, a common hyperkeratotic lesion that arises on areas of skin that have had long-term cumulative sun exposure. There are no features to suggest that it has transformed into a squamous cell carcinoma. There are a variety of topical treatments, of which diclofenac is the only available option from the list above. Alternatives include 5-fluorouracil and imiquimod.
52
acanthosis nigricans associated with what
Oral contraceptive pill 32% Obesity 5% Polycystic ovarian syndrome 5% Insulin-resistant diabetes mellitus
53
sebaceous cyst description
Sebaceous cysts are most frequently located in the scalp and have an associated central punctum.
54
Superficial dermal burns covering >3% TBSA in adults must be
must be referred to secondary care
55
burns what six points need to be referred to secondary care
all deep dermal and full-thickness burns. superficial dermal burns of more than 3% TBSA in adults, or more than 2% TBSA in children - face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck - -any inhalation injury -electrical or chemical burn - non-accidental injury
56
intial mx of burns
initial first aid as above review referral criteria to ensure can be managed in primary care superficial epidermal: symptomatic relief - analgesia, emollients etc superficial dermal: cleanse wound, leave blister intact, non-adherent dressing, avoid topical creams, review in 24 hours
57
A 27-year-old man presents to the emergency department with a 2-day history of fever, tiredness, and a tingling sensation in the lateral aspect of his right thigh. He has found the tingling was initially bearable but has become painful in the past 24 hours. On examination, the area described is erythematous with a macular rash appearing
shingles
58
A 18-year-old female has presented with pustule and nodules in her neck and axillae with a narrow tract visible in the skin. She has noted that they can become swollen, painful and have a small amount of yellow discharge at times. She has a body mass index (BMI) of 25kg/m2 and has a 1-year smoking history. Given the presentation, what is the most likely diagnosis?
Hidradenitis suppurativa is a chronic, painful, inflammatory skin disorder is characterized by nodules, pustules, sinus tracts, and scars in intertriginous areas Intertriginous areas are areas of the body where two skin surfaces touch or rub together, and are prone to irritation and infection. These areas include: Groin folds, Axillae, Gluteal cleft, Neck creases, Breasts, Belly folds, Inner thighs, and Between the toes and fingers.
59
intertriginous areas
Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. The primary intertriginous skin areas include the groin folds, axillae, and gluteal cleft.
60
Initial manifestation involves recurrent, painful, and inflamed nodules. casuing rope like scarrin g
Hidradenitis suppurativa
61
Encourage good hygiene and loose-fitting clothing Smoking cessation Weight loss in obese Acute flares can be treated with steroids (intra-lesional or oral) or flucloxacillin. Surgical incision and drainage may be needed in some cases. Long-term disease can be treated with topical (clindamycin) or oral (lymecycline or clindamycin and rifampicin) antibiotics. Lumps that persist despite prolonged medical treatment are excised surgically.
62
Hidradenitis suppurativa differentials
Acne vulgaris - It primarily occurs on the face, upper chest, and back, whereas HS primarily involves intertriginous areas. Follicular pyodermas (folliculitis, furuncles, carbuncles) - Unlike HS, follicular pyodermas are transient and respond rapidly to antibiotics Granuloma inguinale (donovanosis) - It is a sexually transmitted infection caused by Klebsiella granulomatis. Suspect donovanosis if there is an enlarging ulcer that bleeds in the inguinal area.
63
skin patch testng used when
Useful for contact dermatitis. Around 30-40 allergens are placed on the back. Irritants may also be tested for. The patches are removed 48 hours later with the results being read by a dermatologist after a further 48 hours
64
RAST test when
Determines the amount of IgE that reacts specifically with suspected or known allergens, for example IgE to egg protein. Results are given in grades from 0 (negative) to 6 (strongly positive) Useful for food allergies, inhaled allergens (e.g. Pollen) and wasp/bee venom Blood tests may be used when skin prick tests are not suitable, for example if there is extensive eczema or if the patient is taking antihistamines
65
skin prick testing used when
Most commonly used test as easy to perform and inexpensive. Drops of diluted allergen are placed on the skin after which the skin is pierced using a needle. A large number of allergens can be tested in one session. Normally includes a histamine (positive) and sterile water (negative) control. A wheal will typically develop if a patient has an allergy. Can be interpreted after 15 minutes Useful for food allergies and also pollen
66
what is pompholyx
Pompholyx is a type of eczema which affects both the hands (cheiropompholyx) and the feet (pedopompholyx). It is also known as dyshidrotic eczema.
67
what precipitates pompholyx
Pompholyx eczema may be precipitated by humidity (e.g. sweating) and high temperatures.
68
sx and mx of pomphyolyx
Features small blisters on the palms and soles pruritic often intensely itchy sometimes burning sensation once blisters burst skin may become dry and crack Management cool compresses emollients topical steroids

Yr 4 and 5 dermatology (11 decks)

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