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1
Q

Naevus sebaceous growth risks

A

Trichoblastoma
BCC
Syringocystadenoma papilliferum

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2
Q

Multiple facial tumours

A 
ANTTSS on the face
Adenoma sebaceum
Neurofibromas
Trichilemmoma
Trichoepithelioma
Syringoma
Sebaceous hyperplasia
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3
Q

CALM associations

A 
BATANS
Blooms
Albrights
TS
Ataxia telangiectasia
Neurofibromatosis
Silver-Russell syndrome
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4
Q

Acute attack porphyrias

A

VAH
Variegate porphyria
Acute intermittent
Hereditary coproporphyria

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5
Q

Porphyria acute attack triggers

A 
FIGBEANS
Fever
Infection
Griseofulvin
Barbituates
Oestrogen
Alcohol
Nutrition
Sulfonamides
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6
Q

Subepidermal blister with neutrophils

A 
Herpetic LIPS
Dermatitis herpetiformis
Lupus (bullous)
Linear IgA
Pemphigoid
Sweets
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7
Q

Subepidermal blister, cell poor

A 
Blistering APE
BP and ischaemic blister
Amyloidosis
PCT
EB
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8
Q

Septal panniculitis differentials

A 
Always Make Septal Panniculitis Easy Nowadays
Alpha 1 antitrypsin deficiency
Scleroderma/morphoea
PAN
EN
NLD
Migratory thrombophlebitis
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9
Q

Associations with EN

A 
NoDOSUM
No cause
Drugs - iodide, sulfonamide
OCP
Sarcoid, Lofgrens
Ulcer - Behcets, UC, Crohns
M - microbiology
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10
Q

Papillomatosis differential

A 
CAVES
CARP
Acanthosis nigricans, acrochordon, acrokeratosis verruciformis
Verruca vulgaris
Epidermal naevus
Seb k, syringocystadenoma
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11
Q

Colloidon baby

A 
Lamellar ichthyosis
Congenital ichthyosiform erythroderma
Sjogren Larson
Conradi Hunermann
Trichothiodystrophjy
Ectodermal dysplasia
Infantile Gaucher disease
Hay-Wells
Neutral lipid storage disease
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12
Q

Grenze zone ddx

A

LG
Leukaemia/lymphoma
Granuloma faciale, EED

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13
Q

Hairy tongue causes

A 
- Drugs
- Poor oral hygiene
- Smoking or chewing tobacco
- Drinking alcohol
- Cocaine
- Chlorhexidine or peroxidase-containing mouthwash
- Coloured beverages, including coffee
- Dehydration
- Hyposalivation (dry mouth)
- Radiation therapy
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14
Q

Elastosis perforans serpinginosa associations

A 
MADPORES
Marfans
Acrogeria
Down's syndrom
Pseudoxanthoma Elasticum
Osteogenesis Imperfecta
Rothmund Thompson
Ehlers Danlos
Scleroderma
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15
Q

Differential for facial papules

A

Hair and cysts: angiofibromas, trichoepithelioma, tricholemmoma, fibrofolliculoma, trichodiscoma, syringoma, hidrocystoma

acne, rosacea, acne agminata, perioroficial dermatitis, demodecosis

Lymphocytoma cutis, Jessners, lymphoma
Sarcoidosis 
TB, lichen scrofulosorum 
Sweets
Granuloma faciale 
LCH/nLCH
Amyloidosis, scleromyxoedema, lichen myxoedematosus

Erythromelanosis follicularis faciei

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16
Q

Brooke Spiegler three skin things they get

A

Cylindroma
Trichoepithelioma
Spiradenoma

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17
Q

Can you get hair loss in lichen striatus

A

Yes it can be peri follicular.

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18
Q

Complications of nethertons baby

A

Hypernatraemic dehydration

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19
Q

Sporotrichoid spread ddx

A

SLAMN

Sporotrichosis, sweets, sarcoidosis, staph, strep, sporothrix schenkii
Leishmaniasis, lymphoma
Actinomycosis, anthrax
M Marinum, mycobacteria TB etc, metastases
Nocardia
+ tuleraemia

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20
Q

Birt Hogg Dube mnemonic

A 
FAT TRAP
Fibrofolliculomas, FLCN gene
Acrochorcons 
Trichodiscomas 
Thyroid goiter, carcinoma 
Renal cancer
AD, angiolipomas 
Pulmonary cysts, pneumothorax
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21
Q

BRAF inhibitor adverse effects mnemonic

A

Rash - acneiform, maculopapular
Alopecia
Palmoplantar dysaesthesia, Photosensitivity
Itchiness
Dry skin
SCC, AK, KA, Seb-derm like eruption, also eruptive melanocytic naevi
KP-like eruption
Also: arthralgia, fatigue, nausea, headache, altered taste, hepatotoxicity

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22
Q

DDx for CALMS mnemonic

A 
TS
Neurofibromatosis 1 & 2 and Noonans
Fanconi anaemia, Familial
Bloom's
LEOPARD, Legius
Ataxia telangiectasia
McCune Albright, Maffucci’s syndrome
Endocrine neoplasia, multiple - MEN 2B
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23
Q

eGFR Reactions mnemonic

A

HANDI
Hair: curly, brittle hair, alopecia, hypertrichosis
Acneiform eruption
Nail changes: paronychia, pyogenic granuloma, onycholysis
Dryness
Itchiness

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24
Q

Eosinophilic fasciitis aetiologic factors mnemonic

A 
THIRDS
Thyroiditis
Haem malignancies / dyscrasias
Infection (Borrelia)
Radiation
Drugs (L-tryptophan, atorvastatin)
Strenuous exercise
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25
Facial papules ddx
``` BASKET IN CASE Syndromic BCC – Gorlin’s Angiofibromas - TS Sebaceous neoplasms – Muir Torre KAs – Ferguson-Smith, Gryzbowski Epidemoid cysts – Gardner’s, Gorlin’s Trichoepitheliomas - BSS Tricholemmomas – Cowden’s Trichodiscomas - BHD Non-syndromic Cysts, Colloid milium Acne, acne agminata, rosacea, POD, demodex folliculitis Sarcoid, syringomas Eruptive milia Other: lipoid proteinosis (along eyelid margin) Infections (warts) Neurofibromas ```
26
Flushing causes ddx mnemonic
``` TRAMPED Thyrotoxicosis Rosacea Alcohol Menopause, masocytosis, Malignancy (pancreatic, renal) Physiological Endocrine tumours eg phaeochromocytoma, medullary thyroid cancer, carcinoid syndrome Drugs ```
27
Leonine facies ddx mnemonic
Carcinoid, CAD, Cutis verticis gyrata Leishmaniasis, leprosy Acromegaly, Amyloidosis, Alopecia mucinosis, Atopic dermatitis (Airborne) MF, Multicentric Reticulohistiocytosis Phymatous rosacea, Pachydermoperiostosis (genetic condition) Sarcoidosis, Scleromyxoedema, Syphilis
28
Mastocytosis drugs to avoid ddx mnemonic
``` ROMAN V Radiocontrast Opioids Muscle relaxants, depolarising (suxamethonium) Alcohol NSAIDs inc aspirin Vancomycin, venom ```
29
What to do with biológics psoriasis patient who wants to fall pregnant And then if they are pregnant
Cimzia - Pegylated TNF alpha - unsure if available General advise to cease pre conception - conservative advice is 6 month wash out Biológic data so far reassuring particularly for TNF alphas- baby can’t have live vaccines until 6 months old
30
Is phototherapy fine in pregnancy?
UVB fine but ensure folic acid supplementation | PuVa not ok
31
Types of sarcoidosis - classic
``` Angiolupoid Annular Papular Plaque Scar Subcutaneous- Darrier Roussy EN LUPUS PERNIO Maculopapular Modular ```
32
Types of atypical sarcoidosis
``` Verrucous A Lp or LE like Ulcerated Erythroderma Atrophic ``` ``` Hypo or hyperpigmentation PPK Psoriatic Ichthyotic Mucosal Alopecia Nail ```
33
Where is angiolupoid sarcoid
Particularly face: marked telangiectatic component | Classic location is near the medial canthus
34
Most common cutaneous manifestation of sarcoid
Papular Arises in crops Face and extensor limbs Favourable prognosis
35
Which cutaneous sarcoid represents systemic sarcoid changes
Scar sarcoid So if worsening be concerned of systemic worseninf Not itchy
36
Distribution of subcutaneous sarcoid (Darier Roussy)
Extremities: upper over lower Systemic involvement usually present Tender OR painless nodules
37
Associations of lupus pernio
``` Respiratory tract sarcoidosis Bone cysts Lacrimal gland involvement Renal sarcoidosis Hyperglobulinaemka Hypercalcaemia ```
38
Which sarcoid are chronic - ie worse
Plaque Lupus pernio EN is acute
39
Heerfordts syndrome
``` Sarcoidosis: Parotid gland enlargement Uveitis Fever Facial nerve palsy ```
40
Specific findings for histo for sarcoid
Schaumann body (basophils) Crystalline inclusion: colour less oval inclusions ? Precursor of Schaumann bodies Asteroid bodies: eosinophilix And then obviously non case aging sarcoidal granuloma
41
Utility of doing ACE level in sarcoidosis
Elevated in about 75% of untreated sarcoid Poor sensitivity and specificity Lots of other conditions cause elevation of In terms of monitoring - unclear
42
UVB spectrum
290-320
43
NBUVB spectrum
311-313
44
Excimer laser nm
308 nm
45
UVA1 spectrum
340-400
46
UVA spectrum
320-400
47
UVC spectrum
2000-290
48
Lamellar ichthyosis mutation
TGM1
49
Harlequin ichthyosis mutation
ABCA12
50
Fabry disease associations
f - febrile episodes A - angiokeratomas and alpha galactose b - burning pain - peripheral neuropathy in hands and feet R - renal failure and retinal abnormalities Y - young death C - cardiovascular and cerebrovascular disease C - ceramide trihexoside
51
REGISCAR Diagnostic criteria for DRESS
``` >5 is definite, 4-5 is probably 6 clinical: 1. Fever 2. Cutaneous >50% 3. Cutaneous eruption that looks like DRESS 4. Lymphadenopathy 5. Resolution >15 days 6. Internal organ involvement 4 investigations: 1. Biopsy consistent with 2. Atypical lymphocytes 3. Eos >1.5 4. Negative for ANA, mycoplasma, chlamydia, hepatitis and blood cultures ```
52
J-SCAR Diagnostic criteria for dress
4 clinical, 3 investigations Clinical 1. Fever 2. Maculopapular rash >3 weeks after starting select medication 3. Lymphadenopathy 4. Long time to resolve once removal of medication Investigations 1. HHV-6 reactivation 2. LFT derangement ALT >1000 3. Leukocyte abnormality: lymphocytosis, lymphocyte abnormalities, eosinophilia
53
Drugs that cause acanthosis nigricans
OCP, growth hormone, niacin, steroids, protease inhibitors
54
What is the glucagonoma syndrome
Consists of necrolytic migratory erythema, adult onset diabetes, weight loss and glossitis Can also have anaemia and personality changes
55
Medications that cause Telogen effluvium
OCP cessation Retinoids Anticoagulants- particularly heparin Anti thyroid: propylthiouraxil, methimazole Anti convulsants- valproate, carba, phenytoin Heavy metals Beta blockers
56
What is diagnostic for Telogen effluvium
20% telogen count
57
HLA for allopurinol
B*5801 for Han Chinese and Taiwanese
58
HLa for carbamazepine
Han chinese 1502 SJS
59
Lamotrigone hla
1502 for SJS - Taiwanese
60
Most common cause of serum sickness like drug eruption
Cefaclor 1/2000 kids
61
ANCA positive vasculitis drug causes
Propylthiouracil Hydralazine Levamisole Minocycline
62
AGEP medications
``` CHANT: Calcium channel blockers, carbamazepine, cetirizine Herbal medicines Abx, acetaminophen, anti malarials NSAIDs Terbinafine ```
63
Medications that cause SWEETS
``` Change Checkpoint inhibitor, contraceptives Hydralazine Azathioptine and abx (Mino, TMP-SMX, quinolone) GCSF Efflux of fluid - frusemide ```
64
Timeline for immunologically mediated drug reaction
8-21 days
65
Exanthematous eruption time interval
4-14 days
66
FDE time interval
1-2 week at first, re exposure <48 hours
67
AGEP time
<4 days
68
DRESS time
15-40 days
69
Drugs that cause ANCA positive vasculitides
PTU Hydralazine Levamisole Minocycline
70
Drugs that cause sweets
``` CHANGE Checkpoint inhibitors, imatinib, contraceptives Hydralazine Abx TMP SMX minocycline quinolones GCSF Efflux of fluid: frusemide ```
71
Meds that cause FDE
``` Abx sulfonamides tetracyclines over beta lactam NSAIDS Paracetamol Azole anti fungals PPI Dapsone Barbituates ```
72
Drugs that cause linear IgA bullous dermatosis
``` CAPPINPISS Vancomycin Captopril, cephalosporin, cyclosporine Amiodarone, allopurinol Phenytoin Interferon alpha NSAIDS Penicillins Sulfonamides Somatostatin ``` Frusemide Lithium
73
Drugs that cause BP
``` Gliptins TNF alphas Abx - amoxicillin Anti PD1s NSAIDS Diuretics ```
74
Drugs that induce pemphigus
Those with a thiol group - bind to desmosomal antigen complex Penicillamines Captopril and other ACEI Gold Non thiols Beta lactams Nifedipine Propranolol
75
Common phototoxic agents
STAND UP C**T ``` Sulfonamides Tetracyclines Triazole antifungals: voriconazole Anti arrhythmics: amiodarone NSAIDS Diuretics PDT and psoralens Calcium channel blockers - diltiazem Tars ```
76
Drugs that cause pseudoporphyria
``` FIND Frusemide Isotretinoin NSAIDs Dapsone and doxy ```
77
Drugs that cause photoallergy
Sulfur moieties: thiazide diuretics, sulfonamide abx, sulfonylureas Others: quinine, quinidine, TCA, griseo, NSAIDs
78
Hydroxyurea cutaneous effects
Painful ulcerations of maleolar region of legs
79
Drugs that cause alopecia
``` Telogen: Anticoagulants: heparin > warfarin Beta blockers Interferons Lithium Retinoids ``` ``` Anagen: Anti neoplastics Arsenic Gold Etc ```
80
Drugs that cause SCLE
TTTCHANGE ``` Terbinafine, thiazides, TNF alpha Calcium channel blocker, carbamazepine HMG coa reductase ACEI NSAIDs Griseo Esomeprazols Beta blockeds ```
81
Meds that cause psoriasis
``` Beta blockers Lithium NSAIDs TNF alphas Interferons ```
82
Genes associated with HS
NCSTN PSEN1 and PSENEN
83
Treatment for Erythema migrans
Can I actually diagnose Cefuroxime 500 mg BD Amoxicillin 500 mg TDS Doxycycline 100 mg BD
84
Medications that cause flushing
STOP CHIN MAD FAG ``` Sildenafil Tamoxifen Opiates Prostaglandins Calcium channel blockers, calcitonin, chlorpropamide, cyclosporine Hydralazine Nicotinic, nitrates Monosodium glutamate, sodium nitrate Alcohol Disulfiram Foods – fish ACE inhibitor Gold ```
85
Antibodies for systemic sclerosis
Anti-topoisomerase I (anti-Scl70), anti-RNA polymerase III and anti-centromere
86
Type 6 PRP
HIV associated follicular syndrome | HIV, PRP, nodulocystic acne, follicular spines including lichen spinulosis
87
Ddx for follicular papules with keratotic picture
``` Phrynoderma Keratosis circunscripta Follicular ichthyosis juvenile PRP Trichodysplasia Follicular mucinosis Demodex ```
88
Antibodies for systemic sclerosis
Anti-topoisomerase I (anti-Scl70), anti-RNA polymerase III and anti-centromere
89
Variants of vitiligo
``` Vitiligo ponctue (confetti) Trichome vitiligo Blue vitiligo Inflammatory vitiligo Hypochromic vitiligo (seborrhoeic distribution) Isomorphic Koebner phenomenon Childhood vitiligo ```
90
Subtypes of vitiligo
Generalized: Vulgaris Acrofacial Universalis Localized: Focal Segmental Mixed
91
What is Vogt Kayanagi Harada classified by
1. Uveitis 2. Aseptic meningitis 3. Otic involvement - dysacusia (difficulty hearing because can't process input) 4. Vitiligo - particularly of face or sacral region, and associated poliosis
92
Allezandrini syndrome - what is it classified by
- Rare disorder, believed to be closely related to Vogt-Koyanagi-Harada syndrome - Characterized by unilateral whitening of scalp hair, eyebrows, eyelashes - Ipsilateral depigmentation of facial skin and visual changes - Affected eye: decreased visual acuity and an atrophic iris
93
Gene associated with DH
HLA DQ2 or HLA DQ8
94
Pathogenesis of hydroa vacciniforme
Trigger: sun EBV implicated- When severe EBV --> evidence of NK cell lymphocytosis, exaggerated response to mosquito bites and haemophagocytic syndrome - Subset of children and adults with EBV driven lymphorpoliferative disorder so screen for that: LN, hepatosplenomegaly, fever
95
Hydro vacciniforme main clinicals
M>F Within hours tender bullae, blisters, vesicles, plaques, papules. Heals with telangiectasias and varioliform scars Can get fever, headache, malaise Can't play outdoors - Basically this will get worse with sun exposure, and result in facial swelling, ulcerated nodules, mosquito bite reactions ++. fevers, hepatosplenomegaly, pancytopaenias, deranged LFTs, increased NK lymphocytes, high EBV DNA load - Rarely, ocular findings may be present: such as photophobia, lacrimation, conjunctivitis, corneal infiltration with vascularization, keratitis, or uveitis [37-39]. Referral to an ophthalmologist is recommended if eye symptoms are presen
96
Treatment for hydroa vacciniforme
- ecalcitrant - Photoprotection: tinted windows, barriers - Anecdotal: phototherapy, PUVA, beta-carotene, antimalarials, azathioprine, thalidomide, cyclosporine, dietary fish oil
97
CAD resolution
10% over 5 years, 50% of 15 years
98
Rothmund Thompson gene and clinical features
RECQL4 1. Teeth abnormalities 2. Hypogonadism 3. Ocular: bilateral cataracts 4. Microcephaly 5. Poikiloderma and photosensitivity 6. Short stature, skin cancers 7. Osteosarcoma 10-30% + other cancers: gastric, Hodgkin lymphoma, malignant eccrine poroma 8. No hair, Sparse hair, hypoplastic nails, acral keratoses
99
Systemic photoallergic agents
- Antiarrhythmics: quinidine - Antimalarials: quinine - Antifungals: griseofulvin - Antimicrobials: sulfonamides - NSAIDs: piroxicam - Photoallergic reactions include: those with sulfur moiety - Thiazide diuretics - Sulfonamide abs - Sulfonylureas - Phenothiazines - Others: quinine, quinidine, TCA, griseo, NSAIDs
100
Which ingredient in sunscreen is most common cause of photoallergy
Oxybenzone
101
Associations with EPS
POO DAMPER: Penicillamine, Osteogenesis imperfecta, Downs, Acrogeria, Marfan, PXE, Ehlers Danlos, Rothmund Thomson
102
HS genes
PSEN1, PSENEN, NCSTN
103
Causes of interstitial granulomatous drug reactions
Calcium channel blockers Statins TNF alpha inhibitors
104
Drugs that cause acne
``` MISPLACE MEK inhibitors (trametinib) Iodides, isoniazid Steroids Phenytoin, progestins Lithium Anabolic steroids - danazol, testosterone Corticotropin, cyclosporin EGFR inhibitors ```

Derm (57 decks)

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