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Y2 Dermatology > Rashes > Flashcards

Rashes Flashcards

1
Q

how long should patients with mild/moderate acne be treated before a review?

A

three months

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2
Q

what is the topical treatment for mild/moderate acne?

A

benzoyl peroxide
retinoids
topical antibiotic

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3
Q

what are three topical retinoids?

A

adapalene
isotretinoin
tretinoin

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4
Q

if patients under 12 have a poor response to topical treatment for mild/moderate acne what should be given?

A

erythromycin or clarithromycin

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5
Q

if patients over 12 have a poor response to topical treatment for mild/moderate acne what should be given?

A

doxycycline

erythromycin or clarithromycin

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6
Q

what medication could be considered in females with acne?

A

anti androgens

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7
Q

what management should be started for severe cystic acne with scarring?

A

systemic antibiotics

refer for systemic isotretinoin

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8
Q

how does discoid eczema appear on the skin?

A

in circular or oval patches

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9
Q

what is the most common site affected by contact eczema?

A

hand

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10
Q

what body part is associated with varicose eczema?

A

lower legs

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11
Q

what is varicose eczema associated with?

A

venous insufficiency

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12
Q

what body parts are affected by seborrheic dermatitis?

A

nose
eyebrows
ears
scalp

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13
Q

how does dyshidrotic eczema present?

A

tiny blisters on the hands and feet

very itchy

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14
Q

what are the general measures for managing dermatitis?

A

remove triggers
loose, cotton clothes
emollients

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15
Q

what is given for mild dermatitis?

A

mild topical steroids

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16
Q

what is given for moderate dermatitis?

A

moderate topical steroids

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17
Q

what is given for severe dermatitis?

A

a potent topical steroid

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18
Q

what options are available for managing dermatitis in secondary care?

A

phototherapy
systemic immunosuppressants
biological agents

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19
Q

how does psoriasis present?

A

symmetrical red scaly plaques that are well defined

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20
Q

what are some common sites for psoriasis?

A

scalp
elbows
knees

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21
Q

what is Auspitz sign?

A

bleeding when surface scale is removed

seen in psoriasis

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22
Q

what is the koebner phenomenon?

A

when psoriasis develops in areas of skin trauma

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23
Q

what five topical therapies for psoriasis are used?

A 
vitamin D analogues 
coal tar 
dithranol 
steroid ointments 
emollients
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24
Q

what are two types of vitamin D analogues used in psoriasis?

A

calcipotriol (dovonex)

calcitriol

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25
Q

when is dithranol used in psoriasis?

A

localised plaques

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26
Q

what is a whitehead?

A

a closed comedone

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27
Q

what is a blackhead?

A

an open comedone

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28
Q

what is acne vulgaris?

A

chronic inflammatory disease of the pilosebaceous gland

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29
Q

what sites are commonly affected by acne?

A

face

upper back chest

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30
Q

what classifies mild acne?

A

scattered papules and pustules

comedones

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31
Q

what classifies moderate acne?

A

numerous papules and pustules

mild atrophic scarring

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32
Q

what classifies severe acne?

A

cysts
nodules
significant scarring

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33
Q

where does rosacea affect?

A

nose
chin
cheeks
forehead

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34
Q

what lesions are present in rosacea?

A

papules
pustules
erythema

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35
Q

what can exacerbate rosacea?

A

temperature changes
alcohol
spicy foods

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36
Q

what is rhinophyma and what skin condition is that associated with?

A

an enlarged misshapen nose

rosacea

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37
Q

what effects can rosacea have on the eyes?

A

conjunctivitis

gritty eyes

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38
Q

what are possible psychiatric complications of acne?

A

depression

anxiety

39
Q

what is the timescale for management of mild to moderate acne in primary care?

A

topical treatment for 3/12 then review

if poor response after three months, consider systemic treatment

40
Q

what is involved in the initial treatment for mild to moderate acne?

A

topical benzoyl peroxide
topical retinoids
topical antibiotics

41
Q

name three retinoids

A

adapalene
isotretinoin
tretinoin

42
Q

what systemic treatment can be considered after topical treatment for acne fails in patients under 12 in primary care?

A

erythromycin or clarithryomycin BD

43
Q

what systemic treatment can be considered after topical treatment for acne fails in patients over 12 in primary care?

A

lymecycline 400mg OD
doxycycline 100mg OD
erythromycin/clarithromycin 500ng BD

44
Q

what is the initial management for severe cystic acne with scarring?

A

systemic antibiotic therapy

refer for consideration of systemic isotretinoin

45
Q

describe the appearance of discoid eczema

A

occurs in circular or oval patches

46
Q

when does contact eczema occur?

A

when the body comes into contact with a specific substance

often affects the hands

47
Q

what part of the body is affected by varicose eczema?

A

the lower legs

48
Q

what is varicose eczema associated with?

A

venous insufficiency

49
Q

what parts of the body are affected by seborrheic eczema?

A

nose
eyebrows
ears
scalp

50
Q

how does dyshidrotic eczema present?

A

tiny blisters on the hands and feet

very itchy

51
Q

what conditions make having eczema more likely?

A

allergies
asthma
hayfever

52
Q

what are the general conservative management options for eczema?

A

remove triggers
wear loose cotton clothing
emollient use

53
Q

what is the management for mild eczema?

A

mild topical steroid

54
Q

what is the management for moderate eczema and name examples?

A

moderate topical steroid

e.g. betamethasone valerate 0.25% or clobetasone butyrate 0.05%

55
Q

what is the management for moderate eczema on the face?

A

mild steroid on the face - can increase in potency if needed to moderate

56
Q

what is the management for severe eczema and state an example?

A

potent topical steroid on inflamed areas e.g. betamethasone valerate 0.1%

57
Q

when should adults with eczema be referred to secondary care?

A 
failure to respond to moderate steroids 
sleep problems 
recurrent infection 
erythrodermic eczema 
contact allergy
58
Q

when should children with eczema be referred to secondary care?

A

uncontrolled despite maintenance + flare treatment
psychological or social difficulties
diagnosis uncertain

59
Q

what options are available for management of eczema in secondary care?

A

phototherapy
systemic immunosuppressants
biological agents

60
Q

how does guttate psoriasis present?

A

post strep infection

widespread small plaques

61
Q

what is another name for chronic plaque psoriasis?

A

psoriasis vulgaris

62
Q

what are unstable psoriasis plaques and what can trigger this?

A

rapid extension fo new or existing plaques

stress, infection, drugs, withdrawal

63
Q

what is the koebner phenomenon?

A

presence of new psoriatic plaques at the site of skin injury

64
Q

describe flexural psoriasis

A

affects body folds and genitals

smooth, well defined

65
Q

what microbe colonises flexural psoriasis?

A

candida

66
Q

what is sebopsoriasis?

A

the overlap of seborrheic dermatitis and psoriasis

affects the scalp, face, ears and chest

67
Q

what microbe colonises sebopsoriasis?

A

malassezia

68
Q

what is auspitz sign in psoriasis?

A

bleeding when surface scale removed

69
Q

what causes psoriasis?

A

multifactorial - genetic and environmental inputs

70
Q

what sites are commonly involved in chronic plaque psoriasis?

A 
extensors (elbow, knee)
scalp
sacrum
hands
feet
trunk
nails
71
Q

describe the plaques in chronic plaque psoriasis

A

symmetrical
well demarcated
scaly
erythematous

72
Q

name some nail signs seen in psoriasis

A

onycholysis
nail pitting
dystrophy
subungual hyperkeratosis

73
Q

what biomarkers are raised in psoriasis?

A

those of systemic inflammation

74
Q

name some comorbidities associated with psoriasis

A 
psoriatic athritis 
metabolic syndrome
crohn's
cancer
depression
uveitis
75
Q

how can severe psoriasis reduce life expectancy?

A

increased CVD risk reduces expectancy by 4 years

76
Q

can psoriasis be cured?

A

no - important to ensure that the patient knows this and to set realistic goals

77
Q

describe mild acne

A

scattered papules and pustules

comedones

78
Q

describe moderate acne

A

numerous papules
pustules
mild atrophic scarring

79
Q

describe severe acne

A

cysts
nodules
significant scarring

80
Q

what parts of the body are affected by rosacea?

A

nose
chin
cheeks
forehead

81
Q

what lesions are seen in rosacea?

A

papules
pustules
erythema
no comedones seen

82
Q

what can exacerbate facial flushing in rosacea?

A

changes in temperature
alcohol
spicy foods

83
Q

what change can affect the nose in rosacea?

A

rhinophyma - an enlarged, unshapely nose

84
Q

what topical therapies can be given for rosacea?

A

metronidazole

ivermectin

85
Q

what oral therapies can be given for rosacea?

A

long term oral tetracycline

low dose isotretinoin in severe disease

86
Q

what can be used to treat telangiectasia in rosacea?

A

vascular laser

87
Q

what can be done to manage rhinophyma in rosacea?

A

surgery

laser shaving

88
Q

what characterises lichenoid eruptions?

A

damage and infiltration between the epidermis and the dermis

89
Q

name the two most common types of lichenoid eruptions

A

lichen planus

lichenoid drug eruption

90
Q

what is the pathology behind lichen planus?

A

T cell mediated inflammation targeting a protein in the skin + mucosal keratinocytes

91
Q

describe the lesions seen in lichen planus

A

pink/purple flat topped shiny papules
wickham’s striae - white lacey pattern on the surface
itchy

92
Q

what body parts are usually affected by lichen planus?

A

volar wrists/forearms
shins
ankles

93
Q

how long does lichen planus usually last?

A

12-18 months

94
Q

how is lichen planus managed?

A

emollients
topical steroids (oral if extenisve)
UVB phototherapy if severe

Y2 Dermatology (17 decks)

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