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Skin Flashcards

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1
Q

What are the key features of eczema (atopic dermatitis)?

A

Itchy, dry, inflamed skin, often affecting flexural areas in children.

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2
Q

What is the first-line treatment for eczema?

A

Emollients and topical corticosteroids (mild to potent depending on severity).

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3
Q

What clinical complication should you watch for in eczema?

A

Secondary bacterial infection (usually Staphylococcus aureus).

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4
Q

What are the key features of psoriasis?

A

Well-demarcated, silvery scales on extensor surfaces and scalp.

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5
Q

What is the first-line treatment for chronic plaque psoriasis?

A

Topical vitamin D analogues (calcipotriol) and topical corticosteroids.

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6
Q

Name two important clinical signs associated with psoriasis.

A

Koebner phenomenon and Auspitz sign.

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7
Q

What are the key features of acne vulgaris?

A

Comedones, papules, and pustules on face, back, and chest.

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8
Q

What are the key features of seborrhoeic dermatitis?

A

Greasy, scaly rash on the scalp (dandruff) and face (nasolabial folds).

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9
Q

What is the first-line treatment for seborrhoeic dermatitis?

A

Antifungal shampoo (ketoconazole) and mild topical steroids if inflamed.

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10
Q

What conditions are associated with seborrhoeic dermatitis?

A

Parkinson’s disease and HIV.

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11
Q

What are the key features of rosacea?

A

Central facial flushing, telangiectasia, and papules without comedones.

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12
Q

What is the first-line treatment for rosacea?

A

Topical ivermectin, metronidazole or azelaic acid; oral tetracyclines for moderate cases.

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13
Q

What common triggers exacerbate rosacea?

A

Alcohol, sunlight, and spicy foods.

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14
Q

What are the key features of tinea (dermatophyte infection)?

A

Ring-shaped rash with a raised active edge, commonly on body, scalp, feet, or groin.

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15
Q

What is the first-line treatment for tinea?

A

Topical antifungals like terbinafine/imidazole; oral terbinafine for scalp or nails.

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16
Q

How can tinea diagnosis be confirmed?

A

Skin scrapings and microscopy/culture. (Only do if intractable or scalp)

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17
Q

What are the key features of impetigo?

A

Golden crusted lesions, typically on the face of children.

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18
Q

What is the first-line treatment for localized impetigo?

A

Topical fusidic acid. (Or mupirocin is suspected resistance to fusidic acid)

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19
Q

When is oral antibiotics indicated in impetigo?

A

If lesions are extensive or systemic symptoms are present (e.g., flucloxacillin).

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20
Q

What are the key features of scabies?

A

Intense nocturnal itching and burrows in web spaces and axillae.

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21
Q

What is the first-line treatment for scabies?

A

Permethrin 5% cream applied to whole body, repeat after 7 days.

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22
Q

What important management step is needed with scabies?

A

Treat all close contacts simultaneously to prevent reinfestation.

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23
Q

What are the key features of urticaria?

A

Transient, itchy, blanching wheals that may come and go quickly.

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24
Q

What is the first-line treatment for urticaria?

A

Oral non-sedating antihistamines (e.g., cetirizine, loratadine).

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25
What signs indicate anaphylaxis in a patient with urticaria?
Angioedema, difficulty breathing, hypotension.
26
What are the key features of contact dermatitis?
Red, itchy rash localized to area of skin contact with irritant or allergen.
27
What is the first-line treatment for contact dermatitis?
Avoidance of trigger, emollients, and topical corticosteroids.
28
How is allergic contact dermatitis confirmed?
Patch testing.
29
What can keretiacanthoma rarely become?
SCC (refer as 2ww)
30
What’s best to use if acne and pregnant?
Duac
31
What is in epiduo?
Adapalene and benzoyl peroxide (no antibiotic)
32
What is duac?
Benzyl peroxide and clindamycin
33
Is acne is severe what could you add to epiduo?
Oral antibiotic e.g. lymecycline/doxycycline
34
Alternatively to epiduo + oral AB. What else could you use for moderate to severe acne?
Topical azelaic acid + oral antibiotic
35
Do not give concurrent oral and topical antibiotics TRUE OR FALAE
True
36
In impetigo if MRSA is suspected or confirmed what should you do?
A local microbiologist should be consulted
37
With fungal nail you start therapy and send clippings at the same time True or false
FALSE only start therapy if infection confirmed
38
When do you check LFTs when starting on antifhngals?
At a month - risk of liver problems
39
When would you consider acyclovir in chicken pox?
Onset of rash <24h and 1 of the following -severe pain ->14 years -taking steroid -smoker -oral rash
40
When would you give acyclovir in shingles?
>50 and within 72hours of rash OR if one of the following -active ophthalmic -Ramsey hunt -eczema -non truncal involvement -moderate-severe pain or rash (If not within 72h but within a week and old/immunocompirmised/severe pain)
41
What percentage of people are protected by the first dose of the measles vaccine?
90%
42
How is measles primarily spread?
Droplet spread
43
What is the incubation period for measles?
7-18 days
44
List the prodromal symptoms of measles.
* Cold * Red eyes * Fever * Koplik spots
45
What are Koplik spots?
Grey white spots in mouth prior to body rash
46
When does the rash appear after the prodrome in measles?
3-5 days
47
Describe the progression of the measles rash.
* Starts as small dots * Gets bigger * Eventually joins together
48
When is a person with measles infectious?
From prodrome to 4 days post rash
49
What is the school exclusion policy for measles?
Until 5 days after onset of rash providing they are well
50
What percentage of measles cases may require hospital admission?
About 10%
51
What type of sample is needed for measles specific immunoglobulin M (IgM) testing?
Salivary swab or serum sample
52
When should vulnerable contacts be identified for post-exposure prophylaxis?
Within 5 days
53
What is the effectiveness of MMR vaccination if given within 72 hours of exposure?
May be effective for susceptible individuals
54
When should the pneumococcal vaccine be administered?
* 12 weeks * 1 year * Age 65 and if at risk
55
At what age should the shingles vaccine be given?
Age 70-79 (2 doses)
56
What is the prophylaxis AB with bites?
Co-amox
57
What should be assessed if a human bite occurs?
* Risk of tetanus * Rabies * HIV * Hepatitis B
58
What is this classical of? Bilateral conjunctival injection without exudate Erythema and cracking lips Strawberry tongue, erythema of oral and pharyngeal mucosa Oedema and erythema in hands and feet Polymorphous rash Cervical lymphadenopathy
Kawasaki disease
59
How do you treat Kawasaki disease?
Aspirin Admit for urgent bloods and immunoglobulins
60
What is the treatment for AK
Solaris (3% diclofenac) 12 weeks Second line imiqimod (Also consider efudix or could do cryotherapy)
61
What is medical name for dry scaly skin?
Ichthyosis vulgaris (AD condition affects gene encoding the filaggrin gene) emollients usually helpful
62
When would you consider potent corticosteroids in vitaligo?
If <10% of the body - betamethasine valerate 0.1% for 2 months
63
Who gets factor 50 in the NHS
Vitaligo
64
What are examples of non sedating antihistamines?
Ceririzine Loratidube Fexofenodine
65
What does necrobiosis lipoidica look like?
Dusky red nodules on the shin which become flat, irregular and yellow-brown
66
What condition is neceobiosis lipoidica associated with?
Diabetes
67
What do you suspect if Sore throat, strawberry tongue, sandpaper rash
Scarlett fever (notifiable)
68
How do you treat head lice?
Wet combing and malathion 0.5% scalp application
69
When would use erythromycin rather than lymecycline as an add on in acne?
Only when lymecycline CI e.g. pregnancy
70
What is first line in hidradrnitis suppurativa?
Lymecycline or doxycycline
71
What is the most common type of BCC
Nodular
72
73
What is the pinch test used in diagnosis of?
Dermatofibroma
74
How do you treat erythema toxicum neonatorum?
Advice and reassurance (usually in first 2-14 days of birth, due to focal aggregation of mast cells in the dermis)
75
What is pityriasus rosacea and when does it occur?
Single scaling patch (herald patch)followed by several on chest and back. Often occurs following URTI, self limiting
76
How do you treat severe eczema in a systemically well patient
A potent topical cortisosteroid
77
78
What is pyoderma gangrenosum and what is it associated with?
An auto inflammatory condition which presents as rapidly enlarging very painful necrotic ulcer. Associated with IBD, arthritis and haematological conditions
79
Psoriasis of the face, flexures or genitals that has had a mild-moderate corticosteroid for a Max of two weeks. What’s next?
Refer to dermatology
80
Eczéma Craquelé often affects the elderly and can be caused by drugs. What are the 4 systemic causes
Under active thyroid Malnutrition Severe weight loss Lymphoma
81
What questionnaire assessed the impact of a skin condition on someone’s life??
DLQI
82
What are pyogenic granulomas?
Acquired benign proliferations of capillary blood vessels
83
What does dermatitis herpetiformis look like?
Intensely itchy supepidermal blistering condition
84
How much emollient should an adult with widespread dermatitis be using
500g a week
85
In lichen planus there is often mouth and nail involvement. True or false
True
86
What would make you think guttate psoriasis?
Preceding by a sore throat More common in smokers Can be precipitated/exacerbated by beta blockers
87
What can be used in those with acne and PCOS that first like hasn’t worked
Co-cyprindiol
88
After starting a non sedating histamine for urticaria what is the next step? My
Increase antihistamine dose (can go up to 4x) Other options: specialist referral, sedating antihistamine, LTRA e.g. montelukast, antipuritic cream e.g. calamine If symptoms severe can do a short course of oral steroids
89
What should be avoided in infants under 6 months due to cross-reactivity and tolerance issues when suspecting CMPA?
Soy formula ## Footnote Avoiding soy formula is crucial to prevent adverse reactions in infants with potential cow's milk protein allergy (CMPA)
90
By what age do most children outgrow CMPA?
3-5 years ## Footnote CMPA is commonly outgrown by early childhood for many children
91
What should be monitored regularly in children with CMPA?
Growth and nutritional status ## Footnote Regular monitoring is essential to ensure proper development and health in children with CMPA
92
When should a referral to allergy/immunology or dietitian be made in CMPA cases?
If diagnosis is uncertain or symptoms are severe ## Footnote Referrals are important for appropriate management and treatment of CMPA
93
What are the key symptoms of CMPA?
GI and skin symptoms, sometimes anaphylaxis ## Footnote CMPA can manifest through various symptoms, including gastrointestinal and dermatological reactions
94
How is the diagnosis of CMPA confirmed?
Clinical diagnosis confirmed by elimination and challenge ## Footnote The elimination diet followed by a challenge test helps confirm CMPA
95
What should breastfeeding mothers do if CMPA is suspected?
Eliminate cow's milk protein ## Footnote Removing cow's milk protein from the diet can help manage symptoms in breastfed infants
96
What is the first-line formula for managing CMPA?
Extensively hydrolysed formula ## Footnote This formula is designed to be easier to digest for infants with CMPA
97
What type of formula should be used if CMPA is severe?
Amino acid formula ## Footnote Amino acid formula is used for infants with severe CMPA due to its hypoallergenic properties
98
True or False: Soy formula is safe for infants under 6 months with CMPA.
False ## Footnote Soy formula may cause cross-reactivity in infants with CMPA, hence should be avoided
99
What is the purpose of referring a child with CMPA to a specialist?
To provide appropriate management and treatment ## Footnote Specialists can offer tailored interventions for complex cases of CMPA
100
What types of immune responses can cow's milk protein intolerance trigger?
IgE mediated (<2hrs) or non-IgE mediated (>2hrs) ## Footnote IgE mediated responses involve immediate reactions, while non-IgE mediated responses involve delayed reactions.
101
What are the symptoms of a Type 1 reaction to cow's milk protein?
* Itch * Rash * Urticaria * Angio-oedema * Upper respiratory symptoms ## Footnote Type 1 reactions are typically IgE mediated and occur within 2 hours.
102
What are the symptoms of a Type 4 reaction to cow's milk protein?
* Itch * Eczema * GORD * Loose stools * Abdominal pain * Colic * Constipation * Perianal redness * Blood or mucus in stools ## Footnote Type 4 reactions are delayed and involve various gastrointestinal and dermatological symptoms.
103
Fill in the blank: A Type 1 reaction to cow's milk protein is mediated by _______.
IgE
104
True or False: Type 4 reactions to cow's milk protein occur within 2 hours of exposure.
False
105
What gastrointestinal symptoms can be associated with cow's milk protein intolerance?
* Loose stools * Abdominal pain * Colic * Constipation * Blood or mucus in stools ## Footnote These symptoms indicate a non-IgE mediated response.
106
What is the time frame for symptoms to appear in a non-IgE mediated reaction to cow's milk protein?
>2 hours ## Footnote Non-IgE mediated symptoms develop more slowly compared to IgE mediated reactions.

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