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MBChB > Skin > Flashcards

Skin Flashcards

(56 cards)

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1
Q

What gene mutation may predispose a person to a BCC?

A

PTCH

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2
Q

Describe a nodular BCC

A

Module >0.5cm
Shiny surface
Telangectasia
Often ulcerated centrally

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3
Q

Describe a superficial BCC

A

Not raised
Rolled margin
Telangectasia
More indolent - doesn’t ulcerate

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4
Q

Describe a pigmented BCC

A

Rolled shiny margin
Telangectasia
Ulcerated
Pigmented

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5
Q

Describe a morphemic/sclerotic BCC

A

Harder to diagnose as filtrating underneath the skin at a slow rate
Harder to manage

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6
Q

Describe the management of a BCC

A 
Surgical exicision: 3-4mm margin
Curettage and cautery
Cryotherapy
Photodynamic therapy 
Topical imiquimod/5-flurouracil cream
Mohs micrographic surgery
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7
Q

What are the pre-malignant variants of SCC?

A

Actinic keratoses

Bowen’s disease

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8
Q

What are high risk sites of metastasis in SCC’?

A

Ears

Lips

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9
Q

What are the clinical features of SCC?

A

Keratin appearance - crusty, scaly
No rolled shiny margin
No ulceration (unless aggressive)

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10
Q

Describe the management of SCC

A

Surgical excision - 4mm margin
Curettage and cautery

If pre-malignant:
Topical imiquimod/5-flurouracil cream
Cryotherapy
Photodynamic therapy

Sun protection

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11
Q

What determines 5y survival of melanomas?

A

Breslow thickness

0-1mm = 97%
1.01 - 2mm = 91%
2.01-4mm = 79%
>4.00mm = 71%

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12
Q

Describe acral melanoma

A

Hands and feet - more likely to present in people with darker skin types

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13
Q

Describe subungal melanoma

A

Underneath nails

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14
Q

Describe amelonatic melanoma

A

No pigment, can be missed, rare

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15
Q

Describe lentigo maligna

A

Pre-malignant melanoma on the face

Can develop into lentigo maligna melanoma

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16
Q

Describe the clinical features of a melanoma

A

No symmetry
Different shades
Pattern of pigmentation is different

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17
Q

What margin is required if Breslow depth is <1mm?

A

1cm

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18
Q

What margin is required if Breslow depth is >1mm?

A

2cm

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19
Q

Describe Gorlin’s syndrome

A

Multiple BCCs
Jaw cysts
Risk of breast Ca

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20
Q

Describe Brook Spiegler syndrome

A

Multiple BCCs

Trichoepitheliomas

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21
Q

Describe Gardner syndrome

A

Soft tissue tumours
Polyps
Bowel Ca

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22
Q

Describe Cowden’s syndrome

A

Multiple hamartomas

Thyroid and breast Ca

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23
Q

Describe pathogenesis of acne

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A

Keratin build up in hair follicle
Increased sebum production and thickness - sebaceous glands
Propionibacterium acnes proliferation

24
Q

What are the clinical features of acne

Study These Flashcards
A

Papules
Pustules
Comedones

25
What type of acne is a dermatological emergency?
Acne fulminans
26
Describe acne inversus
Papules Pustules Cysts Affects groin/buttocks
27
How is acne graded?
Leeds Acne Grading System
28
What is first line therapy for reducing the plugging of the hair follicle in acne management?
Topical benzoly peroxide
29
What Abx can be used to reduced the amount of bacteria in acne treatment?
Topical Abx = erythromycin/clindamycin | Oral Abs = tetracyclines, erythromycin
30
What can be used to reduce sebum production in acne management?
Anti-androgens OCP
31
What can be used in the management of severe acne vulgaris?
``` Oral Isotretinion Oral retinoid (concentrated form of Vit A) ```
32
How does oral risotretinoin help with the management of severe acne vulgaris?
Reduces sebum production Reduces plugging of hair follicle Reduces bacteria load
33
How long is the standard course of oral isotretinoin?
16 weeks (1mg/kg)
34
What is the major side effect associated with oral isotretinoin?
Teratogenicity (every girl must be on OCP and have monthly pregnancy tests)
35
Side effects associated with oral isotretinoin
``` Trivial: Dry lips Nose bleeds Dry skin Myalgia ``` ``` Serious: Deranged LFTs Raised lipids Mood disturbances Teratogenicity ```
36
What are three triggers of vasculitis?
Infection Drugs Connective tissue disease
37
Describe fixed drug rash
Rash that occurs in the same area every time the same drug is used
38
Describe drug induced psoriasiform rash
Psoriasis-like Well demarcated erythema with scale Sudden onset, no FHx
39
What drugs are associated with a fixed drug rash?
Paracetamol
40
What drugs are associated with a drug induced psoriasiform rash?
Lithium | Beta-blockers
41
Give 2 examples of drug induced blistering disorders
Steven Johnson Syndrome | Toxic Epidermal Necrolysis
42
Give 2 examples of immunobullous diseases
Bullous pemphigoid | Bullous pemphigus
43
Describe the management of Toxic Epidermal Necrolysis
``` Dermatology, ITU, burns involvement Analgesia Fluid balance Special mattress, sheets Infection control, prophylaxis Non-adherent dressings Requires urological, gynaecologist and ophthalmological input ```
44
Describe erythema multiform
Self-limiting allergic reaction Target lesions Associated with HSV, EBV, occasionally drug
45
Describe bullous pemphigoid
Splits at basal layer | Distinct intact blister
46
Describe pemphigus vulgaris
Split is scattered through the epidermis | Don't have an intact blister
47
Describe the management of an immunobullous disorder
``` Oral steroids (reduce autoimmune reaction) Steroid sparing agents - aziathioprine Burst any blisters Dressings and infection control Check for oral/mucosal involvement Screen for underlying malignancy ```
48
What is dermatitis herpetiformis associated with?
Coeliac disease
49
How can dermatitis herpetiformis be treated?
Topical steroids Gluten free diet Oral dapsone
50
Describe urticaria
Itchy wheals Last <24 hours Non-scarring Can be acute/chronic (<6 weeks/>6weeks)
51
What are potential causes of urticaria?
Immune related - type I IgE response Non-immune mediated - Direct mass cell degranulation Opiates, Abx, contrast media, NSAIDs
52
What treatment can be used in urticaria?
Antihistamines Steroids Immunosuppression Omiluzimab
53
What are potential causes of acute urticaria?
``` Unknown Viral infections Medication - NSAIDs, aspirin, ACEi Food and food additives Parasitic infections Physical stimulants - cold, pressure, solar, cholinergic, aquagenic ```
54
Define erythroderma
Erythema affecting 80-90% of body
55
What are potential causes of erythroderma?
Psorasis Eczema Drug reaction Cutaneous lymphoma
56
How can erythroderma be managed?
Treat underlying skin disorder Supportive Fluid/temperature balance

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