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dermatology > Skin Signs Of Systemic Disease > Flashcards

Skin Signs Of Systemic Disease Flashcards

1
Q

What is a leg ulcer

A

Open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks

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2
Q

What is the most common cause of leg ulceration

A

Venous blood stasis

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3
Q

What causes arterial ulcers

A

Insufficient blood supply due to peripheral vascular disease

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4
Q

What causes venous ulceration

A

Increased hydrostatic pressure in the vessels

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5
Q

Where do the majority of venous ulcers occur

A

The gaiter area

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6
Q

Describe venous ulcers

A

Shallow exudative and warm

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7
Q

Give some signs of venous insufficiency

A

Ankle swelling
Varicose veins
Haemosiderin deposition
Venous eczema
Lipodermatosclerosis

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8
Q

What is lipodermatosclerosis

A

Inflammation and fibrosis of the subcutaneous fat layer, usually in the lower legs

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9
Q

How does lipodermatosclerosis present

A

Woody texture, skin appears hardened and reddish-brown

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10
Q

Where do arterial ulcers tend to affect

A

The foot

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11
Q

Presentation of arterial ulcers

A

Punched-out appearance, cold, white and shiny skin

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12
Q

Clinical signs or PAD

A

Absent peripheral pulses, delayed capillary refill, intermittent claudication

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13
Q

Investigations for leg ulcers

A

ABPI for arterial
Bloods
Patch testing for treatments
Biopsy to check for malignancy

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14
Q

Management of arterial ulcers

A

Managed by reducing modifiable risk factors

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15
Q

Management of venous ulcers

A

Compression stockings + elevation
De-sloughing if necessary
Control pain

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16
Q

Complications of leg ulceration

A

Infection
Contact allergy to dressings and topicals
Malignant transformation

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17
Q

What is epidermolysis bullosa

A

A group of inherited disorders with blister formation in response to mechanical trauma

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18
Q

What are the 3 main types of epidermolysis bullosa

A

Simplex, Junctional and dystrophic

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19
Q

Investigations for epidermolysis bullosa

A

Skin biopsy

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20
Q

Management of epidermolysis bullosa

A

Mainly supportive

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21
Q

Clinical presentation of epidermolysis bullosa

A

Skin blisters and erosions

22
Q

What is neurofibromatosis type 1

A

A genetic condition that causes tumours along the nervous system

23
Q

Inheritance in neurofibromatosis type 1

A

Autosomal dominant

24
Q

What causes neurofibromatosis type 1

A

Mutations in the NF1 gene

25
Q

Main clinical sign of neurofibromatosis type 1

A

Cafe au lait macules

26
Q

Other clinical signs of neurofibromatosis type 1

A

Plexiform neuroma, axillary or inguinal freckling, 2 or more lisch nodules

27
Q

What mediates a type 1 allergic reaction

A

IgE

28
Q

Routes of exposure that cause a type 1 allergic reaction

A

Skin contact, inhalation, ingestion and injection

29
Q

Sensitisation stage of a type 1 allergy

A

Production of IgE by B cells in response to an initial allergen exposure
Residual antibodies mind to circulating mast cells by Fc receptors

30
Q

Allergic stage of a type 1 allergy

A

On re-exposure, allergen will bind to IgE coated mast cells, causing degranulation of histamine etc.

31
Q

Clinical presentation of type 1 allergy

A

Urticaria, angioedema, wheezing, anaphylaxis

32
Q

What are other names for urticaria

A

Hives, wheals, nettle rash

33
Q

What is urticaria

A

Very itchy lesions which appear with 1 hour of interaction with an allergen

34
Q

What is angioedema

A

Localised swelling of subcutaneous tissue or mucous membranes

35
Q

Is angioedema pitting or non-pitting

A

Non-pitting

36
Q

What investigations confirms anaphylaxis

A

Serum mast cell tryptase level

37
Q

Testing for a type 1 allergy

A

Specific IgE bloodwork
Prick testing
Challenge test

38
Q

What is used to manage anaphylaxis

A

Adrenaline autotinjector

39
Q

What can be used to help asthma in patients with allergies

A

Mast cell stabiliser

40
Q

Name one mast cell stabiliser

A

Sodium cromoglycate

41
Q

Long term management of a type 1 allergy

A

Avoidance
Antihistamines as first line
Corticosteroids as second line

42
Q

3 step plan for an acute allergic reaction

A

Chrophenamine at first sign of reaction
Prednisolone if no resolution
Adrenaline IV if symptoms get worse: become blue or collapse

43
Q

What is the inheritance in tuberous sclerosis

A

Autosomal dominant

44
Q

How is tuberous sclerosis characterised

A

By a range of benign tumours in various organ systems

45
Q

Earliest cutaneous signs of tuberous sclerosis

A

Ash leaf macules

46
Q

What are ash leaf macules

A

Depigmented macules

47
Q

Other clinical signs of tuberous sclerosis

A

Shargreen patches and enamel pitting

48
Q

How may an infant present with tuberous sclerosis

A

Seizures

49
Q

Tumours seen in tuberous sclerosis

A

Periungual fibromas
Facial angiofibromas
Hamartomas/angiomyolipomas
Bone cysts

50
Q

What are periungual fibromas

A

Benign tumours around the nail

dermatology (13 decks)

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