Spotter Flashcards
(119 cards)
1
Q
Dx? [1]
Tx? [1]
A
Actinic keratoses
- hyperkeratotic papules on a background of sun-damaged skin
Topical fluorouracil:
- Actinic keratoses are premalignant skin lesions and therefore, often require treatment to prevent any further malignant changes.
2
Q
A
Lentigo maligna
The asymmetrical nature of the lesion would however point away from a diagnosis of solar lentigo. These patients should be referred to dermatology
3
Q
How do you differentiate between solar lengtio and lentigo maligna? [2]
A
Solar lentigo - Usually well circumscribed and can appear in clusters in sun-exposed areas, such as the face or the back of the hands/forearm
Lentigo Maligna - Slow growing, often large, Irregular borders, variable pigmentation - characteristics you would associate with a melanoma
4
Q
A
Solar lentigo
5
Q
Describe this [1]
What is the cause? [1]
A
Filiform wart (viral wart)
6
Q
A
pityriasis versicolor
7
Q
A
8
Q
PMH: DM
A
Granuloma annulare
9
Q
PMH: microtrauma at site
Dx? [1]
A
Pyogenic granuloma
10
Q
Dx? [1]
A
Lichen planus
11
Q
Dx? [1]
A
Discoid eczema
12
Q
Desribe this [1]
Dx? [1]
A
Vesicles in crops
HSV-1
13
Q
Dx? [1]
A
Herpatic whitlow
14
Q
Which antibodies are
A
Bullous pemphigoid
15
Q
Singular bullae
A
Insect bite - often caused by gram +ve bacteria
16
Q
Name three drugs that can cause this skin change [3]
A
Erythema multiforme:
* penicillin
* sulphonamides
* carbamazepine
* allopurinol
* NSAIDs
* oral contraceptive pill
* nevirapine
17
Q
A
Nodular prurigo
18
Q
A
BCC
19
Q
Dx [1]
A
condrodermative helicis nodularis
20
Q
A
hidradenitis suppurativa
21
Q
PMH: tonsilitis
Dx? [1]
A
Guttate psoriasis
22
Q
A
PR
23
Q
A
Mongolian blue spot
Some dermal nests of melanocytes haven’t migrated to epidermis - when they’re deep in the dermis they look blue
24
Q
Describe this distribution [1]
A
BLASKOID distribution
25
Describe this [1]
**Open comedomes** (black heads)
26
What further test should you perform for this person? [1]
**HIV**
Dx: seborrheic dermatitis
27
Dx? [1]
**Bed bugs**
Breakfast lunch dinner distribution
28
Dx? [1]
**Palmoplantar pustulosis** is an uncommon chronic pustular condition affecting the palms and soles. It is also called pustulosis palmaris et plantaris. It is related to a common skin condition, psoriasis.
29
First line treatment? [1]
**Topical fluorouracil cream**
| Dx: acitinic keratosis
30
31
*Slow growing; asymptomatic*
Dx? [1]
Main DDx? [1]
Dx:
**Lentigo maligna** is a type of melanoma in-situ. It typically progresses slowly but may at some stage become invasive causing lentigo maligna melanoma.
- The **asymmetrical** nature of the lesion would however point away from a diagnosis of solar lentigo.
DDx:
- **Solar lentigo**
32
Keratoacanthoma
Seborrhoeic keratoses
Actinic keratosis
Basal cell carcinoma
Pyoderma gangrenosum
**Keratoacanthoma**
Seborrhoeic keratoses
Actinic keratosis
Basal cell carcinoma
Pyoderma gangrenosum
33
Tx? [1]
ketoconazole shampoo
## Footnote
**Pityriasis versicolor**
34
*7 year old girl; itchy*
Dx? [1]
Main DDx? [1]
**Tinea capitis** - area without hair often have pustular, boggy masses which appear as numerous bright yellow areas with the skin surface surrounded by regions of hair loss and flakiness.
DDx: **Alopecia areata** - areas without hair are clear
35
Early treatment for this presentation? [1]
early keloids may be treated with **intra-lesional steroids e.g. triamcinolone**
36
Dx? [1]
Risk factors? [2]
**Pompholyx** is a type of **eczema** which affects both the hands (cheiropompholyx) and the feet (pedopompholyx). It is also known as dyshidrotic eczema.
Pompholyx eczema may be precipitated by **humidity** (e.g. **sweating**) and **high** **temperatures**.
37
Given the likely diagnosis, what needs to be screened for in this patient? [1]
Shingles is a disease caused by the reactivation of the varicella zoster virus, which lies dormant in nerve ganglia following primary infection (chickenpox). Shingles typically occurs in the elderly population; if shingles occurs in young adults (or children in this case), it is important to screen for immunological issues.
38
Dx? [1]
Risk factors? [1]
typical **erythema ab igne** rash.
- over exposure to infrared radiation (e.g. hot water bottle)
39
Dx? [1]
Causative organism? [1]
**Athlete's foot** is also known as **tinea pedis.**
- It is usually caused by fungi in the genus **Trichophyton**.
40
slow-growing; often occur on sun-exposed areas such as the head
Dx? [1]
**Bowen's disease**
## Footnote
**NB**: precursor to squamous cell carcinoma.
41
**Dx [1]**
**Acute Eczema**
* Acute flare ups can vary from vesicles to areas of poorly demarcated redness
| Just because theres no scale doesn't mean not eczema
42
**Rhinophymatous rosacea**
43
Bullous pemphigoid
44
**Cherry haemangiomas (Campbell de Morgan spots)**
45
Dermatitis herpetiformis.
46
Dx? [1]
How does this typically present? [2]
**Eczema herpeticum**
- Eczema herpeticum describes a severe primary infection of the skin by herpes simplex virus 1 or 2.
- **rapidly progressing painful rash**
- monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameter are typically seen.
## Footnote
Clinical emergency - should be admitted
47
Dx [1] and Tx? [1]
**Erysipelas** - **flucoxacillin**
48
Causative agent? [1]
Erysipelas is localised skin infection caused by **Streptococcus pyogenes**.
49
Dx? [1]
What is a typical history? [1]
**Erythema ab igne** is a skin disorder caused by over exposure to **infrared radiation**
A typical history would be an **elderly women who always sits next to an open fire.**
50
Name and description? [1]
**Erythema multiforme**
- Erythema multiforme is a **hypersensitivity** **reaction** that is most commonly triggered by **infections**. It may be divided into minor and major forms.
51
Dx? [1]
**Seborrhoeic keratoses**
52
Dx? [1]
- caused by an overgrowth of the **diphtheroid []**
**Erythrasma**
- generally asymptomatic, flat, slightly scaly, pink or brown rash usually found in the groin or axillae. It is caused by an overgrowth of the **diphtheroid Corynebacterium minutissimum**
## Footnote
**NB**: The brown or brick-red color may appear similar to acanthosis nigricans, but there is no velvety thickening of the skin with erythrasma.
53
What staining is being used? [1]
Dx? [1]
Tx? [1]
**Erythrasma**:
* coral-red fluorescence
* Treat with topical miconazole
54
Dx? [1]
*Streptococcal 2 weeks prior*
**Guttate psoriasis**
55
**Hidradenitis suppurativa**
56
Dx? [1]
Tx? [3]
**Impetigo** - Staphylcoccus aureus or Streptococcus pyogenes
Tx:
- **Hydrogen peroxide 1% cream** for 'people who are not systemically unwell or at a high risk of complications'
- topical antibiotic creams: **topical fusidic acid**; **topical mupirocin** should be used if fusidic acid resistance is suspected
- Extensive disease: **oral flucloxacillin**; **oral erythromycin** if penicillin-allergic
57
**keloid scar** at the site of abdominal surgery.
58
Slow growing
Dx? [1]
**Lentigo maligna**
59
Leukoplakia
60
**Lichen planus** - pruritic eruption on the shins
61
**Livedo reticularis**
- Livedo reticularis describes an purplish, non-blanching, reticulated rash caused by obstruction of the capillaries resulting in swollen venules.
62
**Milia** are small, benign, keratin-filled cysts that typically appear around the face. They may appear at any age but are more common in newborns.
63
(not eczema or psoriasis)
**Mycosis fungoides**:
- Mycosis fungoides is a **rare form of T-cell lymphoma that affects the skin.**
- Proper differentation is by **biospy**
64
Dx is via what type of test? [1]
What type of HS? [1]
**Skin p4tch test - HS4**
65
**Pemphigus vulgaris**
66
**Periorificial dermatitis**
67
**Pityriasis rosea**
On the left a typical herald patch is seen. After a few days a more generalised 'fir-tree' rash appears
68
Targetoid lesions: **erythema multiforme**
69
SJS
70
DH:
- Allopurinol
SJS
71
TEN
72
children < 5 yrs
Staphylococcal Scalded Skin Syndrome (SSSS)
73
First line treatment? (if mild)
**Topical hydrogen peroxide**
74
Dx? [1]
Main DDX? [1]
**Folliculitis**
DDx: **acne vulgaris**
75
**Perioral Dermatitis**
76
**Acne conglobate**
77
Acne fulminans
78
**Acne conglobate**
79
Rosacea
80
Folliculitis decalvans
81
Tinea corporis of the axilla
82
pityriasis rosea
83
**Pityriasis versicolor**
84
**Pyogenic granuloma**
85
What is the blue arrow pointing at? [1]
What is this pathognomonic for? [1]
**Wickham striae**
- pathognomonic for **Lichen Planus**
86
**Porphyria cutanea tarda (PCT)** is a rare disorder characterized by painful, blistering skin lesions that develop on sun-exposed skin (photosensitivity).
87
PV
88
What is the first line treatment for this? [1]
**Erythromycin** is the oral antibiotic of choice to treat **erythrasma**
89
Dx? [1]
Key RF? [1]
**Pyogenic** **granuloma**
- commonly occur at the site of a minor injury such as a splinter.
90
Name this [1]
How do you differentiate from pyogenic granuloma? [1]
**amelanotic melanoma**
- occurs **spontaneously**, no hx of trauma
- More common in elderly
**Pyogenic granuloma**
- occurs after trauma
91
excessive osteoclastic resorption followed by increased osteoblastic activity
92
Name? [1]
Circinate balantis
93
Dx? [1]
Lichen sclerosus
94
Dx? [1]
Cherry **Hemangioma**
95
Seborrhea
96
Infantile eczema.
97
**Sebaceous hyperplasia**. Numerous tiny yellow-white papules on this infant’s nose will gradually fade without treatment.
98
**Nevus flammeus** (port-wine stain).
99
**salmon patch**
100
101
A patient is stung by a bee.
They present are extremely itchy and present with the following rash.
What medication would you give first and second line? [2]
non-sedating antihistamines (e.g. **loratadine or cetirizine**) are first-line
**prednisolone** is used for severe or resistant episodes
102
PMH:
- Multiple sunburns
Dx? [1]
Tx? [1]
**Bowens disease** - treat with **topical 5-fluorouracil**
103
Recurrent epistaxis (nosebleeds) are a common symptom of this patient.
Dx? [1]
**Hereditary haemorrhagic telangiectasia**
104
105
This skin condition is though to occur as a result of a reaction to which species? [1]
Seborrhoeic dermatitis - an inflammatory reaction to **Malassezia furfur**
106
Dx? [1]
**Basal cell carcinoma**
107
Ptx with PCOS.
1st line Tx? [1]
**Topical eflornithine** is the treatment of choice for facial hirsutism
108
Dx? [1]
Risk factor? [1]
**Actinic keratoses**
- common premalignant skin lesion that develops as a consequence of chronic sun exposure
109
110
Dx? [1]
**seborrhoeic keratosis**
111
What is the most appropriate treatment option for this patient?
**Topical betamethasone valerate 0.1%**
112
**oral prednisolone**
113
Acne **rosacea**
114
Painless ulcer. Dx? [1]
**SCC** - rapidly expanding painless, ulcerate nodules
Don't be fooled into thinking this is a basal cell carcinoma (BCC) by the presence of telangiectasia near the lesion. With BCC's these are generally found on the rolled edges of the lesion rather than being scattered around the periphery.
115
**Seborrhoeic keratosis.**
116
**Malassezia furfur** - pityriasis versicolor.
117
**nodular Basal Cell Carcinoma**
118
Tx? [2]
**Lichen planus with oral involvement**
- potent topical steroids, with benzydamine being used for oral involvement.
119
Tx? [1]
Topical potent corticosteroids
