1. Jim > Derm > Flashcards

Derm Flashcards

(58 cards)

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1
Q

Jock itch?

A

Tinea Cruris (most common cause is T.rubrum)

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2
Q

DDx for inflammatory skin condition (7)

A
  • Atopic dermatitis (ECZEMA)
  • Discoid eczema
  • Contact dermatitis
  • Chronic plaque psoriasis
  • Guttate psoriasis
  • Lichen Planus
  • Pityriasis Rosea
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3
Q
A

Flexural Psoriasis (axillary)
- Often colonised with candida
- note no central sparing/changes as in fungal

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4
Q

Psoriasis features of management
5 + 5

A
  1. Advice - avoid triggers, etoh, smoking, obesity
  2. Emollients
  3. Topical steroids
  4. Topical Vit D analogue (calcipotriol)
  5. Coal Tar solution

Refer to Derm for:
1. UVB
2. MTX
3. Acicretin
4. ciclosporin
5. biologics

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5
Q

Treatments of tinea infections

A

Tinea capitis + onychomycosis
- Oral terbinafine 250mg OD for 12wks
Tinea corporis/cruris/pedis
- Topical Terbinafine 1% 1-2wks

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6
Q

Treatment for Melasma - 3 pharma + 2 non pharma

A
  1. Topical hydroquinone 2%
  2. Topical tretinoin nocte
    3 Topical Kligmans formula ( hydroquinone + tretinoin + dexamethasone), twice daily, for 3-4weeks (ideally in winter)
  3. Strict sun protection with zinc oxide
  4. Cease COCP (hormonal trigger)
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7
Q

DDx of pruritic erythematous plaque (5)

A
  1. Flexural psoriasis
  2. Candidal intertrigo (+ pustules, +- foul smelling)
  3. Irritant contact dermatitis (vesication or bullae, painful)
  4. Seborrhoeic dermatitis (yellow scales)
  5. Erythrasma (brown macules, minimally itchy)
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8
Q

Features of melasma

A
  • Brown to dark brown facial hyperpigmentation
  • predominantly in reproductive aged women of colour
  • NOT PRURITIC
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9
Q

DDx of melasma (facial hyperpigmentation)

A
  • Post- inflammatory hyperpigmentation
  • Drug-induced hyperpigmentation
  • Actinic lichen planus
  • Exogenous ochronosis (2ndry to hydroquinone use)
  • discoid lupus erythematosus
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10
Q

Pityriasis rosea treatment

A

1 - Reassure no specific treatment required, slef limiting in 6-8wks
2. severe itch can be treated with betamethasone valerate 0.02% topically, OD-BD

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11
Q

intermittent rash on face. No itch, burning or pain. Worsens in winter and with stress

A

Seborrheic dermatitis
- Unclear cause, malassezia often thought to contribute
- Different treatments depends on area
- Scalp - shampoo daily -> anti-yeast shampoo twice weekly -> add topical steroid
- Face/flexural/scrotal - hydrocort 1% + clotrim 1% OD-BD until clear/2wks

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12
Q

Management of pinworm

A

Family hygiene
- Hands washed after toilet and before food
- Short fingernails
- Wear pajamas and shower each morning
Pharma for pt and household contacts - pyrantel single dose +Rpt in 2-3wks

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13
Q

23yo M, lesion on calf, unclear how long, frequent sun exposure. Uniform, dimples on pinching

A

Dermatofibroma
- benign
- often on lower legs
- solitary firm papule
- overlying skin dimples on pinching
- pink-light brown in white skin, dark brown-black in dark skin
- some appear paler in centre

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14
Q

68F, lesion on right arm, noticed a few months ago, but has rapidly expanded. Not painful or itchy
What is it?

A

Keratocanthoma
- variant of SCC
- cant be reliably distinguished, so surgical treatment
- often starts as pimple like lesion with more solid core
- then grows quickly

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15
Q

15yo, rapid onset rash. Otherwise well, IUTD, no sick contacts. Rash over torso and proximal limbs

A

Guttate Psoriasis
- most frequently Dx adolescents +young adults
- not fully understood relationship to post streptococcal infection
- unpredictable course, may remit over several wks-moths, may progress to chronic plaque psoriasis

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16
Q

4yo, 2/7 of fever, sorethroat and vomiting. Followed by rash appeared at neck, then spread, most prominent in skin folds, absenst from her face/palm/soles

A

Scarlet fever (streptococcus pyogenes)

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17
Q

Common triggers/factors that exacerbate psoriasis? (6)

A
  1. Obesity
  2. Smoking
  3. ETOH
  4. NSAID (ACE-I, b-blockers, Lithium)
  5. Stress
  6. Infections (Strep + viral)
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18
Q

Topical agents for psoriasis based on location (4)

A
  1. Scalp = steroid lotion (advantan)
  2. Trunk/limbs/palms = LPC+salicylic acid
  3. Nails - Daivobet ointment nocte
  4. Flexural + face - Advantan fatty ointment + avoid calcipotriol OR salicylic acid
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19
Q

Sweaty stinky feet, look like this. What is it and 2x treatment options

A

Pitted Keratolysis
1st line - Topical clindamycin BD for 10 days
2nd line - multiple. Can trial high concentration antiperspirants (15% aluminium chloride)

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20
Q

Differential causes for this painful nodular rash (7)

A

Erythema Nodosum
1. Idiopathic
2. Sarcoidosis
3. Infections - Strep, TB, chlamydia, more
4. Crohns
5. Medications - COCP, tetracyclines, sulphonamides
6. Malignancy
7. Pregnancy

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21
Q
A

Spa folliculitis - caused by pseudomonas
Usually self limiting
Rx with Ciprofloxacin

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22
Q

Recent UTI, had recurrence of rash had couple of months ago.
?Diagnosis ?common triggers (1/3/3)

A

Fixed drug reaction
Triggers
- NSAIDs
- ABx: Sulfonamides, tetracyclines, penicillin
- AEDs: Phenobarbital, lamotrigine, phenytoin

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23
Q

KFP: Non pharma management advice for pt with melanoma (5)

A
  1. Advise regular skin + LN check by doctor every 3-12months
  2. Advise regular self skin-check every 3months
  3. Advise regarding sun protection (sunscreen)
  4. Advise regarding suspicious skin lesions
  5. Advise return for review if notices any worrying lesions
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24
Q

40F presents with pain localising to toes bilaterally. Feel numb + burning, especially during colder months. Cool but normal pulses. Dx + Mx (3)

Study These Flashcards
A
  1. Topical Elocon ointment
  2. Vasodilation - topical GTN OR nifedipine CR
  3. Wear thick warm socks
25
DDx for ulcerated genital lesions in young person (5)
1. Genital Herpes 2. Apthous ulcers 3. Allergic OR contact dermatitis 4. Self harm/exocriation related/trauma related 5. Molluscum contagiosum (~~)
26
Pharmacological Rx of acute Genital herpes (2)
Oral valciclovir 500mg BD for 5-10days Topical lignocaine gel PRN
27
12yo with this on back of arms, wants treatment?
Keratosis Pillaris Rx with 10% Urea cream, OD
28
KFP: DDx for this skin lesion - useful for any non pigmented growth (4)
1. SCC (or keratocanthoma) 2. Amelanotic melanoma 3. BCC 4. Atypical fibroxanthoma (head+neck)
29
Non pharma management of acne (4)
1. Mild non soap cleanser once daily 2. Use non comedogenic cosmetics+sunscreens 3. Refrain from picking or squeezing pimples 4. Avoid hot+humid environments
30
39F with rash on her wrist over last 2months, often very itchy?
Lichen Planus Rx with potent topical steroid
31
57M had this intensely itch rash on his body. Seems to be worse when he sweats
Grovers Disease (transient anantholytic dermatosis) - unclear cause, commonly mistaken for heat rash - last for months to years - Rx with potent steroid (antroquoril)
32
Spot diagnosis and association
Acanthosis nigricans - insulin resistance assoc with obesity
33
Rx of mild recurrences of oral HSV (2)
1. Topical aciclovir 5x/day for 5/7 2. oral famciclovir stat dose
34
Rx of initial episode oral HSV (non severe) (2) + Severe (1)
1. Topical difflam Q2-3H 2. Topical lignocaine viscous Severe - oral famciclovir BD for 7/7
35
Supressive therapy for recurrent oral HSV (1)
1. Valciclovir OD for 6/12 then review
36
Common triggers of this (4)
Target lesion = Erythema multiforme Triggers: 1. Infections (HSV) 2. Medications (NSAIDs, AEDs, Abx) 3. Inflammatory Bowel disease 4. Leukaemia/lymphoma/solid organ cancer
37
General dermatological exam findings that confer higher risk? (5)
1. >5+ atypical naevi 2. >50 naevi in total 3. Naevi >5cm 4. Fitzpatrick skin type I or II 5. Evidence of actinic skin damage
38
Pharm Mx of peri-orificial dermatitis (4)
NB: Same as rosacea 1st line - Ivermectin cream OD 2nd line - topical metronidazole OD-BD Then orals oral doxy OD for 3-8wks if doxy CI - oral erythromycin BD
39
Spot Dx of these 2
Superficial BCC - could be slow growing but likely given hx such as - slow growing, not responding to treatment, RFs for skin cancer
40
Treatment options for superficial BCC (3)
1. Excision with 3-5mm margins 2. Imiquimod cream - 3-5x/week for 6-16wks 3. Cryotherapy with double freeze-thaw Others - photodynamic therapy, referral to plastics
41
pharma treatment for oral candidiasis (1)
Miconazole 2% gel QID (1st line option for both adults + <2yo)
42
Risk factors for melanoma (5Hx + 3Ex)
1. Unprotected UV exposure 2. Hx short intense sun exposure/burns 3. Immunosupression 4. FHx of melanoma in 1st degree relative 5. PMHx of melanoma (or non-melanocytic skin cancer) Examination: 1. Fitzpatrick 1/2 - light fair hair, blue/green eye colour 2. >50 naevi 3. >5+ atypical/dysplastic naevi
43
Skin lesion on older individuals face
Lentigo maligna (an in-situ melanoma) - mostly on severely sun damaged skin - mainly older patients
44
Spot diagnosis
Acral lentiginous melanoma - most common melanoma in dark skin types - palms, soles or nail bed
45
Itchy vesicles on elbows, knees, and lumbosacral area - Dx to consider?
Dermatitis Herpetiformis Associated with coeliacs
46
Young kid with this. Dx + Mx (3)
Pityriasis alba - mild form of dermatitis in which post inflammatory hypopigmentation is marked - - - - less clear borders, differentiates from vitiligo Mx - use soap substitues - emollient BD - HC 1% if itch
47
Itchy painful toes after exposed to cold. No clear pattern - Rx (4)
1. Warm gradually with socks/blankets 2. Potent steroid BD (advantan) 3. If recurrent - GTN ointment 4. Nifedipine CR OD - for recurrent + severe
48
Differentiating seborrhoiec dermatitis on face, from rosacea (4)
1. Rosacea triggered by heat, seb derm more often in winter 2. Rosacea has sterile acneiform papules/pustules, seb derm doesn't 3. Age - Rosacea rare <25 4. Location - Rosacea just face, seb derm can affect other sites Rosacea - old, hot and angry Seb derm - young dry + flaky
49
Tinea infections that warrant oral Rx (5)
1. Onychomycosis 2. Tinea capitis 3. Extensive skin involvement 4. Failed topical treatment 5. Immunosupressed
50
DDx for vesicular rash (5)
1. HSV 2. Shingles/varicella zoster 3. Chickenpox 4. Dermatitis Herpetiformis 5. Pompholyx
51
DDx for intertrigo (6)
1. Contact irritant dermatitis 2. Thrush - candida intertrigo, quick developing, satellites 3. Tinea - slowly spread, irregular annular plaques 4. Flexural psoriasis - well defined, smooth shiny red, symmetrical 5. Seborrhoiec dermatitis - often unnoticed, ill defined salmon pink 6. Erythrasma - Asx brown patches
52
Topical treatment option for HPV wart (2)
1. Warticon cream BD for 3days/week for 4-6wks (podophullotoxin) 2. Imiquimod 3x/week at bedtime until resolution
53
Dx + Treatment
Cervical ectropion - no treatment required
54
Histo back on suspected melanoma, when to refer (3)
1. >1mm thick 2. >0.75mm thick + high risk features (ulceration, clark 4/5, invasion) 3. Unable to excise yourself with appropriate margins Essentially ends up as all but in-situ
55
Treatment of Genital HSV - first episode + episodes
Initial - oral aciclovir TDS for 10/7 Episodes - oral aciclovir TDS for 2/7
56
Treatment of headlice 1+2pharma
1. Wet combing + Pharma: 1st line: benzyl alcohol lotion topically for 10mins, rpt at 7 + 14 days 2nd line: oral ivermectin single dose, rpt at 7 days
57
Dx
Fibroepithelial polyp
58
Combination of painful mouth ulcers, genital ulcers, eye problems and skin lesions
Behcet disease
1. Jim
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