DERM TABLE Flashcards by . .

What is Acne Vulgaris?

A skin condition characterized by the blockage of the pilosebaceous unit (PSU) leading to comedones, inflammation, and pustules.

Acne Vulgaris is the most common form of acne.

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What components make up the pilosebaceous unit (PSU)?

Hair follicle and sebaceous gland.

Sebaceous glands produce sebum, which lubricates hair and skin.

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What causes the formation of comedones in acne?

Clogging of hair follicles with sebum and dead skin cells.

Comedones are a primary feature of acne.

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What are the two types of comedones?

Open (blackhead) - clogged pore remains open
Closed (whitehead) - clogged pore covered by skin

Blackheads appear black due to oxidation of debris inside.

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What is a papule?

A small raised solid lesion less than 1 cm in size.

Papules can be a result of inflamed comedones.

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What is a pustule?

A small pus-filled lesion less than 1 cm in size.

Pustules are typically superficial in nature.

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What are the treatment options for mild to moderate acne?

Benzoyl peroxide (BPO)
Clindamycin
Erythromycin
Trimethoprim (in pregnant/breastfeeding)
Retinoids (Adapalene/Tretinoin)
COCP for women as alternative to antibiotics

Combination creams like DUAC (BPO and clindamycin) can also be used.

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What is Isotretinoin used for?

Treatment for severe acne, including nodules, cysts, and scarring.

Isotretinoin requires monitoring due to potential side effects.

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What is acne fulminans?

A severe form of acne characterized by sudden eruptions and systemic illness, treated with oral steroids and low-dose isotretinoin.

Acne fulminans is rare and requires immediate medical attention.

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What are the side effects of Isotretinoin?

Dry skin, mouth, eyes, lips
Low mood
Hair thinning
Intracranial hypertension
Nose bleeds
Photosensitivity
Teratogenic effects

Women must avoid pregnancy while on Isotretinoin due to its teratogenic effects.

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What is Acne Rosacea?

A skin condition characterized by facial flushing, redness, and visible blood vessels, primarily affecting women aged 30-60 with fair skin.

Triggers include sun exposure, stress, and certain foods.

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What is vitiligo?

An autoimmune condition resulting in the loss of melanocytes, leading to white patches on the skin.

It often affects the peripheries and can be associated with other autoimmune diseases.

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What characterizes psoriasis?

A chronic autoimmune inflammatory disorder with abnormal T-cell activity leading to scaly red patches.

Psoriasis is exacerbated by stress and certain infections.

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What is the Koebner phenomenon?

The appearance of new skin lesions on previously healthy skin following injury.

It is associated with conditions like psoriasis and vitiligo.

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What is dermatitis herpetiformis?

An autoimmune condition linked to gluten sensitivity, characterized by intense itching and blistering rash.

It typically resolves with a gluten-free diet.

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What is the primary treatment for bullous pemphigoid?

Systemic oral steroids until no new lesions develop for a year.

Topical steroids may be used at onset.

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What is the difference between bullous pemphigoid and bullous pemphigus vulgaris?

Bullous pemphigoid has tense blisters and spares mucous membranes, while bullous pemphigus vulgaris has flaccid, fragile blisters and may involve mucous membranes.

Nikolsky’s sign is positive in pemphigus vulgaris.

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What is erythema nodosum?

A hypersensitivity reaction causing tender, erythematous nodules on the shins.

It is often idiopathic or associated with conditions like sarcoidosis and IBD.

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What is atopic dermatitis?

A chronic inflammatory skin disorder characterized by itching, erythema, and dryness.

It often presents in childhood and is associated with asthma and allergic conditions.

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What is the first line treatment for mild eczema?

Liberal emollient usage and mild corticosteroids (e.g., hydrocortisone).

Emollients should always accompany corticosteroids.

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What is contact dermatitis?

Inflammation of the skin due to contact with irritants or allergens.

It can be classified as allergic or irritant contact dermatitis.

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What triggers urticaria?

IgE response to allergens such as food, medication, or insect stings.

Urticaria presents as raised itchy welts that can appear and disappear quickly.

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What is Steven Johnson syndrome?

A rare, life-threatening hypersensitivity reaction characterized by severe skin and mucous membrane blistering.

It is often triggered by medications and can present with flu-like symptoms initially.

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What medication is often used for trigeminal neuralgia?

Carbamazepine

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What are common triggers for certain skin reactions?

Medication, viruses, bacterial infections

What symptoms can appear within a week of medication intake?

Flu-like symptoms

What are the initial symptoms of a flu-like prodrome?

Sore throat, cold, fever

What type of skin changes follow the initial flu-like symptoms?

Erythematous macules/skin changes

What kind of skin rash can develop from these symptoms?

Red or purple skin rash that develops into blisters

What is a positive Nikolsky sign?

Peeling of skin when touched

What are painful ulcers in mucosal areas indicative of?

Mucosal ulceration in at least 2 areas (mouth, conjunctiva, urethra, pharynx)

What does a skin biopsy show in severe skin reactions?

Necrotic keratinocytes and sparse lymphocyte infiltrate

What percentage of body surface involvement is considered significant in these conditions?

10% of body surface

What is a major complication of these skin reactions?

Dehydration

What treatments may be used for severe skin reactions?

IV Fluid, electrolyte management, IV steroid, IVIG

Name a group of drugs that can cause severe skin reactions.

*Sulfonamides *Beta-lactams (penicillins and cephalosporins) *Antiepileptics (e.g., phenytoin, carbamazepine) *Allopurinol *NSAIDs *Rifampin *Bactrim (sulfamethoxazole/trimethoprim)

What is toxic epidermal necrolysis?

A life-threatening skin disorder most commonly due to drug reactions

What characterizes the severe reaction in toxic epidermal necrolysis?

Life-threatening widespread immune response with massive skin and mucosal sloughing

What is the Nikolsky sign related to in toxic epidermal necrolysis?

Epidermis separates with mild lateral pressure

What is Staphylococcal Scalded Skin Syndrome (SSSS)?

A reaction to toxins from staphylococcal infection

What do exfoliative toxins target in SSSS?

Desmoglein 1, a protein that helps skin cells stick together

What is the common age group affected by SSSS?

Primarily newborns, infants, and immunocompromised individuals

What is the appearance of lesions in SSSS?

Initial bullous lesions followed by widespread desquamation

What is the treatment for SSSS?

IV antibiotics (flucloxacillin), fluids, wound care

What is scarlet fever caused by?

Streptococcus (GAS) group A beta-hemolytic strep pyogenes

What are the initial symptoms of scarlet fever?

Fever, malaise, sore throat

What distinctive feature appears in scarlet fever?

Strawberry tongue

What type of rash is associated with scarlet fever?

Sandpaper rash

What antibiotic is commonly prescribed for scarlet fever?

Penicillin V for 10 days

What serious complications can arise from scarlet fever?

*Abscess formation (quinsy) *Acute rheumatic fever *Post-streptococcal glomerulonephritis *Toxic shock syndrome (TSS)

What causes toxic shock syndrome?

Superantigen causes intense T-cell stimulation

What are the symptoms of toxic shock syndrome?

*Diffuse maculopapular rash *Fever *Mucosal changes *Profuse diarrhea

What is the main treatment for toxic shock syndrome?

IV antibiotics and fluid resuscitation

What is impetigo?

Infectious superficial infection of the epidermis

What bacteria commonly cause impetigo?

*Staphylococcus aureus *Streptococcus pyogenes

What is a characteristic feature of impetigo lesions?

Golden crusted skin lesions

What is the treatment for localized non-bullous impetigo?

Hydrogen peroxide 1% cream

What is cellulitis?

Bacterial infection affecting the dermis and subcutaneous tissue

What are common symptoms of cellulitis?

*Erythema *Swelling *Pain *Heat

What is the main cause of cellulitis?

Streptococcus pyogenes or Staphylococcus aureus

What is erythema migrans associated with?

Lyme disease

What is the characteristic rash of Lyme disease?

Bulls-eye rash with a central clearing

What is Erythema multiforme?

An immune-mediated skin reaction

What triggers Erythema multiforme?

Most commonly caused by Herpes simplex virus (HSV) or EBV

What do the lesions of Erythema multiforme look like?

Target-like lesions on peripheries that can blister

What is Molluscum contagiosum?

Viral skin infection caused by molluscum contagiosum virus

What is the characteristic appearance of molluscum contagiosum lesions?

Small, raised, round lesions with a dimpled center

What is the primary treatment for troublesome molluscum contagiosum?

Topical treatments or cryotherapy

What virus causes viral warts?

Human papilloma virus (HPV)

What is a characteristic feature of warts?

Rough surface

What is the treatment for warts?

Cryotherapy or topical treatments (salicylic acid, podophyllotoxin)

What disease is measles caused by?

Paramyxovirus

What are the initial symptoms of measles?

High fever, coryzal symptoms, conjunctivitis

What is a characteristic rash of measles?

Maculopapular rash

What are Koplik spots?

Small grey discolorations of mucosal membranes in measles

What is the main treatment for measles?

Supportive care and vitamin A administration for children under 2

What virus causes chickenpox?

Varicella zoster virus

What is the characteristic progression of chickenpox lesions?

Starts as raised, red, itchy spots, progresses to fluid-filled blisters

What is the treatment for chickenpox?

Symptomatic treatment, keep fingernails short, and cooling measures

What triggers shingles?

Reactivation of the varicella zoster virus

What is the typical presentation of shingles?

Erythematous papules along one or more dermatomes

What is scabies caused by?

Sarcoptes scabiei mites

What is a classic symptom of scabies?

Itching worse at night

Where do scabies rashes typically occur?

Inter-web spaces, flexures of wrist, abdomen, and groin

What are common areas affected by itching in scabies?

Inter-web spaces, flexures of wrist, axilla, abdomen, and groin ## Footnote Itching is often worse at night.

What are the characteristics of burrows in scabies?

Small brown lines ## Footnote Burrows are indicative of scabies infestation.

Describe the typical rash associated with scabies.

Itchy rash that is usually popular or vesicular ## Footnote Vesicles are small fluid-filled blisters less than 1cm.

What is the recommended treatment for scabies?

Permethrin 5% cream and oral Ivermectin ## Footnote Permethrin should be applied from head to toe for 8-12 hours.

What is hand, foot, and mouth disease primarily caused by?

Coxsackievirus A16 and Enterovirus 71 ## Footnote This disease primarily affects children.

How does hand, foot, and mouth disease spread?

Direct contact with secretions, coughing, sneezing, contaminated surfaces

What are the symptoms of hand, foot, and mouth disease?

Red rash on hands, feet, buttocks, mouth sores, fever, malaise ## Footnote Mouth sores can cause painful ulcerations.

What is Erythema infectiosum also known as?

Fifth disease ## Footnote It presents with a 'slapped cheek appearance'.

What characterizes Hidradenitis suppurativa?

Painful/intermittent lumps in axilla ## Footnote It is associated with T2DM, obesity, and inflammatory conditions.

What are Seborrheic keratosis lesions like?

Benign skin growths that are often warty and vary in color ## Footnote Common in individuals over 50.

What is actinic keratosis?

A pre-malignant skin condition that can lead to squamous cell carcinoma ## Footnote It presents as dry/scaly patches of skin damaged by the sun.

What are the risks associated with actinic keratosis?

Fair skin (type 1 or 2) and a history of sunburn

What is the appearance of squamous cell carcinoma?

Keratinized, scaly, crusted, irregular nodules ## Footnote It may present with a cauliflower-like appearance.

What is the most common malignant tumor in older adults?

Basal cell carcinoma ## Footnote It originates from basal keratinocytes.

What are the ABCD criteria for malignant melanoma?

Asymmetry, Border irregularity, Color variation, Diameter > 6mm ## Footnote Elevation or evolution of a skin lesion is also a criterion.

What is Pityriasis versicolor caused by?

Malassezia yeast overgrowth ## Footnote It is common in warm climates and during summer months.

What are the characteristics of vitiligo?

Autoimmune, slower onset, symmetrical, non-scaling, asymptomatic ## Footnote Lesions are well-defined and have clear borders.

What is the definition of a macule?

Small flat circumscribed area – altered color

What is a vesicle?

Small fluid-filled cavity less than 1cm

What does an abscess represent?

Large pus-filled cavity that needs incision and drainage

What is the appropriate investigation for a suspected fungal infection?

Skin scrapings, nail clippings, hair samples ## Footnote Fungal cultures may also be conducted.

What does the acronym MC&S stand for?

Microscopy, Culture, and Sensitivities

DERM TABLE Flashcards

(106 cards)