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Year 3 - GP Block > Dermatology > Flashcards

Dermatology Flashcards

1
Q

When taking a dermatological history, what aspects should be explored?

A

Presenting complaint History of presenting complaint Past medical history Family history Social history Drug history Quality of life impact and ICE

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2
Q

What aspects of the presenting complaint should be explored?

A

Nature (rash/lesion) Site Duration and changes

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3
Q

What aspects of the history of the presenting complaint should be explored?

A

Initial appearance and evolution Symptoms (particularly itch/pain) Aggravating and relieving factors Previous and current treatments

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4
Q

What aspects of the past medical history should be explored?

A

Systemic diseases History of atopy Skin cancer Sunburn/sun-bed use Skin type

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5
Q

What are the atopic conditions?

A

Asthma Eczema Hay-fever

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6
Q

What system can be used to analyse skin type?

A

Fitzpatrick skin types

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7
Q

What aspects of family history should be explored?

A

Family history of skin disease (e.g. psoriasis) Family history of atopy Family history of autoimmune disease (e.g. alopecia, vitiligo)

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8
Q

What aspects of social history should be explored?

A

Occupation Sun exposure Exposure to chemicals Improvement of symptoms when away from work

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9
Q

What aspects of a drug history should be explored?

A

Regular and recent drugs Systemic and topical treatments used

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10
Q

How should the use of topical treatments be explored?

A

Where applied? How much? How long for?

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11
Q

How should quality of life impact and ICE be explored?

A

Impact of skin on life Ideas Concerns Expectations

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12
Q

When examining the skin what parts should be examined?

A

All sites, including: Nails Mucosa Hair

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13
Q

How should a dermatological examination be conducted?

A

Inspect Palpate Describe

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14
Q

When palpating the skin, what should be assessed?

A

Flat/raised Warmth

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15
Q

What mnemonic can be used to describe the skin?

A

S - site and distribution/size and shape C - colour A - associated changes M - morphology

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16
Q

How can colour be described?

A

Erythema (blanching redness) Purpura (red or purple non-blanching) Pigmented/hyperpigmented (brown/black) Hypopigmented

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17
Q

How can a lesion/rash’s morphology be described?

A

Macule Papule Patch Plaque Nodule Vesicle Pustule Bulla Annular Wheal Discoid Comedone

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18
Q

How does a macule feel on palpation?

A

Flat

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19
Q

How does a papule feel on palpation?

A

Raised but in a small area

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20
Q

How does a patch feel on palpation?

A

Flat but in a large area

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21
Q

How does a plaque feel on palpation?

A

Raised, but broader than it is high

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22
Q

How does a nodule feel?

A

Like a papule but >1cm

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23
Q

What is a vesicle?

A

A clear fluid filled lesion

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24
Q

What is a pustule?

A

A pus filled lesion

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25
Q

What is a bulla?

A

A large fluid filled lesion

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26
Q

What shape is an annualar lesion?

A

Ring shaped

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27
Q

What presents with a wheal?

A

Urticaria

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28
Q

What shape is a discoid lesion?

A

Coin shaped

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29
Q

What forms can a comedone come in?

A

Open (black head) Closed

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30
Q

How can pigmented lesions be assessed?

A

A - asymmetry B - border C - colour D - diameter E - evolution

31
Q

What surface features can be described?

A

Scale Crust Excoriation Erosion/ulceration Fissures

32
Q

What is scale?

A

Built up keratin

33
Q

What is crust?

A

Dried exudate

34
Q

What is excoriation?

A

Erosion from scratching

35
Q

What is erosion/ulceration?

A

Partial/full thickness loss of skin

36
Q

What are fissures?

A

Cracks

37
Q

What hair findings can be found on examination?

A

Alopecia Hypertrichosis Hirsuitism

38
Q

What is alopecia?

A

Alopecia describes hair loss, can be patchy or diffuse

39
Q

What is hypertrichosis?

A

Excess of hair

40
Q

What is hirsuitism?

A

Excess androgenic pattern of hair in women

41
Q

What nail findings can be found on examination?

A

Koilonychia Pitting Onycholysis

42
Q

What is koilonychia?

A

Spooning of the nails

43
Q

What can koilonychia indicate?

A

Iron deficiency

44
Q

What disease is pitting of the nails associated with?

A

Psoriasis

45
Q

What is onycholysis?

A

Separation of the nail from the nail bed

46
Q

What diseases is onycholysis associated with?

A

Psoriasis Thyroid disease

47
Q

How common is acne?

A

Very common

48
Q

When can acne occur?

A

Infantile (due to maternal hormones in breast milk) Adolescent Adult (12% of women and 5% of men, 5% of both genders will have it for life)

49
Q

What are the risks associated with acne?

A

Painful Scarring Can have severe psychological affects

50
Q

Where on the body is acne most common?

A

T-zone of the face Shoulders Chest

51
Q

Describe the pathophysiology of acne

A

Follicular plugging occurs, causing increased sebum Then become infected by propionobacterium acnes

52
Q

What can cause acne?

A

Hormones Cosmetics Medication (especially the POCP)

53
Q

When should acne be referred early?

A

In patients with darker skin types who are more prone to scarring

54
Q

What is another name for eczema?

A

Atopic dermatitis

55
Q

What symptom is required for an eczema diagnosis?

A

Itchy

56
Q

Where does eczema typically affect in children?

A

Face

57
Q

Where does eczema typically affect in adults?

A

Flexures e.g. cubical fossa and popliteal fossa

58
Q

What do eczema lesions most commonly become infected with?

A

Staph aureus

59
Q

What can indicate a staph aureus infection in eczema?

A

One side looks different to the other

60
Q

What is a serious complication of eczema?

A

Infections with herpes zoster/herpes simplex

61
Q

What does eczema management consist of?

A

Education and advice Moisturiser Steroids Antibiotics to treat infection

62
Q

What education and advice should be given to eczema patients?

A

Keep nails short Regular bath/shower (no soaps) Avoid aqueous creams

63
Q

How should eczema patients use moisturisers?

A

Apply as often as possible, at least 3-4 times/day Use ointments or creams

64
Q

What is another name for moisturisers?

A

Emollients

65
Q

When are creams more suitable then ointments?

A

For use in the day as they are less oily

66
Q

What should be done in the case of resistant eczema?

A

Investigate compliance Consider inadequate steroid treatment Consider infection Consider incorrect diagnosis

67
Q

What is the most common form of psoriasis?

A

Plaque psoriasis

68
Q

What is the average age of onset for psoriasis?

A

28

69
Q

Describe the pathophysiology of plaque psoriasis

A

Increased rate of skin turnover leading to keratin excess

70
Q

What is the normal turnover rate of skin?

A

23 days

71
Q

What is the turnover rate of skin in plaque psoriasis?

A

5 days

72
Q

Where does plaque psoriasis typically affect?

A

Elbows Knees Trunk

73
Q

When can psoriasis look less scaly?

A

In flexural or genital psoriasis where the sweat makes it look more red and moist

74
Q

What can flexural/genital psoriasis often be confused for?

A

Fungal infection

Year 3 - GP Block (5 decks)

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