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Dermatology

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riaria18's version from 2014-06-14 11:40

Section 1

Question Answer
Impetigo
Erythema nodosum
Lupus pernio
Discoid lupus
Discoid lupus
Heliotrope rash - Dermatomyositis
Gottran's papules (scaly lesions over knuckles) - Dermatomyositis
Sclerodactyly (tight shiny skin around fingers) - Scleroderma
Beaked nose + xerostomia - Scleroderma (also get telangiectasia)
Vasculitis (purpura w/ necrosis either vasculitic/ embolic (IE) )
Neurofibromatosis
Periungal fibroma - Tuberous sclerosis
Ash leaf spots - Tuberous sclerosis
Shagreen patch - Tuberous sclerosis
Acanthosis nigricans - Insulin resistance (if in weird places: tongue, lips, hands - suspect cancer! - most commonly gastric adenocarcinoma)
Eruptive xnthomas - hypertriglyceridaemia - ORANGE nodules
Kaposi's sarcoma
Paget's disease of the breast - eczematous changes in the nipple suggestive of underlying breast cancer
Erythema gyratum repens - 'multiple gyrate erythematous plaques showing a wood-grain pattern' - paraneoplastic most commonly assoc. w/ lung
Erythroderma - >90% body erythema - EMERGENCY
Eczema herpeticum - if eye involvement call OPTHALMOLOGIST - EMERGENCY
Pemphigus vulgaris - much more aggressive than bullous pemphigoid - EMERGENCY
Bullous pemphigoid - normally not emergency but can be
Acute generalised pustular psoriasis - EMERGENCY
Erythema multiforme - NEEDS IMMEDIATE REVIEW if eye/oral involvement (may be SJS)
Stevens-Johnson syndrome - LIFE-THREATENING EMERGENCY - involves mucous membranes
Toxic Epidermal Necrolysis - LIFE THREATENING EMERGENCY - more severe form of SJS. TEN>SJS>EM
Morbilliform rash - Measles or Drug eruption (emergency)
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Section 2

Question Answer
Chronic plaque psoriasis - Emollients, Topical steroids, Vit D analogues, Tar, Phototherapy
Lichen planus - Emollients, POTENT topical steroids, phototherapy, systemic steroids
Melanoma - Do narrow excision biopsy - if Breslow thickeness > 1mm then wide local excision + sentinel node biopsy
Seborrhaeic keratosis - NOT pre-malignant, only freeze if symptomatic
Lentigo maligna - pre-malignant
Pityriasis rosea - 'Herald patch' - Emollients, bath salts, soap substitutes, phototherapy - resolves spontaneously but takes 4 months so better to treat
Basal cell carcinoma - raised rolled edge, pearlescent w/ central ulceration and telangiectasia
Acne rosacea - topical metronidazole (or systemic), retinoids, antiandrogens for women
Pompholyx eczema - vesicles coalescing into blisters - topical emolients, salts, soap substitutes, topical steroids super potent, patch test for irritants/allergens
Dermatitis herpetiformis- Coeliac disease - biopsy, anti TTG blood, colonoscopy - atrophic villi --> gluten free diet
Tinea - (tinea incognito worsens with steroids) - skin scraping --> clotrimazole
Herpes simplex - clustered vesicles - PCR fluid from vesicle --> aciclovir PO/topical
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