10.2 - Dermatology Diseases Flashcards
What are the words to describe small and large lumps
- papule are small (less than 5mm)
- nodules are larger (more than 5mm)
What are the words to describe small and larger water blisters
- vesicle is small water blister
- bulla is larger water blister
What is the word to describe pus-filled vesicle
Pustule
What is the word for redness
Erythema
What is the word to describe a non-palpable area of discolouration (large and small)
- macule are small
- patch are larger (2cm +) macules
- Non-palpable means its in line with skin
What is a palpable, flat topped area (greater than 2cm)
Plaque
Palpable – raised from skin
What is the medical word for a scratch
Excoriation (mention the length of them)
Word for stretch marks
Striae
Word for itch
Pruritis
What does ‘atrophy’ mean
Thinning
What is a telangiectasia
- A thread vein
- Can be normal or pathological
What is ichthyosis
Scaling of skin
What are the words for loss of epidermis, and loss of epidermis + dermis
- erosion if loss of epidermis (eg scrape of knee). Superficial
- ulcer if loss of epidermis and dermis (eg due to venous insufficiency.
What is lichenification
Thickening of the skin with exaggerated skin markings
What are the words for too much hair and too little/thinning hair
What are the words for too much hair and too little/thinning hair
- hirsutism is too much hair
- alopecia is too little hair
The process of inflammation results from three major events…
- vasodilation - cells coming into inflamed areas
- increased microvascular permeability resulting in production of protein rich exudate, so body can fight off infection
- influx of leukocytes
Main signs + symptoms of inflammation
- Rubor (redness/erythema)
- Tumor (growing/swelling)
- Calor (heat)
- Dolor (pain)
- Functio laesa (loss of function eg joint inflammation)
Features and possible causes of psoriasis
- Presence of acanthosis (thicker layer that is raised from the skin)
- Reduced epidermal transit time of keratinocyte from basal → superficial layer (stratum corneum) ☞ results in thicker layer of epidermis
- Erythema – due to increased vascularity of the upper dermis → more blood
cause: may be inherited, since family members suffer from psoriasis simultaneously. There may be triggers that can cause a flare up in individuals with an underlying presdisposition to psoriasis. Triggers on different card.
What are some common psoriasis triggers
these can trigger a flare-up in individuals who are already predisposed to psoriasis
- An injury to skin
- Excessive alcohol
- Smoking
- Stress
- Hormonal changes (more important in women, eg puberty + menopause)
- Certain medications (eg lithium, antimalarial meds, anti-inflammatory, ACE inhibitors)
- Other immune disorders
How to differentiate between eczema + psoriasis
usually found on extensor surfaces, whereas eczema usually on flexor surfaces
- Psoriasis found on knees, elbows, forehead
- Eczema usually found behind knees + elbows
What are some other common signs of psoriasis (not plaques on skin)
- Pitting of nails
- Increased growth of nail, causing separation of the nail from the nail bed (nails also have keratin)
- Joint problem
Treatment of psoriasis
topical
- Emollients
- Salicyclic acid
- Topical steroids
- Vitamin D analogues
systemic
- Psoralen + PUVA (UV light treatment)
- Cytotoxic drugs
- Retinoids (caution women of childbearing age)
- Monoclonal antibodies
What is atopy
Asthma, hayfever and eczema all together
What is eczema + it’s features
- Dermatitis: inflammation of the skin
- A chronic dermatological disease
- Can be found all over the body, but most commonly on flexor surfaces eg back of wrists, behind knees and behind elbows
- Very itchy and red
What are the causes of eczema
internal - born with it. Usually with atopy (triad of asthma, hayfever and eczema)
external - where skin is irritated by something. Often occupation-related eg by chemicals
What are some treatments of eczema
topical
- Emollients
- Topical steroids
- Topical immunosuppressants
systemic
- Anti-histamines
- Immunosuppressants
What is malignant melanoma + features
- Skin cancer very common
- Most melanomas occur in the trunk or legs
- Most common on scalp in bald people (due to extra exposure to UV light)
- Different stages, depending on how deep they go
- Eg stage III is spread to lymph nodes, stage IV is where they spread to other organs
What are some risk factors for malignant melanoma
- Some families have genetic predisposition to melanoma
- This can be caused by a mutation in the CDKN2A cell regulatory gene
- Non-inherited mutations eg BRAF can also affect cell growth regulation, and have been identified in melanoma patients
- Sun exposure + insufficient sun protection
- Type of skin: more common in paler people due to having less melanin
What are some treatments for malignant melanoma
- Wide local excision: removal of melanoma and surrounding tissue
- Radiotherapy and chemotherapy
- This is decided based on the type of cancer and how deep it is
What is vitiligo and it’s symptoms
skin no longer producing melanin → becomes depigmentated
☞ Pale white patches develop on skin
☞ more at risk of UV damage on patches
☞ Two types – segmental + non-segmental
☞ usually occurs before age 30
☞ most commonly affects:
- Skin around mouth and eyes
- Fingers and wrists
- Armpits
- Genitals + groin
- Inside the mouth
What is the difference between segmented + non-segmented vitiligo
segmented = non symmetrical patches on both sides
non-segmented = symmetrical
What are the causes of vitiligo
- autoimmune where immune system destroys melanocytes
- trigger eg stress
- hereditary
- environment eg more UV
- risk factors eg if already have other immune conditions like T1 DM, anaemia, addison’s, lupus, psoriasis, rheumatoid arthritis
What are the common treatments and management of vitiligo
- Topical steroids
- Calcineurin inhibitors (immunosuppressants) eg tacrolimus/pimecrolimus
- Cosmetic camoflague (makeup)
- Sunscreen for preventative
What is alopecia areata + its causes
- Spot baldness
- Usually found on scalp
- Autoimmune cause
What are some treatments/management of alopecia areata
- Topical steroids
- Calcineurin inhibitors (immunosuppressants) eg tacrolimus
- Cosmetic methods eg wigs
- Psychological impact: anxiety and depression
What is acne and it’s common symptoms/signs
- Skin condition that affects sebaceous glands
- Commonly found on face and back (areas that have most oil)
- Papules, pustules, nodules, cysts, scars and comedones (open or closed)
What are open and closed comedones
- open ie blackheads. Skin pigments
- closed ie whiteheads. Due to hair follicle and pit being closed
What are some common causes + triggers of acne
- hormones eg androgens stimulate sebaceous glands to make more sebum
- medications eg corticosteroids, lithium and testosterone
- diet carbohydrate rich foods may worsen acne
- stress may exacerbate acne
what are some common treatments for acne
- Treatment depends on acne
- Lifestyle factors eg diet and stress management, adjusting medications
- Topical agents → oral agents → surgical/intralesional injections + stronger oral agents
- Note that skin may become hyperpigmented, hypopigmented or scarred even after acne has cleared
