19 Skin and its Pathology Flashcards

1
Q

Objectives

A

Normal skin - structure and function

Common pathologies

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2
Q

Functions

A
Largest organ of the body
Protective barrier against environmental insults
Temperature and water loss regulation
Sensation
Vitamin D synthesis
Appearance
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3
Q

Common Terminology

A

Macule: A flat area of altered colour 0.5cm

Plaque: Palpable scaling raised lesion >0.5cm in diameter

Papule: Solid raised lesion 0.5cm in diameter with a deeper component

Vesicle: Raised, clear fluid-filled lesion 0.5cm in diameter

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4
Q

Pathology

A

Benign lesions

Malignant lesions

Inflammatory conditions

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5
Q

Benign Lesions

A

Skin tags
Moles
Cysts
Papillomas

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6
Q

Fibroepithelial Polyps

A

Common
Generally in middle-age and older people
Neck, trunk, face, axilla and groin
Flesh coloured bag like lesion

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7
Q

Naevi

A

Proliferation of melanocytes (pigment-producing cell)
Naevus cells within the
dermo-epidermal junction (junctional naevi)
dermo-epidermal junction and dermis (compound naevi)
just in dermis (intradermal naevi)

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8
Q

Sebaceous Cyst”

A

Clinical term encompasses 2 types of cysts
Derived from invagination of epithelium

2 types:
Epidermoid cyst
Pilar cyst

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9
Q

Seborrhoeic Keratosis

A

Middle aged and older people

Arise spontaneously

Trunk, head and neck

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10
Q

Haemangioma

A

Benign vascular tumours of the dermis

Tend to occur in children

Bluey red surface

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11
Q

Malignant Lesions

A

Basal cell carcinoma (BCC)
Squamous cell carcinoma (SCC)
Bowen’s disease
Melanoma

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12
Q

Basal Cell Carcinoma

A

Most common human cancer
Slow growing tumours
Rarely metastasize
Occur at sun exposed sites

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13
Q

Bowen’s Disease

A

Precursor to SCC
Epidermal dysplasia
Sun damage

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14
Q

Squamous Cell Carcinoma

A

Second commonest skin tumour of sun-exposed sites in older people

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15
Q

Melanoma

A

Fairly common
Arises in sun damaged skin
Can be very aggressive and spread widely
Used to be universally fatal but early diagnosis means can be removed

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16
Q

Melanoma

A
Asymmetry
Border - irregular
Colour - variable pigmentation in lesion
Diameter - mostly >6mm
Enlarge
17
Q

Rashes

A
Inflammatory skin reactions
Eczema
clinical term that encompasses many different conditions
literally means “to boil over”
itching, burning, rash, blisters
18
Q

Psoriasis

A

Commonly affect elbows, knees, scalp, lumbosacral area and glens penis.
Can be associated with nail changes, arthritis, myopathy, enteropathy and spondylic joint disease.
Well demarcated, salmon pink plaques with silver scaling

19
Q

Scabies

A

common and very itchy
caused by human scabies mites.
common in the young and the elderly.
Spread by direct skin-to-skin contact with someone who already has scabies.
mites are found mainly in the web spaces of the fingers and on the palms of the hands, the wrists, ankles and soles of the feet.
Burrows appear as small greyish lines on the skin

20
Q

Skin in Systemic Disease

A

Meningitis
SLE
Internal malignancy

21
Q

Meningitis

A

Unwell (headache, stiff neck, dislike of bright light)
Can deteriorate rapidly (aching limbs (particularly leg pain), cold hands and feet).
The majority (over 50%) with meningococcal septicaemia develop a rash of tiny ‘pink prick’ spots which can rapidly develop into purple bruising.
Non blanching rash

22
Q

Summary

A

Normal skin
Benign – skin tags, moles, naevi, cysts
Malignant- BCC, Bowen’s, SCC, melanoma
Rashes and skin in systemic disease