7 - Skin Conditions

Question 1

What is this an example of and what are some complications with this condition?

Answer 1

Erythroderma

Question 2

What cell types are in the epidermis and how do you get pathology in the epidermis?

Answer 2

• Change in epidermal turnover
• Change in the surface of the skin
• Change in pigmentation of the skin

Question 3

What are a few examples of disease affecting the epidermis?

Answer 3

• Psoriasis
• Vitiligo

Question 4

What is the dermis made up of and what are some diseases of the dermis?

Answer 4

• Made of collagen, elastin and GAGs giving strength and elasticity
• Contains immune cells, nerve cells, skin appendages, lymphatics and blood vessels
• Dermatographism, Acne (sebaceous glands comedones)

Question 5

What are the two types of sweat gland?

Answer 5

stimulated by the conversion of androgen to dihydroytestosterone

Question 6

What are the presenting symptoms of dermatitis?

Answer 6

• Group of inflammatory conditions affecting the epidermis, one is eczema
• Can be inflammed, dry, red, cracked, flaky, thickened and skin pigmentation changes and vesicles and extreme itching

Question 7

What are the symptoms of eczema (atopic dermatitis)?

Answer 7

• Atopic or family history of atopy
• Occurs on flexure areas, e.g back of knees
• Dry thickened itchy areas
• Skin often becomes lichenified and excoriated
• Usually bilateral, made worse by cold and allergies like pets

Question 8

How can we manage eczema?

Answer 8

- Remove trigger factors e.g heat, diet

- Regular emollients

- Intermittent topical steroids for flares

• Sometimes antibiotics, phototherapy, antihistamines (stop itching) and immunosuppressants

Question 9

What are the presenting sympoms of acne vulgaris?

Answer 9

• Mainly affects adolescents, more severe in adulthood
• On face but can spread to neck and back etc
• Individual lesions are centred on the pilosebaceous unit but can all coalesce
• Lots of papules and comedones

Question 10

How can we grade acne?

Answer 10

Question 11

How can we treat acne vulgaris?

Answer 11

Mild: topical anti-acne preparations, lasers and lights

Moderate: antibiotics like tetracyclines or OC pill

Severe: course of oral isotretinoin (reduces sebum production)

Question 12

What are the presenting symptoms of psoriasis?

Answer 12

• Red and scaly plaques with well defined edges. Often silvery
• Plaques found in scalp, elbows and knees mainly (extensor)
• Mild itch but if severe can lead to lichenification, painful cracks and fissures
• When a plaque clears can leave pigmented area
• Can have pitting nails and nail separation
• Common in caucasians, has genetic and autoimmune component

Question 13

What are some things that can aggravate psoriasis and what health conditions is it associated with?

Answer 13

Associated with:

• Coeliacs
• IBS
• Psoriatic arthritis
• T1DM

Question 14

How can we treat psoriasis?

Answer 14

- Avoid smoking, alcohol and maintain optimal weight

- Topical: emollients, corticosteroids, Vit D analogues, salicyclic acid

- Phototherapy

- Systemic agents (severe): methotrexate and corticosteroids (avoided a lot due to withdrawal flares and systemic effects)

Question 15

what are the four cell types found in epithelia

Answer 15

Question 16

what are the four layers of the skin

Answer 16

stratum lucidum is only found in areas of thicker skin like palms and soles

each layers shows a different maturation level of a kerinatocyte

Question 17

what are the different types of hair

Answer 17

lanugo hair (soft fine hair covering and protecting a foetus in utero)

vellum hair (short hair all over body)

terminal hair (coarse long hair)