Big Derm Flashcards
What kind of tissue is the epidermis
stratified cellular epithelium
What is another name for the Prickle Cell Layer
Spinous layer
What are Blaschko’s lines
Developmental growth of skin (not following nerves, vessels or lymphatics)
What kind of hormones can be synthesised in the skin
Hormones
e.g testosterone
How long does it take for a keratinocyte to go from the bottom to the top of the epidermis
28 days
Which epidermal layer is one cell thick and what shape are the cells
basal layer
cuboidal
Which epidermal layer is made up of polyhedral cells
Prickle cell (spinous)
Which layer of the the epidermis is highly metabolically active
Basal layer
What is the difference in how basal cells and all other cells are connected
All other cells - desmosomes
Basal cells - hemidesmosomes
What are langerhan’s cells
Antigen presenting cells of the skin
What structure are Langerhans’ cells characterised by
Birbeck granule
shaped like a tennis racquet
Which epidermal layer contains lamellar bodies
Granular layer
What are the mechanoreceptors called and which skin layer are they found in
Merkel cells
Basal layer
What are the 3 phases of hair growth and what do they mean
Anagen - growing
Catagen - involuting
Telogen - resting
What is the difference between a nodule and a papule
Nodule - >0.5cm
Papule - <0.5cm
What does Petechial suggest
pinpoint-sized macule of blood in the skin
What is a weal
Itchy raised nettle rash due to dermal oedema
Which glands are the smelly ones and where are they found
Apocrine
Axilla and perineum
What are the actual sweat glands called
Eccrine
Causes of Impetigo
Staph Aureus typically
can be strep
Treatment of impetigo
Flucloxacillin for Staph
penicillin for strep
How is Impetigo spread
Direct contact
What colour is Impetigo and where is it found
Weeping, exudative area
honey coloured, typically on face, around mouth
How does Staphylococcal scalded skin syndrome (SSSS) present
Scald-like skin appearance followed by large flaccid bulla
What type of Impetigo can cause Staphylococcal scalded skin syndrome (SSSS)
Bullous Impetigo
What is the treatment for Staphylococcal scalded skin syndrome (SSSS)
Flucloxacillin
How can you differentiate between SSSS and TEN (toxic epidermal necrolysis)
Mucosal involvement only occurs in TEN
What are the causes of cellulitis
Beta-haemolytic streptococcus most commonly
Treatment for cellulitis
penicillin and flucloxacillin
Types of Necrotising fascitis and the difference between them
Type 1 - Mixed anaerobes
Type 2 - Strep Pyogenes
Investigation for Parovirus B19
Parovirus B19 IgM test
What is Parovirus B19 also known as
Slapped Cheek syndrome
Erythema Infectiosum
What joint pathology can Parovirus B19 cause
Arthritis
What do monomorphic punched out lesions suggest
Eczema herpeticum
What is the treatment for Eczema Herpeticum
Anti-virals
What is Shingles called after 4 weeks
Post Herpetic Neuralgia
Which types of HPV are associated with cervical cancer
16 & 18
Which types of HPV are associated with genital warts
6 & 11
What is the treatment for Molluscum Contagiosum
Self limiting
What is Orf
Disease of the sheep due to a pox virus infection
What is Tinea cruris
Dermatophyte infection of the groin
What is Tinea pedis
Dermatophyte infection of the foot (Athlete’s foot)
What is Tinea manuum
Dermatophyte infection of the palms
What is Tinea unguium
Dermatophyte infection of the nails
What is the treatment for dermatophyte infections
Clotrimazole cream
Topical Anti-fungal
How is scabies spread
Prolonged close contact and sexual contact
What is a pathogmonic sign of scabies
Linear or curved skin burrows
How is scabies diagnosed
Skin scraping
Treatment for scabies
Malathion lotion overnight
What is Norwegian scabies and what sort of people does it affect
Chronic crusted form of scabies
Affects immunosuppressed
What is another name for eczema
Atopic Dermatitis
Which gene is linked to eczema
Filaggrin gene
What immunoglobulin would be seen in skin affected by Eczema
IgE
Atopy
What is the guidance on when to use which strength of steroids on skin
The face should only be treated by mild steroids
In young children, the body should be treated with mild and moderately potent steroids
Treatment of the palms and soles may require potent or very potent steroids as the skin is much thicker
Where does Sebhorrhoeic Eczema affect the body
Body sites rich in sebaceous glands
What does a “crazy paving pattern” indicate
Asteatotic Eczema
What is Asteatotic Eczema
Dry plate-like cracking of the skin with a red, eczematous component
What should be suspected if the eczema is in an unusual or localised distribution
Allergic or Irritant Contact Dermatitis
What type of hypersensitivity is allergic dermatitis
Type 4 (delayed)
What is Lichen Simplex
Thickened, scaly and hyperpigmented areas of lichenification
What drugs can make psoriasis worse
Lithium
Anti-malarials
Beta-blockers
What nail changes can accompany psoriasis
Nail Pitting
Onycholysis
What is suggested by “raindrop-like psoriasis”
Guttate Psoriasis
What are the three derm symptoms associated with allergy
Urticaria
Angioedema
Anaphylaxis
Order of investigations for allergy
History Specific IgE (RAST) Skin prick Challenge test Serum mast cell tryptase level (during anaphylaxis)
Three cardinal features of acne vulgaris
Comedones
Pustules
Inflammatory papules
What is the difference between whiteheads and blackheads
Whiteheads are closed from the air
Blackheads are open
What is acne fulminans
Severe necrotic and crusted acne lesions
Requires urgent treatment with oral prednisolone
What is the first line keratolytic used in Acne Vulgaris
Benzoyl peroxide
What topical antibiotics are given for Acne Vulgaris
Erythromycin
Clindamycin
What oral antibiotic can you give for Acne Vulgaris
Tetracycline
Antibiotic given for Acne Rosacea
Topical Metronidazole
Target lesions indicative of
Erythema Multiforme
What is Pyoderma Gangrenosum
Erythematous nodules or pustules that frequently ulcerate
Treatment for Pyoderma Gangrenosum
Very potent topical steroids
Immunosuppressants may be used in resistant cases
What drug other than immunosuppressants can be given for dermatomyositis
Hydroxychloroquine
Which systemic autoimmune disease can cause erythema nodosum
Sarcoidosis
How many cafe-au-lait spots suggest genetic disease
More than 5
greater than 2.5cm in diameter
What is the inheritance of NF type 1
Autosomal dominant
Ash leaf pigmentation suggests what
Tuberous sclerosis
Which bullous disease has mucosal involvement
Pemphigus Vulgaris
Which is more common out of bullous pemphigus and pemphigoid
Pemphigoid
Which antibody is associated with pemphigus vulgaris
Anti-Desmoglein 3 IgG
Which GI disease is dermatitis herpeformitis associated with
Coeliac Disease
What is another name for a basal cell papilloma
Seborrhoeic keratosis
What are two precursors to squamous cell carcinoma
Bowen’s disease
Actinic keratoses
What are the 4 types of malignant melanoma
Lentigo Maligna
Superficial Spreading
Nodular
Acral
Which type of ulcer do you use compression bandaging for
Venous
not arterial
What is androgenic alopecia
Male pattern baldness
May occur in females following menopause
What is Alopecia areata
Immune mediated hair loss
Patches of baldness
What is Telogen effluvium
Diffuse hair loss that occurs some 3 months after pregnancy or a severe illness
‘Stress’ puts all the hairs into the telogen phase of hair shedding at the same time.
Hair fully recovers and normal hair cycle resumes within a few months
What is hirsutism
Male pattern hair growth seen in females
What is hypertrichosis
State of excessive hair growth at any site and occurs in both sexes
Which topical therapy contains preservatives
Creams
What does erythematous bullseye lesions suggest
erythema migrans
lyme disease
What does cauliflower appearance suggest
Plantar Warts
Who is affected by Kaposi’s sarcoma
HIV Patients
Immunosuppressed Patients
What is fish scale skin
Ichythosis
What does velvety thickened lesions in axillae suggest
Acanthosis nigricans
What protein defect increases risk of eczema, hay fever and asthma
Filaggrin
What kind of hypersensitivity is involved in a skin prick test
Type 1 hypersensitivity
What kind of hypersensitivity is involved in a patch test
Type 4 hypersensitivity
What is sentinel lymph node
Is the first lymph node or group of nodes draining a cancer
What is Ramsay-hunt syndrome
Vesicle and pain in auditory canal and throat
Can result in CN VII palsy, leading to facial drooping
Which skin cells are responsible for Vitamin D metabolism
Keratinocytes
What do Pancinian corpuscles sense
Pressure
What senses vibration in the skin
Meissner’s corpuscles
What is acantholysis
lysis of intercellular adhesion sites
Is acantholysis seen in Pemphigus or Pemphigoid
Pemphigus
NOT seen in Pemphigoid
