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derm (mine) > common skin conditions > Flashcards

common skin conditions Flashcards

covers itch, psoriasis, acne, rosacea, lichen planus

1
Q

what is hyperkeratosis

A

increased thickness of keratin

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2
Q

what is parakeratosis

A

persistence of nuclei in the keratin layer

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3
Q

what is acanthosis

A

increased thickness of epithelium

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4
Q

what is papillmatosis

A

irregular epithelial thickening

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5
Q

what is spongosis

A

oedema between squames, will increase prominence of intercellular prickles

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6
Q

what is puritus

A

a unpleasant, poorly localised, non-adapting, sensation that provokes the desire to scratch

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7
Q

where is the itch sensation processed

A

parts of the forebrain and hypothalamus

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8
Q

what are the 4 types of itch, give examples

A

pruritoceptive = something triggers itch e.g. eczema, dry skin, psorasis

neuropathic = damage to nerves e.g. MS

neurogenic = no evidence of damage to the CNS but it has been affected e.g. opiates

psychogenic = pyschological cause with no CNS damage e.g. delusion

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9
Q

what is the treatment for itch

A 
determine and treat underlying cause
antihistamine
emollients
antidepressants 
phototherapy
opiate antagonists
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10
Q

what is the most common type of psoriasis

A

chronic plaque psoriasis aka psoriasis vulgaris

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11
Q

describe psoriasis

A

symmetrical
Commonly affects the extensors, scalp, sacrum, hands, feet, trunk and nails
Sharply demarcated, scaly, erythematous plaques which are reversible

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12
Q

what are auspitz signs, what condition are they associated with

A

removal of surface scale reveals tiny bleeding points

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13
Q

what is the kobner phenomenon

A

psoriasis develops in areas of skin trauma e.g. scratch marks or scars

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14
Q

describe nails found in psoriasis

A

pitting
dystrophy
sublungal hyperkeratosis
onycholysis

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15
Q

what is the buzzword description for psoriasis

A

Sharply demarcated, scaly, erythematous plaques which are reversible

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16
Q

what is psoriasis associated with

A 
arthritis
crohns
cancer
depression
uvetitis
obesity/hypertension/dibetes/lipid abnormalities
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17
Q

what is the management of psoriasis

A 
emollients = 1st line 
steroid ointments =2nd line
vitamin D analogues
coal tar
dithranol
can combine with phototherapy
last line = systemic treatments
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18
Q

give examples of vitamin D analogues

A

Calciptriol

calcitrol

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19
Q

what is Guttate psoriasis

A

small lesions over the upper trunk and proximal extremities classically trigged by a bacterial infection usually a URT infection

aka eruptive

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20
Q

what is palmoplantar pustular psoriasis

A

chronic condition affecting the soles and palms, can occur without psoriasis

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21
Q

what is eruthrodemic psoriasis

A

this is a rare aggressive, inflammatory form of psoriasis. Symptoms include a peeling rash across the entire surface of their body. The rash can itch or burn intensely and it spreads quickly.

aka widespread pustular

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22
Q

what is acne vulgaris

A

chronic inflammatory disease of the pilosebaceous unit

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23
Q

what is the cause of acne (3)

A

increased androgens at puberty = increased sebum
keratin plugging of pilosebaceous units = blockage
infection with anaerobic bacteria “corynebacteium acnes” = infection

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24
Q

describe the appearance of acne

A 
relates to sites with the most sebaceous glands
comedones: open = blackheads, closed = whiteheads
pustules, papules, and cysts
erythema
secondary features include:
   scars
   texture change
   hypertrophic changes
25
Q

what are the gradings of acne

A

mild, moderate and severe

26
Q

describe mild acne

A

scattered papules, pustules and comedones

27
Q

describe moderate acne

A

numerous papules, pustules and mild atrophic scarring

28
Q

describe severe acne

A

cysts, nodules, and significant scarring

29
Q

what i the treatment of acne

A 
most will spontaneously resolve with time 
benzoyl peroxide 
vitamin A derivatives
antibiotics (topical or oral)
isotrentinoin (oral)
30
Q

what is rosacea

A

prominent facial flushing exacerbated by sudden change

31
Q

what commonly affects rosacea

A

spicy foods
alcohol
change in temperature

32
Q

describe rosacea

A 
located on chin, cheeks, and forehead
papules, pustules but no Comedones
erythema = visible blood vessels
thickening of skin (rhinophyma) = enlarged, unshapely nose
conjunctivitis/gritty eyes
33
Q

what is the management of rosacea

A 
reduce aggravating factors
metronidazole
ivermectin = reduces mite numbers
tetracycline (long term)
isotretinon at low dose if severe
34
Q

treatment of telangiectasia

A

vascular laser

35
Q

treatment of rhinophyma

A

surgery.laser shaving

36
Q

what is lichen planus

A

type of lichenoid eruption which is characterised by damage and infiltration between the epidermis and dermis

Itchy, non-infectious rash

37
Q

describe the appearance of lichen planus

A

Violaceous (pink/purple), flat-topped shiny papules

Wickham’s striae = fine, lace-like pattern on surface of papules and buccal mucosa

38
Q

what is the treatment of lichen planus

A

generally lasts 12-18 months before disappearing on its own

topical or oral steroids

39
Q

what is vasculitis

A

group of disorders in which there are inflamed blood vessels

40
Q

what are the symptoms of vasculitis

A

wide range:

pain
sudden onset
purpuric rash/pustules
necrotic

41
Q

what is a chronic leg ulcer

A

open lesion between the knee and the ankle joint that remains unhealed for at least 4 weeks

42
Q

what are the causes of leg ulcers

A 
venous (60-80%)
arterial (22%)
mixed venous and arterial (10-20%)
rheumatoid arthritis (9%)
diabetes (5%)
43
Q

describe a venous leg ulcer

A

lower leg
shallow edged
shallow base
may have other venous pathologies (e.g. varicose veins)

44
Q

describe a arterial leg ulcer

A

punched out appearance
deep
very painful
may have other arterial pathologies (e.g. pale, hairless, shiny, cool to the touch)

45
Q

what are the symptoms of leg ulcers

A 
pain
leakage
smell 
Lipodermatosclerosis/ hyperpigmentation 
infection
46
Q

what are the investigations of leg ulcers

A 
ABPI
bloods 
patch testing
duplex scan
swab
47
Q

what would a ABPI tell you

A

if the ulcer was arterial

48
Q

what is the normal range for ABPI

A

1

49
Q

what range suggests vascular disease in ABPI

A

<0.8

50
Q

what range suggest calcification in ABPI

A

> 1.5

51
Q

when would you do a patch test for a leg ulcer

A

if there is associated eczema or an allergy/irritant is suspected

52
Q

when would you take a swab of an leg ulcer

A

if infection is suspected

53
Q

what is the treatment of leg ulcers

A 
non-adherent dressing
de-sloughing 
compression application 
compression stockings
leg elevation 
pain relief
54
Q

what must you consider if normal treatments aren’t working with leg ulcers

A

malignancy

55
Q

what treatment should be considered for psoriasis of the scalp

A

greasy ointments
tar shampoo
steroid shampoo
vit D analogues

56
Q

what treatment should be considered for psoriasis of the axilla

A

calcineurin inhibitor

57
Q

what is the buzzword for lichen planus

A

Irregular sawtooth acanthosis

58
Q

where does lichen plans typically affect

A

Typically effect volar wrists/forearms, shins and ankles

59
Q

what is the histology of lichen planus

A

Hypergranulosis = thicken granular layer
orthohyperkeratosis = hyperkeratosis with no nuclei
Band-like upper dermal infiltrate of lymphocytes

derm (mine) (11 decks)

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