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Skin Pathology > CP 63 - inflammatory skin diseases > Flashcards

CP 63 - inflammatory skin diseases Flashcards

1
Q

what the 2 types of chlamydia

A

a] Trachoma is a tropical disease which infects the corneum and conjuctiva. Common cause of blindness.

b] Mild disease due to Chlamidia types d-k, aquired during birth from infection in genital tract

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2
Q

what can cause retina infections

A

toxoplasma - cat poo

toxocara canis - dog poo

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3
Q

what is macular degeneration

A

Damage to macule, the central part of vision.

  • dry - age related
  • wet - new vessel growth beneath retina
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4
Q

what can cause cataracts

A 
senil degeneration 
rubella 
down's syndrome 
irradiation
Diabetes 
Uveitis
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5
Q

what conditions can happen in the retina?

A

ischaemia
hypertensive retinopathy
diabetic retinopathy

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6
Q

what tumours can arise from the retina?

A

retinoblastoma - genetic, occurs in retina,

Melanoma - arise from melanocytes of Uveal tract (Iris, ciliary body or choroid)

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7
Q

what is leprosy?

A

chronic granulomatous infection which can involves nerves, loss of sensation

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8
Q

what causes leprosy?

A

mycobacterium leprae

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9
Q

what are some of the common fungal infections

A

ringworm - tinia pedis (athelete’s foot), tinea cruris (groins) - infectiob by trichophuton species

trush - candida infection

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10
Q

what is another name for eczema?

A

dermatitis

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11
Q

what are the 3 clinical stages of dermatitis

A

1 - acute dermatitis (skin red, weeping serous exudate +/- small vesicles.)

2- subacute dermatitis (skin is red, less exudate, itching ++, crusting.)

3 - chronic dermatitis (skin thick and leathery secondary to scratching)

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12
Q

what are the microscopy of the different stages of dermatitis

A

1 - spongiosis (intercellular oedema within epidermis)

2 - Chronic inflammation - predominantly superficial dermis.

3 - Epidermal hyperplasia and hyperkeratosis - mild in acute dermatitis, marked in chronic dermatitis

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13
Q

what can atopic eczema be associate with?

A

asthma and hay fever

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14
Q

what kind of reaction id eczema?

A

type 1 hypersensitivity to allegen

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15
Q

what is contact irritant dermatitis

A

direct injury to skin by irritant, eg acid, alkali, strong detergent, etc

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16
Q

what is contact allergic dermatitis

A
  • nickel, dyes, rubber. Act as haptens which combine with epidermal protein to become immunogenic.
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17
Q

what is seborrhoeic dermatitis ?

A

affect areas rich in sebaceous glands: scalp, forehead, upper chest

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18
Q

what is nummular dermatitis

A

coin shaped lesions

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19
Q

what is psoriasis?

A

well defined, red oval plaques on extensor surfaces - knee elbows, sacrum

fine silvery scale, Auspitz sign

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20
Q

what is the distinct psoriasiform hyperplasia

A

regular elongated club shaped rete ridges

thinning of epidermis over dermal papillae

parakeratotic scale

collections of neutrophils in scale

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21
Q

what is the pathogenesis of psoriasis

A

massive cell turnover

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22
Q

what is the aetiology of psoriasis

A

problems in the MHC on chromosome 6p2 (same area involved in other autoimmune disorder)

required environmental trigger factors

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23
Q

what does patients with psoriasis have increased risk of?

A

non-melanoma skin cancer

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24
Q

what types of different lupus erythmatosus are there?

A

discoid - skin only

systemic - visceral disease +/- skins

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25
Q

how is lupus erythematosus present clinically?

A

Red scaly patches on sun-exposed skin +/- scarring, scalp involvement causes alopecia

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26
Q

what would butterfly rash on cheek and nose indicate?

A

SLE

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27
Q

what sort of condition is lupus erythematosus

A

Auto-immune disorder primarily affecting connective tissues of the body

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28
Q

what are the microscopical feature of lupus erythematosus

A

thin atrophic epidermis, . Inflammation and destruction of adnexal structures.

LE band - IgG deposit in basement membrane

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29
Q

what are presentation of dermatomyositis

A

peri-ocular odema and erythema (heliotropic rash)

30
Q

what does dermatomyositis indicate in some population?

A

In adults 25% associated with underlying visceral cancer

31
Q

what does the bullous disease

A

Formation of fluid filled blisters

32
Q

what does intra-epidermal bulla represent?

A

pemphigus

33
Q

what does sub-epidermal bulla represent?

A

pemphigoid

34
Q

what is pemphigus

A

Group of disorders characterised by loss of cohesion between keratinocytes resulting in an intraepidermal blister.

35
Q

how does pemphigus manifest?

A

Autoantibodies, directed against intercellular material

36
Q

how does bullous pemphigoid manifest?

A

Autoantibodies to glycoprotein in basement membrane.

37
Q

what is deematitis herpetiformis

A

Small intensely itchy blisters. Extensor surfaces

38
Q

what can dermatitis herpetiformis indicate?

A

coeliac disease

39
Q

what is acanthosis nigricans

A

darty warty lesions in armpits

40
Q

what can acanthosis nigricans indicate

A

internal malignancy

41
Q

what can xanthoma indicate

A

hyperlipaemis

42
Q

what can porphyria indicate

A

problem with production of haem

43
Q

what can porphyria be presented?

A

acute abdo pain, psycho problem, peripheral neuropathy, urine goes dark on light exposure

44
Q

what is the most common form of porphyria?

A

porphyria cutanea tarda

45
Q

what can cause porphyria cutanea tarda

A

20% FH, 80% acquired through Hep C

46
Q

what is the most common malignant skin tumour?

A

basel cell carcinoma

47
Q

aetiology for BCC?

A

sun exposed site (face), occasionally radiotherapy

48
Q

what are some of the clinical presentation for BCC?

A

early - nodule, late - ulcer

microscopically - tumour composed of islands of basaloid cells with peripheral palisade

49
Q

what can cause squamous cell carcinoma?

A 
UV irradiation (sun exposed) 
radiotherapy - treatment of melonoma 
chemical exposure - tars, mineral oils
chronic scars/ulcers
immunosuppression - renal transplant patients at increased risk 
drugs (new drugs for melanoma)
50
Q

what are some of the clinical presentation of SCC?

A

Nodule with ulcerated, crusted surface

51
Q

is SCC particularly invasive

A

no really (still more invasive for BCC) -

52
Q

what is actinic keratosis

A

dry scaly patches of skin caused by damage from years of sun exposure - patches can be pink brown in colour

pre-malignant disease of SCC

53
Q

what is the cause of actinic keratosis

A

dysplasia to squamous epithelium

54
Q

what is the function of melanocytes

A

to form melanin which is transferred to epidermal cells to protect the nucleus from UV radiation

55
Q

what are the benign tumour arise from melanocytes?

A

naevi (moles)

56
Q

what are the malignant tumour arise from melanocytes?

A

melanoma

57
Q

what is naevi?

A

local benign collections of melanocytes

58
Q

what is naevus syndrome

A

families with increased incidence of melanoma, multiple clinically atypical moles, increased risk of developing melanoma

59
Q

what is the acronym for identifying naevus and melanoma

A

melanoma -

asymmetrical
borders uneven
colour variation
diameter >6mm

60
Q

what is the causes of melanoma

A

sun exposure (especially short intermittent severe exposure)

race - celtic with red hair
FH - dysplastic naevus syndrome

61
Q

what is lentigo maligna

A

elderly ppl have face patches which is slow growing, flat, pigmented patches

62
Q

what is the microscopic feature of lentigo maligna

A

Proliferation of atypical melanocytes along basal layer of epidermis. Skin also shows signs of chronic sun damage.

63
Q

will lentigo maligna become invasive?

A

might do later on in the disease, melanocytes may invade dermis with potential to metastasis

64
Q

where does acral lentigenous melanoma affect the most?

A

palms and soles, occasionally subungula

65
Q

which race is acral lentigenous melanoma affect the greatest?

A

afro-caribbeans

66
Q

what is the superficial spreading melanoma

A

commonest type in Britain

67
Q

where does superficial spreading melanoma

A

Early: flat macule. Late: blue/black nodule

68
Q

what is nodular melanoma

A

Starts as pigmented nodule. +/- ulceration. Poor prognosis.

69
Q

what is the microscopic features of nodular melanoms

A

invasive atypical melanocytes invade dermis to produce nodules of tumour cells

70
Q

what is breslow thickness

A

measure on microscope from granular layer of epidermis to base of tumour

71
Q

what is the treatment of melanoma

A

surgery

BRAF inhibitors 60% melanoma have mutation in b-raf gene

Skin Pathology (3 decks)

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