Derm

Question 1

what is hyperkeratosis

Answer 1

increase in stratum corneum / increased keratin

Question 2

what is parakeratosis

Answer 2

nuclei in stratum corneum

Question 3

what is acanthosis

Answer 3

thickened (increase) in stratum spinosum > darkening of skin

Question 4

what is acantholysis

Answer 4

decreased cohesions between keratinocytes

Question 5

what is spongiosis

Answer 5

intracellular odema

Question 6

what is lentiginous

Answer 6

linear pattern of melanocyte proliferation within pidermal basal cell layer

Question 7

explain general prsentation of psoriasis

Answer 7

well demarcated red scaly plaques

Question 8

explain chronic plaque psoriasis

Answer 8

salmon pink plaques with silver scales

affect extensor aspects of knees, elbows, scalp

Question 9

what occurs if you rub psoriasis

Answer 9

rubbing causes pin-point bleeding (Auspitz’ sign)

Question 10

WHat is Koebner phenomenon

Answer 10

lesions form at site of trauma

Question 11

what are histological features of psoriasis

Answer 11

parakeratosis, loss of granular layer, clubbing of rete ridges giving test tubes in a rack appearance

Question 12

what does guttate psoriasis occur after

Answer 12

after group A strep throat

Question 13

explain nail changes in psoriasis

Answer 13

POSH

Pitting
Onycholysis
Subungal hyperkeeratosis

Question 14

explain presentationo of LIchen planus

Answer 14

Pruritic 
Purple 
Polygonal 
Papules 
Plaques

with

• mother of pearl sheen
• fine white network on surface called Wickam’s striae

Question 15

where does lichen planus occur

Answer 15

on inner wrists OR oral mucous membrane

Question 16

what does erythema multiforme occur in response to

Answer 16

Viral: HSV, mycoplasma
Drugs: SNAPP (Sulphonamide, NSAID, Allopurinol, Penicillin, Phenytoin)

Question 17

what are seborrhoeic keratoses

Answer 17

rough plaques, waxy, stuck on

in middle aged/elderly

Question 18

what are. actinic solar /senile keratoses

Answer 18

rough sandpaper like scaly lesions on sun exposed areas

Question 19

what is a keratoacanthoma

Answer 19

rapidly growing dome shaped nodule
develops a necrotic, crusted centre
grows over 2-3 weeks tgen clears

Question 20

what does bowens disease look like

Answer 20

flat, red scaly patches on sun exposed areas

Question 21

how is the basement membrane in bowrens

Answer 21

INTACT - non invading the dermis

Question 22

what is Bowens disease

Answer 22

intra-epidermal squamous cell carcinoma in situy

Question 23

when does epithelial SCC occur

Answer 23

when Bowens invades the BM, speading to dermis

Question 24

describe a BCC

Answer 24

RODENT ULCER

Rolled pearly edge, telangectasis, with central ulcer

Question 25

what is the msot important prognostic factor for melanoma

Answer 25

Breslow thickness

Question 26

what are the four subtypes of melanoma and when do they occur

Answer 26

- superficial preading: irregular bordr with variation in colour - nodular: spreads deep - acral lentigionous: on palms and soles of afro-carribeans . lentigo maligna: on sun exposed area of elderly caucasian, flat and slow growing

Question 27

What does SJS > TEN occur due to

Answer 27

drugs e.g. sulphonamides, anticonvulsants

Question 28

how are SJS and TEN different

Answer 28

amount of skin detachment <10% body surface on SJS >30% body surface in TEN

Question 29

what sign occurs in SJS/TEN

Answer 29

Nikolsky positive