Derm and misc Flashcards
What is acne?
Localised skin inflammation as a result of overactivity of the oil glands at the base of specialised hair follicles
Why does acne occur?
Acne occurs when hair follicles become blocked and nearby sebaceous (oil) glands begin to produce too much sebum. This mixes with dead skin cells and forms a plug in the follicle
What are the symptoms of acne?
Whiteheads (closed plugged pores) Blackheads (open plugged pores) Small, red, tender bumps (papule) Pimples (pustules) Large, solid, painful lumps beneath the surface of the skin (nodules)
How is acne diagnosed?
Skin exams
How is acne managed?
Over the counter acne products, medications that can - control the acne, avoid scarring
Combined oral contraceptive pill
Steroid injection
What is eczema?
An inflammatory condition of the skin characterised by redness, itching and vesicular lesions
What are the 2 types of causes of eczema?
Atopic: itchy rash of the folds of the elbow/knee
Exogenous: itchy rash following contact with an irritant
How does eczema present?
Atopic: itchy red rash, scaling and oozing
Exogenous: red, crusting and scaling, fissures, hyperpigmentation
How is eczema diagnosed?
Skin exam, patch tests to exclude other skin diseases
How is eczema managed?
Atopic: avoid irritants, regular emollients to hydrate, corticosteroids
Exogenous: avoid irritants, steroid cream
What is psoriasis?
A chronic relapsing skin disorder associated with abnormal hyper proliferation of the epidermis
What are known factors that trigger psoriasis?
Stress, infections, climate, alcohol, smoking, trauma
What are the different types of psoriasis?
Chronic plaque psoriasis, flexural psoriasis, guttate, erythrodermic and pustular
How does psoriasis present?
Well-demarcated erythematous plaques with adherent silvery scale
Elbows, knees, scalp
How is psoriasis diagnosed?
Skin exam, biopsy to rule out other disorders
How is psoriasis managed?
Topical corticosteroids
What is skin ulceration?
Ulcers are abnormal breaks in an epithelial surface
What causes skin ulcers?
Neuropathy, lymphedema, vasculitis, malignancy, infection, trauma
How are skin ulcers diagnosed?
Skin exam, skin and ulcer biopsy to assess for malignant change.
How are skin ulcers managed?
Treat cause and focus on prevention - optimise nutrition
Charing-Cross 4 layer compression bandaging
What is the major risk factor for skin cancers?
UV radiation exposure
How do malignant melanomas present?
Pigmented skin lesions demonstrating ABCD:
Asymmetry, irregular Borders, uneven Colour, Diameter >6mm
How are malignant melanomas managed?
Urgent excision - curative
Chemotherapy for metastatic disease
How do squamous cell carcinomas present?
Skin plaques or nodules, often with a keratinous surface crust.
Ulceration may be present
How are squamous cell carcinomas managed?
Excision + radiotherapy to treat recurrence
How do basal cell carcinomas present?
Most appear as pearly papule or nodules on sun-exposed skin
Ulceration may occur
How are basal cell carcinomas managed?
Excision, cryotherapy
What is HIV?
A retrovirus which infects and replicates in human lymphocytes and macrophages
What is AIDS?
Acquired immunodeficiency syndrome - progressive immune system dysfunction, opportunistic infection and malignancy
Who is at most risk of HIV?
Men who have sex with men, migrant workers, IV drug abusers, commercial sex workers, truck drivers
What does HIV bind to in the human body?
CD4 receptors on helper T cells, monocytes and macrophages
Describe the virology of HIV
Attachment, cell entry, interaction with host cells, replication, assembly, release
How is HIV transmitted?
Unprotected sex, contaminated needles, breast milk and transmission from mother to baby at birth
How does HIV present?
Flu-like symptoms, erythematous/ maculopapular rash.
Fever, lymphadenopathy, sore throat, myalgia, rash and mouth ulcers
How is HIV diagnosed?
Two markers: CD4 cell count and HIV viral load.
ELISA for HIV antibody and antigen
Viral load: used to monitor response to ART
How can HIV be prevented?
Condom use, post-exposure prophylaxis, pre-exposure prophylaxis (ART for high risk people)
How does antiretroviral therapy work?
CCR5 antagonists inhibit the entry of the virus into the cell by blocking the CCR5 co-receptor
What are the risk factors for breast carcinoma?
Early menarche/ late menopause
Increased weight/ high alcohol consumption
Oral contraceptive use
Positive family history
How are breast lumps assessed?
Clinical examination
Histology/ cytology
Mammography/ ultrasound
How is breast cancer staged?
Stage 1: confined to breast, mobile
Stage 2: growth confined to breast, lymph nodes in ipsilateral axilla
Stage 3: tumour fixed to muscle
Stage 4: complete fixation of tumour to chest wall, distant metastases
How are breast carcinomas managed?
Local disease (1-2): surgery, radiotherapy, chemotherapy Distant disease (3-4): radiotherapy to bony lesions, tamoxifen
Name 3 differential diagnoses for breast lumps
Fibroadenoma
Intraductal papilloma
Breast cyst
