Derm Misc PT

Question 1

What cells are present in the epidermis?

Answer 1

keratinocytes (produces keratin – hair, nails), melanocytes (melanin pigment), Langerhans cells (immunity)

Question 2

Cells in the dermis?

Answer 2

fibroblasts (produces connective tissue – collagen, elastin), sebaceous and sweat glands, hair follicles, Meissner’s corpuscle (light touch) and Pacinian corpuscle (coarse touch/vibration)

Question 3

Cells in the subcutis/hypodermis?

Answer 3

subcut. fat

Question 4

Functions of the skin?

Answer 4

Sensation
Temperature regulation
Vitamin D synthesis
Immunosurveillence
Protective barrier
Fluid/electrolyte balance (sweating)
7)   Structural (body shape)
8)   Waterproofing
9)   UV barrier

Question 5

How is acne vulgaris caused?

Answer 5

Colonisation of the pilosebaceous duct with Propionibacterium acnes

Question 6

How do u treat mild acne?

Answer 6

closed comedones. Topical retinoids or benzoyl peroxide

Question 7

Name some topical retinoids

Answer 7

tretinoin, isotretinoin, or adapalene

Question 8

How do u treat moderate acne? (papules and pustules)

Answer 8

Combined therapy of topical retinoids. and topical antibiotic (clindamycin and erythromycin) or oral abx

Question 9

Name oral abx?

Answer 9

tetracycline

or doxycycline

Question 10

name a topical abx?

Answer 10

clindamycin and erythromycin

Question 11

Where is atopic eczema normall seen?

Answer 11

asthma or hay fever

Question 12

possible asthma triggers?

Answer 12

Soaps and detergents, animal dander, house-dust mites, extreme temperatures, rough clothes, pollen, some foods and stress

Question 13

PAthophysiology of eczema?

Answer 13

Abnormalities in epidermal barrier protein fillagrin poor barrier function and dry skin allows antigen penetration into epidermis  hyperreactivity, induction of IgE antibodies

Question 14

treaments for eczema?

Answer 14

Avoid triggers and scratching. emollients.
mild/ potent topical corticosteroid for immunosuppression (eg hydrocortisone mild)
potent corticosteroid (clobetasone butyrate)
Severe - antihistamines - cetirizine
severe - oral CS - prednisolone

Question 15

How do you treat infected ecsema>?

Answer 15

Localised areas – topical antibiotic

Generalised areas – oral antibiotic (flucloxacillin or erythromycin)

Question 16

What is psoriasis?

Answer 16

A systemic, immune-mediated, inflammatory skin disease - typical relapsing-remitting course

Question 17

What are nail changes in psoriasis?

Answer 17

Nail pitting, discolouration, onycholysis (detachment from the nail bed)

Question 18

treatment for psoriasis?

Answer 18

emollient,
a potent topical corticosteroid
plus a topical vitamin D preparation (calcipitriol)
coal tar preparation

Question 19

Describe a venous ulcer?

Answer 19

Large, exudative, non painful, sloping and gradual. medial gaiter region. covered with slough

Question 20

Describe an arterial ulcer?

Answer 20

Mainly in toe, heel and ankle region. punched out well defined and painful, small, covered with slough and necrotic tissue

Question 21

Risk factors nd signs for venou ulcers?

Answer 21

DVT, varicose veins. signs are leg oedema, normal peripheral pulses,. MX with compression bandaging

Question 22

Artierl ulcer RF and signs?

Answer 22

Arterial disease, smoking, LDL, cholesterol, DM. Treateted with vascular reconstruction.

Question 23

Signs of Artierl ulcer?

Answer 23

Cold skin, loss of hair, shiny pale skin, abscent peripheral pulses. leg pain worse when elevated

Question 24

What is cellulitis?

Answer 24

caused by infection of the dermis and subcutaneous fat, typically affects the lower leg or arm and may spread proximally

Question 25

What is Erysipelas/

Answer 25

caused by infection of the upper dermis and superficial lymphatics, typically more common on the face and is more sharply demarcated.

Question 26

Most common skin cancer? what are the RF?

Answer 26

BCC (80) - Uv exposure, aging, skin type 1, slow growing. radiotherapy or surgery.

Question 27

What are the skin cancers?

Answer 27

BCC, Squamous cell carcinoma and malignant melanoma

Question 28

How does a squamous cell carcinoma present?

Answer 28

slow growin doesnt spread. UV exposure, chronic inflammation and immunosuppression. scaly and crusty. surgery and radio

Question 29

What is a mlaignant melanoma like?

Answer 29

invasive tumour of melanocytes. black in appearance. bleeding, itching, colour border and large asymmetrical

Question 30

RF for malignant melanomas?

Answer 30

UV exposure, skin type 1, atypicaland multiple moles and family history

Question 31

MX for MMelanoma?

Answer 31

Chemo is mets, radiothwrapy and surgery

Question 32

IV or oral first for cellulitis?

Answer 32

IV flucoxacillin