Derm notes Flashcards
Name 4 appendages of skin
Nails
Hair
Glands
Mucosa
Name 2 diseases where there is a loss of control of epidermal turnover
Skin cancer
Psoriasis
In which epidermal layer is the keratinocyte nucleus lost
Granular layer
origin of the cornified envelope
In which structure in the melanocytes does conversion of tyrosine to melanin take place
Melanosome
How are full melanosomes transferred to adjacent keratinocytes
Via dendrites
What is Merkel cell cancer caused by
Viral infection
What type of hypersensitivity is bullous pemphigoid
Type 2 hypersensitivity
What are the 4 parts of a hair follicle
External root sheath
Internal root sheath
Cortex
Medulla
What is sebum made up of and which glands is it secreted from
Squalene, wax esters, triglycerides & free fatty acids
Secreted by sebaceous glands
What is acute skin failure clinically known as
Toxic Epidermal Necrolysis
What are 3 structurally important proteins in the keratin layer
Filaggrin
Involucrin
Keratin
What are the main type of T cells found in the epidermis and the dermis
Epidermis - CD8+ cells
Dermis - CD4 & CD8+ cells
What types of Th cells are involved in psoriasis and atopic dermatitis
Psoriasis - Th1 & Th17
Atopic Dermatitis - Th2 & Th17
Where are T cells sensitized
Thymus
Which T cell type can kill cells directly
CD8+ cells (Cytotoxic)
What are the two types of dendritic cells in the dermis
Dermal
Plasmacytoid
What is the difference between dermal and plasmacytoid dendritic cells
Dermal Dc’s involved in antigen presenting
Plasmacytoid Dc’s produce IFN-alpha (found in diseased skin)
When is an Arthus reaction seen
Skin testing in type 3 hypersensitivity
What is the scale used to classify the colour of people’s skin
Fitzpatrick scale
Skin types I - VI
Which Staph species is associated with foreign objects
Staph Epidermidis
What should you suspect in a female with multi-system involvement and hypotension
Toxic Shock Syndrome
Give an example of a toxic (non-allergic) reaction
Scombroid Fish toxin
What are the chemistry related factors which make a drug more likely to cause a drug eruption
High Molecular weight
B-lactam compounds, NSAID’s
What type of reaction is a Xanthematous drug eruption
Type 4
How do emollients work
Enhance rehydration of epidermis
How do calcineurin inhibitors work and give an example
Tacrolimus
Suppress Lymphocyte activation
Can be used topically in eczema
What is the treatment for Pityriasis Versicolor
Ketoconazole
How does Capsaican work and what is it used for
Depletes substance P
used as an anti-pruritic
What is the treatment for genital warts
Podophyllin
What are the 4 treatment options for MRSA
Doxycycline
Co- trimoxazole
Clindamycin
Vancomycin
Which staph. can cause urinary tract infections in women of child-bearing age
Staph Sacrophyticus
What is the treatment for a dermatophyte infection of the scalp (Not clotrimazole)
Terbinafine or Itraconazole Orally
What is Vagabond’s disease
Pediculus Corporis (Body Louse)
Which organism which can cause pneumonia can also cause Erythema Multiforme
Mycoplasma Pneumoniae
What is aplastic crisis and which derm disease can cause it
A drop in haemoglobin due to cessation of RBC production
Slapped cheek disease (Parvovirus B19)
How is Lyme disease diagnosed
Antibody blood test
The dermis contains which types of collagen
Type 1 and 3
What is ground substance made up of
Hyaluronic acid & Chondroitin Sulphate
What is the epidermal basement membrane made up of
Laminin & Collagen type 4
Define Hyperkeratosis
Increased thickness of keratin layer
Define Parakeratosis
Persistence of nuclei in keratin layer
Define Acanthosis
Increased thickness of epithelium
Define Papillomatosis
Irregular thickening of epithelium
Define Spongiosis
Oedema fluid between squames
Define psoriasiform disease
Elongation of rete ridges
Define lichenoid disease
Basal layer damage
Define vesiculobullous disease
Blistering
What are Munro micro-abscesses
Complement attracts neutrophils to keratin layer
seen in psoriasis
Which gene is associated with dermatitis herpetiformis
HLA-DQ2
What is rhinophyma
A large red bullous nose
What are the 4 types of itch
Pruritoceptive
Neuropathic
Neurogenic
Psychogenic
What is the Leser-Tralet sign
Eruptive appearance of many lesions
suggests Internal malignancy
What is the pathology of erythema nodosum and what is the treatment
Inflammation of subcutaneous fat
No active treatment
Which class of antibiotics can be implicated with Toxic Epidermal Necrolysis
Penicillins
What is Keratoderma Blenorrhagia and which MSK syndrome is it associated with
Waxy yellow papules on soles of feet
Reiter’s syndrome
What is alopecia areata and what is a drug which can be given
Autoimmune hair loss (spots)
Minoxidil
Which GI and endocrine pathologies are associated with acanthosis nigricans
GI malignancies
Type 2 diabetes mellitus
Name a GI disease and an MSK disease which are associated with pyoderma gangrenosum and the treatment for it
Crohn’s disease
Rheumatoid Arthritis
–> Oral steroid
What is a port wine stain and what is the treatment
Flat capillary malformation seen at birth
No treatment
Pearly white papules with a central umbilication
What should you suspect
Molluscum Contagiosum
What is Pityriasis Versicolor and what is the treatment
Infection caused by Malassezia fungus
Ketoconazole shampoo
Which hair growth can chronic malnutrition cause
Lanugo hair
Someone on the pill presents with a central red papule with capillaries, on their upper body
What should you suspect
Spider Naevus
What pathology is described as premalignant white hard spots on the mucous membranes of the mouth
Leukoplakia
What are the 1st and 2nd line treatments for psoriasis
Emollient
Topical steroid + Topical Calcipotriol
What is the treatment for moderate and severe Impetigo
Moderate - Topical Fusidic acid
Severe - Oral Flucloxacilin
What is hyperhidrosis and what is the treatment
Excessive sweating
Topical Aluminium Chloride
What is Guttate Psoriasis preceded by
Strep Infection 2-4weeks prior
What do papules with a white lace pattern suggest and what is the treatment
Lichen Planus
Topical steroids
How would you describe the pathology of Bowen’s disease
Intra-epidermal squamous cell carcinoma
Why should you immediately admit a child who presents with new onset purpura
To rule out meningococcal disease and acute lymphoblastic leukaemia
Which derm disease tends to spare the nasolabial folds
Acne Rosacea
Which derm disease presents with a Herald patch
Pityriasis Rosea
Which condition is characterised by melanin-stimulating hormone being produced in excess by the pituitary
Nelson’s syndrome
