Dermatological terminology Flashcards
Cellulitis and erysipelas
Cellulitis
- inflammation of dermal + subcutaneous connective tissue caused by bacteria
- Erysipelas is inflammation of dermis + upper subcutaneous tissue - form of cellulitis
- area raised above surrounding tissue
- redness of skin, pain and swelling
- mostly affects lower limbs
Severe cellulitis
- rapid progression of swelling, blistering + systemic upset
- Treatment; antibiotics, elevation
Impetigo
- Highly contagious
- yellow fluid-containing vesicles/pustules that rupture to form a golden / brown crusting
- Treatment = antibacterial cream
Cutaneous abscess
Abscess defined as a collection of pus in the dermis + deeper skin tissues
- breaks in skin can give rise to infection, that through necrosis + liquefaction can lead to abscess formation
- typically surrounded by erythematous tissue
- treatment; incision + drainage
- wound should be left open to promote continued drainage of any residual septic material
- if abscess results from hair follicle = pilonidal abscess
Furuncle and carbuncle
- Staphylococcal hair follicle infection common
- A furuncle (boil) = more extensive infection at base of hair follicle
- a carbuncle occurs when several furuncles in same site = inflammatory mass
Hidradentitis suprative
recurrent abscess formation in areas of body that produce high concentrations of sweat e.g. axilla, breast, thigh, groin + buttocks
Animal + human bite wounds
Cat bites
- carry higher risk of osteomyelitis, abscess formation + septic arthritis as they have pointed hollow teeth
Human bites
- tend to be occlusive wounds (teeth enclosed in an area of tissue)
Oral amoxicillin
Viral soft tissue infections
Herpes simplex
- cold sore
- hyperaesthesia of skin, vesicle formation progresses into a painful ulceration
- virus remains dormant in trigeminal ganglia - can be reactivated
- Antiviral cream
Varicella zoster (chicken pox + shingles)
- chicken pox - manifests as pyrexial illness with myalgia + headache, followed by macular to vesicular rash
- virus lays dormant in dorsal root + cranial nerve ganglia - can present later in life as shingles
- shingle - antiviral medication e.g. acyclovir used to reduce illness + risk of developing post infective neuralgia
Molluscum contagiosum
- pearly or skin coloured papules
- highly infectious + debilitating
Fungal soft tissue infections
Tinea pedis (athletes foot)
- jungle infection between toes
- treatment; topical anti fungal agents
- breaks in skin can lead to cellulitis
Candida albicans
- commensal of mouth - can cause infection of skin
- e.g. genital thrush (white plaques + white vaginal discharge)
Tinea capitis
- fungal infection of scalp
- areas of alopecia
- treatment - anti fungal
Infestations
Scabies
- skin eruptions (papules, vesicles, pustules + nodules) that arise from burrows made from mite (sarcoptes scabiei)
- most common infected areas; hands/wrists, feet, ankles, genitalia, buttocks + abdomen
- crusted scabies - found in immunocompromised + elderly pts
DON’T MISS - SKIN
Necrotising Fasciitis
- infection of subcutaneous tissues
- initially resembles cellulitis but severe pain
- systemic toxicity with high temps + features of sepsis
Treatment; debridement, antibiotics
PRIMARY SKIN LESIONS
MACULES
Small, flat areas of change in skin colour
e.g. freckles
PRIMARY SKIN LESIONS
PATCHES
Larger, flat areas of change in skin colour
PRIMARY SKIN LESIONS
PAPULES
Elevated lesions <1 cm
PRIMARY SKIN LESIONS
PLAQUES
Raised lesions >1 cm
Surface area is greater than elevation
e.g. psoriasis
PRIMARY SKIN LESIONS
VESICLES
Small, raised cavities containing fluid <1 cm
e.g. chicken pox
What is pruritus?
Itch
- normal body response-protection from external factors
- rush of cytokines + histamine to an area
- can cause excoriation
Primary skin disorders causing pruritus
- dry skin
- psoriasis
- scabies
- urticaria
Systemic conditions causing pruritus
- cholestasis
- chronic kidney disease
- pregnancy
- lymphoma
- iron deficiency
- endocrine disease e.g diabetes
What causes dry skin?
Occurs when skin loses excessive water or oil
- age
- weather
- eczema
- chlorine
- excessive hand washing
What conditions cause skin discolouration?
Erythema
- skin redness caused by skin injury, infection or inflammation
- dilation + irritation of superficial capillaries
Jaundice
- yellowing of skin due to build of of bilirubin
Hyperpigmentation
- patches of darker skin due to excess melanin
Hypopigmentation
- patches of lighter skin
What is oedema?
- Excess fluid collecting in tissues
- angioedema = rapid swelling of dermis, subcucatenous tissue or mucosa
What is discharge / exudate?
- Pus discharge from infection - made from dead leukocytes, tissue and debris
- Yellowy fluid discharge from impetigo
- Fluid filled blisters (bullous pemphigoid)
- Fluid cushions tissue underneath , protecting from further damage
What causes an ulcer?
Inadequate blood flow + repercussion injury
- ischaemia + cell death
Define dermatology
The study of both normal and abnormal skin and associated structures such as hair, nails, and oral and genital mucous membranes. Primarily the diagnosis and treatment of skin disorders.
What is flexural distribution?
Occurring in the flexor surfaces, such as the antecubital fossa and back of the knee.
What is extensor distribution?
Occurring on the extensor surfaces, such as over the tip of the elbow and usually just below the patella.
What is neoplasia?
Presence or formation of new, abnormal growth of tissue
What are the different types of skin?
- Epidermis (outermost layer of skin - provides waterproof barrier)
- Dermis (contains tough connective tissue, hair follicules + sweat glands)
- Deeper subcutaneous tissue (hypodermis) made of fat + connective tissue
Lesions
Lesions - area of altered skin
Rash - widespread eruption of lesions >20 lesions
Dermatisis - inflammation of the skin
Annular - groupe in a circle
Gyrante rash - appears to be whirling in a circle
Linear lesion - striate
Nummular or discord - round / coin shaped lesions
Target lesions - concentric rings like archery target
What is purpura?
Red / purple colour (due to bleeding of skin or mucus membrane)
- doesn’t blanch on pressure
Inspection of lumps…
- Site
- Shape
- Colour
- Contour (texture of skin overlying lump)
- Tenderness
- Temperature
- Consistency (hard/soft)
- Tethering (freely mobile?)
- Pulsatility
- Lymphadenopathy
- Transillumination
- Compressibility (emptied by pressure but reappear spontaneously)
- Bruits
Psoriasis
- Red raised patches of skin
- Treatment = corticosteroids
Urticaria?
- Caused by hypersensitive reaction to a specific trigger
What are the 4 types of angioedema?
- Acute allergic
- Non-allergic drug reaction
- Idiopathic
- Hereditary (C1 inhibitory deficiency)
S&S:Oedematous around eyes & mouth Doesn’t have to have urticaria/rash May be pruritic
What is Steven Johnsons syndrome?
- AKA toxic epidermal necrolysis
- Autoimmune response to foreign antigens associated with medications such as anticonvulsants.
Which animal transmits Lyme disease?
Ticks
commonly involve an initial skin lesion with expanding erythema around the site of the bite called erythema migrants or target lesion.
What is SCC?
Squamous cell carcinoma
- a malignancy of the upper layers of the dermis, e.g. the squam cells.
- Characterised by bleeding, hyperkeratosis, ulceration. Raised lesion with irregular edges and tethered to the underlying skin/tissues.
- Invasion of local organs and tissues and spread around the body primarily brain and lungs.
- MAIN CAUSE: ultraviolet exposure
- MANAGEMENT: surgery and radiotherapy
What is a BCC?
Basal Cell Carcinoma
- Rodent ulcer
- Malignant change in the basal cell layer of the dermis;
Presents as slowly enlarging lesion, often described as pearlized (white and smooth). - although malignant, it does not metastise.
- CAUSE: UV light (common sights include ears, nose)
- MANAGEMENT: surgery and radiotherapy.
What is malignant melanoma?
- A malignant change in the malanosites of the dermis layer which presents as irregular hyperpigmentation and the lesion(mole) raised with irregular edges, tethered to the skin.
- can bleed
- Will metastasise to the other structures in the body.
What are the different patterns a lesion can follow?
- linear
- annular (ring-shaped
- reticulated (net like)
- serpiginous (snake like)
- grouped
Skin symptom Hx
P = what brought it on e.g. viral illness, medication
Quality = (what does it look like/ painful/ itchy)
Quantity = (how many? / how much of body does it cover? / how bad are symptoms)
Recent events (illness, contact with someone with rash)
Site = (where on body did it start / where is it now)
Symptoms (e.g. fever, coryza symptoms)
Time Course = (how long has it been there? / how quickly has it spread?)
Treatment tries (e.g. steroid creams, antihistamines)
What drugs can sensitise the skin to sunlight?
- diuretics
When referent pt to GP with eczema/
- Infected eczema
- widespread paediatric eczema
- eczema not responding to emollients or mild-moderate topical steroids
What is lymphangitis
- red streaks arriving from wound
- indicate the infection is spreading
