Dermatology Flashcards
HSV 1 causes
primary herpes simplex(herpetic gingovstomatitis)
HSV.1 causes what in choldren
gingivostomatitis
signs and symptoms of HSV1
- often asymptomatic or very mild in presentation
- fever, restlessness and excessive dribbling
- drinking and eating painful
- halitosis
- gingiva red swollen and bleed easily
- white vesicles rupture to form ulcers on the tongue, throat palate and inside the cheeks
- local lymph nodes often enlarged and tender
management of HSV1
o self limiting
o fever subsides after 3-5 days and recovery complete within 2 wks
o rest, fluids and antipyrexials/analgesics
o oral lesions may require chlorhexidine mouthwashes, difflam for pain
recurrent HSV1
cold sore
signs and symptoms of recurrent hsv 1
- itching or burning
- followed by irregular clusters of small closely grouped umbilicated vesicles
- most frequently affect the lips (HS labialis)AKA cold sore
- heal in 7-10 days w/o scarring
herpes simplex on skin
herpetic whitlow-
Swelling, reddening and tenderness of finger.
- Clear vesicles develop that later rupture leaving open sores.
- Very painful.
herpes zoster can also cause
chicken poz leading to shingles
reactivated in dorsal root ganglia nerve cells
zoster
- Pain precedes skin signs by 1-3 days.
- 1-3 days after the onset of pain the characteristic rash appears.
- Starting with a crop of red papules which progress to blistering vesicles which burst and then crust confined to the local distribution of affected nerve.
- Common sites include, chest, neck, and lumbar/sacral regions.
complications of shingles
herpes zoster of opthalmicus
5th C involved
unilateral rash in distribution of trigeminal nerve
Hutchinson’s sign
- skin involvment of the tip of the nose indicates nasocilary nerve involvment
skin infection caused by pox virus
molluscum contagiosum
reacitonary epithelial hyperplasia
- Flesh-coloured to pink, umbilicated, pearly surface, approximately 1–5 mm in- diameter.
cellulitis
bacterial infection affecting lower dermis and SC tissues of the ksin
SC pyrogens or SC aureus
red inflamed skin, painful TPP, warm to touch
managed with Ab
erysipelas
superficial form of cellulitis SC pyogens well defined raised border butterfly distribution treated with Ab
Acne vulagris
inflamm disease of the pilosebaeous follicle
cause of blockages of pilosebaceous follicle
1) increased sebum production,
2) keratin plugging,
3) colonisation by (C. acnes) bacteria,
4) local inflammation
atopic dermatitis - ezema
chronic itchy skin condition
associated with atopic tendency
• Itchy, erythematous, dry scaly patches.
• Acute lesions become erythematous, vesicular and weepy.
• Chronic lesions become excoriated and lichenified.
aetiology of atopic dermatitis
- Inherited abnormalities in the skin barrier
- fillogrin expression
- binds to keratin in epidermal cells - Immune factors
- abnormal balance in TH1 and 2, TH2 elevated
- high IgE Ab - Imbalances in the microbial microflora of the skin.
- External factors that make the skin dry
- eg hard water - Skin irritants
- Stress
psoriasis
• Characterised by clearly defined, red and scaly plaques.
plaque from hyper proliferation of keratinocytes and secondary inflammatory infiltration
management of psoriasis
- Psoriasis Area and Severity Index (PASI) score used in assessment.
- Avoiding precipitating factors i.e. alcohol consumption.
- Emollients to soften scale.
- Topical – vitamin D analogues, topical steroid creams, coal tar, dithranol, salicylic acid, topical retinoids.
- Phototherapy – UVB or psoralen combined with UVA.
- Systemic – methotrexate, retinoids, cyclosporin, mycophenolate
melanotic naevi
mole
hyperplasia of melanocytes
acquired or congenital
subtypes of melanin naevi
junctional naevu - melanocytes found just below the basement membrane of epidermis
dermal naevus - melanocytes found in dermis
compound naevu - Mel…within dermis and at BM of epidermis
combined naevus - 2 diff types of mole within same lesion
ABCDE - for skin lesions not emergency lol
- (Asymmetry, Border irregularity, Colour variation, Diameter > 6 mm).
seborrhoetic keratosis
- Highly variable.
- Stuck on appearance.
- Flat or raised papule or plaque.
- 1 mm to several cm in diameter.
- Grey, light brown, dark brown, black or mixed colours.
- Smooth, waxy or warty surface.
unknonw cuase
spider telangiectasis
acquired vascular malformation
Central red papule (spider body) from which fine red lines (spider legs) extend radially.
dilaton enhance by increased estroenic blood levels
progenic granuloma
benign
reactive proliferation of capillary blood vessels
- Red, brownish, blue-black exophytic growth on the skin. If left untreated they often reach 1–2 cm in size.
often occur @ pregnancy
chondrodermatitis nodular helicis
Benign inflammatory condition affecting the skin and cartilage of the ear (helix)
pressure on ear
- Helix or antihelix of the ear.
- Solitary, firm, oval-shaped nodule, around 4–6 mm in diameter.
- May have a central crust and surrounding erythema.
- located on the sleeping side. i.e. unilateral
cysts
closed sac distinc membrane develop abnormally in a cavity or structure of the body
epidermoid cyst
do not involved sebaceous glands and don’t contain sebum
occluded pilosebaceous unit
mutiple can occur in Garner syndrome
- Normal or slightly pink overlying skin colour.
- Fixed to the skin surface but mobile over deeper layer.
- Has a central punctum.
- Bad smelling cheesy debris can be expressed from the central punctum.
- If secondarily infected - acute pain, swelling , redness, and discharge.
sun damage skin conditions
solar lentigo
actinic elastosis
solar lentigo
patch of darkened skin surrounded by normal skin
UV causes local hyperplasia of melanocytes
(proliferation above the BM, not like moles which are miltilayre)
actinic elastosis
accumulation of abnormal elastic in the dermis of the skin
UV stimulates fibroblast to produce excess collagen and elastin
actinic keratosis
precancerous condition
abnormal keratinocyte development due to DNA damage by short wavelength UVB
• Flat or thickened papule or plaque.
• Tan, pink, red colour with a scaly surface.
• The patch often feels dry or rough to touch.
- may get a cutaneous horn
types of malignant skin disease
melanoma vs non melanoma
basal cell carcima
locally invasive tumours malignant
risk factors for basal cell carcinoma
UV
previous skin cancer
solar elastosis and actinic keratosis
subtypes of BCC
nodular (smooth surface, skin coloured nodule)
superficial (scaly irr plaque, thin translucent rolled border)
morphemic (waxy scare like plaque w/ indistinct borders)
squamous cell carcinoma
invasive malignant tumour of epithelial keratinocytes
risk factors - UV exposure, fiztpartrick skin 1 and 2 types, premalignant conditions
SCC signs and managment
ill defined nodule lesions grow ulcerated or necrotic centre, surface crust staged with TNM surgical, radio, chemo
malignant melanoma
tumour of epidermal melanocytes
risk.- UV Fitzpatrick 1/2, atypical moles, fam history
diagnosis
examination
biopsy
breslow thickness for invative melanomas
TNM classiication
