Dermatology Flashcards
What is the structure of the skin?
Structure of skin more detail
What are the functions of the skin?
• Protection from the environment
Chemical, thermal, physical, UV injury
• Thermoregulation
• Neuroreceptor
External stimuli
• Antigen processing
• Synthesis of vitamin D
• Cosmetic
History taking in a patient with a skin disorder?
• Age, sex occupation
• History of presenting complaint
- symptoms/ initial site/ subsequent involvement
• Relevant systems review
• Current/past treatment
• Past medical history
• Family history
• Drug history
• Allergies
What does examination involve?
• should include careful complete skin inspection
Remember also
• ‘Hidden sites’ e.g. scalp, nails, umbilicus, natal cleft
• mucous membranes
oral mucosa
eyes
nasopharynx
± genitalia
site: e.g. localised / generalised/ distribution skin and/or mucous membranes
morphology: e.g. mono / polymorphic, blister/ erosion/ scarring
background skin: normal/ erythema
What is a macule and what is a patch?
What is a plaque?
What is a papule?
What is a nodule?
What is a vesicle?
What is a bulla?
What is a scale?
What is Lichenification and Excoriation?
What is an ulcer?
What is a scar?
Investigations ?
In order to clarify or confirm a diagnosis the following tests may be
needed:
• Skin swabs/scrapings
Bacteriology, virology, mycology
• Skin biopsy
Histology Culture Immunofluorescence
• Patch tests
Undertaken if a contact allergy is suspected
• Photo-tests
to investigate a possible sensitivity to UV
If a patient is unwell and either infected or in need of systemic therapy, the following blood investigations may be required
• Haematology: FBC, ESR
• Biochemistry: U+E, LFT, glucose, CRP
• Immunology: ANA, DNA, organ specific antibodies
• Virology: herpes simplex serology
Management of skin disorders?
What is eczema?
This is a pruritic inflammatory condition associated with dryness and erythema of skin. Scratching results in excoriation and lichenification
What are the different types of eczema?
Atopic/flexural
Varicose
seborrhoeic
discoid
Lichen simplex
Dermatitis may also be secondary to contact with a substance leading to:
(After eczema slide)
Irritant contact e.g.. over hand washing
Allergic contact dermatitis
What can eczema be secondarily infected by? (2)
Staphylococcus aureus (impetiginised eczema) yellow crust and weeping
Herpes simplex (eczema herpeticum) Monomorphic lesions
Management of eczema
Avoid soap, shower gel and contact with irritants such as domestic cleaning agents
Advise use of:
• Emollients e.g. soap substitutes, moisturisers
• Topical steroids • Oral antibiotics
• Antihistamines (sedative)
• Wet wraps
• Acyclovir if suspect herpes simplex (eczema herpeticum)
What are the clinical features of psoriasis?
• 2% prevalence. Strong family history
• Symmetrical well-defined red plaques with thick silvery scale
• Elbows and knees common sites
• Lasts for many years
• Types
Psoriasis vulgaris
Guttate
Erythrodermic
Pustular
What is psoriasis vulgaris?
Psoriasis - scalp, hairline and nails?
What is Guttate Psoriasis
M
Generalised pustular psoriasis
What is the treatment of psoriasis?
What is lichen planus ?
• Unknown aetiology 1-2% population
• Onset 30-60yrs
• Flat-topped violaceous papules on skin
• Predilection for flexor surfaces and lower back
• Clinical variants
Hypertrophic
annular
plantar
Oral – several sub-types
Lip
genital
scalp – lichen planopilaris
Oral lichen planus
Treatment of lichen planus?
Pruritis (itchy skin)
Varicella
What are warts caused by?
Bacterial infections Staphylococcus aureus/ streptococcal infections
Fungal infections
SEE SUMMARY NOTES - VERY VERY IMPORTANT TO LEARN FROM THERE BEFORE THIS FLASHCARDS
