Dermatology Flashcards by Divyesh Joshi

Outermost layer of skin?

And what is it made of?

The epidermis is the outermost layer of skin

stratified squamous epithelium.

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Melanocytes= What job?

Where are melanocytes derived from from?

Melanocytes= pigment production

Melanocytes origin= neural crest

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2 cells in basal layer of the epidermis.

What is the most prominent cell type in the epidermis?

Basel layer= keratinocytes and melanocytes

most prominent= keratinocytes.

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Epidermis contains melanocytes, what do they produce?

melanin

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Order of layers of skin (superficial to Deep) (5)

Keratin Layer
Granular Layer
Prickle Layer
Basal Layer
Dermo-epidermal junction
Dermis

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Which enzyme issue causes EPP (Erythropoietic protoporphyria) ?

ferrochelatase (FECH)

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To make heme, ferrochelatase (FECH) has to add iron to a substance called ZZZ?

What is ZZZ?

ZZZ= protoporphyrin IX

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Where are fibroblasts found, what do they produce, and what is their main function?

Location?

Fibroblasts= dermis

Function = wound healing by producing collagen.

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Where is Sebaceous Gland found, what does it produce:

dermis (not on soles of feet and hands),

sebum

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Melanocytes, where are they found?

Situated in the stratum basale

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Collagen provides what?

tensile strength

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Energy is stored where in the skin?

Subcutaneous fat

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Which bacteria is associated with Panton Valentine Leukocidin (2)

Staphylococcus aureus and MRSA

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Which layer of skin is most metabolically active?

Basel Layer

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neural crest primarily gives rise to structures such ? (1)

melanocytes

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Acute Intermittent Porphyria (AIP) , which enzyme deficient?

porphobilinogen deaminase (PBGD)

Peanut Butter (and) Gelly!

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What are the 2 Porphyrin Precursors Accumulation in AIP?

porphobilinogen (PBG), and δ-aminolevulinic acid (ALA) in the liver.

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What colour does urine turn in Acute Intermittent Porphyria (AIP)?

Port Wine coloured

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Gene associated with Acute Intermittent Porphyria (AIP)

HMBS gene

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Prevalence key buzzword

Any given time

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incidence buzzword

New cases over a given period of time

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Erythropoietic protoporphyria (3)

Affects little children
Skin clear on exam
Ferrochelatase deficiency

Proto IX

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Porphyria Cutanea Tarda (4)

Blistering on sun exposure
Urine colour changes, port wine colour
Liver dysfunction

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Chronic Actinic Dermatitis (3)

Severe photosensitivity in older adults
Eczema-like rash on sun-exposed areas
Chronic UV exposure history

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Polymorphic **Light** Eruption (PLE, 3)

1. Recurrent rash after sun exposure 2. Variability in lesion appearance **3. SUMMER MONTHS**

SJS (Stevens-Johnson Syndrome) 3 buzzwords

Mucosal Involvement <10% skin detachment Target Lesions

TEN (Toxic Epidermal Necrolysis) 3 buzzwords

>30% skin detachment Nikolsky's sign +Ve Looks worse than SJS

Eczema herpeticum 4 buzzwords

herpes simplex virus. Kaposi Varicelliform Eruption Dew Drop on Rose Petal Systemic Symptoms

bullous pemphigus 3 buzzwords

oral legion desmogleins Nikolsky's sign negative

Function of Skin (7)

Barrier Sensation Thermoregulation Immune defence Metabolism (Vitamin D3 and activation of T4-T3 (T4 conversion): Keratinocytes responsible for vitD production Communication

Melanocytes produce Melanin from XXX? Derived from YYY

XXX= tyrosine YYY= Neural Crest

Keratinocytes produce YYY and synthesize XXX?

YYY= Keratin, XXX = Vit D

Merkel cells are XXX found at YYYY layer responsible for ZZZ

Merkel cells are **Mechanoreceptors** found at **Basel** layer responsible for **Light Touch**

Pacinian corpuscle responsible for ?

pressure sensation

Meissner corpuscle Mechanoreceptor responsible for what?

Meissner corpuscle= vibration sensation

Eccrine gland job?

Secrete sweat and are responsible for thermoregulation

Apocrine gland - Found in where? Produce what? Secrete which fluid?

Apocrine gland - Found in axillae and perineum Produce the scent Secrete oily fluid

Sebaceous gland - Found mainly where? Secretes oily XXX that moisturises skin Part of YYY unit

Sebaceous gland - Found mainly on face and chest Secretes oily sebum that moisturises skin Part of pilosebaceous unit

Hair: 3 growth phases After Captain Takesoff gradually eyes (i) Rest

Anagen = growth Catogen = involution Telogen = rest

Dermatitis: Atopic (atopic eczema) Which faulty Gene?

Filaggrin gene mutation

Secondary infection, name? Which virus? Tx?

eczema herpeticum’, monomorphic punched Herpes simplex virus (HSV) Punched out lesion - Tx: URGENT Acyclovir

Contact allergic , delayed, 2 causes Mgt

Cleaning products Metal in clothing and jewelry Patch test and avoid

Contact Irritant , 3 causes

Cleaning products Saliva Urine

Acne Vulgaris Mild Moderate Severe

Mild Mainly comedones with a few papules/pustules Moderate Comedones and many papules/pustules Severe Painful, nodulocystic, scarring

Treatment for Acne Mild to moderate - Moderate to severe -

Mild to moderate - topical benzoyl peroxide with topical clindamycin (once in evening) Moderate to severe - topical adapalene (retinoid) With topical benzoyl peroxide With oral lymecycline or oral doxycycline (Once daily)

Cellulitis Most common association? Bi or Unilateral?

Strep pyogenes, then Staph Aureus Unilateral

2 key investigations for Cellulitis

↑ WBC ↑ CRP

Mgt Cellulitis

Fluclox pen allergic doxy

Melanoma in situ =

Lentigo maligna (premalignant)

Investigation for SCC

Excisional biopsy

Bowen's disease =

SCC in situ (premalignant)

massive skin erythema and shedding, can be FATAL

Erythrodermic psoriasis

Mgx of Psoriasis

1st line vit D analogue + potent topical steroid for up to 4 wks

Topical - vitamin D analogue name

Calcipotriol

1st line for guttate psoriasis

Phototherapy

Investigation 2 buzzwords

Biopsy and immunofluorescence Mucosal involvement Nikolsky’s sign Negative

Treatments for Pemphi VulgariS

Tx: High dose oral Prednisolone and immunosuppressants

Bullous pemphigoiD treatment

Tx: High dose prednisolone and weekly methotrexate

Shingles (Herpes Zoster) , which virus Uni or bilateral?

Varicella Zoster Unilateral

Which nerve

ophthalmic division of trigeminal nerve

Help Every Budding Dermatologist

UVA vs UVB, which penetrates deeper?

UVA

UVA taken with what?

psoralen

UVB, deep or superficial?

superficial

Erythematous bullseye lesions-disease and 3 buzzwords

- lyme disease 1. erythema migrans 2. Camping 3. Tick bite

Ash leaf spots/shagreen patches - disease?

tuberous sclerosis

Honey-colored crust - disease and main cause?

impetigo (caused by staph. Aureus)

Café-au-lait spots - disease?

neurofibromatosis type 1 or 2

Eczema step up (HEBDO):

- hydrocortisone - eumovate - betnovate - dermovate - oral preparations (prednisolone etc.)