Dermatology

Question 1

Describe Urticaria

Answer 1

• mildly raised patches
• red or paler than the surrounding skin
• itchy

Question 2

What is the acronym to describe a skin lesion with?

Answer 2

SCAM
Size (the widest diameter), Shape

Colour
Associated secondary change

Morphology, Margin (border)

Question 3

What do you look for on palpation of a skin lesion?

Answer 3

Surface

Consistency

Mobility

Tenderness. Temperature

Question 4

What is a naevus?

Answer 4

A localised malformation of tissue structures

Question 5

What is a comadome?

Answer 5

A plug in a sebaceous follicle containing altered sebum, bacteria and cellular debris; can present as either open (blackheads) or closed (whiteheads)

Question 6

What is a Koebner phenomenon?

Answer 6

A linear eruption arising at site of trauma

Question 7

A coin-shaped/round lesion

Answer 7

Discoid / Nummular

Question 8

Like a circle or ring

Answer 8

Annular

Question 9

Redness (due to inflammation and vasodilatation) which blanches on pressure

Answer 9

Erythema

Question 10

Red or purple colour (due to bleeding into the skin or mucous membrane) which does not blanch on pressure

Answer 10

Purpura

Question 11

Subclassification of purpura

Answer 11

• petechiae (small pinpoint macules)
• ecchymoses (larger bruise-like patches)

Question 12

What is a Nodule

Answer 12

Solid raised lesion >0.5cm in diameter with a deeper component

Question 13

Plaque

Answer 13

Palpable scaling raised lesion >0.5cm in diameter

Question 14

Vesicle

Answer 14

Raised, clear fluid-filled lesion <0.5cm in diameter

Question 15

Bulla

Answer 15

Raised, clear fluid-filled lesion >0.5cm in diameter

Question 16

Pustule

Answer 16

Pus-containing lesion <0.5cm in diameter

Question 17

Abscess

Answer 17

Localised accumulation of pus in the dermis or subcutaneous tissues.

Question 18

Wheal

Answer 18

Transient raised lesion due to dermal oedema

Question 19

Boil/ Furuncle

Answer 19

Staphylococcal infection around or within a hair follicle

Question 20

Carbuncle

Answer 20

Staphylococcal infection of adjacent hair follicles (multiple boils/furuncles)

Question 21

Excoriation

Answer 21

Loss of epidermis following trauma

Question 22

Lichenification

Answer 22

Well-defined roughening of skin with accentuation of skin markings

Question 23

Flakes of stratum corneum

Answer 23

Scales

Question 24

Subclassification of scars

Answer 24

• atrophic (thinning),
• hypertrophic (hyperproliferation within wound boundary),
• keloidal (hyperproliferation beyond wound boundary)

Question 25

Ulcer

Answer 25

Loss of epidermis and dermis (heals with scarring)

Question 26

Hypertrichosis

Answer 26

Non-androgen dependent pattern of excessive hair growth (e.g. in pigmented naevi)

Question 27

Koilonychia associations

Answer 27

iron-deficiency anaemia, congenital and idiopathic

Question 28

Onycholysis associations

Answer 28

trauma, psoriasis, fungal nail infection and hyperthyroidism

Question 29

Pitting associations

Answer 29

psoriasis, eczema and alopecia areata

Question 30

Functions of normal skin

Answer 30

i) Protective barrier against environmental insults
ii) Temperature regulation
iii) Sensation
iv) Vitamin D synthesis
v) Immunosurveillance
vi) Appearance/cosmesis

Question 31

What are the cell types in the epidermis?

Answer 31

Keratinocytes

Langerhans’ cells

Melanocytes

Merkel cells

Question 32

What do Merckel cells do?

Answer 32

Contain specialised nerve endings for sensation

Question 33

What are the 4 layers of the epidermis?

(from basally)

Answer 33

1. Stratum basale (Basal cell layer)
2. Stratum spinosum (Prickle cell layer)
3. Stratum granulosum (Granular cell layer)
4. Stratum corneum (Horny layer)

+/- stratum lucidum beneath the stratum corneum (paler, compact keratin)