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Special Senses > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How to examine a skin lesion

A

Inspect - site, number of lesions, distribution and configuration
Describe - size, shape, colour, secondary changes, morphology, margin
If pigmented: Asymmetry, irregular Border, two or more Colours, >7mm Diameter
Palpate - consistency, mobility, tenderness, temperature
Systemic check - nails, scalp, hair + mucous membranes

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2
Q

Lesion

A

Area of altered skin

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3
Q

Rash

A

An eruption

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4
Q

Naevus

A

Localised malformation of tissue structures

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5
Q

Comedone

A

Plug in sebaceous follicle containing sebum, bacteria and cellular debris
Open = blackheads
Closed = whiteheads

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6
Q

Generalised

A

All over body

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7
Q

Widespread

A

Extensive

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8
Q

Localised

A

One area of skin only

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9
Q

Flexural

A

Body folds (neck, groin, behind ears, popliteal and antecubital fossa)

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10
Q

Extensor

A

Knees, elbows, shins

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11
Q

Pressure areas

A

Sacrum, buttocks, ankles, heels

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12
Q

Photosensitive

A

Affects sun-exposed areas such as face, neck and back of hands

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13
Q

Distribution

A

Pattern of spread of lesions:
Generalised, widespread, localised?
Flexor/ extensor/ pressure areas/ dermatomes/ photosensitive area?

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14
Q

Configuration

A

Pattern or shape of grouped lesions:

Discrete, confluent, linear, target, annular, discoid

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15
Q

Discrete

A

Individual lesions separated from each other

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16
Q

Confluent

A

Merging together

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17
Q

Linear

A

In a line

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18
Q

Target

A

Concentric rings (bullseye)

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19
Q

Annular

A

Rings

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20
Q

Discoid

A

Coin shaped/ round

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21
Q

Colour

A

Erythema/ purpura

Hypo/ hyper/ depigmented

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22
Q

Erythema

A

Redness which blanches

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23
Q

Purpura

A

Red or purple that does not blanch

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24
Q

Petechiae

A

Purpura - small pinpoint macules

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25
Q

Ecchymoses

A

Purpura - large bruise like patches

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26
Q

Hypo/ hyper/ depigmented

A 
Hypo = paler skin
Hyper = darker skin 
De = white skin due to absence of melanin
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27
Q

Morphology

A

Structure of lesion

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28
Q

Macule

A

Flat area of altered colour (freckle)

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29
Q

Patch

A

Large flat area of altered colour

30
Q

Papule

A

Solid raised lesion <0.5cm (xanthomata)

31
Q

Nodule

A

Solid raised lesion >0.5cm

32
Q

Plaque

A

Palpable scaling raised lesion >0.5cm (psoriasis)

33
Q

Vesicle

A

Raised, clear fluid filled lesion <0.5cm (acute hand eczema)

34
Q

Bulla

A

Raised, clear fluid filled lesion >0.5cm (reaction to insect bites)

35
Q

Pustule

A

Pus containing lesion <0.5cm (acne)

36
Q

Abscess

A

Localised accumulation of pus in dermis

37
Q

Weal

A

Transient raised lesion due to dermal oedema (urticaria)

38
Q

Boil/ furuncle

A

Staph infection around or within hair follicle

39
Q

Carbuncle

A

Staph infection of adjacent hair follicles (multiple boils)

40
Q

Secondary lesions

A

Excoriation, scales, crust, scar, ulcer, fissure, striae

41
Q

Excoriation

A

Loss of epidermis following trauma

42
Q

Scales

A

Excoriations in eczema (psoriasis showing silvery scales)

43
Q

Crust

A

Rough surface made of serum, blood, bacteria and debris
Exuded through eroded epidermis
eg impetigo

44
Q

Scar

A

New fibrous tissue post wound healing
Atrophic = thinning
Hypertrophic = hyperproliferation within would boundary
Keloidal = hyperproliferation beyond wound boundary

45
Q

Ulcer

A

Loss of epidermis and dermis

46
Q

Fissure

A

Epidermal crack due to excess dryness

47
Q

Striae

A

Linear areas going from purple > pink > white

Due to steroid use or growth spurts

48
Q

Hirsutism

A

Androgen dependant hair growth in a female

49
Q

Hypertrichosis

A

Non androgen dependant hair growth

50
Q

Koilonychia

A

Spoon shaped depression of nail due to anaemia

51
Q

Onycholysis

A

Separation of distal end of nail from nail bed

Due to psoriasis or hyperthyroidism

52
Q

Pitting

A

Punctate depressions of nail due to psoriasis and eczema

53
Q

Psoriasis presentation

A

Raised area of red skin covered in silvery scales (plaques). Found on extensor surfaces + scalp, usually widespread confluent lesions. Itchy and painful

54
Q

Pathophysiology of psoriasis

A

New cells move up skin layers to outermost level in 2-6 days - not fully mature cells build up causing red, flaky scales

55
Q

What is guttate psoriasis?

A

In young children and adults
Small pink patches without scaling
Develops after strep throat

56
Q

Treatment for psoriasis

A 
Phototherapy 
Medications:
1) Acitretin (retinoid) - not for women of child bearing age 
2) Ciclosporin 
3) Methotrexate 
4) Hydroxycarbamide
57
Q

Atopic eczema presentation

A

Itchy erythematous dry scaly patches on face and extensor aspects in infants, and flexor aspects in children and adults
Acute lesions are exudative papules and vesicles on erythematous base
Chronic scratching can cause excoriations
May have nail pitting

58
Q

Eczema management

A

Emollients
Topical steroids for flare ups
Oral abx for secondary bacterial infections
Oral steroids for severe resistant cases

59
Q

Eczema complications

A

Secondary bacterial infections
Molluscum contagiosum
Viral warts
Eczema herpeticum

60
Q

Presentation of acne

A

Open and closed comedones

Papules, pustules and nodules

61
Q

Complications of acne

A

Hyperpigmentation
Scarring
Deformity

62
Q

Basal cell carcinoma presentation

A

Nodular is most common
Small, skin coloured papule or nodule with surface telangiectasia + pearly rolled edge
Lesion may have necrotic or ulcerated centre
Usually over head or neck

63
Q

Squamous cell carcinoma presentation

A

Keratotic (scaly, crusty) ill defined nodule, may ulcerate

64
Q

Malignant melanoma presentation

A

Asymmetrical, irregular border, irregular colour, large diameter, changing in size or shape
Common on legs and trunk
May itch or bleed

65
Q

Erythema nodosum

A

Inflammation of SC fat
Causes tender, red nodular lesions over shins/ forearms
Due to strep/ IBD/ sarcoidosis/ penicillins/ COCP

66
Q

Treatment for actinic keratosis

A

Fluoruracil cream or imiquimod cream

67
Q

Treatment for lupus

A

NSAIDs
Corticosteroids
Hydroxychloroquine (especially for the rash)

68
Q

Erysipelas presentation and treatment

A

Sharply demarcated raised edge rash

Treat with penicillin/ erythromycin

69
Q

Treatment for impetigo

A

Fusidic acid or mupirocin

70
Q

Treatment for shingles

A

Oral acyclovir

Special Senses (4 decks)

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