Dermatology Flashcards by Louise Emerson

what does iatrogenic mean

caused by a drug (medication)

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define prevelance

total number of cases (of a disease) within the population at any one time

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define incidence

the number of new cases of a disease defined as the % of the population who develop the disease over a fixed period of time

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what skin conditions are becoming more popular

skin cancers, venous leg ulceration, atopic dermatitis

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what is illness behaviour

the ways in which given symptoms may be differentially perceived, evaluated, acted upon (or not acted upon) by different kinds of person

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what is illness

the experience of discomfort and suffering

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what can stigma relating to a skin problem lead to

a social handicap

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what is acneiform

eruptions that resemble acne vulgaris, dont have comedones (blackheads)

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what is a punctum

puncture mark

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list in order from outer to inner most
basement membrane 
basal layer
connective tissue
keratin layer
prickle cell layer
capillary cell wall 
granular layer

keratin layer
granular layer 
prickle cell layer 
basal layer 
basement membrane 
connective tissue 
capillary cell wall

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what does the ‘venom’ in mosquito bites do

oppose vasoconstriction, blood coagulation, platelet and immune responses

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what are the three main cell types involved in IgE reactions and their roles

B cells (recognised antigen and produce antigen specfic IgE antibody)

T cells (cytotoxic, help B cells)

mast cells (release inflammatory mediators and vasoactive substances)

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what vasoactive substances are released by mast cells

preformed

histamine
tryptase
heparin

synthesised on demand

leukotrienes
prostaglandins
cytokines (IL4 and TNF)

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what effects do the vasoactive substances released by mast cells have on the dermis

increased blood flow

contraction of smooth muscle

increased vascular permeability

increase secretions (at mucosal surfaces)

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what are the 5 defining features of anaphylaxis

laryngeal/ pharyngeal oedema

bronchospasm (wheeze)

tachypnoea (resp rate)

tachycardia

hypotension and potential cardiovascular collapse

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what does indurated mean

beginning to harden

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define cellulitis

spreading infection in the dermis that is not associated with necrosis

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what do sebaceous glands secrete to defend against pathogens

hydrophobic oils, lyzsozome (destroys bac cell walls), ammonia (anti-bac), antimicrobial peptides (defensins)

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name 7 cells of the innate immune response

monocytes/macrophages

neutrophils

dendritic cells

basophils

mast cells

eosinophils

NK cells

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name 3 soluble mediators of the innate immune system

acute phase proteins (CRP)
cytokines
complement

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are antbodies (immunoglobulins) and cytokines innate or adaptive proteins

adaptive

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what does PVL do

kills leukocytes

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what are the antiphygocytic virulence factors of s aureus (2)

capsule, protein A

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what is the adhesin virulence factor of s aureus

fibrinogen binding protein

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from which cells do malignant melanomas of the skin arise

melanocytes in the basal layer of the epidermis

what does breslow thickness refer to

the distance between the granular layer and the deepest tumour cell

what is the cause of the redness in atopic ezema

inflammatory cytokines causing leaky vessels and vasodilation

why is atopic eczema patchy

due to airborne patterns of allergens

what foods can make acne worse

highly processed foods, diary

why does combination pill help acne

blocks testosterone

what are features of severe acne

pseudocysts and nodules

what is the role of eccrine glands

moisten palms/soles for grip, temp regulation

what is the role of apocrine glands

scent glands

what is the role of meissners corpuscles

vibration sensation

what is the role of pacinian corpuscles

pressure sensation

when do sweat glands develop

6 months gestation

what layer of epidermis is most metabolically active

basal layer

how does porhpyria cutanea tarda usually present

in older age, blisters on sun exposed areas, crusting over and scarring

what is maceration

the softening and breakdown of skin resulting from prolonged exposure to water

where are highly metabolically active small cuboidal cells found

in the basal layer

where are odland bodies found

in the granular layer

where is the hyponychium

underlying the free edge of the nail plate

what is the role of fibroblasts

collagen synthesis

what is the role of sebaceous glands

skin lubrication (produce sebum)

name the condition: A 3 year old boy presents on a sunny day in June. His mother reports he keeps crying and rubs at his skin when playing outside and this has been going on for a few weeks. His skin is sometimes a bit red, but there is never a rash and his skin is clear on examination now. He is skin type 1 with a few freckles evident, generally well, on no medication and there is no family history of skin problems. What is the most likely diagnosis?

erythropoietic protoporphyria

what are nails made of

densely packed keratin

do fingernails or toenails grow faster

fingernails

how long does it take for a cell to migrate from the basal layer to the keratin layer

28 days

where does nuclei loss start and finish

starts at granular layer, finishes in keratin layer

what makes up 80% of the keratin layer

keratin and fillagrin

how thick is the granular layer

2-3 cells thick

what percentage of GP consultations are skin problems

19%

what mediates type 2 and 3 reactions

IgG, IgM

what enzyme is deficient in acute intermittent porphyria

porphobilinogen deaminase

give the meaning of each phase: anagen catagen telogen

a-growing phase c- involuting phase t-resting phase

what cell carries out vitamin D metabolism

keratinocytes

where is collagen found

dermis

where do cells in the epidermis proliferate from

basal layer

where are fibroblasts found

dermis

where is ground substance found

in the dermis

what is ground substance

substance found between cells and fibres in the dermis

what component of MRSA causes severe skin infections e.g NF

panton valentine leukocidin

are sebaceous glands attached to hair follicles

yes

what is the most common sweat gland in the face

eccrine

where are langerhan cells formed

in the bone marrow

what is the path of langerhans cells

migrate through the epidermis and dermis and travel via lymphatics to present antigen in lymph nodes

what does the virulence factor aggressin do

causes damage to host directly

what does the virulence factor impedin do

evades hosts defence mechanisms

what does the virulence factor modulin do

casues damage to host indirectly

what does the virulence factor invasin do

invades hosts tissue

how does erythropoietic protoporphyria present

in early childhood with discomfort, itch or tingling in sun exposed skin- often no clinical signs

what enzyme is deficient in Erythropoietic protoporphyria

ferrochelatase- causes a build up of protoporphyrin IX

what allows the passive diffusion of topical steroids across plasma membranes

their lipophillic properties

what are the effects of topical steroids

anti-proliferatives (inhibit cell growth) anti-inflammatory vasoconstrictive

what affects absorption of topical steroids

skin thickness, skin state, occulsion, vehicle, drug concentration

what investigations for rignworm

skin scraping for microscopy, culture and woods light

what is present in 90% of neurofibromatosis type 1 cases

cafe au lait macules

out of these, which is autosomal dominant - red hair - tuberous sclerosis - atopic dermatitis - xeroderma pigmentosum - psoriasis

tuberous sclerosis

what are signs and symptoms of roscaea

erythema, telangiectasia, papules, pustules and sometimes lymphoedema

what is dithranol used for

psoriasis

what type of HPV causes cervical cancer

16 and 18

why are creams more likely than ointments to cause contact sensitisation

as creams contain preservatives

what is commonly seen in history of patients with bullous pemphigoid

itch in the months preceding the onset of the blistering

what foods do you exclude in coeliac diease

wheat, barley and rye

what is the 1st and 2nd line treatment for roscaea

1st topical metronidazole | 2nd oral tetracycline

what is papillomatosis

rare dermatosis characterised by asymptomatic small, flat and keratosic papules (form of acanthosis nigricans)

does chronic actinic dermatitis (photosensitivity) increase you risk of SCC

does long term topical steroid use in atopic dermatitis increase your risk of SCC

should compression bandages be used in arterial ulcers

what is the difference between nodular and superficial BCC

nodular presents as a raised nodule superficial presents as a slowly growing thin erythematous plaque

what is the order of components of the scalp from inside to outside

``` periosteum loose connective tissue aponeurosis connective tissue skin ``` THINK SCALP

what is the most common cancer in the UK

BCC

what is the chance of getting MM in uk in lifetime

1 in 77