Dermatology Flashcards
1
Q
What is the Epidermis made from?
A
stratified (squamous) cellular epithelium.
2
Q
What is the Dermis made from?
A
connective tissue
3
Q
Where does the epidermis come from?
A
ectoderm cells which form a single layer periderm.
4
Q
Where does the dermis come from?
A
mesoderm cells
5
Q
What are Melanocytes?
A
pigment producing cells from neural crest.
6
Q
What are the layers of the epidermis in order?
A
Keratin layer, granular layer, prickle cell layer and basal layer.
7
Q
What does the skin consist of?
A
epidermis, appendages (nails, hair, glands), dermo-epidermal junction, dermis, sub-cutis (predominantly fat)
8
Q
What muscle pulls the hair follicle in thermoregulation?
A
arrector pili muscle
9
Q
What is the biggest component of the epidermis?
A
Keratinocytes
10
Q
What are keratinocytes?
A
epidermal cell which produces keratin.
11
Q
Where do keratinocytes grow from?
A
the basement membrane up to the epidermis.
12
Q
What are the proper names for the layers of the epidermis in order?
A
stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale
13
Q
What is the outermost layer of the skin?
A
stratum corneum
14
Q
What is the stratum lucidum?
A
A clear layer between the keratin layer and granular layer which is filled with eleidin, an intermediate of keratin.
15
Q
What factors are responsible for the turnover of epidermal cells?
A
growth factors, cell death and hormones.
16
Q
What is the keratin layer like in Psoriasis?
A
thick- this is due to the keratinocytes growing from the basement membrane upwards maintaining continuous regeneration of the epidermis.
17
Q
What is the basal layer?
A
One cell thick with lots of intermediate filaments of keratin and are highly metabolically active. It is also known as stratum basale.
18
Q
What is the prickle cell layer?
A
it contains large polyhedral cells with lots of desmosomes. They are intermediate filaments to connect to desmosomes. Also known as Stratum spinosum.
19
Q
What is the granular layer?
A
2-3 layers of flat cells. It has a high lipid content and no cell nuclei. it is also known as stratum granulosum.
20
Q
What are Corneocytes and where are they found?
A
differentiated keratinocytes that compose mostly all of the stratum corneum.
21
Q
What are melanocytes?
A
they contain the pigment melanin (converted from tyrosine). They are derived from the brain?
22
Q
What is Vitiligo?
A
when the melanocytes are attacked by T cells. it represents an autoimmune disease with loss of melanocytes.
23
Q
What is Albinisim?
A
disorder where there is a genetic partial loss of pigment production
24
Q
What is Nelsons Syndrome?
A
when the melanin stimulating hormone is produced in excess by the pituitary gland. it is caused by too much ACh causing hyperpigmentation.
25
What is a melanocyte?
a tumour of the melanocyte cell line
26
What are Langerhan cells?
They come from the bone marrow and are found in the prickle cell layer. They are involved in the skin immune system as they are antigen presenting cells and move to the lymphatic system after detecting microbes.
27
What are Merkel cells?
in the basal layers between the keratinocytes and nerve fibres. They are mechanoreceptors.
28
What are the phases of hair growth?
Anagen, catagen, telogen
29
What is the shedding phase in hair growth?
telogen- 20% of all hair is in the shedding phase.
30
When is hair more likely to fall out?
after pregnancy and when the implant is inserted.
31
What is the dermo-epidermal junction?
interface between the epidermis and dermis.
32
What is the function of the dermo-epidermal junction?
Support, anchorage, adhesion, growth and as a barrier.
33
What is a consequence of a destroyed dermo-epidermal junction?
Bullous pemphigoid- when the junction goes wrong the skin blisters
34
What is an angioma?
overgrowth of blood vessels.
35
Where are apocrine sweat glands found?
in the genitals and axilla.
36
Where are the eccrine sweat glands found?
They are the major sweat glands of the body. They are found everywhere particularly in the palms and soles.
37
Which sweat gland is responsible for an odorous sweat?
apocrine
38
Which nerve supply innervates the eccrine glands?
sympathetic
39
Which UV radiation has the longest wavelength?
UVA
40
Does longer or shorter wavelengths penetrate the skin?
Longer wavelengths.
41
What are pacinian corpuscles?
mechanoreceptors
42
What are the 4 mechanoreceptors in the skin?
Merkels receptors, Meissners corpuscles, Ruffinis corpuscles, pacinian corpuscles
43
What is the Keratin Layer formed from?
keratinocytes that have differentiated into corneocytes
44
How do keratinocytes help towards immune surveillance?
they sense pathogens via cell surface receptors and help mediate an immune response. They produce antimicrobial peptides that can directly kill pathogens and produce chemokines and cytokines.
45
What are the main immune cells in the skin?
Langerhans Cells
46
Where are CD8 and CD4 found in the skin?
CD8 is found in the epidermis and CD4 in the dermis.
47
What is the role of CD8 and CD4 in the skin?
CD8 cells are cytotoxic so recognise foreign antibodies. CD4 helper cells instruct the immune response by causing inflammation.
48
Where are Dendritic cells found?
in the dermis
49
Mast cells bind to what to cause an immune response?
IgE
50
What surfaces does psoriasis affect?
Extensor and posterior mostly due to low grade trauma.
51
Mutation in what gene can cause atopic Eczema?
fillagrin gene.
52
What mediates type I hypersensitivity?
IgE
53
What mediates Type II and III hypersensitivity?
IgG and IgM
54
What mediates Type IV hypersensitivity?
Th1 cells (t cell mediated response)
55
What kind of hypersensitivity is contact dermatitis?
Type IV
56
What kind of hypersensitivity reaction is Urticaria?
Type I
57
What kind of test can be used in Type I hypersensitivity reactions?
Prick testing
58
What are the controls in Prick testing?
Negative- Saline, Positive- Histamine
59
what is the first line treatment for type I hypersensitivity reactions?
Anti-histamines
60
When using an Epi-pen, how much is given to adults and children?
300mg to adults, 150mg to children.
61
What kind of investigation is used in Type IV hypersensitivity? reactions?
Patch testing
62
What is the treatment for Allergic Contact Dermatitis?
Removal of relevant allergen and steroids (hydrocortisone)
63
What time intervals are used in patch testing?
Readings are done at 48 and 96 hours
64
How is allergic and irritant contact dermatitis differentiated?
via patch testing- it rules out allergic
65
How would you describe this?
A nodule
66
What is the function of melanocytes?
To make melanin which absorbs UV radiation to protect DNA
67
What do Fibroblasts produce?
collagen
68
What is the growing phase of hair called?
Anagen
69
What does Catagen mean?
it is the involuting stage of hair when it degnerates.
70
Which cells carry out Vitamin D metabolism?
Keratinocytes
71
Label each letter
C- Prickle Cell Layer
B- Granular Layer
D- Basal Layer
A- Keratin Layer
E- Dermo-Epidermal Junction
F- Dermis
72
Which layer of the epidermis is the most biologically acitive?
Basal Layer
73
Which enzyme is deficient in Erythropoeitic Protoporphyria?
Ferrochelatase
74
What are the feature of Erythropoeitic Protoporphyria?
Tends to present in childhood as with discomfort, itch or tingling in sun exposed skin.
75
Where are hemi-desmosomes found?
At the Dermo-epidermal junction
76
Where are fibroblasts found in the skin?
the dermis
77
Which enzyme is deficient in Acute intermittent porphyria?
PBG Deaminase
78
How much do nails grow per day?
0.1mm
79
which layer of the epidermis is composed of polyhedral cells with lots of desmosomes?
Prickle cell layer
80
Where would you find Odland Bodies?
Granular Layer
81
Label these
A: nail plate
B: Lanula
C: Cuticle (eponychium)
D: Proximal nail fold
E: nail matrix
F: nail bed
G: Hyponchium
H: tip of the nail/epithelium
82
What kind of gland and what muscle accompanies a hair follicle?
Sebaceous gland and Arrector pili muscle
83
Which glands are the scent glands?
Appocrine glands
84
What are the functions of meissners and pacinian Corpuscles?
Meissners: Vibration sensation
Pacinian: pressure sensation
85
What are the descriptions for Creams/Ointments/Gels/Lotions/Pastes?
Creams: Semisolid emulsion of oil in water, contain preservative, cosmetically acceptable, non greasy.
Ointments: Semisolid grease/oil, no preservative, less cosmetically attractive, greasy.
Gels: Thickened aqueous solutions
Lotions: Liquid formulation
Pastes: Semisolids, stiff, greasy, difficult to apply, often used in cooling, drying, soothing bandages
86
How would you investigate Scabies in the lab?
Skin scraping for microscopy to look for mites
87
How would you investigate Ringworm under the microscope?
Skin scrapings for culture under a wood light.
88
What condition is Cafe au lait spots associated with?
Neurofibromatosis type 1
89
How does Rosacea present?
With erythema and sometimes papules or pustules
90
What strains of HPV are responsible for warts and verrucas?
1-4
91
Why are creams more likley to cause contact sensitisation?
because they contain preservatives
92
Around how much topical therapy is required for an all over application to cover 1 adult?
30g
93
Is Bullous Pemphigoid associated with itch?
Yes- there is a preceding itch in the months before blistering occurs
94
What is first line treatment for rosacea?
Topical metronidazole cream
95
Name These:
A: intraepidermal bulla
B: Hyperkeratosis
C: Papillomatosis
D: Sub-epidermial bulla
E: Spongiosis
96
Where do venous ulcers commonly occur?
the lateral and medial malleolous
97
A 29 year old man presents with a firm slightly pigmented raised lesion of the right shin, present for 6 months and not changing. It is
occasionally itchy but otherwise asymptomatic. He is generally well with no previous skin problems.
Dermatofibroma
98
A 39 year old woman with a longstanding lesion of her neck which in the last year has become more elevated and occasionally itchy. She has atopic dermatitis and mild asthma but is otherwise well.
Melanocytic naevus
99
A 48 year old man with a pigmented lesion on his back first noticed 2 months ago which has become itchy, gradually bigger and
developed a darker area of colour within. He has had no previous skin problems.
Superficial spreadying malignant melanoma
100
A 56 year old man presents with a gradually expanding scaly plaque of his upper back. It is itchy at times and has bled when scratched. He has had no previous skin problems.
Superficial basal cell carcinoma
101
A 72 year old man who has developed a painful nodule of his right helix in the last 2 months preceded by a longstanding scaly area at this site. He is otherwise well.
Squamous Cell Carcinoma
102
A 73 year old woman presents with a red scaly plaque of her right calf present for 4 years. It has gradually grown and now looks unsightly but is otherwise not bothering her. She has no history of skin problems.
Bowens disease (intraepidermal squamous cell carcinoma)
103
A 78 year man of fair skin type who has a gradually enlarging nodule of his nose. It has bled occasionally if knocked but is otherwise asymptomatic. He has had no previous skin disease.
Basal cell carcinoma
104
What is Breslows Thickness? and why it is useful?
It is the depth from the granular layer to the last melanocyte and it gives a prognostic indicator
105
What are the layers of the scalp?
SCALP
Scalp
Connective tissue
Aponeurosis
Loose Connective tissue
Periosteum
106
Which cells do basal cell carcinomas arise from?
Keratinocytes
107
How are spider naevi different from telecangietasia?
Press on them and spider naevi fill from the center whilst telecangiectasia fill from the sides.
108
What causes spider naevi?
Liver disease and the combined contraceptive pill
109
What is Eczema Herpeticum?
A severe viral infection from HSV type 1 or 2 which is commonly seen in children with atopic eczema. it is a medical emergency that required urgent admission and IV antivirals
110
What is Lichen planus?
itchy, papular rash that commonly occurs on the palms, soles, genitals and flexor surfaces of the arms
111
What is Pityriasis Alba?
skin condition resulting in a dry, fine-scaled, pale patches on the face.
112
What is this? associated itch.
Lichen planus
113
What is Koebner Phenomenon?
New lesions appearing at the site of trauma
114
Which drugs can cause lichenoid drug eruptions on the skin?
Gold, thiazides and quinine.
115
What is the treatment for lichen planus?
Topical steroids
116
What other disease is Dermatitis Herpetiformis associated with?
Coeliac Disease
117
Which immunoglobulin mediates dermatitis herpetiformis?
IgA
118
What is the management for Dermatitis Herpetiformis?
Gluten free diet
119
What is Dermatitis herpetiformis?
Itchy, vesicular rash caused by IgA deposits on the dermis. It is an autoimmune blistering condition.
120
Which antibody is positive in Dermatitis herpetiformis?
Anti-tisse transglutaminase antibody
121
A 36-year-old lady presents with localised, well demarcated patches of hair loss and small, broken 'exclamation mark' hairs. What is this likely to be?
Alopecia areata.
122
What is the management for acne vulgaris?
1st line: topical therapy such as retinoids or benzoyl peroxide
2nd line: topical combination therapy: topical antibiotic (tetracycline), retinoid, benzoyl peroxide
3rd line: oral antibiotics such as doxycycline
4th line: oral isotretinoin
123
What is erythema nodosum?
It is inflammation of subcutaneous fat which causes tender, erythematous nodules which tends to resolve within 6 weeks.
124
What are the causes of Erythema Nodosum?
infection, sarcoidosis, IBD, Behcets, malignancy, pregnancy, penicillins, sulphonamides, oral contraceptive pill
125
What is this?
Erythema Nodosum
126
What are the pre-cancerous lesions assocaited with Squamous Cell Carcinomas?
Acitinic Keratosis and Bowen's disease
127
What is first line treatment for Impetigo?
Fusidic Acid
128
What is this?
Seborrhoeic Keratoses
129
What do Molluscum contagiosum look like?
A pink or pearly white papules with central umbilication
130
What is the treatment for Molluscum Contagiosum?
it is a self limiting condition which usually resolves after about 18 months
131
Is mucosal membranes involved in Lichen Planus?
Yes
132
Which bacteria most commonly causes Impetigo?
Staph aureus
133
What is an appropriate investigation for a venous ulcer?
Ankle-Brachial pressure index to assess blood flow to allow healing. Normal is between 0.9-1.2
134
Should compression bandages be used in Venous ulcers?
Yes
135
What is the treatment for Acitinic Keratosis?
Topical fluorouracil or topical diclofenac (NSAID)
136
What is Vitiligo?
When melanocytes are attacked by T cells.
137
What is Nelsons Syndrome?
melanin stimulating hormone is produced in excess by the pituitary gland. it is caused by too much ACh causing hyperpigmentation (bronzed colour). It can be caused by adrenal tumours.
138
Where are Merkel cells found and what is their function?
they are found in the basal layer between the keratinocytes and nerve fibres. They are mechanoreceptors
139
Where are appocrine sweat glands found?
axillae and genitals
140
Where are eccrine sweat glands found?
palms and soles of the feet
141
Which UV type penetrates the skin the deepest?
A
142
How is Vitamin D3 formed?
It is stored as hydroxycholecalciferol in the liver and is then converted to 1,25- dihydroxycholecalciferol in the kidney. UV converts cholecalciferol to vitamin D3.
143
What is the effect of vitamin D3 deficiency in children?
Ricketts
144
Where are melanocytes found in the epidermis?
Basal layer
145
What is hyperkeratosis?
increased thickness of the keratin layer
146
what is parakeratosis?
Presence of nuclei in the keratin layer
147
What is acanthosis?
Increased thickness of the epithelium
148
what is papillomatosis?
Irregular epithelium thickening
149
What is Spongiosis?
Oedema fluid between cells to increase prominence of intracellular prickles
150
What is the disease mechanism of Psoriasis?
epidermis hyperplasia due to increase epidermal turnover
151
What are Munros microabscesses? and what skin disease do they relate to?
They are when complement attracts neutrophils to the keratin layer (stratum corneum). This occurs in psoriasis.
152
What is orthohyperkeratosis and Hypergranulosis and what skin disease do they belong to?
Orthohyperkeratosis: hyperkeratosis without parakeratosis, no nucleus is seen in the cells.
Hypergranulosis: increased thickness of the stratum granulosum.
These are both present in Lichen Planus
153
What is a lichenoid eruption?
skin disease characterised by damage and infiltration between the dermis and epidermis.
154
What is a sawtooth acanthosis?
it is an irregular border of the epithelium. The image below shows this along with hyperkeratosis:
155
What is Pemphigus?
Rare autoimmune bullous disease characteristic of loss of epidermal cell adhesion, flaccid blisters and erosions. Majority of patients have oral involvement, most common in middle aged adults.
156
In Pemphigus, what are the antibodies directed against?
Desmoglein 3
157
What are the antibodies in Pemphigus Vulgaris?
IgG
158
What is Desmoglein 3?
it is expressed in the basal layers and mainstains desomosomal attachments.
159
Which areas of the body does pemphigus vulgaris affect?
face, scalp, axillae, groin and trunk. It may also affect the mucosa which can be fatal
160
What kind of hypersensitivity reaction is Pemphigus vulgaris?
Type II
161
What is Bullous Pemphigoid?
subepidermal blister with no evidence of acantholysis. They are tense blisters often on flexural areas, occasional mucous membrane involvement, more common in the elderly.
162
Is the mucous membranes involved in bullous pemphigoid?
it is rare
163
What is attacked in Bullous pemphigoid that causes the blistering?
IgG is targeted against the hemidesmosomes
164
What is the difference between bullous pemphigoid and pemphigus vulgaris?
Bullous PemphigoiD- Deep
PemphiguS Vulgaris- Superficial
165
What does immunofluorescence show in bullous pemphigoid?
liner IgG complement deposited around the basement membrane
166
What is Dermatitis Herpetiformis?
an autoimmune blistering bullous disease that is linked to coeliac disease
167
What is the hallmark of dermatitis herpetiformis?
Papillary dermal microabscesses
168
What immunoglobulin is associated with dermatitis Herpetiformis?
IgA- they target gliaden component of gluten but cross react with connective tissue matrix proteins. Immune complexes form int he dermal papillae and activate complement and generate neutrophil chemotaxis
169
How are comedones formed?
by keratin and sebum build up (they plug the pilosebaceous units)
170
What is the treatment of Bullous Pemohigoid?
Oral corticosteroids. Topical corticosteroids, immunosuppressants and antibiotics can also be used
171
What is this?
Bullous Pemphigoid
172
What is this?
Pemphigus Vulgaris- you can see the erosions and that the blisters have erupted.
173
How is pemphigus vulgaris managed?
Steroids and immunosuppression
174
At a Breslow thickness of 4mm, what is the prognosis?
50%
175
What is the diagnosis of a melanoma?
A: asymmetry
B: borders irregular
C: colour variation
D: diameter \>6mm
E: evolution/changing
176
What are the characteristics of a basal cell carcinoma?
slow growin, non-healing ulcer, painless, locally invasive
177
What are the risk factors for a SCC?
elderly, sun exposure/tanning beds, fair skin
178
What is the treatment for SCC's?
Small: curettage and cautery +/- radiotherapy and cryoptherapy
Ill defined: Moh's surgery
179
What is the most common type of BCC?
Nodulocystic. it usually develops on the face as a pearly skin coloured cystic papule or nodule with telangiectasia and a rolled edge. It can ulcerate and there may be a history of bleeding.
180
What is the best investigation for epidermal lesions?
superficial shave biopsy
181
What is the best treatment for BCCs?
surgical excision
182
What type of BCC usually requires Moh's surgery?
Morphoeic BCCs as they have ill defined borders
183
What is a Keratocanthoma?
epithelial tumour of hair follicle similar to SCC
184
Describe a junctional naevus
flat and brown
185
Descibe a compound melanocytic naevus
raised, pigmented and can be hairy. Can be left alone or removed via shave excision
186
Describe an intradermal naevus
raised and non-pigmented. Has to be differentiated from a BCC.
187
What is a seborrhoeic Keratosis?
AKA basal cell papilloma. they are benign and very common. Tend to have a stuck on appearance and seem to be superficially attached to the dermis with a crusted surface.
188
What is an epidermoid cyst?
has an epithelial wall surrounding a core of keratin with a central punctum. They are generally found on the face, and trunk
189
What is a dermatofibroma?
a proliferation of fibroblasts in the dermis. Usually presents as a firm hard nodule which can be itchy
190
What is a sign that confirms the diagnosis of a dermatofibroma?
When pressure is exerted laterally, there is a central dimpling.
191
What is Bowen's disease?
a type of intraepidermal squamous cell carcinoma. More common in elderly females. There is around a 3% chance of developing invasive skin cancer (SCC)
192
What is this?
Bowen's disease
193
What is the treatment for Bowen's disease?
protection from sun, topical 5-fluorouracil or imiquimod
194
What is Rhinophyma?
it is when the skin is thickened on the nose and the sebaceous glands are enlarged.
195
What condition is rhinophyma associated with?
Rosacea
196
What class of drugs should be avoided in rosacea?
Steroids
197
What is the treatment for Rosacea?
Mild- topical metronidazole
More severe is treated with oral antibiotics such as tetracyclines
daily suncream
198
What is a complication of Rosacea that affects young girls around the mouth?
Perioral dermatitis
199
What kind of nail characteristics can be seen in psoriasis?
onycholysis, sublingual hyperkeratosis and nail pitting
200
What is discoid Lupus erythematous?
red, inflamed, coin shaped lesions with scaling and a crusty appearance. Most common skin problem associated with SLE
201
what is the treatment of discoid lupus erythematosus?
Sun cream and avoidance, oral and topical steroids.
202
Where would you normall see discoid lupus erythematosus?
scalp, face, upper chest and trunk
203
Where would you expect to see eczema?
flexural surfaces
204
what is the cycle from egg to adult larve in the scabies family?
2 weeks
205
When is there usually symptoms of scabies infestation?
4 weeks after exposure
206
if scabies isnt treated, what can this lead to?
Crusted scabies (Norweigan scabies)
207
What is the treatment for Scabies?
topical insecticides such as 5% permethrin cream or 0.5% malathion liquid- 2 applications, 1 week apart.
208
What virus causes Shingles?
Varicella Zoster
209
Does Porphyria cutanea tarda cause hair growth?
Yes
210
What is the enzyme deficient in acute intermittent porphyria?
Hydroxymethylbilane synthase
211
What is the enzyme deficient in Erythropoetic protoporphyria?
Ferrochelatase
212
What is the enzyme deficient in porphyria cutanea Tarda?
Uroporphyrinogen oxidase
213
What may precipitate guttate psoriasis?
A streptococcal infection
214
How does guttate and plaque psoriasis differ in appearance?
Plaque is a patch of scale and erythema whereas guttate looks like read tear drops
215
What is the treatment for guttate psoriasis?
No treatment, it resolves spontaneously within 2-3 months
216
What is this?
Guttate psoriasis
217
What is Pityriasis Rosacea?
it is a self limiting rash that affects young adults. It is characteristic of Herald's patch (typically on the trunk) followed by oval erythematous scaly patches usually 2 weeks later
218
What is the immunological reaction of psoriasis?
abnormal T cell activity to stimulate keratinocyte proliferation
219
What is the management of Psoriasis?
Emollients, Vitamin D analogue (Calcitriol), topical steroids, coal tar, dithranol, phototherapy
220
What is this
Psoriasis
221
Which is the most common type of porphyria?
Protoporphyria cutanea tarda
222
What investigations are used for the diagnosis of porphyria cutanea tarda?
Woods lamp- if urine turns red on testing then it is positive
223
Which porphyria commonly presents in childhood?
Erythropoeitic protoporphyria
224
What kind of lesion grows outward and heals in the centre?
dermatophyte (ringworm)
225
What investigation is done for suspected ring worm?
Woods lamp
226
What is an irregular sawtooth acanothosis indicative of?
Lichen planus
227
What are the processes going on?
Orthohyperkeratosis and hypergranulosis
228
What is acantholysis?
loss of intracellular connections (desmosomes) between keratinocytes. this happens in pemphigus vulgaris but NOT bullous pemphigoid
229
Where is the split in bullous pemphigoid?
at the dermo-epidermal junction
230
Where is the split in Pemphigus Vulgaris?
Intra-epidermal- there is a loss of integrity of epidermal cell adhesion (acantholysis).
231
When is Nikloskys sign positive? and what is this?
it is positive in pemphigus vulgaris. it is when the top layers slip against lower layers when rubbed.
232
what is a blistering condition that occurs in babies?
Epidermolysis Bullosa- blistering of the skin and mucous membrane
233
Does pemphigus or pemphigoid have a better prognosis?
Pemphigoid has a better prognosis- may be due to pemphigus having mucosal involvement
234
What virus is reactived in shingles?
Varicella zoster
235
What is post herpetic neuralgia?
Pain 4 weeks post shingles
236
what is Ramsay Hunt Syndrome?
Painful vesicles at the auditory canal and in the throat. Also facial palsy of CN VII and irritation of CN VIII causing deafness, tinnitus and vertigo
237
What causes primary gingivostomatitis?
herpes simplex virus
238
What are the characteristics of Priamry gingivostomatitis?
excessive ulceration in and around the mouth, blistering rash at the vermillion border
239
What is the treatment for primary gingivostomatitis?
Aciclovir
240
What is Erythema multiforme?
target lesions initially seen on the back of the hands and feet before spreading to the torso. it is a hypersensitivity reaction trigger by infections
241
What type of infections can trigger erythema multiforme?
HSV, mycoplasma pneumoniae,
## Footnote
drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
connective tissue disease e.g. Systemic lupus erythematosus
sarcoidosis
malignancy
242
What are these target lesions pathognomic of?
Erythema multiforme
243
What virus causes warts/veruccas?
HPV
244
What is the treatment for warts/verrucas?
Topical salicylic acid
245
What is Herpangia?
Blistering at the back of the mouth that is common in childhood.
246
What group of viruses causes herpangia?
Enteroviruses e.g. Coxsackie
247
What group of viruses causes Hand, foot and mouth disease?
Enteroviruses e.g. Coxsackie
248
What virus is responsible for erythema infectiosum/Slap cheek?
Parovirus B19
249
What is a chancre and what is it associated with?
painless ulcer at the site of sexual contact seen in primary syphillis
250
What are the secondary features of syphillis?
red rash all over the body, fever, lymphadenopathy, buccal snail track ulcers, painless warty lesions on the genitalia
251
When would you start to see secondary features of Syphillis?
6-10 weeks after infection
252
What are the tertiary features of syphillis?
CVS symptoms, granulomatous lesions on the skin and bones
253
What is the treatment for syphillis?
IV Penicillin
254
What causes lyme disease?
borrelia burgdorferi which is carried by ticks
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What kind of lesion would you see in lymes disease?
erythema migrans, looks like a bullseye
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What is the treatment for lymes disease?
Doxycyline or amoxicillin
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What kind of inheritance is tuberous sclerosis?
Autosomal dominant
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What is the earliest sign of tuberous sclerosis?
Ash leaf macule (may need a woods lamp to see)
259
What are the three types of epidermolysis bullosa?
simplex: affects the epidermis
Junctional: affects the junction
dystrophic: affects the dermis
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What skin condition is assocaited with GI malignancies?
Acanthosis nigricans
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what is the most common cause of Erythema Multiforme?
HSV
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What is Acne Rosacea?
A pustular erythematous rash that affects 30-50's that can also affect the eyes and is worse on sunlight exposure
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What are the features of pityriasis rosacea?
Herald feature on the trunk followed by erythematous oval scaly lesions
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How long does the rash from pityriasis rosacea usually last?
6-12 weeks
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What is Pityriasis versicolour?
superficial cutaneous fungal infection caused by Malassezia which usually appears on the trunk and back and is scaly
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What is pityriasis alba?
hypopigmentation of the skin which intially appears as pink scaly patches which later leave pale patches on the skin
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What is the first line management for Hyperhidrosis (excessive sweating)?
Topical aluminium chloride
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How do BCC's present?
flat with a raised edge
269
What is a Lentigo malignant melanoma?
it is when melanoma comes from a suspicious mole or freckle
270
What fatal skin condition is a side effect of penicillins?
Toxic epidermal necrolysis
271
How does guttate psoriasis present?
Usually following a strep throat infection and looks like tear drop scaly papules on the trunk and limbs
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When are children allowed to go back to school following impetigo?
48 hours after treatment or when all the scabs have crusted over and they are no longer contagious
273
What class of drugs excerbate plaque psoriasis?
beta blockers
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