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Year 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the Epidermis made from?

A

stratified (squamous) cellular epithelium.

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2
Q

What is the Dermis made from?

A

connective tissue

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3
Q

Where does the epidermis come from?

A

ectoderm cells which form a single layer periderm.

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4
Q

Where does the dermis come from?

A

mesoderm cells

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5
Q

What are Melanocytes?

A

pigment producing cells from neural crest.

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6
Q

What are the layers of the epidermis in order?

A

Keratin layer, granular layer, prickle cell layer and basal layer.

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7
Q

What does the skin consist of?

A

epidermis, appendages (nails, hair, glands), dermo-epidermal junction, dermis, sub-cutis (predominantly fat)

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8
Q

What muscle pulls the hair follicle in thermoregulation?

A

arrector pili muscle

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9
Q

What is the biggest component of the epidermis?

A

Keratinocytes

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10
Q

What are keratinocytes?

A

epidermal cell which produces keratin.

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11
Q

Where do keratinocytes grow from?

A

the basement membrane up to the epidermis.

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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

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13
Q

What is the outermost layer of the skin?

A

stratum corneum

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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.

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15
Q

What factors are responsible for the turnover of epidermal cells?

A

growth factors, cell death and hormones.

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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.

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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.

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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.

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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.

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20
Q

What are Corneocytes and where are they found?

A

differentiated keratinocytes that compose mostly all of the stratum corneum.

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21
Q

What are melanocytes?

A

they contain the pigment melanin (converted from tyrosine). They are derived from the brain?

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22
Q

What is Vitiligo?

A

when the melanocytes are attacked by T cells. it represents an autoimmune disease with loss of melanocytes.

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23
Q

What is Albinisim?

A

disorder where there is a genetic partial loss of pigment production

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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.

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25
Q

What is a melanocyte?

A

a tumour of the melanocyte cell line

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26
Q

What are Langerhan cells?

A

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.

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27
Q

What are Merkel cells?

A

in the basal layers between the keratinocytes and nerve fibres. They are mechanoreceptors.

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28
Q

What are the phases of hair growth?

A

Anagen, catagen, telogen

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29
Q

What is the shedding phase in hair growth?

A

telogen- 20% of all hair is in the shedding phase.

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30
Q

When is hair more likely to fall out?

A

after pregnancy and when the implant is inserted.

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31
Q

What is the dermo-epidermal junction?

A

interface between the epidermis and dermis.

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32
Q

What is the function of the dermo-epidermal junction?

A

Support, anchorage, adhesion, growth and as a barrier.

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33
Q

What is a consequence of a destroyed dermo-epidermal junction?

A

Bullous pemphigoid- when the junction goes wrong the skin blisters

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34
Q

What is an angioma?

A

overgrowth of blood vessels.

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35
Q

Where are apocrine sweat glands found?

A

in the genitals and axilla.

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36
Q

Where are the eccrine sweat glands found?

A

They are the major sweat glands of the body. They are found everywhere particularly in the palms and soles.

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37
Q

Which sweat gland is responsible for an odorous sweat?

A

apocrine

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38
Q

Which nerve supply innervates the eccrine glands?

A

sympathetic

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39
Q

Which UV radiation has the longest wavelength?

A

UVA

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40
Q

Does longer or shorter wavelengths penetrate the skin?

A

Longer wavelengths.

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41
Q

What are pacinian corpuscles?

A

mechanoreceptors

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42
Q

What are the 4 mechanoreceptors in the skin?

A

Merkels receptors, Meissners corpuscles, Ruffinis corpuscles, pacinian corpuscles

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43
Q

What is the Keratin Layer formed from?

A

keratinocytes that have differentiated into corneocytes

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44
Q

How do keratinocytes help towards immune surveillance?

A

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.

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45
Q

What are the main immune cells in the skin?

A

Langerhans Cells

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46
Q

Where are CD8 and CD4 found in the skin?

A

CD8 is found in the epidermis and CD4 in the dermis.

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47
Q

What is the role of CD8 and CD4 in the skin?

A

CD8 cells are cytotoxic so recognise foreign antibodies. CD4 helper cells instruct the immune response by causing inflammation.

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48
Q

Where are Dendritic cells found?

A

in the dermis

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49
Q

Mast cells bind to what to cause an immune response?

A

IgE

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50
Q

What surfaces does psoriasis affect?

A

Extensor and posterior mostly due to low grade trauma.

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51
Q

Mutation in what gene can cause atopic Eczema?

A

fillagrin gene.

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52
Q

What mediates type I hypersensitivity?

A

IgE

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53
Q

What mediates Type II and III hypersensitivity?

A

IgG and IgM

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54
Q

What mediates Type IV hypersensitivity?

A

Th1 cells (t cell mediated response)

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55
Q

What kind of hypersensitivity is contact dermatitis?

A

Type IV

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56
Q

What kind of hypersensitivity reaction is Urticaria?

A

Type I

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57
Q

What kind of test can be used in Type I hypersensitivity reactions?

A

Prick testing

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58
Q

What are the controls in Prick testing?

A

Negative- Saline, Positive- Histamine

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59
Q

what is the first line treatment for type I hypersensitivity reactions?

A

Anti-histamines

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60
Q

When using an Epi-pen, how much is given to adults and children?

A

300mg to adults, 150mg to children.

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61
Q

What kind of investigation is used in Type IV hypersensitivity? reactions?

A

Patch testing

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62
Q

What is the treatment for Allergic Contact Dermatitis?

A

Removal of relevant allergen and steroids (hydrocortisone)

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63
Q

What time intervals are used in patch testing?

A

Readings are done at 48 and 96 hours

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64
Q

How is allergic and irritant contact dermatitis differentiated?

A

via patch testing- it rules out allergic

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65
Q

How would you describe this?

A

A nodule

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66
Q

What is the function of melanocytes?

A

To make melanin which absorbs UV radiation to protect DNA

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67
Q

What do Fibroblasts produce?

A

collagen

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68
Q

What is the growing phase of hair called?

A

Anagen

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69
Q

What does Catagen mean?

A

it is the involuting stage of hair when it degnerates.

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70
Q

Which cells carry out Vitamin D metabolism?

A

Keratinocytes

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71
Q

Label each letter

A

C- Prickle Cell Layer

B- Granular Layer

D- Basal Layer

A- Keratin Layer

E- Dermo-Epidermal Junction

F- Dermis

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72
Q

Which layer of the epidermis is the most biologically acitive?

A

Basal Layer

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73
Q

Which enzyme is deficient in Erythropoeitic Protoporphyria?

A

Ferrochelatase

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74
Q

What are the feature of Erythropoeitic Protoporphyria?

A

Tends to present in childhood as with discomfort, itch or tingling in sun exposed skin.

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75
Q

Where are hemi-desmosomes found?

A

At the Dermo-epidermal junction

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76
Q

Where are fibroblasts found in the skin?

A

the dermis

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77
Q

Which enzyme is deficient in Acute intermittent porphyria?

A

PBG Deaminase

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78
Q

How much do nails grow per day?

A

0.1mm

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79
Q

which layer of the epidermis is composed of polyhedral cells with lots of desmosomes?

A

Prickle cell layer

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80
Q

Where would you find Odland Bodies?

A

Granular Layer

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81
Q

Label these

A

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

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82
Q

What kind of gland and what muscle accompanies a hair follicle?

A

Sebaceous gland and Arrector pili muscle

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83
Q

Which glands are the scent glands?

A

Appocrine glands

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84
Q

What are the functions of meissners and pacinian Corpuscles?

A

Meissners: Vibration sensation

Pacinian: pressure sensation

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85
Q

What are the descriptions for Creams/Ointments/Gels/Lotions/Pastes?

A

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

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86
Q

How would you investigate Scabies in the lab?

A

Skin scraping for microscopy to look for mites

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87
Q

How would you investigate Ringworm under the microscope?

A

Skin scrapings for culture under a wood light.

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88
Q

What condition is Cafe au lait spots associated with?

A

Neurofibromatosis type 1

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89
Q

How does Rosacea present?

A

With erythema and sometimes papules or pustules

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90
Q

What strains of HPV are responsible for warts and verrucas?

A

1-4

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91
Q

Why are creams more likley to cause contact sensitisation?

A

because they contain preservatives

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92
Q

Around how much topical therapy is required for an all over application to cover 1 adult?

A

30g

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93
Q

Is Bullous Pemphigoid associated with itch?

A

Yes- there is a preceding itch in the months before blistering occurs

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94
Q

What is first line treatment for rosacea?

A

Topical metronidazole cream

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95
Q

Name These:

A

A: intraepidermal bulla

B: Hyperkeratosis

C: Papillomatosis

D: Sub-epidermial bulla

E: Spongiosis

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96
Q

Where do venous ulcers commonly occur?

A

the lateral and medial malleolous

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97
Q

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.

A

Dermatofibroma

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98
Q

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.

A

Melanocytic naevus

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99
Q

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.

A

Superficial spreadying malignant melanoma

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100
Q

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.

A

Superficial basal cell carcinoma

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101
Q

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.

A

Squamous Cell Carcinoma

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102
Q

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.

A

Bowens disease (intraepidermal squamous cell carcinoma)

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103
Q

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.

A

Basal cell carcinoma

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104
Q

What is Breslows Thickness? and why it is useful?

A

It is the depth from the granular layer to the last melanocyte and it gives a prognostic indicator

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105
Q

What are the layers of the scalp?

A

SCALP

Scalp

Connective tissue

Aponeurosis

Loose Connective tissue

Periosteum

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106
Q

Which cells do basal cell carcinomas arise from?

A

Keratinocytes

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107
Q

How are spider naevi different from telecangietasia?

A

Press on them and spider naevi fill from the center whilst telecangiectasia fill from the sides.

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108
Q

What causes spider naevi?

A

Liver disease and the combined contraceptive pill

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109
Q

What is Eczema Herpeticum?

A

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

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110
Q

What is Lichen planus?

A

itchy, papular rash that commonly occurs on the palms, soles, genitals and flexor surfaces of the arms

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111
Q

What is Pityriasis Alba?

A

skin condition resulting in a dry, fine-scaled, pale patches on the face.

112
Q

What is this? associated itch.

A

Lichen planus

113
Q

What is Koebner Phenomenon?

A

New lesions appearing at the site of trauma

114
Q

Which drugs can cause lichenoid drug eruptions on the skin?

A

Gold, thiazides and quinine.

115
Q

What is the treatment for lichen planus?

A

Topical steroids

116
Q

What other disease is Dermatitis Herpetiformis associated with?

A

Coeliac Disease

117
Q

Which immunoglobulin mediates dermatitis herpetiformis?

A

IgA

118
Q

What is the management for Dermatitis Herpetiformis?

A

Gluten free diet

119
Q

What is Dermatitis herpetiformis?

A

Itchy, vesicular rash caused by IgA deposits on the dermis. It is an autoimmune blistering condition.

120
Q

Which antibody is positive in Dermatitis herpetiformis?

A

Anti-tisse transglutaminase antibody

121
Q

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?

A

Alopecia areata.

122
Q

What is the management for acne vulgaris?

A

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
Q

What is erythema nodosum?

A

It is inflammation of subcutaneous fat which causes tender, erythematous nodules which tends to resolve within 6 weeks.

124
Q

What are the causes of Erythema Nodosum?

A

infection, sarcoidosis, IBD, Behcets, malignancy, pregnancy, penicillins, sulphonamides, oral contraceptive pill

125
Q

What is this?

A

Erythema Nodosum

126
Q

What are the pre-cancerous lesions assocaited with Squamous Cell Carcinomas?

A

Acitinic Keratosis and Bowen’s disease

127
Q

What is first line treatment for Impetigo?

A

Fusidic Acid

128
Q

What is this?

A

Seborrhoeic Keratoses

129
Q

What do Molluscum contagiosum look like?

A

A pink or pearly white papules with central umbilication

130
Q

What is the treatment for Molluscum Contagiosum?

A

it is a self limiting condition which usually resolves after about 18 months

131
Q

Is mucosal membranes involved in Lichen Planus?

A

Yes

132
Q

Which bacteria most commonly causes Impetigo?

A

Staph aureus

133
Q

What is an appropriate investigation for a venous ulcer?

A

Ankle-Brachial pressure index to assess blood flow to allow healing. Normal is between 0.9-1.2

134
Q

Should compression bandages be used in Venous ulcers?

A

Yes

135
Q

What is the treatment for Acitinic Keratosis?

A

Topical fluorouracil or topical diclofenac (NSAID)

136
Q

What is Vitiligo?

A

When melanocytes are attacked by T cells.

137
Q

What is Nelsons Syndrome?

A

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
Q

Where are Merkel cells found and what is their function?

A

they are found in the basal layer between the keratinocytes and nerve fibres. They are mechanoreceptors

139
Q

Where are appocrine sweat glands found?

A

axillae and genitals

140
Q

Where are eccrine sweat glands found?

A

palms and soles of the feet

141
Q

Which UV type penetrates the skin the deepest?

A

A

142
Q

How is Vitamin D3 formed?

A

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
Q

What is the effect of vitamin D3 deficiency in children?

A

Ricketts

144
Q

Where are melanocytes found in the epidermis?

A

Basal layer

145
Q

What is hyperkeratosis?

A

increased thickness of the keratin layer

146
Q

what is parakeratosis?

A

Presence of nuclei in the keratin layer

147
Q

What is acanthosis?

A

Increased thickness of the epithelium

148
Q

what is papillomatosis?

A

Irregular epithelium thickening

149
Q

What is Spongiosis?

A

Oedema fluid between cells to increase prominence of intracellular prickles

150
Q

What is the disease mechanism of Psoriasis?

A

epidermis hyperplasia due to increase epidermal turnover

151
Q

What are Munros microabscesses? and what skin disease do they relate to?

A

They are when complement attracts neutrophils to the keratin layer (stratum corneum). This occurs in psoriasis.

152
Q

What is orthohyperkeratosis and Hypergranulosis and what skin disease do they belong to?

A

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
Q

What is a lichenoid eruption?

A

skin disease characterised by damage and infiltration between the dermis and epidermis.

154
Q

What is a sawtooth acanthosis?

A

it is an irregular border of the epithelium. The image below shows this along with hyperkeratosis:

155
Q

What is Pemphigus?

A

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
Q

In Pemphigus, what are the antibodies directed against?

A

Desmoglein 3

157
Q

What are the antibodies in Pemphigus Vulgaris?

A

IgG

158
Q

What is Desmoglein 3?

A

it is expressed in the basal layers and mainstains desomosomal attachments.

159
Q

Which areas of the body does pemphigus vulgaris affect?

A

face, scalp, axillae, groin and trunk. It may also affect the mucosa which can be fatal

160
Q

What kind of hypersensitivity reaction is Pemphigus vulgaris?

A

Type II

161
Q

What is Bullous Pemphigoid?

A

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
Q

Is the mucous membranes involved in bullous pemphigoid?

A

it is rare

163
Q

What is attacked in Bullous pemphigoid that causes the blistering?

A

IgG is targeted against the hemidesmosomes

164
Q

What is the difference between bullous pemphigoid and pemphigus vulgaris?

A

Bullous PemphigoiD- Deep

PemphiguS Vulgaris- Superficial

165
Q

What does immunofluorescence show in bullous pemphigoid?

A

liner IgG complement deposited around the basement membrane

166
Q

What is Dermatitis Herpetiformis?

A

an autoimmune blistering bullous disease that is linked to coeliac disease

167
Q

What is the hallmark of dermatitis herpetiformis?

A

Papillary dermal microabscesses

168
Q

What immunoglobulin is associated with dermatitis Herpetiformis?

A

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
Q

How are comedones formed?

A

by keratin and sebum build up (they plug the pilosebaceous units)

170
Q

What is the treatment of Bullous Pemohigoid?

A

Oral corticosteroids. Topical corticosteroids, immunosuppressants and antibiotics can also be used

171
Q

What is this?

A

Bullous Pemphigoid

172
Q

What is this?

A

Pemphigus Vulgaris- you can see the erosions and that the blisters have erupted.

173
Q

How is pemphigus vulgaris managed?

A

Steroids and immunosuppression

174
Q

At a Breslow thickness of 4mm, what is the prognosis?

A

50%

175
Q

What is the diagnosis of a melanoma?

A

A: asymmetry

B: borders irregular

C: colour variation

D: diameter >6mm

E: evolution/changing

176
Q

What are the characteristics of a basal cell carcinoma?

A

slow growin, non-healing ulcer, painless, locally invasive

177
Q

What are the risk factors for a SCC?

A

elderly, sun exposure/tanning beds, fair skin

178
Q

What is the treatment for SCC’s?

A

Small: curettage and cautery +/- radiotherapy and cryoptherapy

Ill defined: Moh’s surgery

179
Q

What is the most common type of BCC?

A

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
Q

What is the best investigation for epidermal lesions?

A

superficial shave biopsy

181
Q

What is the best treatment for BCCs?

A

surgical excision

182
Q

What type of BCC usually requires Moh’s surgery?

A

Morphoeic BCCs as they have ill defined borders

183
Q

What is a Keratocanthoma?

A

epithelial tumour of hair follicle similar to SCC

184
Q

Describe a junctional naevus

A

flat and brown

185
Q

Descibe a compound melanocytic naevus

A

raised, pigmented and can be hairy. Can be left alone or removed via shave excision

186
Q

Describe an intradermal naevus

A

raised and non-pigmented. Has to be differentiated from a BCC.

187
Q

What is a seborrhoeic Keratosis?

A

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
Q

What is an epidermoid cyst?

A

has an epithelial wall surrounding a core of keratin with a central punctum. They are generally found on the face, and trunk

189
Q

What is a dermatofibroma?

A

a proliferation of fibroblasts in the dermis. Usually presents as a firm hard nodule which can be itchy

190
Q

What is a sign that confirms the diagnosis of a dermatofibroma?

A

When pressure is exerted laterally, there is a central dimpling.

191
Q

What is Bowen’s disease?

A

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
Q

What is this?

A

Bowen’s disease

193
Q

What is the treatment for Bowen’s disease?

A

protection from sun, topical 5-fluorouracil or imiquimod

194
Q

What is Rhinophyma?

A

it is when the skin is thickened on the nose and the sebaceous glands are enlarged.

195
Q

What condition is rhinophyma associated with?

A

Rosacea

196
Q

What class of drugs should be avoided in rosacea?

A

Steroids

197
Q

What is the treatment for Rosacea?

A

Mild- topical metronidazole

More severe is treated with oral antibiotics such as tetracyclines

daily suncream

198
Q

What is a complication of Rosacea that affects young girls around the mouth?

A

Perioral dermatitis

199
Q

What kind of nail characteristics can be seen in psoriasis?

A

onycholysis, sublingual hyperkeratosis and nail pitting

200
Q

What is discoid Lupus erythematous?

A

red, inflamed, coin shaped lesions with scaling and a crusty appearance. Most common skin problem associated with SLE

201
Q

what is the treatment of discoid lupus erythematosus?

A

Sun cream and avoidance, oral and topical steroids.

202
Q

Where would you normall see discoid lupus erythematosus?

A

scalp, face, upper chest and trunk

203
Q

Where would you expect to see eczema?

A

flexural surfaces

204
Q

what is the cycle from egg to adult larve in the scabies family?

A

2 weeks

205
Q

When is there usually symptoms of scabies infestation?

A

4 weeks after exposure

206
Q

if scabies isnt treated, what can this lead to?

A

Crusted scabies (Norweigan scabies)

207
Q

What is the treatment for Scabies?

A

topical insecticides such as 5% permethrin cream or 0.5% malathion liquid- 2 applications, 1 week apart.

208
Q

What virus causes Shingles?

A

Varicella Zoster

209
Q

Does Porphyria cutanea tarda cause hair growth?

A

Yes

210
Q

What is the enzyme deficient in acute intermittent porphyria?

A

Hydroxymethylbilane synthase

211
Q

What is the enzyme deficient in Erythropoetic protoporphyria?

A

Ferrochelatase

212
Q

What is the enzyme deficient in porphyria cutanea Tarda?

A

Uroporphyrinogen oxidase

213
Q

What may precipitate guttate psoriasis?

A

A streptococcal infection

214
Q

How does guttate and plaque psoriasis differ in appearance?

A

Plaque is a patch of scale and erythema whereas guttate looks like read tear drops

215
Q

What is the treatment for guttate psoriasis?

A

No treatment, it resolves spontaneously within 2-3 months

216
Q

What is this?

A

Guttate psoriasis

217
Q

What is Pityriasis Rosacea?

A

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
Q

What is the immunological reaction of psoriasis?

A

abnormal T cell activity to stimulate keratinocyte proliferation

219
Q

What is the management of Psoriasis?

A

Emollients, Vitamin D analogue (Calcitriol), topical steroids, coal tar, dithranol, phototherapy

220
Q

What is this

A

Psoriasis

221
Q

Which is the most common type of porphyria?

A

Protoporphyria cutanea tarda

222
Q

What investigations are used for the diagnosis of porphyria cutanea tarda?

A

Woods lamp- if urine turns red on testing then it is positive

223
Q

Which porphyria commonly presents in childhood?

A

Erythropoeitic protoporphyria

224
Q

What kind of lesion grows outward and heals in the centre?

A

dermatophyte (ringworm)

225
Q

What investigation is done for suspected ring worm?

A

Woods lamp

226
Q

What is an irregular sawtooth acanothosis indicative of?

A

Lichen planus

227
Q

What are the processes going on?

A

Orthohyperkeratosis and hypergranulosis

228
Q

What is acantholysis?

A

loss of intracellular connections (desmosomes) between keratinocytes. this happens in pemphigus vulgaris but NOT bullous pemphigoid

229
Q

Where is the split in bullous pemphigoid?

A

at the dermo-epidermal junction

230
Q

Where is the split in Pemphigus Vulgaris?

A

Intra-epidermal- there is a loss of integrity of epidermal cell adhesion (acantholysis).

231
Q

When is Nikloskys sign positive? and what is this?

A

it is positive in pemphigus vulgaris. it is when the top layers slip against lower layers when rubbed.

232
Q

what is a blistering condition that occurs in babies?

A

Epidermolysis Bullosa- blistering of the skin and mucous membrane

233
Q

Does pemphigus or pemphigoid have a better prognosis?

A

Pemphigoid has a better prognosis- may be due to pemphigus having mucosal involvement

234
Q

What virus is reactived in shingles?

A

Varicella zoster

235
Q

What is post herpetic neuralgia?

A

Pain 4 weeks post shingles

236
Q

what is Ramsay Hunt Syndrome?

A

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
Q

What causes primary gingivostomatitis?

A

herpes simplex virus

238
Q

What are the characteristics of Priamry gingivostomatitis?

A

excessive ulceration in and around the mouth, blistering rash at the vermillion border

239
Q

What is the treatment for primary gingivostomatitis?

A

Aciclovir

240
Q

What is Erythema multiforme?

A

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
Q

What type of infections can trigger erythema multiforme?

A

HSV, mycoplasma pneumoniae,

drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine

connective tissue disease e.g. Systemic lupus erythematosus

sarcoidosis

malignancy

242
Q

What are these target lesions pathognomic of?

A

Erythema multiforme

243
Q

What virus causes warts/veruccas?

A

HPV

244
Q

What is the treatment for warts/verrucas?

A

Topical salicylic acid

245
Q

What is Herpangia?

A

Blistering at the back of the mouth that is common in childhood.

246
Q

What group of viruses causes herpangia?

A

Enteroviruses e.g. Coxsackie

247
Q

What group of viruses causes Hand, foot and mouth disease?

A

Enteroviruses e.g. Coxsackie

248
Q

What virus is responsible for erythema infectiosum/Slap cheek?

A

Parovirus B19

249
Q

What is a chancre and what is it associated with?

A

painless ulcer at the site of sexual contact seen in primary syphillis

250
Q

What are the secondary features of syphillis?

A

red rash all over the body, fever, lymphadenopathy, buccal snail track ulcers, painless warty lesions on the genitalia

251
Q

When would you start to see secondary features of Syphillis?

A

6-10 weeks after infection

252
Q

What are the tertiary features of syphillis?

A

CVS symptoms, granulomatous lesions on the skin and bones

253
Q

What is the treatment for syphillis?

A

IV Penicillin

254
Q

What causes lyme disease?

A

borrelia burgdorferi which is carried by ticks

255
Q

What kind of lesion would you see in lymes disease?

A

erythema migrans, looks like a bullseye

256
Q

What is the treatment for lymes disease?

A

Doxycyline or amoxicillin

257
Q

What kind of inheritance is tuberous sclerosis?

A

Autosomal dominant

258
Q

What is the earliest sign of tuberous sclerosis?

A

Ash leaf macule (may need a woods lamp to see)

259
Q

What are the three types of epidermolysis bullosa?

A

simplex: affects the epidermis

Junctional: affects the junction

dystrophic: affects the dermis

260
Q

What skin condition is assocaited with GI malignancies?

A

Acanthosis nigricans

261
Q

what is the most common cause of Erythema Multiforme?

A

HSV

262
Q

What is Acne Rosacea?

A

A pustular erythematous rash that affects 30-50’s that can also affect the eyes and is worse on sunlight exposure

263
Q

What are the features of pityriasis rosacea?

A

Herald feature on the trunk followed by erythematous oval scaly lesions

264
Q

How long does the rash from pityriasis rosacea usually last?

A

6-12 weeks

265
Q

What is Pityriasis versicolour?

A

superficial cutaneous fungal infection caused by Malassezia which usually appears on the trunk and back and is scaly

266
Q

What is pityriasis alba?

A

hypopigmentation of the skin which intially appears as pink scaly patches which later leave pale patches on the skin

267
Q

What is the first line management for Hyperhidrosis (excessive sweating)?

A

Topical aluminium chloride

268
Q

How do BCC’s present?

A

flat with a raised edge

269
Q

What is a Lentigo malignant melanoma?

A

it is when melanoma comes from a suspicious mole or freckle

270
Q

What fatal skin condition is a side effect of penicillins?

A

Toxic epidermal necrolysis

271
Q

How does guttate psoriasis present?

A

Usually following a strep throat infection and looks like tear drop scaly papules on the trunk and limbs

272
Q

When are children allowed to go back to school following impetigo?

A

48 hours after treatment or when all the scabs have crusted over and they are no longer contagious

273
Q

What class of drugs excerbate plaque psoriasis?

A

beta blockers

274
Q
A
275
Q
A

Year 2 (10 decks)

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