Dermatology Flashcards
What is “rodent ulcer” another name for?
Basal cell carcinoma
What are the 2 risk factors to remember for basal cell carcinoma?
Sun exposure
Gorlin’s syndrome
Where do basal cell carcinomas tend to present?
Face, scalp, ears + trunk
What are the 3 types of basal cell carcinoma and which of these is most common?
Nodular-ulcerative (most common)
Morphoeic
Superficial
How do nodular-ulcerative BCCs appear?
Translucent
Pearly edges
Telagiectasia
Describe the appearance of morphoeic BCCs
Reddish, small, may have telangiectasia, often near nose
Describe the appearance of superficial BCCs
pink/brown scaly plaque
Define contact dermatitis
Inflammatory skin disease
Allergic or irritant stimulus
Stimulus is external
Where does contact dermatitis usually present?
Hands
Recall the appearance of a contact dermatitis rash
Redness
Vesicles/papules
Define eczema (exactly)
A pruritic papulovesicular skin reaction to endogenous or exogenous agents
Recall 3 signs of acute eczema
Excoriation
Papules
Vesicles
Recall 3 signs of chronic eczema
Lichenification
Thickened epidermis
Fissures
Differentiate atopic and seborrhoeic eczema
Atopic: erythematous; face and flexures
Seborrhoeic: Yellow and greasy; eyebrows and scalp
What investigation should be done in suspected atopic eczema?
IgE levels
Define erythema multiforme
Acute hypersensitivity reaction of skin and mucous membranes
What is a severe form of erythema multiforme known as?
Stevens-Johnson syndrome
Recall the aetiology of erythema multiforme
Degeneration of basal epidermis –> vesicles form between basal epidermal cells –> lymphocyte infiltration
What is the cause of erythema multiforme?
50% of the time there is a precipitating factor
Recall 3 symptoms of erythema multiforme (quite unusual!)
- May have prodromal URTI
- Lesions appear suddenly and itch
- When lesions fade they may leave an area of hyperpigmentation
Describe the appearance of skin lesions in erythema multiforme
Like targets, symmetrical
Where is the most common site of erythema multiforme skin lesions?
Limbs
Define erythema nodosum
Panniculitis leading to red or violet subcutaneous nodules
What is panniculitis?
Inflammation of subcutaneous fat
In what demographic is erythema nodosum most common?
Young females
Recall the symptoms of erythema nodosum
*Tender erythematous papular rash on shins* Fatigue Anorexia and weight loss Fever Arthralgia
What pathogen is most commonly implicated in erythema nodosum?
Streptococcus
Which serum marker is particularly elevated in sarcoidosis?
ACE
Which systemic disease is particularly associated with erythema nodosum?
Sarcoidosis
Define lipoma
Benign adipose tumour
What would make a lipoma painful?
If it compresses a nerve
Describe the appearance of a lipoma
Smooth surface, skin colour
Define melanoma
Neoplastic transformation of melanocytes
What percentage of melanomas arise from pre-existing naevi?
50%
Recall the mnemonic for and the 4 histopathological subtypes of melanoma
Some Skin Nodules Look Malignant And Looming Superficial spreading Nodular Lentigo maligna Acral lentiginous
Which type of melanoma always arises from an existing naevus?
Superficial spreading
Describe the onset of nodular melanoma
Di novo appearance that grows aggressively
There is no radial growth phase
Describe the appearance of lentigo maligna
Usually on the face
Large and flat
Where do acral lentiginous melanomas arise?
Palms and soles
What mnemonic is used to assess any skin lesion?
ABCDE Asymmetry Border irregularity Colour Diameter (>6mm) Elevation
Define molluscum contagiosum
Infection of a pox virus that mainly affects children
Describe the epidemiology of molluscum contagiosum
So common most people won’t even seek medical attention
What are the symptoms of molluscum contagiosum?
Usually asymptomatic aside from skin lesions
There may be pruritis/eczema around lesions
How long do skin lesions usually last in molluscum contagiosum?
8 months
Desrcibe the appearance of molluscum contagiosum lesions
Firm, smooth papules of 2-5mm diameter
Where is the most common site of molluscum contagiosum in children and in adults?
Children: trunk and extremities
Adults: genitalia and inner thighs
What score is used to determine risk of pressure sores?
Waterlow Score
What is the cause of guttate psoriasis?
Strep throat
What are the main risk factors for palmoplantar psoriasis?
Smoking
Middle-aged
Female
Describe the appearance of discoid psoriasis
Symmetrical, erythematous plaques on extensor surfaces
Describe the appearance of guttate psoriasis
Tear-drop appearance
Describe the appearance of palmoplantar psoriasis
Erythematous and pustular
Recall the different types of psoriasis
Discoid
Guttate
Palmoplantar
Generalised pustular
Other than skin lesions, what other symptoms present in psoriasis?
Nail signs: pitting, oncholysis and subungual keratosis
Psoriatic arthritis
What is a sebaceous cyst?
Blocked hair follicle
Describe the appearance of a sebaceous cyst
Smooth, tethered lump
Recall 2 possible complications of sebaceous cysts
Abscess
Ulceration
Define squamous cell carcinoma
Malignancy of epidermal keratinocytes
Recall 2 unusual risk factors for squamous cell carcinoma
HPV infection
Xeroderma pigemntosa
Recall the relative prevalence of squamous cell carcinoma in males and females
It’s 3 x more common in men
Describe the appearance of a squamous cell carcinoma
Very variable appearance
May bleed or ulcerate
Recall the pathophysiology of urticaria
Mast cell activation
Histamine release
Capillary leakage
Erythema
Describe the appearance of urticaria
Central itchy white papule with surrounding erythematous flare