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Yr 3 MedEd > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Give the subcategories for the following types of lesion:

  • Flat (2)
  • Fluid- filled (3)
  • Raised (2)
A
  • Flat: macule (small), patch (large)
  • Fluid-filled: Vesicle (<0.5cm), pustule (pus filled vesicle), bulla (>0.5 cm)
  • Raised: papule (<0.5cm), nodule (>0.5cm)
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2
Q

Give the arrangement of basal cells, squamous cells and melanocytes in normal epidermis.

Which is the most common and second most common type of skin cancer?

A
  • Squamous above basal in layers.
  • Basal cells in a line, interrupted by occasional melanocyte

Basal cell carcinoma most common. Squamous cell carcinoma second most common

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3
Q

Define squamous cell carcinoma.

Give 4 risk factors for squamous cell carcinoma

A
  • Cancer of keratinocytes in epidermis. 2nd most common skin cancer
    Risk fx:
  • UV light
  • Actinic keratosis (pre-cancerous condition)
  • FHx
  • Lighter skin
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4
Q

Give 5 features of squamous cell carcinoma lesion.

Describe 2 features of its invasion.

A
  • Hyperkeratotic
  • Scaly/ crusty
  • Ulcerated
  • Non-healing
  • Rolled edges
  • Local invasion into dermis, can metastasise
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5
Q

Give definition of basal cell carcinoma

- Give 3 risk factors for basal cell carcinoma.

A 
Cancer of keratinocytes in epidermis in stratum basale
Risk fx:
- UV light
- FHx
- Lighter skin
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6
Q

Give 5 features of basal cell carcinoma lesion

- Describe 3 features of its invasion.

A
  • Nodule
  • Pearly edges
  • Rolled edges
  • Central ulcer (rodent ulcer)
  • Central fine telangiectasia
  • Slow growing, local invasion into dermis, doesn’t metastasise
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7
Q

Give the 4 subtypes of basal cell carcinoma

A
  • Nodular: most common
  • Morpheic: yellow waxy plaque, scar-like
  • Superficial: flat shape
  • Pigmented: dense colour/ specks of colour.
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8
Q

Give 3 risk factors for malignant melanoma

A
  • UV light
  • FHx
  • Lighter skin
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9
Q

Give 5 features of a malignant melanoma lesion

Describe the invasion of malignant melanoma (2)

A

ABCDE

  • Asymmetrical
  • Irregular border
  • Pigmented colour
  • Diameter >6mm
  • Evolution: may bleed, itch, ulcerate, crust over
  • Local invasion- into dermis
  • Can metastasise
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10
Q

Give 4 subtypes of malignant melanoma

A
  • Superficial spreading- most common
  • Lentigo maligna: flat lesions on face, elderly
  • Nodular: domed shape, rapid growth
  • Acral lentiginous: palms, soles, nail beds- non-caucasians
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11
Q

How should the 3 types of skin cancer be referred?

What investigation is used to measure melanoma invasion?

Which investigations can be used for staging skin cancer?

A
  • Melanoma and SqCC urgent referral
  • BCC: routine referral
  • Clark level/ Breslow thickness- obtained by skin biopsy.
  • CT/ MRI/ PET
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12
Q

What are melanocytic lesions?

Give 3 features of their morphology.

A
  • Benign neoplasms of melanocytes in epidermis
  • Often congenital, arise during childhood.
  • Symmetrical, flat, regular borders (not ABCDE)
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13
Q

Give 2 risk factors for eczema aka dermatitis

Give 5 features of eczema lesions

A
  • PMHx/ FHx of atopy- food allergies, hay fever, asthma
  • Immunocompromised
  • Dry
  • Itchy
  • erythematous
  • Flexure distribution
  • Lichenification if chronic
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14
Q

Describe the 6 types of eczema:

  • Atopic dermatitis
  • Contact dermatitis
  • Discoid dermatitis
  • Seborrhoeic dermatitis
  • Dyshidrotic aka pompholyx
  • Eczema herpeticum
A
  • Atopic dermatitis: type 1 hypersensitivity- IgE mediated, flexures.
  • Contact dermatitis: Type 4 hypersensitivity (delayed). Often nickel/ latex. Irritant or allergic
  • Discoid dermatitis: middle aged/ elderly, coin shaped plaques
  • Seborrhoeic: yellow, greasy scaly rash. Eyebrows, nasolabial, scalp distribution (cradle cap)
  • Dishydrotic: itchy/ painful blisters- palms and plantars.
  • Herpeticum: Medical emergency, can disseminate, superimposed HSV-1
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15
Q

Give 3 triggers of psoriasis

Give 4 features of psoriatic lesions.

A
  • Stress, smoking, alcohol.
  • Purple, silvery plaques
  • Dry flaky skin
  • Itchy painful
  • Extensors and scalp.
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16
Q

Give 3 nail signs of psoriasis

A
  • Onycholysis
  • Pitting
  • Subungual hyperkeratosis
17
Q

Give 1 sign of psoriatic arthritis

Give 4 causes of onycholysis

A
  • Symmetrical polyarthritis
  • Psoriasis
  • Fungal infection
  • Trauma
  • Thyrotoxicosis
18
Q

Describe the following subtypes of psoriasis

  • Plaque psoriasis
  • Pustular aka palmo-plantar
  • Guttate
  • Flexural
  • Erythrodermic
A
  • Plaque-most common
  • Pustular: plaques/ pustules on palms and plantars
  • Guttate: raindrop plaques- 2 weeks post-strep
  • Flexural: body folds: axilla, groin, peri-anal area
  • Erythrodermic: systemic body redness and inflammation. Often temperature dysregulation, electrolyte imbalances. Requires hospitalisation
19
Q

Give 3 risk factors for cellulitis and erysipelas.
Both lesions have acute onset and inflammation.
Give two causative organisms of cellulitis and erysipelas.

A
  • Wound, ulcer, bites
  • IV cannula
  • Immunosuppression.
  • Strep. pyogenes or staph aureus
20
Q

Differentiate cellulitis and erysipelas by the following:

  • Site
  • Borders
  • Systemic
  • Sepsis
A

Cellulitis:

  • Dermis, subcutaneous tissue
  • Patchy borders
  • Less common systemic
  • Sepsis more common

Erysipelas

  • Epidermis
  • Well demarcated borders
  • Systemic fevers and rigors
  • Sepsis less common
21
Q

Give 5 complications of cellulitis

A
  • Abscess
  • Sepsis: medical emergency
  • Necrotising fasciitis: surgical emergency
  • Periorbital cellulitis: medical emergency: IV Abx
  • Orbital cellulitis: medical emergency: IV Abx, surgery
22
Q

When would you CT/MRI for cellulitis?

A
  • Orbital cellulitis- need to identify posterior spread of infection
23
Q

Give 3 conservative management steps for cellulitis.

Give 2 reasons to admit to hospital with cellulitis

A
  • Draw around lesion
  • Monitor observations
  • Oral fluids

Admit if
Sepsis: High HR/ RR, low BP
Confusion: AVPU, GCS

24
Q

Give examples of the following causes of erythema nodosum:

  • Infection (3)
  • Systemic disease (3)
  • Drugs (1)
  • Other (1)
A
  • Infection: strep pyogenes, TB, HIV
  • Systemic disease: IBD, sarcoidosis, Behcet’s disease
  • Drugs: sulphonamides
  • other: pregnancy
25
Q

Define erythema nodousm.

Describe 4 features of erythema nodosum lesion.

A

Inflammation of subcutaneous fat (panniculitis): type 4 hypersensitivity.

  • Bilateral nodules
  • Tender
  • Red/ purple
  • Anterior shins/ knees distribution
  • doses not ulcerate, does not scar.
26
Q

Define erythema multiforme.

Give 3 infective and 1 drug cause of erythema multiforme.

A

Inflammation of skin (minor) and mucous membranes (major when both)): type 4 hypersensitivity.

  • Herpes simplex, mycoplasma, HIV.
  • Sulphonamides
27
Q

Give 1 symptom and 3 lesion features of erythema multiforme.

A

Symptom: prodrome: fever and aches.

  • Target lesions: central vesicle with ring of pallor and ring of erythema.
  • Tender/ itchy pain
  • Starts on hands then spreads
28
Q

What is molluscum contagiosum.

Give 2 risk factors.

A
  • Skin infection due to pox virus- molluscum contagiosum virus.
  • Immunocompromised, atopic eczema.
29
Q

Give 4 features of molluscum contagiosum lesion.
How is it transmitted?
What should be tested for if many lesions of molluscum in adults?

A
  • Smooth papule
  • Umbilicated
  • Often painless
  • Often itchy

Transmitted by close contact: swimming pools, sexual contact. Children do not need exclusion from school.

Test for HIV if lots of adult lesions.

Yr 3 MedEd (31 decks)

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