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Dermatology & Haematology > Dermatology basics > Flashcards

Dermatology basics Flashcards

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Dermatology Board Prep flashcards
1
Q

What’s included in examination of the skin?

A

Inspect:

  • site and no. lesions
  • pattern and configuration

Describe individual lesions: SCAM

  • Size
  • Colour
  • Associated 2ndary change
  • Morphology + Margin

Palpate:

  • Surface
  • Consistency
  • Mobility
  • Tenderness
  • Temperature

Systematic check:

  • Scalp + hair
  • Nails
  • Mucous membranes
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2
Q

What are some good ways to describe individual lesions?

A

SCAM

  • Size
  • Colour
  • Associated 2ndary change
  • Morphology + Margin
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3
Q

What is meant by ‘secondary changes’?

A

Secondary lesions

Problems that the rash/skin problem has caused. I.e. not part of original pathology

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4
Q

Define:

  • Pruritus
  • Lesion
  • Rash
  • Comedone
A

Pruritus: itching

Lesion: an area of altered skin

Rash: An eruption of areas of altered skin

Comedone: A plug in a sebaceous follicle containing altered sebum, bacteria and cellular debris. Two types: open (blackheads) and closed (whiteheads)

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5
Q

List and define some ways to describe lesion distribution?

A

Generalised: all over

Widespread: extensive cover

Localised: restricted to one area

Flexural: body folds (groin, neck, behind ears)

Extensor: Knees, elbows, shins

Pressure areas: sacrum, buttocks, heels

Dermatome: area supplied by single spinal nerve

Photosensitive: sun exposed areas (face, neck, back, hands

Koebner’s phenomenon: linear eruption arising at trauma site

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6
Q

What is Koebner’s phenomenon?

A

A linear eruption arising at the site of trauma

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7
Q

What is meant by

  • Configuration
  • Distribution
  • Morphology
A

The pattern or shape of grouped lesions

The pattern of spread of lesions

Structure of the lesions themselves

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8
Q

List and define some ways to describe lesion configuration?

A

Discrete: individual lesions separated from each other

Confluent: lesions merging together

Linear: in a line

Target: concentric rings (circles within circles, like a dart board)

Annular: ring, circle

Discoid: round

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9
Q

Skin can change colour when there’s pathology. List and define terms used to describe.

A

Erythema: redness, caused by inflammation and vasodilatation

Petechiae, purpura, ecchymoses: red, purple colour, due to bleeding into skin or mucous membrane

Hypo-pigmentation: area of paler skin

De-pigmentation: areas of white skin due to absence of melanin

Hyper-pigmentation: darker areas of skin, can be post-inflammation

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10
Q

List and define terms used to describe morphology?

A

Macule: a flat area of altered skin
Patch: large flat area of altered skin

Papule: solid raised lesion < 5mm
Nodule: solid raised lesion >5mm

Plaque: palpable scaling raised lesion > 5mm

Vesicle: raised, clear, fluid filled lesion < 5mm
Bulla: raised, clear, fluid filled lesion > 5mm

Pustule: pus containing lesion < 5mm

Abscess: localised accumulation of pus in dermis or subcutaneous tissues

Wheal: transient raised lesion due to dermal oedema, i.e urticaria

Boil: staph infection around or within a hair follicle
Carbuncle: staph infection of adjacent hair follicles

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11
Q

List and define some examples of secondary lesions?

A

Lichenification: thickened, roughened, darkened skin due to excess itching

Excoriation: loss of epidermis due to itching

Scale: flakes of stratum corneum

Fissure: crack in skin die to excessive dryness

Crust: rough surface of dried serum, blood, bacteria, cellular debris that’s exuded through epidermis

Scar: new fibrous tissue which occurs post wound healing

Ulcer: loss of epidermis and dermis

Striae: linear areas that occur after pregnancy, growth spurt, steroid use

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12
Q

What types of scar are there?

A

Atrophic: thinning

Hypertrophic: hyperproliferation within wound boundary

Keloidal: hyperproliferation beyond wound boundary

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13
Q

What colours do striae progress through?

A

Purple to pink to white

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14
Q

Define:

  • alopecia
  • hirsutism
  • hypertrichosis?
A

Alopecia: loss of hair

Hirsutism: androgen dependent hair growth in women

Hypertrichosis: non-androgen dependent pattern of hair growth, like in a naevus

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15
Q

List and define nail problems that are seen in dermatology.

A

Clubbing: loss of angle between posterior nail fold and nail plate

Koilonychia: spoon shaped depression of nail plate

Onycholysis: separation of the distal end of the nail bed

Pitting: punctuate depressions of nail plate

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16
Q

Causes of:

  • clubbing
  • koilonychia
  • onycholysis
  • pitting?
A

Clubbing: cyanotic heart disease, respiratory disease, IBD

Koilonychia: iron deficiency anaemia, congenital

Onycholysis: trauma, psoriasis, fungal nail

Pitting: psoriasis, eczema, alopecia

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17
Q

What are the functions of the skin?

A 
Protective barrier against environment
Temperature regulation
Sensation
Vitamin D synthesis
Immune system
Appearance
18
Q

What three layers of skin are there?

List the skin appendages? Why are they called this?

A

Epidermis
Dermis
Sub-cutaneous layer

Hair
Nails
Sebaceous glands
Sweat glands
Because they’re formed by skin derived cells
19
Q

Describe the layers of the epidermis? Give a brief description of each layer.

A

4 layers, going from deep to superficial - BSGC

  1. Stratum basale: actively dividing layer, deepest
  2. Stratum spinosum: differentiating cells
  3. Stratum granulosum: cells lose nuclei and contain granules of keratohyaline

(in thick skin i.e. soles there’s an extra layer: Stratum lucidum)

  1. Stratum corneum: layer of keratin, superficial layer
20
Q

Which epidermis layer is this:

  1. Contains granules of keratohyaline
  2. Deepest layer
  3. Superficial layer
  4. Contains paler keratin
  5. Contains differentiating cells
  6. Contains cells with no nuclei
  7. Contains actively dividing cells
  8. Is also called the Horny layer
  9. Only seen in thick skin
A
  1. Granulosum
  2. Basale
  3. Corneum
  4. Lucidum
  5. Spinosum
  6. Granulosum
  7. Basale
  8. Corneum
  9. Lucidum
21
Q

List and briefly describe the types of cells found in the epidermis?

A

Keratinocytes: produce keratin

Langerhans cells: present antigens and activate T lymphocytes

Melanocytes: produce melanin

Merkel cells: contain specialised nerve endings

22
Q

What’s the function of:

  • Keratin
  • Melanin
A

Keratin: acts as a protective barrier

Melanin: gives pigment to skin and protects DNA from UV damage

23
Q

What is the structure of the dermis? Explain the function of each component

A

Mainly collagen, also elastin and glycosaminoglycans
These provide strength and elasticity

Immune cells
Nerves
Skin appendages (sebaceous glands, hair follicles)
Lymph vessels
Blood vessels
24
Q

What produces collagen, elastin and glycosaminoglycans in the dermis?

A

Fibroblasts

25
Q

What are the different types of hair?

A

Lanugo hair: fine, long hair in the foetus

Vellus hair: fine, short hair on all body surfaces

Terminal hair: coarse, long hair on scalp, eyebrows, eyelashes, pubic areas

26
Q

Describe the structure of a hair?

A

Hair shaft: keratinised tube

Hair bulb: actively dividing cells and melanocytes giving pigment to hair

27
Q

What’s the growth cycle of a hair follicle?

A

ACT

Anagen: long growing phase

Catagen: short regressing phase

Telogen: resting/shedding phase

28
Q

What’s the structure of a nail? List some pathologies that occur in each bit?

A

Nail plate: hard keratin
Discoloured, thickened nails

Nail matrix: at posterior nail fold, where the keratin arises
Pits and ridges

Nail bed: capillaries
Splinter haemorrhages

29
Q

What is a sebaceous gland?

A

Produces sebum via a hair follicle

Secrete sebum onto the skin to lubricate and waterproof the skin

30
Q

What is a pilosebaceous unit?

A

Sebaceous gland + hair follicle

31
Q

What stimulates sebaceous glands?

What does sebum do?

A

Conversion of androgens to dihydrotestosterone
So they become active at puberty

Sebum lubricates and waterproofs the skin

32
Q

What are the types of sweat gland?

A

Eccrine: all over skin

Apocrine: in axillae, areolae, genitalia, anus
Only function from puberty onwards

33
Q

What controls sweat glands?

A

Sympathetic nervous system

34
Q

List and give examples of pathologies that can occur in the epidermis?

A

Epidermal turnover time: psoriasis is when there’s a reduced epidermal turnover time

Change in structure or loss of epidermis: scales, ulcers, crusting

Change in pigmentation: hypo or hyper-pigmented

35
Q

List and give examples of pathologies that can occur in the dermis?

A

Loss of dermis or change in contour: papules, nodules, skin atrophy

Disorders of skin appendages: hair problems, sebaceous glands (acne)

Lymphatic and blood vessel: erythema (vasodilation), urticaria (increased permeability of small vessels), purpura (capillary leakage)

36
Q

List and give examples of pathologies that can occur in the hair?

A

Reduced or absent melanin pigment production: grey or white hair

Changes in duration of growth cycle: hair loss (premature entry of hair follicles into the telogen phase)

Shaft abnormalities

37
Q

What’s the pathogenesis of hair loss?

A

Premature entry of hair follicle into the telogen phase, which is shedding

38
Q

List and give examples of pathologies that can occur in the sebaceous glands?

A

Increased sebum production + bacterial colonisation: acne

Sebaceous gland hyperplasia

39
Q

What is:

  • Sebaceous gland hyperplasia
  • Hidradenitis suppurativa
  • Hyperhidrosis?
A

**

40
Q

List and give examples of pathologies that can occur in the sweat glands?

A

Inflammation/infection of the apocrine glands: hidradenitis suppurativa

Overactivity of eccrine glands: hyperhidrosis

41
Q

What are the stages of wound healing?

A
  1. Haemostasis:
    - Vasoconstriction
    - Platelet aggregation
    - Clot formation
  2. Inflammation:
    - Vasodilatation
    - Migration of macrophages + neutrophils
    - Phagocytosis of cell debris and bacteria
  3. Proliferation
    - Granulation tissue formed by fibroblasts
    - Angiogensis
    - Re-epithelialisation
  4. Remodelling
    - Collagen fibre re-organisation
    - Scar maturation
42
Q

What is re-epithelialisation?

Which stage of wound healing is it?

A

Epidermal cell proliferation and migration

In stage 3: proliferation

Dermatology & Haematology (8 decks)

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