Dermatology (General) Flashcards
Define the terms
- macule
- patch
macule - circumscribed area of change in colour of skin, not palpable, <1cm
patch - circumscribed area of change in colour of skin, not palpable, >= 1cm
Define the terms
- papule
- plaque
papule - circumscribed elevation of skin, palpable, <1cm
plaque - circumscribed elevation of skin, palpable, >= 1cm
Define the term
- nodule
nodule - circumscribed elevation of skin, palpable, skinnier than plaque, more raised, >=1cm
Define the term
- wheal
wheal - rounded or flat-topped pale/red elevated areas with cutaneous oedema
- evanescent (disappears quickly)
- changes rapidly in size due to shifting papillary oedema
Define the terms
- vesicle
- bullae
vesicle - circumscribed, elevated superficial cavity containing fluid, <1cm
bullae - circumscribed, elevated superficial cavity containing fluid, >= 1cm
Define the terms
- pustule
- cyst
pustule - circumscribed, elevated, superifical cavity that contains purulent exudate, <1cm
cyst - cavity containing liquid/semisolid, lined by epithelium with fibrous capsule
Define the terms
- petechiae
- purpura
petechiae - smaller bleeding that occurs in the skin and is non-blanchable
purpura - larger bleeding that occurs in the skin and is non-blanchable
Define the terms
- papules
- pustules
papules - circumscribed elevation of skin <1cm
pustules - circumscribed, elevated, superifcial cavity containing purulent exudate, <1cm
State the difference in skin morphlogy in
- erythema mutliforme
- SJS/TEN (steven-johnson syndrome/toxic epidermal necrolysis)
erythema multiforme - 3 or more ring shaped lesions + palpable
SJS/TEN - less than 3 ring shaped lesions + non-palpable
State the difference between
- erosions
- ulcers
- fissures
EROSIONS - defect only in the epidermis (superficial)
- heals without a scar
ULCER - defect extends from epidermis to dermis or deeper
- heals with a scar
FISSURES - narrow and deep crack
- eg: chronic eczema
Explain the terms
- scale
- crust
scale - flaking of stratum corneum
crust - dried serous/purulent/blood exudates
Explain the terms
- hyperkeratosis
- lichenification
hyperkeratosis - thickening of stratum corneum (does not flake off)
lichenification - thickening of skin
- secondary to chronic scratching, leathery
- exaggeration of normal skin lines
Explain INDURATION
INDURATION - dermal thickening causing the cutaneous surface to feel thick, firm and tight
- eg: systemic sclerosis
State the treatment method for syndromes of the
- epidermis
- dermis
- superficial fascia
- subcutaneous tissue
- muscle
epidermis + dermis - antibiotics
superficial fascia and deeper - prompt surgical debridement + antibiotics (fast progression due to absence of skin to hinder spread of infections)
State some common conditions related to the epidermis and dermis layers
- erysipelas
- impetigo
- folliculitis
- ecthyema (deeper impetigo)
- furunculosis (boils) + carbounculosis (multiple boils)
State some common conditions related to the subcutaenous tissue and muscle
subcutaneous tissue - necrotising fasciitis
muscle - myonecrosis (gas gangrene)
State the common causative agents of
1. cellulitis
2. erysipelas
3. lymphangitis
4. cat/dog bites
5. type 1 necrotising fasciitis
6. type 2 necrotising fasciitis
7. gas gangrene
- cellulitis - staph aureus, beta-hemolytic streps
- erysipelas - grp a strep
- lymphangitis - grp a strep (staph aureus) + cat scratch
- cat/dog bites - pasteurella mutlocida
- type 1 necrotising fasciitis - aerobes
- type 2 necrotising fasciitis - grp a strep
- gas gangrene - clostridium perfringens
Stte the major and minor mediators of PRURITUS
PRURITUS
(1) Major mediators
- Histamine
- Tryptase
- Cathepsin S
- Interleukin-31
(2) Minor mediators
- Substance P
- Prostaglandin E
- Miu-opioid receptor agonists
State some possible causes of PRURITUS WITHOUT PRIMARY DERMATOSIS
PRURITUS WITHOUT PRIMARY DERMATOSIS
1. Liver disorders - hyperbilirubinemia
2. Renal disorders - uraemia involvement
3. Benign & malignant haematological disorders - hodgkin’s lymphoma
4. Endocrine disorders - poorly controlled DM, hypothyrodisim, hyperthyroidism
5. Infections - HIV
6. Pregnancy
7. Neuropsychiatric disorders
State some associated symptoms of DECOMPENSATED CHRONIC LIVER DISEASE
DECOMPENSATED CHRONIC LIVER DISEASE
- Jaundice
- Distension of stomach veins
- Pruritus without primary dermatosis
State some associated symptoms of CHRONIC RENAL FAILURE
CHRONIC RENAL FAILURE
- Pedal oedema
- Asteatosis
- Half and half nails
- Haematuria/ frothy urine
- SOB
- Pruritus without priamry dermatosis
State some associated symptoms of HODGKIN’S LYMPHOMA
HODGKIN’S LYMPHOMA
- Fever
- Night sweats
- LOW
- Fatigue
- Mass
- Pallor
- Pruritus without primary dermatosis
FURUNCULOSIS
- ____ abscesses associated with ____
- Most common causative agent =
- Most comonly affects ____, rarely seen in ____
FURUNCULOSIS = BOILS
- CUTANEOUS abscesses associated with HAIR FOLLICLES
- Most common causative agent = STAPH AUREUS
- Most comonly affects ADOLESCENTS AND YOUNG ADULTS, rarely seen in CHILDHOOD
SEBORRHEIC KERATOSIS
- Stuck on appearing ____ and ____ with ____ borders
- ____ onset of numerous SKs may be a cutaneous sign of ____
SEBORRHEIC KERATOSIS
- Stuck on appearing PAPULES and PLAQUES with WELL-DEFINEDborders
- RAPID onset of numerous SKs may be a cutaneous sign of INTERNAL MALIGNANCY
EPIDERMAL CYSTS
- Contents consist of ____ and ____ debris
- Factors - ____ and iatrogenic implantation of ____ elements, occlusion of ____ duct, ____ (virus) or hereditary conditions (____ syndrome)
EPIDERMAL CYSTS
- Contents consist of MACERATED KERATIN and LIPID-RICH debris
- Factors - TRAUMATIC and iatrogenic implantation of EPIDERMAL elements, occlusion of ECCRINE duct, HSV (virus) or hereditary conditions (GARDNER syndrome)
LIPOMA
- Slow-growing, ____ fat cells
- Soft, ____, ____ mobile subcutaneosu masses without overlying skin change
- Often ____ but can be ____
- Usually ____
LIPOMA
- Slow-growing, MATURE fat cells
- Soft, RUBBERY, FREELY mobile subcutaneous masses without overlying skin change
- Often SOLITARY but can be MULTIPLE
- Usually ASYMPTOMATIC
BASAL CELL CARCINOMA
- Most common cancer in humans and most common cancer of the skin
- Benign/Malignant
- Neoplasm of ____
- Greatest risk factor =
- ____ sun exposure is more closely associated with development of SCC than ____ UV exposure
BASAL CELL CARCINOMA
- Most common cancer in humans and most common cancer of the skin
- Malignant
- Neoplasm of BASAL KERATINOCYTES
- Greatest risk factor = SUN EXPOSURE
- INTERMITTENT sun exposure is more closely associated with development of SCC than CUMULATIVE UV exposure
SQUAMOUS CELL CARCINOMA
- ____ most common skin cancer worldwide
- Arises from any skin surace including the ____, but mostly affects the ____ areas
- Risk factors =
SQUAMOUS CELL CARCINOMA
- SECOND most common skin cancer worldwide
- Arises from any skin surace including the MUCOSA, but mostly affects the SUN-EXPOSED areas
- Risk factors = UV EXPOSURE, IMMUNOSUPPRESSION, IONISING RADIATION, CIGARETTE SMOKING, HPV
KERATHOACANTHOMA
- ____ growing, ____ neoplasm of ____ epithelium
- Considered as a ____ grade SCC
- Appears and grows ____ over a few weeks and spontaneously ____ and ____ within 6 months to leave an ____ scar
- ____ system plays a role in ____ regression of keratoacanthomas
KERATHOACANTHOMA
- RAPIDLY growing, WELL-DIFFERENTIATED neoplasm of SQUAMOUS epithelium
- Considered as a LOW-GRADE grade SCC
- Appears and grows RAPIDLY over a few weeks and spontaneously INVOLUTES and RESOLVES within 6 months to leave an ATROPHIC scar
- IMMUNE system plays a role in SPONTANEOUS regression of keratoacanthomas
LEUKEMIA CUTIS
- Skin infiltration by a ____ proliferation by ____
- May be ____ and present as ____ ulcers
- Lesions can ____ or become ____
LEUKEMIA CUTIS
- Skin infiltration by a MALIGNANT proliferation by LEUKOCYTES
- May be POLYMORPHIC and present as HAEMORRHAGIC ulcers
- Lesions can ULCERATE or become BULLOUS
DERMATOFIBROSARCOMA PROTUBERANS
- ____ derived intermeidate soft tissue ____
- Uncommon neoplasm with ____ metastatic potential
- Can be ____ aggressive
- Risk factors =
- Presents as ____ growing, ____ (colour), ____ plaque with ____ nodularity in an adult
- Common site =
DERMATOFIBROSARCOMA PROTUBERANS
- FIBROBLAST derived intermeidate soft tissue SARCOMA
- Uncommon neoplasm with LOW metastatic potential
- Can be LOCALLY aggressive
- Risk factors = AFRICAN DESCENT + FEMALE
- Presents as SLOW growing, RED-BROWN (colour), INDURATED plaque with IRREGULAR nodularity in an adult
- Common site = TRUNK + HEAD AND NECK + PROXIMAL EXREMITIES
CHERRY ANGIOMA
- Acquired ____, ____ proliferation
- ____ walled and ____ capillaries
- Treatment =
- Site =
CHERRY ANGIOMA
- Acquired BENIGN, VASCULAR proliferation
- THIN walled and DILATED capillaries
- Treatment = No treatment unless irritated or bleeeding (Secondary to trauma)
- Site = TRUNK + ARMS (RARE)
XANTHELASMA
- Presents as yellowish ____ or slightly elevated ____ or ____ on the eyelids
- Risk factors =
- Independent risk factor for ____ and subsequently ____
XANTHELASMA
- Presents as yellowish MACULES or slightly elevated PAPULES or PLAQUES on the eyelids
- Risk factors = WOMEN (3X MORE LIKELY)
- Independent risk factor for ATHEROSCLEROSIS and subsequently ICD (ISCHAEMIC CARDIOVASCULAR DISEASE)
KELOID
- ____, ____ tissue nodules typically found at areas of previously ____ skin
- Can become ____, ____ or ____ and grow to become very lare
- Can cause ____ discomfort, ____ and restrict normal ____ motion
KELOID
- DENSE, FIBROUS tissue nodules typically found at areas of previously TRAUMATISED skin
- Can become PAINFUL, TENDER or PRURITIC and grow to become very lare
- Can cause CHRONIC discomfort, DISFIGURING and restrict normal TISSUE motion
KAPOSI SARCOMA
- ____ neoplasm of lympahtic ____ cell origin that occurs in several forms =
- Due to or influced by ____ (virus)
- Lesions are deep red ____, ____, ____, ____ and ____
KAPOSI SARCOMA
- MALIGNANT neoplasm of lympahtic ENDOTHELIAL cell origin that occurs in several forms = AIDS-ASSOCIATED OR NON-AIDS ASSOCIATED
- Due to or influced by HHV-8 (virus)
- Lesions are deep red PATCHES, PAPULES, PLAQUES, TUMOURS and NODULES
SARCOIDOSIS
- ____ disease is the first sign of systemic sarcoidosis
- ____ formation in involved organs
- Asymptomatic/Symptomatic
- Sites =
SARCOIDOSIS
- CUTANEOUS disease is the first sign of systemic sarcoidosis
- GRANULOMA formation in involved organs
- Asymptomatic
- Sites = FACE, NECK, UPPER EXTREMITIES, UPPER TRUNK
State everything you know about MELANOMA
MELANOMA
- malignant tumour of melanocytes
- high metastatic potential
- irregular pigmented lesions
