Dermatology I Flashcards
Define a macule
Localised area of colour or textural change in skin
Define a papule
Small solid elevation of skin <5mm in diameter
Define a nodule
Similar to papule but larder than 5mm.
What might nail abnormalities be associated with
- Skin diseases eg lichen plants or psoriasis
- Systemic diseases - anaemia, CT diseases, endocrine tings, and fuck tonnes of other things
What is finger clubbing associated with
- Inflammatory bowel disease (Crohn’s)
- Malabsorption
- Liver cirrhosis
- Cyanotic congenital heart disease
- Atrioventricular malformation
- Endocarditis
- Graves’ disease
- Lung cancer
- TB
etc
What is finger clubbing
Distorted angle of the nail bed
What is nail pitting associated with
- Psoriasis
- Lichen plans
- Reiter’s syndrome
- Incontinentia pigmenti
- Alopecia areata
What is Koilonychia associated with
- May be normal in infants
- Iron deficiency anaemia
- Haemochromatosis
- Raynaud’s phenomenon
- Systemic lupus erythematosus
- Trauma
What is Koilonychia
Spoon nails that are soft and look scooped out
What are Beau’s lines associated with
- Any severe illness disrupting nail growth
- Raynaud’s phenomenon
- Pemphigus vulgaris
- Trauma
What are splinter haemorrhages in nails associated with
- Trauma
- Infective endocarditis
- Systemic lupus erythematosus
- Rheumatoid disease
- Peptic ulceration
- Malignancy
- Oral contraceptive therapy
- Pregnancy
- Psoriasis
What is Herpetic whitlow
- Swelling, reddening and tenderness of the skin of infected finger
- Due to cutaneous herpes simplex virus infection
- Associated pyrexia and lymphadenopathy
- Initially vesicles form that may burst and coalesce
- Associated pain often seems large relative to apparent clinical features
What is Paronychia
- Localised superficial irritation of epidermis bordering nails
- May be due to infection, chemical irritation or excessive contact with moisture
What are the causes of acute and chronic paronychia
Acute - usually due to staphylococcus aureus
Chronic - several different micro-organisms, mix of yeasts and bacteria
Name some malignant skin tumours
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
- Malignant melanoma
- Cutaneous Lymphoma
What are the predisposing factors of BCC/SCC
- UV radiation
- Skin type I or II (freckles)
- Ionising radiation
- Burn/vaccination scars
- Immunosuppression
- Arsenic
Describe the skin types of the fitzpatrick scale
6 types
Gets more and more towards black skin and the higher the number the less easily it burns and tans
What the some more predisposing factors specifically for BCC
- M>F
- > 40 years old
- Outdoor occupation
- Immunosuppression
- Solar elastosis
- Sites of trauma on the face
- Naevus sebaceus
- Gorlins syndrome
What type of cancer is BCC
Locally invasive cancer of epidermal basaloid cells
Describe the presentation of BCC
- Spontaneous ulcer that fails to heal
- Non-healing asymptomatic lump or sore spot that grows slowly
- May bleed with crust formation that may separate during sleep to leave blood on pillow
- Nodular BCCs
- Superficial BCCs
Describe Nodular BCCs
Most common and mainly affects head and neck - typically a pearly papule with a rolled edge, telangectasia and central depression +/- ulceration
Describe Superficial BCCs
Slowly growing scaly pink patch or plaque, may mimic eczema or psoriasis
Describe the prognosis of BCCs
- Slow growing and non-aggressive
- Only rarely metastasise
Describe the presentation of SCCs
- Malignant tumour of keratinocytes
- Usually arises in areas of damaged skin eg in association with ‘actinic keratosis’
- Typically occurs in people aged >55
- More common in males
- May metastasise
