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CHHD > Dermatology I > Flashcards

Dermatology I Flashcards

1
Q

Define a macule

A

Localised area of colour or textural change in skin

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2
Q

Define a papule

A

Small solid elevation of skin <5mm in diameter

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3
Q

Define a nodule

A

Similar to papule but larder than 5mm.

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4
Q

What might nail abnormalities be associated with

A
  • Skin diseases eg lichen plants or psoriasis

- Systemic diseases - anaemia, CT diseases, endocrine tings, and fuck tonnes of other things

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5
Q

What is finger clubbing associated with

A
  • Inflammatory bowel disease (Crohn’s)
  • Malabsorption
  • Liver cirrhosis
  • Cyanotic congenital heart disease
  • Atrioventricular malformation
  • Endocarditis
  • Graves’ disease
  • Lung cancer
  • TB
    etc
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6
Q

What is finger clubbing

A

Distorted angle of the nail bed

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7
Q

What is nail pitting associated with

A
  • Psoriasis
  • Lichen plans
  • Reiter’s syndrome
  • Incontinentia pigmenti
  • Alopecia areata
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8
Q

What is Koilonychia associated with

A
  • May be normal in infants
  • Iron deficiency anaemia
  • Haemochromatosis
  • Raynaud’s phenomenon
  • Systemic lupus erythematosus
  • Trauma
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9
Q

What is Koilonychia

A

Spoon nails that are soft and look scooped out

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10
Q

What are Beau’s lines associated with

A
  • Any severe illness disrupting nail growth
  • Raynaud’s phenomenon
  • Pemphigus vulgaris
  • Trauma
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11
Q

What are splinter haemorrhages in nails associated with

A
  • Trauma
  • Infective endocarditis
  • Systemic lupus erythematosus
  • Rheumatoid disease
  • Peptic ulceration
  • Malignancy
  • Oral contraceptive therapy
  • Pregnancy
  • Psoriasis
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12
Q

What is Herpetic whitlow

A
  • 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
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13
Q

What is Paronychia

A
  • Localised superficial irritation of epidermis bordering nails
  • May be due to infection, chemical irritation or excessive contact with moisture
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14
Q

What are the causes of acute and chronic paronychia

A

Acute - usually due to staphylococcus aureus

Chronic - several different micro-organisms, mix of yeasts and bacteria

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15
Q

Name some malignant skin tumours

A
  • Basal cell carcinoma (BCC)
  • Squamous cell carcinoma (SCC)
  • Malignant melanoma
  • Cutaneous Lymphoma
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16
Q

What are the predisposing factors of BCC/SCC

A
  • UV radiation
  • Skin type I or II (freckles)
  • Ionising radiation
  • Burn/vaccination scars
  • Immunosuppression
  • Arsenic
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17
Q

Describe the skin types of the fitzpatrick scale

A

6 types

Gets more and more towards black skin and the higher the number the less easily it burns and tans

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18
Q

What the some more predisposing factors specifically for BCC

A
  • M>F
  • > 40 years old
  • Outdoor occupation
  • Immunosuppression
  • Solar elastosis
  • Sites of trauma on the face
  • Naevus sebaceus
  • Gorlins syndrome
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19
Q

What type of cancer is BCC

A

Locally invasive cancer of epidermal basaloid cells

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20
Q

Describe the presentation of BCC

A
  • 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
21
Q

Describe Nodular BCCs

A

Most common and mainly affects head and neck - typically a pearly papule with a rolled edge, telangectasia and central depression +/- ulceration

22
Q

Describe Superficial BCCs

A

Slowly growing scaly pink patch or plaque, may mimic eczema or psoriasis

23
Q

Describe the prognosis of BCCs

A
  • Slow growing and non-aggressive

- Only rarely metastasise

24
Q

Describe the presentation of SCCs

A
  • 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
25
Q

Describe the appearance of SCCs

A

Found in sun exposed sites - face, neck, forearm, hand

Starts with an area of ‘actinic keratosis’ as a small papule that ulcerates and crusts

26
Q

What predisposing factors are there for SCC specifically

A
  • F>M
  • Old age
  • Erythema ab igne
  • Chronic granulomas/ulcers
  • Tar
  • Albinism
  • Xeroderma pigmentosa
27
Q

What are malignant melanomas

A

Malignant tumour of melanocytes that usually arise in the epidermis

28
Q

How do malignant melanomas affect men and women differently

A
  • F>M, 2:1
  • Females most commonly in lower legs
  • Males most commonly in the back
29
Q

What are some of the risk factors for malignant melanomas

A
  • UV radiation
  • Skin type I or II
    Pre-existing melanocytes lesions:
  • Multiple banal naevi
  • Dysplastic/atypical naevi
  • Congenital naevi
  • Previous malignant melanoma
  • Family history of multiple/atypical naevi or melanomas
30
Q

What are some diagnostic features of malignant melanomas

A

the following changes in a naevus or pigmented lesion may suggest diagnosis of malignant melanoma:

  • Size: recent increase
  • Shape: irregular outline
  • Colour: variation
  • Erythema: at edge
  • Crusting, oozing or bleeding
  • Itch: common
31
Q

What are the characteristics of psoriasis and what is psoriasis

A
  • Chronic, non-infectious, relapsing inflammatory condition
  • Increased numbers of cycling epidermal cells
  • Well demarcated, red, scaly patches of skin topped by silvery scales
  • Pitting or onycholysis of nails
32
Q

What are some of the presentation patterns of psoriasis

A
  • Plaque
  • Guttate
  • Flexural
  • Localised forms
  • Generalised pustular
  • Nail involvement
  • Erythroderma
33
Q

What are some precipitating factors of psoriasis

A
  • Koebner phenomenon - following trauma
  • Infection - streptococcal sore throat leading to guttate psoriasis
  • Drugs - beta blockers, lithium, antimalarials
  • Stress
  • Sunlight but in 90% improves it
  • Alcohol
34
Q

What are the characeristic presentations of plaque-like psoriasis

A
  • Well-defined, disc shaped plaques
  • Involving elbows, knees, scalp hair margin or sacrum
  • Plaques usually red and covered by white scales
  • If detached leave bleeding points
  • Sometimes pruritic (itchy)
35
Q

What is psoriatic arthropathy

A

Arthritis you can get if you have psoriasis e.g. distal, rheumatoid, mutilans arthritis or ankylosis spondylitis

36
Q

What are the main treatment options of psoriasis

A
  • Corticosteroids
  • Methotrexate
  • Ciclosporin
37
Q

What are the dental aspects of psoriasis

A
  • Drug-induced gingival hyperplasia
  • Drug-induced oral ulceration
  • Destructive TMJ disease
  • (Suspected association with geographic tongue)
38
Q

What is eczema characterised by

A

A pattern of non-infective inflammatory cutaneous response characterised by:

  • Spongiosis (epidermal oedema) in acute stage
  • Lichenification (thickening of prickle cell layer and hyperkeratosis) in chronic stage
39
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

basically there are a shit ton of endogenous ways that you can get eczema like atomically and other shit idk

40
Q

How common is atopic eczema

A

12-15% of infants affected

41
Q

Patients with atopy have an inherited tendency to develop what conditions?

A
  • Eczema
  • Asthma
  • Hay fever
  • Urticaria
  • Dermographism
    Associated with high serum IgE levels
42
Q

What are some exogenous routes that a patient can develop eczema

A
  • Contact irritant
  • Contact allergic
  • Infective
43
Q

What are the typical presentations of seborrhoeic dermatitis

A
  • Face, scalp and neck frequently involved

- Red and scaly rash - may be exudation and crusting if severe

44
Q

Who is particularly susceptible to seborrhoeic dermatitis

A

Immunosuppressed patients

45
Q

What is seborrhoeic dermatitis associated with

A

Yeast - pityrosporum ovale

46
Q

What is a common treatment method for seborrhoeic dermatitis

A

Responds to topical combination antifungals with a weak corticosteroid

47
Q

What are some treatment routes/options for eczema

A
  • Identify aetiology
  • Treat secondary infection
  • Emollients and soap substitutes
  • Topical corticosteroids
  • Immunosuppressants
48
Q

What are the dental aspects of eczema

A
  • Association with atopy
  • Perioral dermatitis
  • Exfoliative cheilitis
  • Oral allergy syndrome

CHHD (27 decks)

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