dermatology lecture on describing and pattern recognition

Question 1

derm lesion process

Answer 1

inspect - appearance and distributn
describe - shape sieze colour , morphology eg a singl e4mm annular erythematour patch with a scalu edge airising on the uppre back of a 45yr old gentleman

Question 2

lichen planus where should you remember to look

Answer 2

mouth

Wickham striae in the mouth for lichen planus

Question 3

shingles rash does not cross what boundary

Answer 3

the midline - as it is a dermatomal rash

Question 4

treated psoriasis prestns how

Answer 4

no surface scales as untreated will be scaly

Question 5

where in psoarisis do you never get plaques

Answer 5

armpits, groins

Question 6

difference between crust and scale

Answer 6

Crust - yellow - anything wet that has dryed - serous fluids, blood pus, - just dried exudate

Scale - white and dry - dry skin

Question 7

where does eczema start in kids

Answer 7

cheek

in Eczema skin barrier impaired so an emollient stops irritant that gets in such as soap or water and also moisturises the skin. Saliva can also irritate - alternative tacrolimus

Question 8

Side effects of topical steroids

Answer 8

skin thinning ( prolonged use and needs to be relatively potent - face
Steroids can also lead to bruising as affect the collagen in the dermal skin - as collagen holds the blood vessels so willl
Hair follicles - causing folliculitis
Stretch marks and striae especially in groins - topical steroids can cause this

Question 9

Dactylitis - lots of swelling lack of redness

Answer 9

finger swelling

Question 10

how does the pattern of cellulitis spread

Answer 10

systemic features and changes of the skin - tracking that follows the lymphatic system - a red line following regional lymph nodes

Question 12

Psoriasis nail changes

Answer 12

leukonychia - white nails
pitting - nail plate does not form
onycholysis - nails come up
subungal hyperkeratosis - nail thickening

Question 13

acral meaning - opposite of central

Answer 13

hands and feet

Question 14

linear rash example

Answer 14

mosaicism - genetic change in a germline of cells - lichen striatus

Question 15

difference between annular and discoid rash

Answer 15

annular means ring , discoid means filled in circle

Question 16

what is purpura

Answer 16

Purpura - leakage of blood into skin - petechiae( capillary leakage tiny dots)

Question 17

what is ecchymosis

Answer 17

(massive bruising from internal bleeding like in an RTA)- won’t blanch - blood to thin or platelets low

Question 18

macrophage involvemtn in pityriasis versicolor

Answer 18

more in warmer climates - more common in our age group
Macrophages can eat up free melanin in response to inflammation

Question 19

is vitiligo symmetrical

Answer 19

yes

Question 20

macule

Answer 20

flat

Question 21

papule

Answer 21

raised

Question 22

3 itchy conditions

Answer 22

Eczema scabies and dermatitis herpetiformis( elbows and bums)

Question 23

patch or plaque raised

Answer 23

plaque

Question 24

what white blood cell makes pus

Answer 24

neutrophils

Question 24

Calcipotriol - vitamin d analogue -

Answer 24

speed of cell turnover

steriod treats

Question 25

leprosy leads to skin what

Answer 25

hypopigmentation

Question 26

Topical retinoid works on teh comodone - more comodomal acne
Antibiotic work on the infection - pustula acne

What does benzyl peroxide do

Answer 26

Benzyl proxide is like bleech - reduces the comodones and reduces inflammation - problems are that is very dry and bleaches everything

Question 27

Epidermis - keratinocytes - get thinner and flatter as you get to the top - called stratum croneum - waxy layer at top
Dermis - bloof vessels and hair follicles - sebaceous glands attached to bottom of hair follicles - pilosebaceous unit - hari follicle and gland - problem in acne - androgen receptors there - increase sebum production especially during puberty. Keratinocyte action at puberty blocks poures and get back pressure and as secondary problem get infection of that gland

Answer 27

Vesicle - small blister
Arising from normal skin - burn sting friction
Bulla - big blister

Question 28

bcc come from what layer

Answer 28

Bottom layer of keratinocytes callled - basal layer - statrum basale - that is were BCC come from and they push up from level which is why you get a pearly change

Question 29

difference bewteen eroson and ulcer

Answer 29

erosion sup ulcer deep

Question 30

lichenification

Answer 30

a secondary skin lesion that is characterized by hyperpigmentation, thickening of the skin and exaggerated skin line - due to scratcjing or rubbing