Fingers And Skin

Question 1

Trauma of the nail, presents with?

Answer 1

-Biting,
-Nail bed trauma(subungual haematoma)
-Oncholysis (separation of nail)
-Leukonychia (d/t trauma, renal or cardiac failure, hypoalbuminaemia)

Question 2

Infection of the nail, presents with?

Answer 2

Paronychia- pain, swelling and tenderness with green yellow pus.
-d/t: bacterial or fungal infection

Question 3

Inflammatory conditions that affect the nail?

Answer 3

-Splinter hemorrhages- Infective endocarditis, SLE, RA.
-Eczema- dry skin around digits with cracks.
-Psoriatic Arthritis- malunion with cracks of the nail.
- Melanoma- longitudinal black line, subungal lift.

Question 4

Vascular insufficiency of the nail, presents with?

Answer 4

-Raynaud’s phenomenon- pale distal digits.
-Peripheral Cyanosis- blue/pale distal digits.

Question 5

Autoimmune conditions that affect the nail?

Answer 5

-Yellow nail- Jaundice, Lymphedema(post mastectomy), if associated cough—> bronchiectasis, pleural effusion.
-Red nail-Carbon monoxide poisoning.
-Blue nail- Cyanosis
-Clubbing- Lung Ca, infective endocarditis, HIV, IBS, (Sharmoths window)
-Nail Spooning- idiopathic, iron deficiency, trauma
-Nail Pitting- often idiopathic, Psoriasis, Reactive arthritis(Reiter’s), sarcoidosis, SLE.
-Mee’s line- renal failure, chemotherapy
-Terrys nails- liver disease, CHF, kidney failure or diabetes.

Question 6

What is the largest organ in the body?

Answer 6

Skin

Question 7

Skins elasticity can be affected by?

Answer 7

-Ehlers-Danlos (^elasticity)
Decreased:
-UV
-Smoking

Question 8

Trauma in skin can present with?

Answer 8

-Ecchymosis- easily bruised can be bleeding disorder or liver disease.
-Lacerations-deep cut
-Abrasions- scrape

Question 9

Skin color variations/abnormalities?

Answer 9

-Freckles - concentrated melanin
-Birth mark- vascular abnormalities or pigmented melanocytes
-Moles- harmless bump of melanin, should be monitored.
-Café au lait- neurofibromatosis
-Tinea Verisicolor- Natural yeast infection.
-Vitiligo- Depigmentation( MJ)
- Thyrotoxicosis- bruising look
-Haemochromatosis- bronze diabetes.
-Jaudice- yellow d/t high bilirubin in the blood.
-Carotenosis- excess beta carotene from carrots.

Question 10

Types of skin eruptions?

Answer 10

-Psoriasis- scaly patches commonly seen in elbows, knees, scalp and lower back.
-Atopic eczema- red patches that are red, itchy, cracked and sore.
-Dermatophyte infection(ringworm)- tinea corporis, fungal.
-

Question 11

Skin Blistering?

Answer 11

-Burns
-Insect bites
-Necrosis if fascia d/t venom

Question 12

Viral/bacterial conditions of the Skin?

Answer 12

-Herpes simplex
-Varicella (herpes Z)
- Impetigo

Question 13

Pustular/Crusted lesions?

Answer 13

-Acne vulgaris.
-Acne rosacea- Erythema and telangiectasia of the face. >30
-Impetigo- contagious bacterial infection, d/t staphylococcus aureus/streptococcus pyogenes.
-Pustular Psoriasis
-Sarcoidosis
-SLE- malar rash

Question 14

Tumors of the skin?

Answer 14

Benign:
-Angioma- red cherry
-Xanthoma- Xanathelasma around eye (hypercholesterolemia).
-Warts/Verrucas- HPV caused
-Dermatofibroma- pale bump
-Lipoma- fat tumor <5cm.
Malignant:
-Basal cell carcinoma- slow growth, pale and odd shaped.
-Squamous cell carcinoma- red, scaly, irregular border, open sore.
-Malignant Melanoma:(ABCDE)
A- Asymmetry
B- Irregular Border
C- Irregular Color
D- Large Diameter>6mm
E- Evolution