General Dermatology Flashcards

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1
Q

Skin: Adnexal Structures

A

hair
nails
glands
sensory structures

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2
Q

Skin: basic role in brief

A

role in protection, homeostasis and transport of sensations

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3
Q

Sub cutis

A

– fat energy store, insulation, fibrous bands anchour skin to fascia

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4
Q

Dermis

A
  • collagen and elastin matrix with mucopolysaccharide gel also fibroblasts, dermal dendritis cells and macrophages
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5
Q

Epidermis

A

Out layer – 3 cell types keratinocytes majority of cells

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6
Q

Melanocytes

A

– makes melanosomes (collections of melanin) excreted and phagocytoses into keratinocytes where they sit above the nucleus

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7
Q

Langerhans cells

A

– process antigens and migrate to lymph nodes to induce an immune response

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8
Q

Stratum Cornueum

A

Dead cells with a hard protein envelope; the cells contain keratin and are surrounded by lipids.

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9
Q

Stratum Lucidum

A

Dead cells lie within dispersed keratohyalin

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10
Q

Stratum Granulosum

A

Keratohyalin and a hard protein envelope for; lamellar bodies release lipids; cells die.
Keratin Granules

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11
Q

Stratum Spinosum

A

Keratin fibres and lamellar bodies accumulate

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12
Q

Stratum Basale

A

Cells divide by mitosis and some newly formed cells become the cells of the more superficial strata.
Basement membrane
Hemidesmosomes
Desmosomes connecting adjacent cells

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13
Q

Nail

A
Hyponychium
Nail plate
Lateral nail fold
Nail bed
Lunula
Cuticle 
Proximal nail fold
Nail matrix
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14
Q

External Causes:

Photosensitivity

A

Photosensitivity
Commonly caused by medications
Exposed sites affected
Can be sensitive to UVA, UVB, visible light or a combination of these.

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15
Q

External Causes: Cold

A

Cold Injury
Frostbite,
Chilblains
Skin Necrosis

Cold Urticaria

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16
Q

External Causes: Trauma

A

Dermatitis Artefacta

self-induced harm

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17
Q

Internal Causes:

A

Drug reaction

Vary in severity
Think of OTC drugs
Take a good history!

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18
Q

Internal causes: autoimmune

A

Bullous Pemphigoid

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19
Q

Describing skin lesions

A

Morphology is the appearance of skin lesions

Small usually means less than 5mm

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20
Q

Macule

Patch

A

Macule
- Small flat circumscribed area

Patch
- Larger flat circumscribed area

21
Q

Papule

Plaque

A

Papule
- Small raised area

Plaque
- Larger Raised area

22
Q

Vesicle

Bulla

A

Vesicle
Small Fluid filled

Bulla
Large Fluid filled

23
Q

Pustule

Abscess

A

Pustule
Small Pus filled

Abscess
Large Pus filled

24
Q

Erosion

Ulcer

A

Erosion
Loss of Epidermis

Ulcer
Loss of Epidermis and dermis

25
Q

Macule: Small flat circumscribed area

A

Macule: Non-palpable change in skin color with distinct borders

26
Q

Papule: - Small raised area…

A

Palpable, solid lesion less than 1 cm in diameter

27
Q

Plaque: -Larger Raised area…

A

Palpable, solid lesion greater than 1 cm in diameter

28
Q

Nodule:

A

Palpable, lesion more than 1 cm in diameter which is taller than it is wide

29
Q

E.g. Conditions with nodules:

A

Neurofibromatosis Rheumatoid Nodules

30
Q

Vesicle: Small fluid filled…

A

Fluid-containing, superficial, thin-walled cavity less than 1 cm

31
Q

Bulla: Large fluid filled…

A

Bulla: Fluid-containing superficial, thin-walled cavity greater than 1 cm

32
Q

Bulla e.g. condition:

A

bullous pemphigoid

33
Q

Erosion:

A

A skin defect where there has been loss of the epidermis only

34
Q

Erosion: e.g. condition

A

Toxic epidermal necrolysis

35
Q

Ulcer: Loss of Epidermis and dermis…

A

A skin defect where there has been loss of the epidermis and dermis

36
Q

Ulcer: e.g. condition

A

pyoderma gangrenosum

37
Q

Pustule: Small Pus filled…

A

Pus containing, superficial, thin-walled cavity

38
Q

Pustule: e.g. condition

A

acne

39
Q

Abscess: Large pus filled…

A

Abscess:Thick-walled cavity containing pus

40
Q

Distribution of Dermatosis

A

… How the skin lesions are scattered or spread out.
Skin lesions may be isolated (solitary or single) or multiple.
The localisation of multiple lesions in certain regions helps diagnosis, as skin diseases tend to have characteristic distributions.
What is the extent of the eruption and its pattern?
localised, generalised, symmetrical etc

41
Q

Most Common Skin Conditions:

A
Acne 
Psoriasis 
Rosacea
Skin lesions
Uritica
Warts
Leg ulcers 
Scalp/nail disorders
Eczema 
Infections/infestations
42
Q

Skin in general medicineCutaneous signs are useful in diagnosing many conditions:

A
Erythema Nodosum
Sarcoidosis
Vasculitis
Malignancy
Auto-immune conditions
43
Q

Hyperlipidaemia

A

Eruptive xanthoma on skin, not just eyes

44
Q

Acanthosis Nigricans

A

Associated with insulin resistance, obesity, malignancy

Flexural distribution

Hyperkeratosis and Hyperpigmentation, papules

‘velvety’ appearance

45
Q

Thyroid Skin Disease

A

Pretibial myxoedema

5% of Graves Disease

Same process behind eyes – mucinosis

Other skin changes seen in both hyper and hypothyroidism

46
Q

Investigations in Dermatology if bacterial infection suspected

A

Charcoal swab

Ask for MC&S
Microscopy
Culture
Sensitivities

47
Q

Investigations in Dermatology - If viral infection suspected

A

Viral swab for PCR

Can swab vesicle/bulla if vesicular eruption

If systemic illness, can take throat swab

48
Q

Investigations in Dermatology - If fungal infection suspected

A

Skin scraping
Nail clipping
Hair sample
–> Fungal cultures

49
Q

Simple way to take a skin biopsy

A

punch biopsy - epi, derm, subcutis - all three layers of skin