General information Flashcards
GUT/SKIN AXIS
Common characteristics shared by gut and skin (7)
- Heavily Vascularized
- Richly perfused
- Densely innervated
- Integrated to the immune system
- Highly associated with the endocrine system
- Extensively colonized with recognizable microbiota
- Both helps our body to communicate with its external environment
SKIN PATHOLOGIES AND GUT
Numerous intestinal pathologies have been linked to skin comorbidities. Intestinal dysbiosis is associated with what inflammatory skin pathologies? (4)
- Atopic dermatitis
- Psoriasis
- Acne Rosacea
- Acne vulgaris
BRANCHES OF SKIN DISORDERS
Types of skin disorders
- Inflammatory disorders
- Infections
- Disorders of hair follicles and sebaceous glands
- Alterations in skin pigmentation
- Neoplasia and alterations in cell differentiation
- Disorders related to sweat glands
Name the 3 skin conditions in top 10 most prevalent globally in 2010
- Fungal skin diseases
- Other skin and subcutaneous diseases
- Acne vulgaris
Name the 5 skin conditions in top 50 most prevalent
- Pruritus
- Eczema
- Impetigo
- Molluscum contagiosum/warts
- Scabies
Describe the Etiology/cause and appearance of the following 15 most common disorders:
- Eczema
- Psoriasis
- Acne vulgaris
- Pruritus (itching
without attributable
cause) - Alopecia areata
- Decubitus ulcer
- Urticaria
- Scabies
- Fungal skin diseases
- Impetigo
- Abscess
- Bacterial skin diseases
- Cellulitis
- Viral warts
- Molluscum
contagiosum
How do you assess skin condition?
- You observe the eyes
- Colour/palor of skin
- Hair distribution
- Lumps
- Cuts/grazes/trauma/bruising
- Derma (hydration, elasticity, irritation, reactions)
- Nails
What produces melanin and what can change the function of these cells?
Melanocytes,
and any change to hormones or genetics can change the functional state
COLOUR VARIATION
What are birth marks?
Vascular abnormalities/pigmented melanocytes
COLOUR VARIATION
What are moles? (3)
- They are concentrated bumps of melanin
- May develop throughout life
- Harmless, but susceptible to malignancy
COLOUR VARIATION
How many moles can a person have?
Average 30, up to 400. They should be monitored regularly
COLOUR VARIATION
What size are cafe au lait spots and at what size should you be concerned that a DDx should include neurofibromatosis?
0.5-1.5cm are the usual size. Any cafe au lait spots larger than 1.5cm you should consider possibility of neurofibromatosis
COLOUR VARIATION
What is Tinea versicolour - What is its appearance and cause? How is it treated?
It is a yeast infection of the skin. It looks flaky and interrupts the normal pigmentation of the skin. It is due to changes in UV and occurs within immunocompromised persons
Treated with anti-fungal creams
COLOUR VARIATION
What is Vitiligo? What is its appearance and cause? How is it treated?
Vitiligo is an acquired depigmenting disorder of the skin, in which pigment cells (melanocytes) are lost. Vitiligo is due to the loss or destruction of melanocytes, which are the cells that produce melanin. Vitiligo is thought to be a systemic autoimmune disorder, associated with deregulated innate immune response (different classifications of vitiligo are thought to have different pathophysiology)
There is no cure, but steroids and immunosuppressive drugs can improve appearance of the skin. There is also topical ointments as well as re-pigmentation through surgery or depigmentation through various methods
COLOUR VARIATION
What is Cyanosis? What is its appearance and cause? How is it treated?
Cyanosis refers to a bluish-purple hue to the skin. It is most easily seen where the skin is thin. Cyanosis indicates a person may have deoxygenated hemoglobin or disorders of abnormal hemoglobin
Causes of Cyanosis:
- Hypoventilation
- Pulmonary causes (leading to ventilation-perfusion mismatch)
- Cardiovascular causes
- Polycrythemia
- High altitude
- Hypothermia
- Obstructive sleep apnea
Treatment focuses on managing the underlying condition
COLOUR VARIATION
What is Jaundice? What is its appearance and cause? How is it treated?
Jaundice is the yellow discoloration of skin, eyes and bodily fluids. Jaundice is caused by hyperbilirubinaemia
Causes of excess bilirubin:
- Hepatitis
- Acetaminophen overdose
- Chronic liver disease (alcohol abuse/excessive smoking)
- Gallstones
- Blood disorders
- Cancer of the pancreas
- Bile buildup in gallbladder
Bilirubin is part of the pigment released from used, broken down red blood cells. If there’s a dysfunction with the liver, it is unable to filter this pigment and is then excreted into feces and 10-20% undergoes enterohepatic circulation
Treatment focuses on managing the underlying condition
COLOUR VARIATION
What is Carotenosis? What is its appearance and cause? What are the associated conditions? How is it treated?
Carotenosis is a benign and reversible medical condition where an excess of dietary carotenoids results in orange discoloration of the outermost skin layer. It is caused by excessive dietary intake of β-carotene
Associated medical conditions include:
- Diabetes mellitus
- Hypothyroidism
- Liver disease
- Kidney disease
- Anorexia nervosa
Treatment is usually a matter of reducing carotene intake
Patients with secondary carotenaemia should be treated for the underlying condition
COLOUR VARIATION
What is Atopic dermatitis? What is its appearance and cause? How is it treated?
Atopic dermatitis (Eczema) is a condition that makes the skin red and itchy. It tends to be chronic
Treated with medications - steroids, antihistamine or topical antiseptic. Certain creams may provide relief from itching
TRAUMA
What is Echymosis?
Bruising caused by direct trauma to the skin
BRUISING
If someone bruises easily, what is this a sign of? and what changes in colour are seen?
- A bleeding disorder or liver disease
- Changes in colour from purple-blue-green-yellow-brown. This helps age the bruise