Inflammatory Skin Diseases, Skin Tumours, The Eye - Skin and Soft tissue pathology Flashcards
herpes Varicella Zoster can cause scarring of the eye. What nerve needs to be inolved for this to happen?
Trigemminal nerve
Chlamydia has 2 forms which affect the eye. What is the tropical disease that infect the corneum and conjuctiva causing blindess?
Trachoma
What can cause cataracts?
1) Senile degeneration
2) Rubella
3) Down’s Syndrome
4) Irradiation
5) Diabetes Mellitus
6) Uveitis
Retinal infections can be caused by this parasite. The cat is the host of the parasite and the oocyst are in the faeces.
Toxoplasma
Retina Infections can be caused by this parasite. It can be transferred from infected dog faeces. The larva then migrate to the retina and die causing inflammation.
Toxocara canis
What can cause retinal vascular disease?
1) Ischaemia
2) Hypertensive Retinopathy
3) Diabetic retinopathy
Flame shaped haemorrhages and exudates seen by an opthalmoscope are associated with ….
Hypertensive retinopathy
dot and blot haemorrhages and exudates seen by an opthalmoscope are associated with . . .
Diabetic retinopathy
What type of macular degeneration is age related and affects 60+ ?
Dry Macular degeneration
What type of macular degeneration is due to new vessel growth beneath the retina. and is treated with drugs and lasers?
Wet macular degeneration
Deletion of the long arm of chromosome 13 and the loss of the RB gene leads to what kind of eye tumour?
Retinoblastoma
Tumors arising from the melanocytes that reside within the uvea giving color to the eye are called?
Uveal Melanoma
What common viral infection presents as genital warts?
HPV
Out of HSV1 and HSV2 which causes cold sores / genital herpes?
HSV1 = cold sores HSV2 = genital herpes
Which out of the following is a superficial / deep bacterial infection of the skin?
1) Impetigo
2) Cellulitis
1) Impetigo - superficial
(usually caused by staph aureus infection)
2) Cellulitis - deep
(usually caused by strep pyogenes)
What skin infection is granulomatous and involves nerves leading to loss of sensation?
Leprosy (mycobacterium Leprae)
What mycobacterium usually affects those who work with fish causing a fish tank granuloma?
Mycobacterium Marinum
What is an abscess?
collection of pus
What fungal infections like hot, moist areas and are caused by Trichophyton species?
1) ringworm
2) Tinia pedis (athletes foot)
3) Tinea cruris (groins)
What are the 3 stages of Dermatitis (eczema)?
1) Acute Dermatitis = red, weeping serous exudation (with or without vesicles)
2) subacute dermatitis - red skin, less exudate, itching, crusting
3) Chronic dermatitis - thick/leathery skin secondary to scratching
What is spongiosis?
intracellular oedema within the epidermis
What is Atopic Eczema?
Type 1 hypersensitivity reaction to an allergen. Often associated with asthma and hay fever.
eczema that starts in childhood. Often has a family history.
what is contact irritant dermatitis?
direct injury to to skin by an irritant.
OR
allergic reaction
What is nummular dermatitis?
coin shaped lesions on the skin
What does Psoriasis look like?
Red oval plaques on skin. scaly.
what are the histological features of Psoriasis?
1) elongated rete ridges
2) Thinning of epidermic over dermal papiallae
3) Parakeratotic scale
4) Neutrophils in scale
Chromosome 6p2 is implicated in what skin condition?
Psoriasis
A butterfly rash on nose and cheeks is characteristic of what condition?
Systemic Lupus Erythematosus
an auto-immune disorder primarily affecting connective tissued of the body. Can affect any part of the body but most importantly the kidneys
Lupus Erythematosus
What investigations are used to identify the presence of autoantibodies in the skin?
Immunofluorescence
A heliotroic rash and peri-ocular oedema and muscle weakness are assosiated with . .
Dermatomyositis
*dermomyositis is associated with underlying cancer in 25% of cases
Formation of fluid filled blisters is associated with?
Bullous diseases
What is the difference between Pemphigus and Pemphigoid?
Pemphigus = superficial (intra-epidermal bulla - with intracellular immunoflouresence)
Pemphigoid = Deep (sub epidermal bulla) - with basement membrane immunoflouresence
A group of disorders characterised by the loss of cohesion between keratinocytes resulting in an intraepidermal blister is called . . .
Pemphigus
In pemphigus where are the autoantibodies directed?
In Pemphigus, autoantibodies are directed at the intercellular material.
*can be detected by IMF (immunoflourescence)
Diseases characterised by subepidermal blisters which are large and do not rupture easily are called…
Bullous Pemphigoid
In bullous pemphigoid where are the autoantibodies directed?
In bullous pemphigoid the autoantibodies are directed at the glycoproteins in the basement membrane.
*can be detected by IMF
Small itchy blisters associated with coeliac disease?
Dermatitis Herpetiformis
In what condition is IgA deposition detected in dermal papillae on IMF?
Dermatitis Herpetiformis
What systemic disease can be associated with dermatomyositis?
visceral cancer
What systemic disease is associated with dermatitis herpetiformic
coeliac disease
What systemic disease is associated with acanthosis nigricans (dark warty lesions in armpits)
internal malignancy
What systemic disease is associated with necrobiosis Lipoidica (red/yellow plaques on leds)?
Diabetes Mellitus
What systemic disease is associated with Erythema Nodosum (red tender nodules on shins)?
infections elsewhere esp. lungs
What skin lesions are associated with metabolic disorders?
1) Xanthoma (yellow plaques often on eyelids) (hyperlipeamis)
2) Gout
3) Porphyria ( a group of disorders caused by defective synthesis of haem)
What virus can caused acquired Porphyria Cutanea Tarda?
Hepatitis C
porphyria is the defective syntheis of haem
what is the commonest malignant tumour of the skin?
Basal Cell Carcinoma
Where does squamous cell carcinoma usually occur
sun exposed sites
What type skin cancers are rodent ulcers associated with?
Basal Cell Carcinoma
A nodule with ulcerated, crusted surface is associated with what type of skin cancer?
Squamous cell carcinoma
What is the pre-malignant disease that leads to squamous cell carcinoma?
Actinic Keratosis
dyslpasia to squamous epithelium is very common chronic sun exposed sites
What are Naevi
Benign collections of melanocytes
What is the criterial for assessing moles (Naevi)?
ABCD Assymetrical? Borders uneven? Colour variation? Diameter (greater than 6mm)
Then melanoma
what inherited condition increases risk of melanoma?
1) Dysplastic Naevus Sydrome has many large atypical moles that have an increased risk of becoming malignant.
2) Giant congenital naevi have a small risk of becoming malignant.
A small growing, flat pigmented patch that occurs on the face of elderly people?
Lentigo Maligna
*proliferation of atypical melanocytes along basal layer of epidermis.
**Late in disease melanocytes may invade the dermis causing lentigo maligna melanom - with a potential to metastasise.
What areas of skin is affected by acral lentigenous melanoma?
Palms and soles (sometimes subungual aka beneath finger nail)
What melanoma is caused by BRaF mutations. It is also the commonest type of melanoma in britain.
Superficial spreading melanoma
Invasive atypical melanocytes invade the dermis to produce nodules of tumour cells - what type of tumour is this?
Nodular Melanoma
What is Breslow Thickness?
It is a measure of prognosis (5year survival %) of a tumour.
4mm thickness = 45-60% survival
Why is the sentinel node significant in skin tumours?
The sentinal node is the lymph node which drains from the melanoma first.
If it is positive when removed, the rest of the lymph nodes in the area are removed to try and stop disease progression.
What is the treatment for skin cancer?
1) surgery (excision of area and lymph nodes if sentinel node is positive)
2) BRAF inhibitors in melanoma
