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Dermatology > Intro to General Dermatology > Flashcards

Intro to General Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the three layers of the skin?

A
  1. Epidermis
  2. Dermis
  3. Hypodermis (subcutaneous tissue)
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2
Q

Describe the epidermis of the skin

A
  • Keratinised squamous cell epithelium
  • 3 cell types: keratinocytes, melanocytes and langerhans cells
  • Avascular and so receives O2 from diffusion from atmosphere
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3
Q

What are melanocytes?

A

Cells in the epidermis which make melanosomes (collections of melanin) excreted and phagocytose into keratinocytes where they sit above the nucleus

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4
Q

What are langerhans cells?

A

Cells in the epidermis which processes antigens and migrates to lymph nodes to induce an immune response

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5
Q

Describe the dermis of the skin

A

Collagen and elastin matriculates with mucopolysaccharide gel also fibroblasts, dermal dendritic cells and macrophages

  • Contains hair follicles and the follicular bulge contains stem cells
  • Muscle - thermoprotective mechanisms
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6
Q

Describe the hypodermic of the skin

A

Fat energy store, insulation, fibrous bands anchour skin to fascia

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7
Q

Name the five layers of the epidermis

A
  1. Stratum corneum
  2. Stratum lucidum
  3. Stratum ganulosum
  4. Stratum spinous
  5. Stratum basale
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8
Q

What is found in the 5. stratum corneum of the epidermis?

A

Dead cells with a hard protein envelop: cells contain keratin and surrounded by lipids

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9
Q

What is found in the 4. stratum lucidum of the epidermis?

A

Dead cells lies within dispensed keratohyalin

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10
Q

What is found in the 3. stratum granulosum of the epidermis?

A

Keratohyalin and a hard protein envelop: lamellar bodies release lipids -> cells die

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11
Q

What is found in the 2. stratum spinosum of the epidermis?

A

Keratin fibres and lamellar bodies accumulate

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12
Q

What is found in the 1. stratum basale of the epidermis?

A

Cells divide by mitosis and some of the newly formed cells become the cells of the superficial strata

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13
Q

What are the different parts to the nail anatomy?

A
  • Hyponychium (epithelium underlying free edge of the nail plate)
  • Nail plate
  • Lateral nail fold
  • Nail bed
  • Lanula (visible part of nail matrix)
  • Cuticle
  • Proximal nailfold
  • Nail matrix
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14
Q

What are the three stages of the hair cycle?

A
  1. Anagen
  2. Catagen
  3. Telogen
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15
Q

What is the anagen stage of the hair cycle?

A

Active growing phase

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16
Q

What is the catagen stage of the hair cycle?

A

2-3 week phase growth stops/follicle shrinks

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17
Q

What is the telogen stage of the hair cycle?

A

Resting phase for 1-4 months

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18
Q

What are the functions of the skin?

A

• Thermoregulation - insulation
• Skin immune system - innate and adaptive functions
• Barrier
- Protection against mechanical, chemical, UV light
- Keeps in water and electrolytes
• Sensation
• Vitamin D synthesis
• Interpersonal communication (self-identity)

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19
Q

Describe the innate and adaptive immune functions of the skin

A
  • Innate is non-specific with leukocytes i.e. natural killer cells, mast cells
  • Adaptive is specific and T cell regulates; antigen presenting cells which present to T cells to produce specific antibodies
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20
Q

Describe the vitamin D synthesis that occurs in the skin

A

UV light converts 7-dehydrocholesterol to cholecalciferol (which is then processed through the liver and kidney into the active form)

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21
Q

What are the 5 Ds as to why skin disease is important?

A
  • Disfigurement
  • Discomfort
  • Disability
  • Depression
  • Death
22
Q

What are the two categories of causes of skin disease?

A

External and internal

23
Q

What are external causes of skin disease?

A
  • Temp
  • UV
  • Chemical (allergen to irritant)
  • Infection
  • Trauma
24
Q

What are the internal causes of skin disease?

A
  • Systemic disease
  • Genetics
  • Drugs
  • Infection
25
Q

Describe the external cause of photosensitivity

A
  • Commonly caused by medications
  • Exposed sites affected (t-shirt lines)
  • Can be sensitive to UVA, UVB, visible light or a combination
  • Test patients against different light of electrochemical spectrum
26
Q

Describe the external cause of cold injury

A
  • Vasoconstriction and skin necrosis
  • Chillblains - small, itchy swellings on the skin
  • Frostbite is a cause, but also other diseases i.e. cryoglobulinaemia (more circulated protein) which causes similar response at normal temps
27
Q

What is cold urticaria?

A

Skin disease with external cause (cold water/weather etc)

28
Q

What is dermatitis artefacts?

A

Condition in which skin lesions are solely produced or inflicted by the patient’s own actions; manifestion of psychological problem

29
Q

Name a condition cause by trauma

A

Dermatitis artefacts
• Unusual distribution
• Most caused by scratches

30
Q

Name conditions cause by genetics (internal cause)

A
  • Neurofibromas

* Ichthyosis vulgaris

31
Q

What are the features of conditions caused by drug reactions (internal causes)?

A
  • Widespread rash
  • Need detailed history as drug can be taken over a month prior
  • Think of OTC and herbal remedies as well
32
Q

Name an autoimmune disease of the skin (internal cause)?

A

Bullous pemphigoid

33
Q

Describe bullous pemphigoid (autoimmune disease of skin)

A

Basement membrane joins epidermis to dermis; autoimmune system can attack this causing the top layer of the skin to detach

34
Q

What type of skin lesions do macule and patch describe?

A
  • Macule - small circumscribe area (no change in skin texture and is flat)
  • Patch - larger circumscribe area
35
Q

What type of skin lesions do papules and plaques describe?

A
  • Papule - small raised area

* Plaque - larger raised area

36
Q

What type of skin lesions do vesicles and bullas describe?

A
  • Vesicle - small fluid filled

* Bulla - large fluid filled

37
Q

What type of skin lesions do pustules and abscesses describe?

A
  • Pustule - small pus filled

* Abscess - large pus filled

38
Q

What type of skin lesions do erosions and ulcers describe?

A

• Erosion - loss of epidermis
- Superficial as epidermis is thin, so quick to heal and usually no scar
• Ulcer - loss of epidermis and dermis
- Contracture and granulation to heal (can go as deep as bone) and usually scars

39
Q

What is urticaria?

A

Outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly

40
Q

What is the distribution of a dermatosis (disease of the skin)?

A

How the skin lesion are scattered or spread out

41
Q

How might a dermatosis be distributed?

A
  • May be isolated (solitary or single) or multiple
  • Localisation of multiple lesions in certain regions helps diagnosis, as skin disease tend to have characteristic distribution
42
Q

What can be used to describe the extent of the eruption and its pattern?

A

Localised, generalised, symmetrical etc

43
Q

Name 5 common skin conditions

A
  • Acne
  • Psoriasis
  • Rosacea
  • Eczema
  • Warts
44
Q

What conditions can be diagnosed using cutaneous signs?

A
  • Erythema Nodosum
  • Sarcoidosis
  • Vasculitis
  • Malignancy
  • Auto-immune conditions
45
Q

How would you treat eruptive xanthoma (hyperlipidaemia)?

A

Manage underlying hyperlipidaemia

46
Q

What is acanthosis nigricans?

A
  • Brown to black, poorly defined, velvety hyperpigmentation of the skin
  • Flexural distribution
  • Hyperkeratosis and hyperpigmentation, papules
  • Associated with insulin resistance, obesity, malignancy
47
Q

Name a skin disease caused by thyroid abnormality

A

Pretibial myxoedema (in 5% Grave’s disease)

  • Mucinous, gelatinous material causing nodules and lumps on skin
  • Other skin changes seen in bother hyper and hypothyroidism
48
Q

What investigations are used in bacterial infection suspected?

A
  • Charcoal swab

* Ask for MC+S (microscopy, culture, sensitivities)

49
Q

What investigations are used in viral infection suspected?

A
  • Viral swab for PCR
  • Can swab vesicle/bulla if vesicular eruption
  • If systemic illness, can take throat swab
50
Q

What investigations are used in fungal infection suspected?

A
  • Skin scraping
  • Nail clipping
  • Hair sample

• Fungal cultures

51
Q

How are biopsies taken?

A

Punch biopsy with local anaesthetics

Dermatology (8 decks)

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