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Intro to General Dermatology 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
Describe the external cause of photosensitivity
* 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
Describe the external cause of cold injury
* 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
What is cold urticaria?
Skin disease with external cause (cold water/weather etc)
28
What is dermatitis artefacts?
Condition in which skin lesions are solely produced or inflicted by the patient's own actions; manifestion of psychological problem
29
Name a condition cause by trauma
Dermatitis artefacts • Unusual distribution • Most caused by scratches
30
Name conditions cause by genetics (internal cause)
* Neurofibromas | * Ichthyosis vulgaris
31
What are the features of conditions caused by drug reactions (internal causes)?
* Widespread rash * Need detailed history as drug can be taken over a month prior * Think of OTC and herbal remedies as well
32
Name an autoimmune disease of the skin (internal cause)?
Bullous pemphigoid
33
Describe bullous pemphigoid (autoimmune disease of skin)
Basement membrane joins epidermis to dermis; autoimmune system can attack this causing the top layer of the skin to detach
34
What type of skin lesions do macule and patch describe?
* Macule - small circumscribe area (no change in skin texture and is flat) * Patch - larger circumscribe area
35
What type of skin lesions do papules and plaques describe?
* Papule - small raised area | * Plaque - larger raised area
36
What type of skin lesions do vesicles and bullas describe?
* Vesicle - small fluid filled | * Bulla - large fluid filled
37
What type of skin lesions do pustules and abscesses describe?
* Pustule - small pus filled | * Abscess - large pus filled
38
What type of skin lesions do erosions and ulcers describe?
• 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
What is urticaria?
Outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly
40
What is the distribution of a dermatosis (disease of the skin)?
How the skin lesion are scattered or spread out
41
How might a dermatosis be distributed?
* 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
What can be used to describe the extent of the eruption and its pattern?
Localised, generalised, symmetrical etc
43
Name 5 common skin conditions
* Acne * Psoriasis * Rosacea * Eczema * Warts
44
What conditions can be diagnosed using cutaneous signs?
* Erythema Nodosum * Sarcoidosis * Vasculitis * Malignancy * Auto-immune conditions
45
How would you treat eruptive xanthoma (hyperlipidaemia)?
Manage underlying hyperlipidaemia
46
What is acanthosis nigricans?
* Brown to black, poorly defined, velvety hyperpigmentation of the skin * Flexural distribution * Hyperkeratosis and hyperpigmentation, papules * Associated with insulin resistance, obesity, malignancy
47
Name a skin disease caused by thyroid abnormality
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
What investigations are used in bacterial infection suspected?
* Charcoal swab | * Ask for MC+S (microscopy, culture, sensitivities)
49
What investigations are used in viral infection suspected?
* Viral swab for PCR * Can swab vesicle/bulla if vesicular eruption * If systemic illness, can take throat swab
50
What investigations are used in fungal infection suspected?
* Skin scraping * Nail clipping * Hair sample • Fungal cultures
51
How are biopsies taken?
Punch biopsy with local anaesthetics

Dermatology (8 decks)

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