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Dermatology > Introduction to General Dermatology > Flashcards

Introduction to General Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

Which cells are found in higher numbers in darker skin?

A

Melanozomes rather than melanocytes

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2
Q

Which layer of the skin provides its strength?

A

The dermis

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3
Q

What is the most populous cell type in the dermis gel?

A

Fibroblasts

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4
Q

In which layer of the skin are the majority of its components found?

A

The dermis

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5
Q

What are the three main layers of the skin?

A

Epidermis
Dermis
Hypodermia (subcutaneous tissue)

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6
Q

Describe the basal cells becoming superficial dead skin cells

A

The basal cells of the stratum basale divide by mitosis and begin to migrate upwards getting more superficial. As they do this they lose their nuclei and begin to flatten. After around one month, they are dead and flattened cells that have reached the surface and from the stratum corneum, the most superficial part of the skin

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7
Q

Give some functions of the skin

A

Thermoregulation
Skin immune system - inane and adaptive functions
Barrier - against mechanical, chemical, microorganisms, UV light. Keeps in water, electrolytes, macromolecules
Sensation - temperature, touch, pain
Vitamin D synthesis
Interpersonal communication - physical appearance, smell, self-identity

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8
Q

What proportion of the population are affected by skin disease?

A

Around 25%

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9
Q

Give some external causes of skin disease

A 
Temperature
UV
Chemical - allergen or irritant
Infection
Trauma
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10
Q

Give some internal causes of skin disease

A

Systemic disease
Genetics
Drugs
Infection

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11
Q

How does photosensitivity present?

A

With obvious neck and arm ‘tan lines’ which can come on after very brief UV light exposure

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12
Q

What is the most common cause of photosensitivity?

A

Drug induced

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13
Q

Why must patients with photosensitivity be tested for various wavelengths of light?

A

They may be sensitive to any of, including a combination of, UVA, UVB and visible light

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14
Q

What is cold urticaria?

A

An abnormal response to cold stimuli

There is a mast cell hypersensitivity in the skin which causes an abnormal nettle sting-like reaction to non-extreme cold stimulation

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15
Q

What is dermatitis artefacta?

A

Traumatic skin injury/disease inflicted by the patient. Usually the patient reports no memory of how the damage occurred and these cases are commonly linked with psychiatric illness

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16
Q

What is the most common internal cause of skin disease and the most common in-hospital referral type for dermatologists?

A

Drug reactions

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17
Q

What is the pathophysiology of bullies pemphigoid?

A

Autoimmune condition where the body attacks the proteins which anchor the epidermis and so it is severed from the layer below and bull appear pushing through the surface

18
Q

What is the difference between pemphigoid and pemphigus?

A

Pemphigoid is deep bullae whereas pemphigus is more superficial and blister-like

PemphigoiD = DEEP
PemphiguS = SUPERFICIAL
19
Q

What are macules and patches?

A

A macule is a small 1cm circumscribed area

They cannot be felt by touch but are identifiable and clearly bounded by their colour change

20
Q

What are papules and plaques?

A

A papule is a small 1cm raised area

21
Q

What are vesicles and bullae?

A

A vesicle is a small 1cm fluid filled lump

22
Q

What are pustules and abscesses?

A

A pustule is a small 1cm pus filled lump

23
Q

What are erosions and ulcers?

A

An erosion is a loss of only the epidermis - it will not scar
An ulcer is a loss of at least the epidermis and dermis (but may progress to an unlimited level) - it will scar

24
Q

What area of disease is pyoderma gangrenosum

A

Bowel disease

25
Q

Will erythema blanch with pressure? Why?

A

Yes, the blood vessels are dilated but there is no haemorrhage so they can be compressed

26
Q

Do haemorrhagic skin lesions blanch with pressure?

A

No, the vessels have haemorrhaged and the blood is contained so will not move with pressure and therefore dos not blanch

27
Q

What are petechiae?

A

Very small haemorrhagic skin lesions

28
Q

What are pupura?

A

Larger haemorrhagic skin lesions (>1cm)

29
Q

If the dermatosis if generalised and widespread is the trigger usually external or internal?

A

Internal

30
Q

What conditions may cause erythema nodosum?

A

(Contraceptive pill)
Sarcoidosis
TB

31
Q

In vasculitis what is indicative that there is large vessel damage?

A

Ulcers

32
Q

What is Eruptive Xanthoma?

A

Cutaneous lipid deposits caused by hyperlipidaemia, can be medication induced

33
Q

What conditions are acanthosis nigricans associated with?

A

Insulin resistance
Obesity
Malignancy - if sudden in onset

34
Q

What is thyroid skin disease? What test should be done if this is suspected?

A

Grave’s dermopathy/pretibial myexodema
A severe skin manifestation of thyroid disease
Presents in 5% of Grave’s cases
There is an increase in mucin which causes the skin to bulge out below the tibia

TFTs

35
Q

What are the two factors which define a treatment as topical?

A

Any medication which is applied to the skin…

Which contains an active component

36
Q

What is important when considering which topical treatment to use for a patient?

A

The vehicle of delivery must be considered based on the situation and the individual

37
Q

Give some examples of topical medication vehicles

A 
Solution
Gel
Paste
Cream
Lotion
Ointment
Foam
Spray powder
Shampoo
38
Q

What are some examples of medication types that may be given topically?

A 
Corticosteroids
Antibiotics
Antivirals
Chemotherapy
Coal tar
Parasticidals
NSAIDs
39
Q

Can topical medications be used for generalised infections?

A

No, they are only useful for localised infection

40
Q

What is relevant about flexor vs extensor skin sites in application of topical medications?

A

Flexor sites are far more absorbent then extensor sites

41
Q

What must be avoided when prescribing topical medications?

A

Not prescribing enough - give the patient plenty!

And do not under-dose based on fear of side effects

42
Q

What are some possible side effects of topical therapy?

A 
Thinning/atrophy
Striae
Bruising
Hirsutism
Telangiectasia
Acne/rosasia/perioral dermatitis
Glaucoma
Systemic absorption
Cataracts

Dermatology (8 decks)

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