Lecture 2 - Common Skin Conditions Flashcards
What is atopic eczema/atopic dermatitis?
Inflammation of the skin causing it to be really dry, itchy, red and flaky
What parts of the body does atopic eczema usually present on?
Flexural surfaces (elbows, backs of knees)
What is eczema called when it occurs in response to a specific trigger?
Contact dermatitis
How is atopic eczema diagnosed?
A clinical diagnosis meaning it can be diagnosed by taking a Hx and an exam alone
What is a typical Hx for a patient with atopic eczema?
Family Hx
Atopy
Normally happens in childhood
How is atopic eczema treated?
Education and support
Avoid triggers like smoke ad fragrances causing flare ups
Topical changes:
Emollients
Soap substitutes
Steroids and or calcineurin inhibotrs
Phototherapy
Or systemic therapy
What is the function of steroids in treating atopic eczema?
Reduces inflammtion
What is the function of calcineurin inhibitors in atopic eczema?
Topical immunosuppressants
What is acne vulgaris?
Chronic skin disease where the hair follicles in the skin get blocked
Who does Acne vulgaris typically affect?
Adolescents to young adults
How is acne vulgaris diagnosed?
Clinical diagnosis (Hx and exam alone)
What are the ways that acne vulgaris is thought to be caused?
Increased sebum (oil) production due to androgen influence
Excessive deposition of keratin in pores (dead skin cells)
Overgrowth of cutibacterium acne’s (a skin commensals)
What is the microbe involved in acne vulgaris?
Cutibacterium acnes
What supports the growth of cutibacterium acne’s in acne vulgaris?
The oily environment caused by the excess sebum production
What is the treatment for acne vulgaris?
Topical treatments which can be antibiotic or non antibiotic
What are some non antibiotic treatments for acne vulgaris?
Retinoids
Benzoyl peroxide
What are some topical antibiotics for acne vulgaris?
Erythromycin
Clindamycin
What are some systemic treatments for acne vulgaris?
Abx
Oral contraception
Isotretinoin
Why is isotretinoin heavily regulated in its use for treatment of acne vulgaris?
Highly teratogenic (so try and avoid using in fertile woman and defo onto in pregnant women)
Also can cause depression, psychiatric disorder and suicidal tendencies
How does psoriasis present?
Chronic skin condition
Plaques
Silvery scales
Normally on the extensor surfaces (knees, elbows and scalp)
Relaxing and remitting course
May come after new medications
How is psoriasis diagnosed?
Clinical diagnosis
What is tthe cause of psoriasis?
T cell cytokine production is stimulated leading to keratinocytes proliferation (rapid maturation of skin cells)
What is the treatment for psoriasis?
Topical treatments
Phototherapy (exposure to UV)
Systemic drugs (oral and injectable)
What are the potential systemic treatments for psoriasis?
Methotrexate
Ciclosporin
What are the potential iatrogenic causes of psoriasis?
Beta blockers
ACE Inhbitors
What is urticaria?
Appears as hives
Associated with angiooedma
Looks kinda like me when i write on my skin
What triggers urticaria?
Foods
Inhaled allergens viral infection
What is the pathophysiology of urticaria?
Mast cells degranulation and histamine is released leading to increased capillary permeability and leakage of fluid into surrounding tissue
What is considered acute urticaria?
What is considered chronic urticaria?
Acute < 6weeks
Chronic >6weeks
How is urticaria treated?
General education
Systemic treatments mainly H1 anti-histamines
Others like steroids, ciclosporin, montelukast and omaluzimab
What type of virus is the pox virus?
Molluscum contagiosum
What is molluscum contagiosum/pox virus?
Common infection in child’s that happens when a child comes into direct contact with a skin lesions nor contaminated object
How does molluscum contagiosum/pox virus present?
Small firm spots anywhere on the body (small dome shaped papules)
Itchy
Self limiting
What causes shingles?
Varicella Zoster Virus
How does shingles present?
Painful rash
Tingling feeling prior to rash
Vesicular and Dermatomal
How is shingles treated?
Antivirals
Avoiding particular patient groups
What antivirals are often given tot treat shingles and when are these often given?
Acyclovir
When patient is immunosuppressed or with Trigeminal herpes
What is impetigo?
Highly contagious bacterial skin infection
What is the most common causative organism for impetigo?
Staph or strep
How does impetigo present?
Golden brown crust like corn flakes
How is impetigo treated?
Topical antibiotics
What is the main example of a fungal skin infection?
Dermatophytosis
What is dermatophytosis?
Superficial fungal infection where dermatophytes grow in the keratin of the skin
How does dermatophytosis present?
Raised itchy scaly patches, can be on scalp, feet or groin
What is dermatophytosis of the scalp called?
Tinea capitis
What is dermatophytosis of the feet called?
Tinea pedis
What is dermatophytosis of the groin called?
Tinea cruris
What is a good topical anti fungal for dermatophytosis?
Clotrimazole
What is some patient advice given to those with dermatophytosis?
Don’t share towels and clothing
What are the 3 main types of skin cancer?
Malignant melanoma
Squamous cell carcinoma
Basal cell carcinoma
What is malignant melanoma and what causes it?
Cancer of the melanocytes
Caused by Uv light exposure which can come from the sun and sun beds
How does malignant melanoma present?
New mole or changes in appearance of an existing mole
What are tthe risk factors for developing malignant melanoma?
Pale skin
Ginger
Lots of freckles
Lots of UV exposure
How is it treated malignant melanoma treated?
Surgery
Possible radiotherapy if spread
Where are people with dark skin tines likely to develop malignant melanoma?
Palms and feet (soles)
What is the ABCDE approach to examining pigmented lesions?
Asymmetrical?
Border
Colour
Diameter
Evolving (changing)
What cells are affected in squamous cell carcinoma?
Squamous cells in the epidermis
Where do squamous cell carcinomas develop on the body?
Areas of skin exposed to sun
Face, nose, forehead and cheeks
What age group is normally diagnosed with squamous cell carcinoma?
Middle aged or older
What is the most common type of skin cancer?
Basal cell carcinoma
How does basal cell carcinoma normally present?
Dark, pearly shiny and glossy look to lesion
Slow growing
May spontaneously bleed
What causes basal cell carcinoma?
Skins basal cells develop DNA mutation often due to UV
How is basal cell carcinoma treated?
Surgery
What are some functions of the skin?
Sensation
Thermoregulation
Vit D synthesis
Barrier to infection (innate immunity)
Microbial secretions
Go to the last slide and label the layers of the skin:
1 = stratum basale
2 = stratum spinosum
3 = stratum granulsum
4 = stratum Corneum
What is the layer in the skin which is only present in the hands and the feet?
Stratum lucidum
What is a good way to remember the layers of the skin?
Come (Corneum)
Let’s. (Lucidum only in hands and feet)
Get (granulosum)
Sun (spinosum)
Burnt (basale)
What are the 4 main cell types in the epidermis of the skin?
Melanocytes
Langerhans cells
Keratinocytes
Merkel cells
What is the function of melanocytes?
Produce melanin to protect DNA from UV
What are Langerhans cells?
Immune function (macrophages in skin)
What is the function of keratinocytes?
Produce keratin needed for structural support
What is the function of merkel cells?
Nerve endings for sensation.
What are some extra intestinal manifestations of GI diseases?
Erythema nodosum
Pyoderma gangrenosum
Arthritis
