Lecture 2 - Common Skin Conditions Flashcards

1
Q

What is atopic eczema/atopic dermatitis?

A

Inflammation of the skin causing it to be really dry, itchy, red and flaky

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2
Q

What parts of the body does atopic eczema usually present on?

A

Flexural surfaces (elbows, backs of knees)

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3
Q

What is eczema called when it occurs in response to a specific trigger?

A

Contact dermatitis

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4
Q

How is atopic eczema diagnosed?

A

A clinical diagnosis meaning it can be diagnosed by taking a Hx and an exam alone

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5
Q

What is a typical Hx for a patient with atopic eczema?

A

Family Hx
Atopy
Normally happens in childhood

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6
Q

How is atopic eczema treated?

A

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

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7
Q

What is the function of steroids in treating atopic eczema?

A

Reduces inflammtion

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8
Q

What is the function of calcineurin inhibitors in atopic eczema?

A

Topical immunosuppressants

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9
Q

What is acne vulgaris?

A

Chronic skin disease where the hair follicles in the skin get blocked

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10
Q

Who does Acne vulgaris typically affect?

A

Adolescents to young adults

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11
Q

How is acne vulgaris diagnosed?

A

Clinical diagnosis (Hx and exam alone)

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12
Q

What are the ways that acne vulgaris is thought to be caused?

A

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)

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13
Q

What is the microbe involved in acne vulgaris?

A

Cutibacterium acnes

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14
Q

What supports the growth of cutibacterium acne’s in acne vulgaris?

A

The oily environment caused by the excess sebum production

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15
Q

What is the treatment for acne vulgaris?

A

Topical treatments which can be antibiotic or non antibiotic

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16
Q

What are some non antibiotic treatments for acne vulgaris?

A

Retinoids
Benzoyl peroxide

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17
Q

What are some topical antibiotics for acne vulgaris?

A

Erythromycin
Clindamycin

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18
Q

What are some systemic treatments for acne vulgaris?

A

Abx
Oral contraception
Isotretinoin

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19
Q

Why is isotretinoin heavily regulated in its use for treatment of acne vulgaris?

A

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

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20
Q

How does psoriasis present?

A

Chronic skin condition
Plaques
Silvery scales
Normally on the extensor surfaces (knees, elbows and scalp)
Relaxing and remitting course
May come after new medications

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21
Q

How is psoriasis diagnosed?

A

Clinical diagnosis

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22
Q

What is tthe cause of psoriasis?

A

T cell cytokine production is stimulated leading to keratinocytes proliferation (rapid maturation of skin cells)

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23
Q

What is the treatment for psoriasis?

A

Topical treatments
Phototherapy (exposure to UV)
Systemic drugs (oral and injectable)

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24
Q

What are the potential systemic treatments for psoriasis?

A

Methotrexate
Ciclosporin

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25
Q

What are the potential iatrogenic causes of psoriasis?

A

Beta blockers
ACE Inhbitors

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26
Q

What is urticaria?

A

Appears as hives
Associated with angiooedma

Looks kinda like me when i write on my skin

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27
Q

What triggers urticaria?

A

Foods
Inhaled allergens viral infection

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28
Q

What is the pathophysiology of urticaria?

A

Mast cells degranulation and histamine is released leading to increased capillary permeability and leakage of fluid into surrounding tissue

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29
Q

What is considered acute urticaria?

What is considered chronic urticaria?

A

Acute < 6weeks

Chronic >6weeks

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30
Q

How is urticaria treated?

A

General education
Systemic treatments mainly H1 anti-histamines

Others like steroids, ciclosporin, montelukast and omaluzimab

31
Q

What type of virus is the pox virus?

A

Molluscum contagiosum

32
Q

What is molluscum contagiosum/pox virus?

A

Common infection in child’s that happens when a child comes into direct contact with a skin lesions nor contaminated object

33
Q

How does molluscum contagiosum/pox virus present?

A

Small firm spots anywhere on the body (small dome shaped papules)

Itchy
Self limiting

34
Q

What causes shingles?

A

Varicella Zoster Virus

35
Q

How does shingles present?

A

Painful rash
Tingling feeling prior to rash
Vesicular and Dermatomal

36
Q

How is shingles treated?

A

Antivirals
Avoiding particular patient groups

37
Q

What antivirals are often given tot treat shingles and when are these often given?

A

Acyclovir

When patient is immunosuppressed or with Trigeminal herpes

38
Q

What is impetigo?

A

Highly contagious bacterial skin infection

39
Q

What is the most common causative organism for impetigo?

A

Staph or strep

40
Q

How does impetigo present?

A

Golden brown crust like corn flakes

41
Q

How is impetigo treated?

A

Topical antibiotics

42
Q

What is the main example of a fungal skin infection?

A

Dermatophytosis

43
Q

What is dermatophytosis?

A

Superficial fungal infection where dermatophytes grow in the keratin of the skin

44
Q

How does dermatophytosis present?

A

Raised itchy scaly patches, can be on scalp, feet or groin

45
Q

What is dermatophytosis of the scalp called?

A

Tinea capitis

46
Q

What is dermatophytosis of the feet called?

A

Tinea pedis

47
Q

What is dermatophytosis of the groin called?

A

Tinea cruris

48
Q

What is a good topical anti fungal for dermatophytosis?

A

Clotrimazole

49
Q

What is some patient advice given to those with dermatophytosis?

A

Don’t share towels and clothing

50
Q

What are the 3 main types of skin cancer?

A

Malignant melanoma
Squamous cell carcinoma
Basal cell carcinoma

51
Q

What is malignant melanoma and what causes it?

A

Cancer of the melanocytes

Caused by Uv light exposure which can come from the sun and sun beds

52
Q

How does malignant melanoma present?

A

New mole or changes in appearance of an existing mole

53
Q

What are tthe risk factors for developing malignant melanoma?

A

Pale skin
Ginger
Lots of freckles
Lots of UV exposure

54
Q

How is it treated malignant melanoma treated?

A

Surgery

Possible radiotherapy if spread

55
Q

Where are people with dark skin tines likely to develop malignant melanoma?

A

Palms and feet (soles)

56
Q

What is the ABCDE approach to examining pigmented lesions?

A

Asymmetrical?
Border
Colour
Diameter
Evolving (changing)

57
Q

What cells are affected in squamous cell carcinoma?

A

Squamous cells in the epidermis

58
Q

Where do squamous cell carcinomas develop on the body?

A

Areas of skin exposed to sun
Face, nose, forehead and cheeks

59
Q

What age group is normally diagnosed with squamous cell carcinoma?

A

Middle aged or older

60
Q

What is the most common type of skin cancer?

A

Basal cell carcinoma

61
Q

How does basal cell carcinoma normally present?

A

Dark, pearly shiny and glossy look to lesion

Slow growing

May spontaneously bleed

62
Q

What causes basal cell carcinoma?

A

Skins basal cells develop DNA mutation often due to UV

63
Q

How is basal cell carcinoma treated?

A

Surgery

64
Q

What are some functions of the skin?

A

Sensation
Thermoregulation
Vit D synthesis
Barrier to infection (innate immunity)
Microbial secretions

65
Q

Go to the last slide and label the layers of the skin:

A

1 = stratum basale
2 = stratum spinosum
3 = stratum granulsum
4 = stratum Corneum

66
Q

What is the layer in the skin which is only present in the hands and the feet?

A

Stratum lucidum

67
Q

What is a good way to remember the layers of the skin?

A

Come (Corneum)
Let’s. (Lucidum only in hands and feet)
Get (granulosum)
Sun (spinosum)
Burnt (basale)

68
Q

What are the 4 main cell types in the epidermis of the skin?

A

Melanocytes
Langerhans cells
Keratinocytes
Merkel cells

69
Q

What is the function of melanocytes?

A

Produce melanin to protect DNA from UV

70
Q

What are Langerhans cells?

A

Immune function (macrophages in skin)

71
Q

What is the function of keratinocytes?

A

Produce keratin needed for structural support

72
Q

What is the function of merkel cells?

A

Nerve endings for sensation.

73
Q

What are some extra intestinal manifestations of GI diseases?

A

Erythema nodosum
Pyoderma gangrenosum
Arthritis