Lecture 20 - Dermatology Flashcards
Terminology to describe size of lumps/bumps
Papule
Nodule
What is a papule?
A small lump
SMALL = Less than 5mm
What is a Nodule?
A large lump
Between 5-10mm
What is the term used to define Small Water Filled Blisters? A papule containing water
Vesicles
What is the term used to define a Large Water Filled Blister? A Nodule Containing water.
Bulla
What is the name to define a Pus-filled vesicle?
Pustule
What term is used to define the colour change of redness?
Erythema
What does palpable mean?
To be able to be touched or felt
What is a Macule?
A non palpable area of discolouration (Flat lesions = e.g freckles)
What is the term to define a Macule that is over 2cm in size?
Patch
What is a Patch?
A non palpable area of discolouration that is over 2cm in size
What is a flat lesion called when it is both palpable and has an area of over 2cm?
Plaque
What does the term Excoriations mean?
Scratches
What is the term to define stretch marks?
Striae
Term to describe an itch
Pruritus
Term to describe Thinning
Atrophy
Term to describe Thread vein
Telangiectasia
What can scaling also be called?
Ichthyosis
What is Erosion?
Loss of the epidermis (superficial so the top layer)
Define an Ucler
Loss of Epidermis and dermis (so deep loss)
Often Hypodermis is visible
What is Lichenification?
Thickening of the skin with exaggerated skin markings (bruising)
What is Hirsutism?
Too much hair
What is Alopecia?
Too little/no/thinning hair
What are the 3 main events that take place in Inflammation?
Vasodilation
Increased micro vascular permeability
Influx of leukocytes
The 5 important signs of Inflammation
Rubor
Tumor
Calor
Dolor (symptom)
Function laesa
What is Rubor?
Redness (erythema)
What is Tumor?
Swelling (Like a tumour)
What is Calor?
Heat
(CALORies are burnt releasing HEAT)
What is Dolor?
Pain
(Symptom not sign)
What is Functio laesa?
Loss of function
List 6 common skin conditions
-Psoriasis
-Eczema
-Malignant Melanoma
-Vitiligo
-Alopecia Areata
-Acne
What is caused in Psoriasis?
Red, flaky, crusty patches of skin that are covered in silvery scales
Where are patches most commonly found in Psoriasis?
Extensor region of Elbows and Knees
Scalp
Lower back
What type of disease is Psoriasis?
Auto immune disease
Likely inherited
What causes the red flaky crusty silver scaled patches of skin in Psoriasis?
Reduced Transit time of Keratinocyte form basal layer to Stratum Corneum (Abundance of Stratum Corneum)
The cells don’t have enough time to mature/differentiate (Parakeratosis)
Increased vascularity of upper dermis (erythema)
What is Parakereatosis?
The incomplete maturation of keratinocytes casuing them to retain their nuclei
Causes the Stratum Corneum to retain nuclei in cells
Signs that may indicate Psoriasis
Pitting and discolouration of nails
Swollen joints (Psoriatic arthritits)
What is Topical Treatment?
Treatment added/applied to particular place in the body
For example like a cream or lotion
Think topic is about 1 thing, added to 1 place
What is Systemic treatment?
Treatment that uses drugs that travel through the blood stream reaching and affecting cells all over the body
What 2 types of categories are there for treatments of the Skin?
Topical Treatments (Try Topical Steroids)
Systemic Treatments
Always try Topical Treatments first since they cause less side effects
Biopsychosocial impact of Psoriasis
People are treated as if they are contagious when psoriasis is not contagious
Common triggers of Psoriasis
Injury to skin
Excess alcohol
Smoking
Stress
What is Eczema?
Chronic Skin Inflammation
Skin inflammation = Dermatitis
What causes Eczema?
Internal Cause (Atopy/Atopic Dermatitis)
External cause (occupation related for example)
What is Atopy?
(Triad)
Asthma
Hay fever
Eczema
Main symptoms of Eczema
Red, dry, itchy skin rash
Patches usually seen in creases of elbows and knees (flexor region)
Inflammation, cracking and bleeding may occur
Treatments for Eczema
Topical Steroids
Systemic (Anti-histamines)
What is malignant melanoma?
Skin cancer that affects Melanocytes (Cells that produce Melanosomes that make Melanin)
Risk factors for Malignant Melanoma
Genetics (CDKN2A mutation)
UV Exposure
Type of skin
Biopsychosocial effects of Eczema
CHildren have worse quality of life
Children may miss days off school, skip activities, social isolation
2 Types of Malignant Melanoma
Nodular Melanomas
Lentigo maligna
What characterises a Nodular Melanoma?
Lump changing colour like black to red
Often bleed or ooze as a symptom
How is Lentigo Maligna characterised
Initially flat and develop sideways (slowly)
May gradually get bigger and change shape
How is Malignant melanoma treated
Wide local excision (surgically removed if not too deep)
Radio/chemotherapy (bad side effects)
What is Vitiligo?
Long term condition where pale white patches develop on the skin due to lack of pigmentation (lack of melanin production)
What causes vitiligo?
Autoimmune condition
Hereditary (genetics)
Trigger events (stress)
What are the 2 Types of Vitiligo?
Segmental (Unilateral vitiligo)
Non-segmental (Bilateral vitiligo)
What is non-segmental Vitiligo?
When the symptoms appear SYMMETRICALLY on both sides of the body as white patches
MOST COMMON FORM OF VITILIGO
What is segmental vitiligo?
When the symptoms of vitiligo (the white patches) only affect one part of the body
Less common form of Vitiligo
Biopsychosocial problems with Vitiligo
Discredited stigma
Treating vitiligo
Topical steroids
Make up (cosmetic camouflage)
Sunscreen
Calcineurin inhibitors (immunosuppressants)
What causes non segmental vitiligo?
Autoimmune condition
T Cells attack and destroy healthy Melanocytes
Less melanosomes so less melanin produced to protect DNA from UV damage
What causes segmental vitiligo?
Nerve endings in skin release neurochemicals
Neurochemicals increase [ROS]
Causes melanocytes to autolyse (so less melanin)
What causes Alopecia?
Autoimmune condition
Bodies T cells attack healthy hair follicles and suppress or stop growth
What is Acne?
Skin condition affecting the sebaceous glands
What are sebaceous glands?
Holocrine glands that produce and release sebum
Sebum = mixture of oils
Lubricates skin protecting it from friction
Symptoms of Comedonal Acne = Non inflammatory acne
Open Comedones = black head (melanin trapped in open pits
Closed Comedones = White heads (hair follicle is blocked) Papules
Symptoms of Inflammatory Acne
Pimples filled with pus (dead cells and oils)
Pustules
Scars
