Lecture 22: Dermatology

Question 1

What are the 14 things to ask about during a dermatology consult?

Answer 1

1. Site of onset - where?
2. Evolution - has it changed?
3. Distribution - asymmetrical or symmetrical?
4. Mucous membranes?
5. Sun exposed - yes or no and how long?
6. Duration - acute / chronic?
7. Symptoms
8. Exacerbating factors - what makes it worse?
9. Relieving factors - what makes it better?
10. Past medical history
11. Personal and family of skin disease
12. Drug history including timeline and non prescribed treatments
13. Social, occupational, travel and sexual history
14. Psychosocial impact of disease

Question 2

What do you have to examine during a dermatological examination?

Answer 2

1. Ensure good lighting
2. Check skin, scalp, mucous membranes and nails
3. Comment on morphology
4. Palpate
5. Examine other systems if appropriate

Question 3

What is psoriasis caused by?

Answer 3

Skin cells replaced more quickly than usual, supposed to take 3-4 weeks but takes 3-7 days

Question 4

What are the symptoms of psoriasis?

Answer 4

Red, flaky, crusty patches of skin covered with silver colored scales, on elbows, knees, scalps and lower back

Question 5

What are 7 triggers of psoriasis?

Answer 5

1. Injury to skin
2. Excessive drinking
3. Smoking
4. Stress
5. Hormonal changes
6. Some medicines
7. Immune disorders

Question 6

What is eczema?

Answer 6

Atopic dermatitis - chronic skin condition that makes skin dry, red, itchy and cracked

Question 7

What are the symptoms of eczema?

Answer 7

Dry, itchy skin and rash

Can also have inflammation, cracking and bleeding and pain

Usually in skin creases

Question 8

What are 4 triggers of eczema?

Answer 8

Food allergies
Soap
Detergents
Stress

Question 9

What is melanoma?

Answer 9

Type of skin cancer that can metastasize to other organs in the body

Question 10

What is a common sign of melanoma?

Answer 10

Appearance of new mole or change in existing mole (shape, size or color)

Question 11

What are 2 common types of malignant melanoma based on appearances?

Answer 11

1. Nodular

2. Lentigo

Question 12

How do nodular melanomas look like?

Answer 12

Changing lump on skin, black to red in color

Question 13

How do nodular melanomas develop?

Answer 13

Faster developing type of melanoma that can quickly grow downwards into deeper layers of skin if mot removed

Question 14

How do lentigo maligna melanoma look like?

Answer 14

Initially flat and develop sideways in the surface layers of skin, look like a freckle but larger, darker and stand out more

Question 15

How do lentigo melanomas develop?

Answer 15

Gradually get bigger, change shape, develop sideways in surface layers. May grow downwards into deeper layers of skin and form lumps

Question 16

What is the cause of melanoma?

Answer 16

Skin cells that begins to develop abnormally - sudden intense sun exposure leading to sunburn

Question 17

What is vitiligo?

Answer 17

Long term condition where pale white patches develop in skin caused by lack of melanin

Question 18

What are 2 main types of vitiligo?

Answer 18

Non segmental and segmental

Question 19

What is non segmental vitiligo?

Answer 19

Symptoms appear on both sides of body as symmetrical white patches

Question 20

What is segmental vitiligo?

Answer 20

White patches only affect one area of body

Question 21

What causes non segmental vitiligo?

Answer 21

Autoimmune condition, T cells attack healthy melanocytes and kill them

Question 22

What causes segmental vitiligo?

Answer 22

Neurochemicals released from nerve endings in the skin, increases the concentration of reactive oxygen species in interstitial space, causing melanocytes to autolyse

Question 23

What is alopecia areata?

Answer 23

Spot baldness, hair is lost from some or all areas

Question 24

What causes alopecia areata?

Answer 24

Systemic autoimmune disorder where body attacks anagen hair follicles and suppresses or stops hair growth