Lecture 22: Dermatology Flashcards
What are the 14 things to ask about during a dermatology consult?
- Site of onset - where?
- Evolution - has it changed?
- Distribution - asymmetrical or symmetrical?
- Mucous membranes?
- Sun exposed - yes or no and how long?
- Duration - acute / chronic?
- Symptoms
- Exacerbating factors - what makes it worse?
- Relieving factors - what makes it better?
- Past medical history
- Personal and family of skin disease
- Drug history including timeline and non prescribed treatments
- Social, occupational, travel and sexual history
- Psychosocial impact of disease
What do you have to examine during a dermatological examination?
- Ensure good lighting
- Check skin, scalp, mucous membranes and nails
- Comment on morphology
- Palpate
- Examine other systems if appropriate
What is psoriasis caused by?
Skin cells replaced more quickly than usual, supposed to take 3-4 weeks but takes 3-7 days
What are the symptoms of psoriasis?
Red, flaky, crusty patches of skin covered with silver colored scales, on elbows, knees, scalps and lower back
What are 7 triggers of psoriasis?
- Injury to skin
- Excessive drinking
- Smoking
- Stress
- Hormonal changes
- Some medicines
- Immune disorders
What is eczema?
Atopic dermatitis - chronic skin condition that makes skin dry, red, itchy and cracked
What are the symptoms of eczema?
Dry, itchy skin and rash
Can also have inflammation, cracking and bleeding and pain
Usually in skin creases
What are 4 triggers of eczema?
Food allergies
Soap
Detergents
Stress
What is melanoma?
Type of skin cancer that can metastasize to other organs in the body
What is a common sign of melanoma?
Appearance of new mole or change in existing mole (shape, size or color)
What are 2 common types of malignant melanoma based on appearances?
- Nodular
2. Lentigo
How do nodular melanomas look like?
Changing lump on skin, black to red in color
How do nodular melanomas develop?
Faster developing type of melanoma that can quickly grow downwards into deeper layers of skin if mot removed
How do lentigo maligna melanoma look like?
Initially flat and develop sideways in the surface layers of skin, look like a freckle but larger, darker and stand out more
How do lentigo melanomas develop?
Gradually get bigger, change shape, develop sideways in surface layers. May grow downwards into deeper layers of skin and form lumps
What is the cause of melanoma?
Skin cells that begins to develop abnormally - sudden intense sun exposure leading to sunburn
What is vitiligo?
Long term condition where pale white patches develop in skin caused by lack of melanin
What are 2 main types of vitiligo?
Non segmental and segmental
What is non segmental vitiligo?
Symptoms appear on both sides of body as symmetrical white patches
What is segmental vitiligo?
White patches only affect one area of body
What causes non segmental vitiligo?
Autoimmune condition, T cells attack healthy melanocytes and kill them
What causes segmental vitiligo?
Neurochemicals released from nerve endings in the skin, increases the concentration of reactive oxygen species in interstitial space, causing melanocytes to autolyse
What is alopecia areata?
Spot baldness, hair is lost from some or all areas
What causes alopecia areata?
Systemic autoimmune disorder where body attacks anagen hair follicles and suppresses or stops hair growth
