part 1

Question 1

what are the layers of the skin?

Answer 1

(stratum corneum)
epidermis
dermis
subcutaneous tissue

Question 2

what is the role of the stratum corneum?

Answer 2

varies in thickness, more in the hands = more protective. Sheds in normal skin to give the skin a healthy appearance.

Question 3

what is the role of the epidermis?

Answer 3

an infective barrier

Question 4

what is the cause of psoriasis?

Answer 4

hyperproliferation of the epidermis

Question 5

what is atopy?

Answer 5

Atopy refers to the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis (eczema).

the tendency to produce an exaggerated IgE immune response to otherwise harmless environmental substances

Question 6

why should you examine the joints of a psoriasis patient?

Answer 6

may have arthritic psoriasis

Question 7

what is the difference between a papule and a nodule?

Answer 7

papule = small lump (<5mm)

nodule = larger lump (>5mm|)

Question 8

what is the difference between a vesicle and a bulla?

Answer 8

vesicle = small water blister

bulla = large water blister

Question 9

define

• alopecia
• hirsutism
• excoriations
• telangiecta

Answer 9

alopecia = hair loss
hirsutism = hairiness

excoriations = scratch marks

telangiecta = thread vein

Question 10

what are striae?

Answer 10

stretch marks

Question 11

define

• pruritus
• atrophy

Answer 11

pruritus = itching

atrophy = thinning

Question 12

define the term

• macule
• patch
• plaque

Answer 12

macule = non palpable area of discolouration

patch = macule >2cm

plaque = palpable, flat topped area >1-2cm

Question 13

what is an ulcer?

Answer 13

superficial loss of epidermis

Question 14

what is Lichenification?

Answer 14

loss of epidermis (superficial)

loss of epidermis and dermis (deep)

thickening of the skin with exaggerated skin marking

Question 15

what is contact dermatitis?

Answer 15

Contact dermatitis is an allergic or irritant skin reaction caused by an external agent.

Question 16

what are the types of contact dermatitis?

Answer 16

2 types of contact dermatitis,

irritant contact dermatitis is caused by direct toxicity and can occur in any person without prior sensitisation.

Allergic contact dermatitis is a delayed hypersensitivity reaction, which requires prior sensitisation.

Question 17

what is the pathophysiology of allergic contact dermatitis?

Answer 17

Allergic contact dermatitis is a type 4 or delayedhypersensitivityreaction and occurs 48–72 hours after exposure to theallergen. The mechanism involves CD4+ T-lymphocytes, which recognise anantigenon the skin surface, releasingcytokinesthat activate the immune system and cause the dermatitis

Question 18

what are the symptoms of allergic contact dermatitis?

Answer 18

Results in localised burning, stinging, itching, blistering, redness, and swelling at the area of contact with the allergen or irritant.

Question 19

what can predispose people to contact dermatitis?

Answer 19

a history of atopy

Question 20

how is irritant contact dermatitis treated?

Answer 20

irritant = moisturisers or topical corticosteroids and irritant avoidance

allergic (mid-moderate) = topical corticosteroids + allergen avoidance. can also try topical calcinurin inhibitors

of severe, topical corticosteroids, if this doesn’t work, oral corticosteroids.

Question 21

what is patch testing?

Answer 21

if cant treat allergic dermatitis in primary care, can refer to dermatology to do patch testing for the allergen to avoid it

Question 22

what are the features of a basal cell carcinoma and how is it diagnosed?

Answer 22

ulcer raised rolled edge
prominent fine blood vessels around lesions
nodule on skin

can usually diagnose visually but confirm with excision biopsy

Question 23

who usually gets basal cell carcinomas?

Answer 23

occur in middle age and elderly, usually on face

Question 24

how are basal cell carcinoma’s managed?

Answer 24

complete excision is ideal
can use radiotherapy if surgery isn’t appropriate

refer routinely, if low risk can manage in a community skin cancer clinic

high risk features, refer to dermatology

Question 25

what is psoriasis?

Answer 25

chronic inflammatory condition

presents as erythematous, circumscribed scaly papules and plaques

may be associated with arthritis (psoriatic arthritis)

can be classified as

• plaque psoriasis
• guttate
• erythrodermic
• pustular

Question 26

how is psoriasis treated?

Answer 26

lifestyle e.g smoking, drinking, reduce stress

treatment
- mild = topical corticosteroid and/or topical vitamin D analogue, applied at different times, until the skin is clear

Question 27

what are the features of a squamous cell carcinoma?

Answer 27

dry
scaly
bleeds easily
worse than basal cell carcinoma