Session 4: Dermatology Flashcards
History of presenting complaint in dermatological disease.
Initial appearance and then its evolution.
Symptoms such as itch or pain.
Aggravating factors and relieving factors
Previous and current treatments
Past medical history in a patient with dermatological disease.
Systemic diseases
History of atopy
History of skin cancer or pre-cacner
History of sunburn/sunbathing/sun-bed use
Skin type
Social history
Drug history
How is a pigmented lesion described? (ABCD)
Asymmetry
Border (irregular or blurred/defined or ill-defined)
Colour
Diameter
How is a skin complaint described? (SCAM)
Site and distribution/Size and shape
Colour
Associated changes
Morphology
How is this described?
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Generalised
How is this described?
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Flexural
How is this described?
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Extensoral
How is this described?
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Photosensitive
How is this described?
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Discrete
How is this described?
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Confluent
How is this described?
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Linear
How is this described?
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Target
How is this described?
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Erythematous
Blanching
How is this described?
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Purpuric
Non-blanching
How is this described?
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Hyperpigmentation/pigmented
How is this described?
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Hypopigmentation
How is this described?
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Scaly
Due to build up of keratin
How is this described?
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Crust
Due to dried exudate
How is this described?
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Excoriation
Erosion from scratching
How is this described?
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Erosion/Ulceration
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Macule
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Papule
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Patch
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Plaque
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Nodule
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Vesicle
(filled with serous/water)
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Pustule
(filled with pus)
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Bulla
(just a large vesicle > 1 cm)
Describe appearance
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Annular
Describe appearance
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Wheal
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Discoid/nummular
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Comedone
(Either closed or open)
Open = blackhead
Closed = whitehead
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Patchy alopecia
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Diffuse alopecia
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Hypertrichosis
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Hirsutism
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Koilonychia
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Pitting
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Onycholysis
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Clubbing
Name condition
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Erythroderma
Functions of the skin
Protective barrier against environmental insult
Temp reg
Sensation
Vit D synthesis
Immunosurveillance
Cosmesis
Complications of erythroderma
It is described as a total skin failure where there will be impairments of each function of the skin:
Hypothermia
Infection
Renal failure (insensible loss)
High output cardiac failure due to dilated skin vessels
Protein malnutrition because there is a high turnover of skin
Causes of erythroderma
Psoriasis
Eczema
Drugs
Cutaneous T cell lymphoma
Symptoms of erythroderma
Pruritus
Fatigue
Anorexia
Feeling cold
Signs of erythroderma
Erythematous
Thickened skin
Inflamed skin
Scaly skin
No sparing skin
Cell types of epidermis
Keratinocytes (protective)
Langerhan cells (APCs)
Melanocytes (protection against UV)
Merkel cells (sensation)
Layers of the epidermis
Straum basale
Stratum spinosum
Stratum granulosum
Stratum corneum
And also stratum lucidum in thick skin.
Turnover time of skin
30 days
Composition of dermis
Collagen
Elastin
Glycosaminoglycans
This provides strength and elasticity to the skin.
It also contains immune cells, nerve cells, skin appendages, lymphatics and blood vessels.
Explain the properties of the sebaceous glands.
Produce sebum through hair follicles.
This is done in order to lubricate the skin and will first become active after puberty.
They are stimulated by the conversion of androgen to DHT.
Give an example of a condition that can arise from too much sebum production.
Acne vulgaris
Function of the eccrin and apocrine glands.
Regulate body temp.
Innervation of the glands.
Sympathetics
Where can eccrine glands be found?
Widespread throughout the body
Where can the apocrine glands be found?
After puberty at and around axillae, areolae, genitalia and anus.
3 main types of hair.
Lanugo
Vellum
Terminale
Growth cycle of hair.
Anagen
Catagen
Telogen
What is this?
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Melanonychia
Can be malignant melanoma