Skin Flashcards
What is Mealses
Viral respiratory infection that can also present with a rash, can show tiny white spots intra-orally
What is Rubella
(German measles), viral infection that presents with rough-feeling spotty rash
What is the associated Risk with Rubella
High risk to unborn children + pregnant women, will cause foetal abnormalities with 90% mother->child transmission rate
what is chickenpox
Varicella zoster virus, highly contagious vial infection
Describe the presentation of chickenpox
Small red spots, which become very itchy blisters
first appear on face, back and chest
how can you differentiate chickenpox and measles
Measles is respiratory so will see a runny nose, sore throat, hacking cough
chickenpox, the red spots will turn into itchy blisters
In an adult pt, what is the progression of chickenpox from the spots?
Virus will retreat to CNS, will lay dormant until a trigger can reactivate it (e.g becoming unwell, temp immunocompromised) and can cause shingles
where is shingles most commonly associated?
will affect skin in a dermatome area, frontal division of trigeminal on face
What is the treatment for HSV-1
Acyclovir (prevents viral DNA replication)
What are oral manifestations of HSV-1
primary herpetic gingival stomatitis - clusters of vesicles/ulcers in mucosa and tongue
What is herpetic whitlow
Herpes in the fingers, vesicles form and burst on the fingers,
painful, red, swell
What is the aetiology of warts
Human papilloma virus (describes a group of viruses to include HPV),
what is the Tx for warts
Cryotherapy, salicylic acid cream
what is the association with HPV
Cervical cancer, screening is present to all women aiming to identify intra-epithelial neoplasia
Outline Folliculitis
Bacterial infection around a single follicle on the skin
Describe a Boil
bacterial infection, extending redness with liquefaction of tissue, creating a painful lump filled with pus
What is a carbuncle
An extension of a boil - undermining the skin, bacterial infection involving multiple sites to form a dome for a cluster of boils
What is Erysipelas and how does it present
Infection of stept. into dermis layer of skin
Presents as a large, very red swelling forming a clear margin > needs A&E w./ antibiotics
What is impetigo and how does it present
Highly contagious infection from either Strept. or Staph.
Will form a vesicle with surrounding area of redness, will rupture to form a yellow crust
involves the outer keratin layer
What causes Eczema
Type 1 hypersensitivity reaction, IgE-mediated inflammation
Where does Eczema normally present?
moist skin, flexor surfaces, will be incredibly itchy
What is the management for eczema?
moisturise the skin, avoid strong soaps that’ll wash off natural oils, topical antihistamine and corticosteroids
what is the presentation of psoriasis
white, scaly patches of itchy skin, normally extensor surfaces
Name the differences between psoriasis and eczema
(both immunologically mediated)
Eczema = Flexor surfaces, Psoriasis = Extensor surfaces
Psoriasis not type 1 hypersensitivity reaction
Name the differences between psoriasis and eczema
(both immunologically mediated)
Eczema = Flexor surfaces, Psoriasis = Extensor surfaces
Psoriasis not type 1 hypersensitivity reaction
Eczema = broken red skin, Psoriasis = scaly white skin
What is SLE?
Systemic Lupus Erythematosus,
Systemic autoimmune condition that affects skin, joints, liver, kidney, GI
Unknown aetiology, SLE is most common type of lupus
How does SLE present?
‘Butterfly rash’ across the nose and cheeks
Management for SLE
Depends on severity and what body systems are involved
Steroids, biological response modifiers, methotrexate (antimetabolite)
What is DLE
Discoid Lupus Erythematosus, a milder form of systemic LE that affects the skin (can progress into systemic LE)
Describe the presentation of DLE
Round sores, as disks of skin break down to form vesicles
What is Raynaud’s phenomenon, and what is it associated with
- Descreased blood flow to the fingers, causing them to go white and cold
- Scleroderma (thickening, hardening of the skin)
What is the aetiology behind lichen planus
Cause unknown, immunologically mediated T cell infiltrate
Describe oral presentation of lichen planus
- typically bilateral
- Whickham’s striae >spiderweb appearance of lacy white lines
- erosive: oral ulcers, persistent areas of redness, covered in yellow slough
Management of Oral Lichen planus
- Benzydamine hydrochloride mouthwash
- SLS free toothpaste
- topical and systemic steroids
What is the difference between Pemphigus and pemphigoid
(both auto-immune conditions that produce vesicles of bullae in oral mucosa)
- Pemphigus is auto-immune against desmosomes, pemphigoid is auto-immune against hemidesmosomes
- Pemphigus produce easily broken intra-epithelial vesicles, pemphigoid produce sub-epithelial lesions which are less delicate
what is a desmosome and which skin condition is associated with it
Structure involved in holding epithelial cells together, which are auto-immune attacked in Pemphigus
What is a hemidesmosome, and which skin condition is associated with it?
Hemidesmosome connects the cells to the basal lamina, associated with pemphigoid
What oral condition can disguise itself as a cyst?
Chronic discharging dental sinus (can put in a gp point and radiograph it to track it back to tooth causing the issue)
Categories for describing skin lesions
Where is it
Size and shape
Does it move
Consistency
Compressable, pulsatile, any associated lymphadenopathy/sinus/nerve issues
Describe what telangiectasia is and how it presents
Vascular lesion, very small clusters of red spots, can be associated with nose bleeds
Describe what spider navi is and how it presents
common lesions, red ‘spiderweb’ expanding form a point
Associated with liver failure (hepatitis, cirrhosis)
Describe appearance of Sturge-weber syndrome
Vascular lesion, causes ‘port wine staining’ (big swathe of dark red across skin)
unilateral distribution along trigmenal nerve
can present alongside epilepsy
What are the managements for vascular lesions
-refer to GP
- laser treatment
- surgical resection
- beware intra-oral > can bleed excessively
Where are melanocytes in the skin structure?
Basal Layer of epidermis
7-point checklist for melanoma:
- change in size (panic if larger than pencil end)
- irregular pigmentation
- irregular border
- itch, altered sensation
- larger than other lesions
- inflammation
- oozing
What is the difference in basal and squamous cell carcinoma?
Affect different cell types, Squamous is more likely to metastasize, more aggressive than BCC
How are skin cancers Diagnosed
biopsy
