Skin Flashcards
How do you describe skin lesions
- Site,
-size
, shape,
-mobility
-consistency (firm? hard? soft? bony?rubbery? fluctuant)
-overlying skin
-pulsatile?
-compressive?- does it fill and rempty
sinus involvement? - nerve involvement?
-lymphadenopathy? - other skin lumps
What are the derivatives of pigmented lesions
- Vasculaar
- melanin
- foreign object
What is the colour of the lesion determined by?
- depth of lesion (purple if deep, red if superficial
- Blood flow (oxygenated is brighter red)
How does Telangiectasia present?
Red small spots
How does Hereditary haemorrhagic telangiectasia present
- genetic
- defect in vessel walls (assocviated woth frequent noseblee
How does Spider Naveus present
Red spider like lesion
- associated with liver diease
Where are melanocytes present
Basal layer. same number in all but how much melanin produced differs
What is a melanoma, risk factors & how to avoid it
Invasivr pigmented lesion
can be aggressive
- most common on trunk and legs
risk factors: UV radiation
Prevention: slip, slap, slop (top, suncream, shade)
7 features of melanoma
change in size
irregular border
irregular pigmentation
itch/ altered sensation
larger than other
inflammation
oozing
How does Basal cell carcinoma present and its associations
Non-melanoma skin cancer
- presents as a slow growing lesion on face and neck
- pearly edges
- ulcerated as they get bigger
- basal cell carcinoma vary when they leave and come back
associations: uv, older age, lots of time outdoors
How does squamous cell carcinoma differ to BCC
- More aggressive- more likely to ulcerate
- ## more likely to metastasie
How is skin cancer treated
- early diagnosis is key: biospy, staging and grading, CT/ MRI
- primary lesion treated wide local excision: 4mm for BCC, 20mm clearnace fgor melanoma - TMN grading
- Chemotherapy/ immunotherapy/ teargete
What are the signs of measales
resolves in 7-10 days
- small number develop meningitis, pneuomonia
- dry cough, body pains, sore throat, koplik spots, light sensitive
- loss of appetite
What are the risks of rubella
High risk to pregnancy: <20 weeks, foetal abnormalities, deafness
What is chickenpox
Varicella Zoster virus- lays dormannt in the dorsal root horns
- up to years
- triggered by stress/ immunocompromised (
different dermatomes are affected
What are the different type of herpes simplex virus
HS1- Oral to oral contact
primary herpetic gingivostomatitis- vesicles in labial mucosa/ tongue
(dormant in trigeminal ganglion)
- reactivated by stress/ steroids/ UV radiation
HSV2: Genital contacts, STD
- Blister that ruptures
What is the tx of herpes
Acyclovir
inhibit DNA replication
- shortens the length of illness
- prevent viral replication
What conditions are associated with herpes
- Ocular herpes- cataracts, gylcoma
- Herpetic whitlow:
- painful,red, swollen finger/ nail
Which HPV cause cancer
16 &18
- link to cervical, head and neck, genital warts
What is the tx of HPV
Self limiting
cryotherapy
salicylic acid
What is erysipelas
streptococcus infection
- invade through sfot tissues
- tender/ sore skin, oedema, clear margins
How is erysipelas mx
- draw blue to track margins
- Antibiotics
What is impetigo
mixture of staphylococcus and streptococcus
- tender area form vesicles with localised redness
- yellow crust
What is eczema cycle?
type 1 hypersensitivity, IgE mediated, histamine
target: damp, moist area, flexor surfaces on arms and legs
- broken skin
- increased permeability
- Antigen entry
- inflammation
- brokem skin
What is the management of eczema
break the cycle
- moisturiser: skin emolients with fats
- topical antihistamine
- topical steroids
What is psorasis
Inflammatory condition: unknown cause
HLA association: increased rate of skin proliferation, increased thickness of skin
- white, itchy, shiny, scaly patches
What is the tx for psorasis
- aims to slow down keratinocytes proliferation
-vitamin D
-phototherapy - systemic steroids
What is systemic lupus erythematous ***
varies in severity
- autoimmune disorder: present in other ways
1. skin, joint, kidney, liver, GIT, vascular blood
-can block
presentations: butterftyl rash, joint ache, kidney problems
What is discoid lupus erythematosis
Discs of skin that breakdown and form vesicles
What is the management of lupus
depends on severity: steroids, methotrexate, biological response modifiers
What is scleroderma
Thickening & hardening of skin
- may affect GI tract & other organs
- cause obstructions/ restrictions
- may result in raynauds: poor perfusion
- renal crisis
What is lichen planus
immunologically mediated : distinctive t- cell infiltrate
- idiopathic
potentially:
- drugs: oral lichenoid drug reactions
- dental restorative materials
- viral infections (Hep C)
What are the clinical signs of lichen planus
cluster of red/white patches
- Wickhams striae (white streaks)
- koebner phenomenon: scratch healthy skin, develop diseases in that area
What are the oral manifestations of lichen planus
reticular with wickhams striae
- desequamative gingivits: typical appearance of wide range
- erosive lichen planus: atrophy, erosion of mucosa
What is the management of lichen planus?
diflam, (benzydamine hydrochloride )mouthwash
Occasionally steroids: topical/ systemic
SLS free toothpaste
What is pemphigus & pemphigoid
auto-immune disease
- production of vesicles/ bullae: blisters and ulcerations
What is pemphigus ?
pemphigus?
- DESOSOMES: Holding skin together
- intrapeithelial vesicles
form delicate bullae tat are easily broken
- appear more flat
What is by pemphigoid
antibodies attaching HEMIDESMOSOMES- hold. basal layer and cells against membrane
subeptiehlial lesions- seem more bulbous>
What are the signs of lichen planus
flat planar
multiple sites
papular- less than 5mm
plaques- greater than 5mm
purple
itchy
in mouth- wickmans straie
