Skin Flashcards

1
Q

How do you describe skin lesions

A
  • 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
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2
Q

What are the derivatives of pigmented lesions

A
  • Vasculaar
  • melanin
  • foreign object
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3
Q

What is the colour of the lesion determined by?

A
  1. depth of lesion (purple if deep, red if superficial
  2. Blood flow (oxygenated is brighter red)
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4
Q

How does Telangiectasia present?

A

Red small spots

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5
Q

How does Hereditary haemorrhagic telangiectasia present

A
  • genetic
  • defect in vessel walls (assocviated woth frequent noseblee
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6
Q

How does Spider Naveus present

A

Red spider like lesion
- associated with liver diease

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7
Q

Where are melanocytes present

A

Basal layer. same number in all but how much melanin produced differs

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8
Q

What is a melanoma, risk factors & how to avoid it

A

Invasivr pigmented lesion
can be aggressive
- most common on trunk and legs

risk factors: UV radiation
Prevention: slip, slap, slop (top, suncream, shade)

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9
Q

7 features of melanoma

A

change in size
irregular border
irregular pigmentation
itch/ altered sensation
larger than other
inflammation
oozing

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10
Q

How does Basal cell carcinoma present and its associations

A

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

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11
Q

How does squamous cell carcinoma differ to BCC

A
  • More aggressive- more likely to ulcerate
  • ## more likely to metastasie
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12
Q

How is skin cancer treated

A
  1. early diagnosis is key: biospy, staging and grading, CT/ MRI
    - primary lesion treated wide local excision: 4mm for BCC, 20mm clearnace fgor melanoma
  2. TMN grading
  3. Chemotherapy/ immunotherapy/ teargete
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13
Q

What are the signs of measales

A

resolves in 7-10 days
- small number develop meningitis, pneuomonia

  • dry cough, body pains, sore throat, koplik spots, light sensitive
  • loss of appetite
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14
Q

What are the risks of rubella

A

High risk to pregnancy: <20 weeks, foetal abnormalities, deafness

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15
Q

What is chickenpox

A

Varicella Zoster virus- lays dormannt in the dorsal root horns

  • up to years
  • triggered by stress/ immunocompromised (

different dermatomes are affected

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16
Q

What are the different type of herpes simplex virus

A

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

17
Q

What is the tx of herpes

A

Acyclovir
inhibit DNA replication
- shortens the length of illness
- prevent viral replication

18
Q

What conditions are associated with herpes

A
  1. Ocular herpes- cataracts, gylcoma
  2. Herpetic whitlow:
    - painful,red, swollen finger/ nail
19
Q

Which HPV cause cancer

A

16 &18
- link to cervical, head and neck, genital warts

20
Q

What is the tx of HPV

A

Self limiting
cryotherapy
salicylic acid

21
Q

What is erysipelas

A

streptococcus infection
- invade through sfot tissues
- tender/ sore skin, oedema, clear margins

22
Q

How is erysipelas mx

A
  1. draw blue to track margins
  2. Antibiotics
23
Q

What is impetigo

A

mixture of staphylococcus and streptococcus

  • tender area form vesicles with localised redness
  • yellow crust
24
Q

What is eczema cycle?

A

type 1 hypersensitivity, IgE mediated, histamine

target: damp, moist area, flexor surfaces on arms and legs

  1. broken skin
  2. increased permeability
  3. Antigen entry
  4. inflammation
  5. brokem skin
25
What is the management of eczema
break the cycle - moisturiser: skin emolients with fats - topical antihistamine - topical steroids
26
What is psorasis
Inflammatory condition: unknown cause HLA association: increased rate of skin proliferation, increased thickness of skin - white, itchy, shiny, scaly patches
27
What is the tx for psorasis
- aims to slow down keratinocytes proliferation -vitamin D -phototherapy - systemic steroids
28
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
29
What is discoid lupus erythematosis
Discs of skin that breakdown and form vesicles
30
What is the management of lupus
depends on severity: steroids, methotrexate, biological response modifiers
31
What is scleroderma
Thickening & hardening of skin - may affect GI tract & other organs - cause obstructions/ restrictions - may result in raynauds: poor perfusion - renal crisis
32
What is lichen planus
immunologically mediated : distinctive t- cell infiltrate - idiopathic potentially: - drugs: oral lichenoid drug reactions - dental restorative materials - viral infections (Hep C)
33
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
34
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
35
What is the management of lichen planus?
diflam, (benzydamine hydrochloride )mouthwash Occasionally steroids: topical/ systemic SLS free toothpaste
36
What is pemphigus & pemphigoid
auto-immune disease - production of vesicles/ bullae: blisters and ulcerations
37
What is pemphigus ?
pemphigus? - DESOSOMES: Holding skin together - intrapeithelial vesicles form delicate bullae tat are easily broken - appear more flat
38
What is by pemphigoid
antibodies attaching HEMIDESMOSOMES- hold. basal layer and cells against membrane subeptiehlial lesions- seem more bulbous>
39
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