Skin Flashcards
What is a macule?
A flat lesion <5mm
What is a patch?
A flat lesion >5mm
What is a papule?
A raised solid lesion <5mm
What is a nodule?
A raised solid lesion >5mm
What are target lesions and what causes them?
Red concentric rings, caused by erythema multiforme
What is Koebners phenomenon and what causes it?
Skin lesions appearing on lines of trauma - caused by lichen planus
What is erythroderma?
Erythema and scaling that affects the entire body, which can lead to heart failure and dehydration
What does monomorphic mean and what is it characteristic of?
A cluster of same-sized vesicles, caused by eczema herpeticum
What is the difference between an ulcer and an erosion?
Ulcer - break in dermis and epidermis
Erosion - break in epidermis
What is eczema?
AKA dermatitis - red, itchy, dry, scaly skin caused by dehydration
What are the exogenous causes of eczema?
- Irritant
- Allergic
- Photodermatitis
What are the 7 endogenous causes of eczema and describe them?
- Atopic - absence of filaggrin
- Seborrhoeiac - affects the scalp, hormone related
- Discoid
- Pompholyx - vesicles that burst on hands and feet
- Varicose - dilated lichenified veins in legs
- Asteatotic - elderly, lack of sebum, very dry
- Lichen simplex - very itchy and thick, neck and ankle
Where does atopic eczema affect?
Young children - extensor surfaces
Everyone else - flexor surfaces
How is eczema treated?
Emollients
Topical steroids - hydrocortisone, betamethasone
Topical tacromilus
What is eczema herpeticum?
A disseminated viral infection characterised by fever and itchy blisters (from chronic eczema)
What is psoriasis?
Well-defined scaly plaques due to fast turnover of skin cells
What are the 7 types of psoriasis?
Guttate - teardrop shaped on trunk, Group A strep Plaque - elbows and knees Scalp Nail - pitting Flexural - groin, buttocks, elbows Pustular - hands and feet Erythrodermic
How is psoriasis treated?
Emollients
Topical steroids - hydrocortisone, betamethasone
Vitamin D3 analogues - calcipotrol (reduces cell turnover)
Salicyclic acid
Dithranol
Coal tar preparations
If eczema and psoriasis still persist from treatment, how can they be managed?
Phototherapy, methotrexate (anti-inflammatory)
What are the characteristics of a basal cell carcinoma?
Rolled, nodular, pearly edge, telangiectasia, slow-growing, erosions, locally invasive, sun-exposed areas
How is a BCC managed?
Excision
Cryotherapy
Topical flurouracil or imiquimod
(NOT 2WW)
What are the characteristics of a squamous cell carcinoma?
Ulcerated, firm, keratotic with hard raised edges, sun-exposed areas
How is an SCC managed?
2WW - Excision and radiotherapy
What is a malignant melanoma, and what is the criteria for diagnosis?
ABCDE Asymmetry Border - irregular Colour - non-uniform Diameter - >7mm Elevation
Ask about changes in shape, size, colour, bleeding
What are the 2 main types of malignant melanoma, and name 2 others?
Superficial spreading - grow slowly
Nodular melanoma - invade deeply, metastatize early, often amelanotic
Others include - lentigo maligna, acral melanoma (palms,soles)
How is malignant melanoma managed?
2WW (even if just one change) - surgical excision, chemotherapy
What is Breslows thickness?
The length from the granular layer of the epidermis to the base of the skin cancer, correlating with approximate survival time
What are solar (actinic) keratosis?
Premalignant tumour - Crumbly yellow crusts on sun-exposed areas that can become SCCs after years
How are actinic keratosis treated?
Cryotherapy
Topical fluorouracil or imiquimod
How do fluorouracil and imiquimod work?
They cause erythema –> vesiculation –> erosion –> ulceration –> necrosis –> healing
Warn patients of expected inflammatory reaction
What is Bowen’s disease?
Premalignant tumour - Slow-growing red scaly plaque (carcinoma in situ) that can become SCCs after years
How is Bowens disease treated?
Cryotherapy
Topical fluorouracil
Photodynamic therapy
What is lentigo maligna?
Premalignant melanoma in situ that consists of malignant cells but does not show invasive growth - can become malignant melanoma
What is extramammary Paget’s disease?
Chronic eczema-like rash around the genitals that can be associated with underlying cancer
What is seborrheic keratosis?
Benign skin-growth that resembles malignant melanoma
