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Dermatology > Skin > Flashcards

Skin Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the layers of the skin (biggest organ of the body)

A

Epidermis
Dermis
Hypodermis = subcutaneous tissue which anchos skin to fascia (useful in insulation)

Skin appendages = derived from skin cells

  • Hair
  • Nails
  • Sebaceous glands
  • Sweat glands
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2
Q

What is the epidermis made up of and what pathology can affect

A

Striatum cornea (thick top layer made up of keratin)
- Thickest in palms and soles
- Thin at eyelids
Keratonocytes - produce keratin
Melanocytes - produce melanin
Lagerhan’s - immune (process antigen and migrate to LN)
Average turnover = 30 days

Pathology

  • Change in turnover e.g. psoriasis
  • Change in surface or loss of epidermis e.g. scales / ulcer
  • Change in pigmentation
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3
Q

What is the dermis made up of

A 
Collagen = mainly 
Fibroblasts synthesis elastin 
Dendiritc cells for immune
Nerves + blood vessels 
Adrenal structures - hair / glands / sensory

Pathology

  • Change in contour / loss of dermis
  • Disorder of skin appendages - hair / acne (Sebaceous gland)
  • Change lymphatics / blood vessel - erythema, urticaria, purpura
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4
Q

What are nails made up of

A 
Nail plate (hard keratin) which arises from nail matrix at posterior nail fold and rests on nail bed 
Nail bed contains capillaries which give colour
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5
Q

What is the stages of the hair cycle and types of hair

A

Lanugo - fine long hair in fetus
Vellus - fine short hair on all areas
Terminal - coarse long hair on scalp, eyebrows, eyelash and pubic

Hair shaft - keratinised tube
Hair bulb - actively dividing cells and melanocyte which gives pigment

Anagen = active growing
Catagen = growth stops + follicle shrinks
Telogen = resting phase
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6
Q

What are the functions of the skin

A 
Thermoregulation - insulation / sweat / blood flow 
Immune system - innate and adaptive 
Barrier
Sensation
Synthesis of Vitamin D
Personal communication
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7
Q

What causes skin disease

A

Photosensitivity - often medication
Temperature - frost bite / necrosis / cold urticaria
Trauma - dermatitis artefacts
Genetics - eczema / psoriasis / acne / neurofibroma
Autoimmune - bullous pemphigoid
Infection
Systemic

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8
Q

What is a macule

A

Small flat circumscribed area <5mm of altered colour

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9
Q

What is a patch

A

Larger flat area of altered colour >5mm

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10
Q

What is a papule

A

Small raised area <0.5cm

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11
Q

What is a plaque

A

Large raised area >0.5cm

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12
Q

What is a vesicle

A

Small fluid filled lesion <0.5cm

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13
Q

What is a bullae

A

Large fluid filled

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14
Q

What is a pustule

A

Small pus

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15
Q

What is an abscess

A

Large pus in dermis or subcutaneous tissue

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16
Q

What is wheal

A

Transient raised lesion due to localised oedema

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17
Q

What is an erosion

A

Superficial loss of epidermis

Heals without scarring

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18
Q

What is an ulcer

A

Loss of epidermis and denims

Heals with scarring

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19
Q

Why can skin regenerate

A

Has stem cells

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20
Q

What causes purpura in children

A 
Thrombocyotpenia 
Meningococcal septicaemia - non-palpable 
ALL
Congenital bleeding disorder 
ITP
HSP - tend to be palpable 
NAI
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21
Q

What should you do to all children with new onset purpuric rash

A

Always admit to exclude life threatening
Ax prior to transfer to hospital as may be due to menigococcal septicaemia
Clotting screen and platelet to exclude coagulation disorder

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22
Q

What causes purpura in adults

A 
Vasculitis
Bone marrow failure
ITP
Drugs
Nutrition
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23
Q

What can distribution of skin disease be

A

Localised
Generalised
Symmetrical

24
Q

How can you investigate skin disease

A 
Charcoal swab - bacterial and fungal 
Viral swab - vesicular eruption
Skin scraping
Nail scraping 
Dermoscopy
25
Q

What do you send swab for

A

MC+S if charcoal
PCR if viral
Biopsy

26
Q

Do you swab in cellulitis

A

No as will have pyrexia so need blood culture

27
Q

What do you do if fungal suspect

A

Skin scraping
Nail clipping
Hair sample
Fungal culture

28
Q

What is important in HPC of skin problem

A 
Duration 
Initial appearance and evolution 
Symptoms - itch / pain
Aggravating and relieving factors 
Previous and current Rx 
Recent contact / stress / travel
Hx sunburn or sunbeds
Skin type
29
Q

What else is important

A 
PMH - atopy / skin cancer
FH - skin disease
SH - occupation / do skin lesions improve
DH
QOL
30
Q

How do you examine skin lesion

A

Inspect
Describe
Palpate
Systematic check

31
Q

What do you look for on inspetion

A

Site and number of lesions

Pattern of distribution

32
Q

How do you describe each individual lesion

A 
SCAM
Site
Shape 
Colour 
Associated secondary change
Morphlogy / Margin
33
Q

What are you feeling for on palpation

A 
Surface
Consistency 
Mobility
Tenderness
Temperature
34
Q

What systemic check do you do

A

Examine nail, scalp, hair and mucous membrane

35
Q

General terms and meaning

A 
Pruritus = itch
Lesion = area altered skin 
Rash = eruption
Naevus = localised malformation
Comedone = plug in sebaceous follicle containing sebum and bacteria
- If open = black head
- If closed = white head
36
Q

How do you describe distribution

A

Generalised = all over body
Extensive = widespread
Localised = one area of skin
Flexural = body folds
Extensor
Pressure area - sacrum / buttock / ankle / heel
Dermatome - supplied by single spinal nerve
Photosensitive - affects sun exposed area
Koebner - linear eruption arising at site of trauma

37
Q

What can colour of lesions be

A

Erythema - redness due to inflammation which blanches
Purpura - red or purple due to bleeding which doesn’t blanch
- Petechiae = small pinpoint macules
- Ecchymoses = large bruising patches
Hypo-pigmentation
DE-pigmentation due to lack of melanin
Hyperpigmentation

38
Q

How do you describe morphology/ structure of lesion

A

See above

39
Q

How do you describe secondary morphology that arises from primary

A

See below

40
Q

Excoriation

A

Loss of epidermis following trauma

41
Q

Lichenification

A

Well-defined roughening of skin

42
Q

Scaling

A

Flakes of stratum corneum

43
Q

Crusting

A

Rough surface consisting of dried serum, blood, bacteria that has exude through eroded epidermis

44
Q

Scar

A

New fibrous tissue post wound healing

  • Atrophic = thinning
  • Hypertrophic = within boundary
  • Keloid - beyond boundary
45
Q

Fissure

A

Epidermal linear split

46
Q

Striae

A

Linear areas from purple-pink-white

Associated execessive steroid / growth / pregnancy

47
Q

Hair terms

A 
Alopecia = loss of hair
Hirsutism = androgen dependent hair growth in female
Hypertrichosis = non-adorgen dependent hair growth
48
Q

Nail terms

A 
Clubbing = Loss of angle between posterior nail fold and plate 
Koilonychia = spoon shaped depresion
Onycholysis = separation of distal nail plate from nail bed 
Pitting = punctate depression
49
Q

What is onycholysis associated with

A

Trauma
Psoriasis
Fungal
Hyperthyroid

50
Q

What is pitting associated with

A

Psoriasis
Eczema
ALopeia acreana

51
Q

What do sebaceous glands do

A

Produce sebum via hair follicles (pilosebaceous unit)
Lubricates and waterproofs skin
Become active at puberty

52
Q

What do sweat glands do

A

Regulate body temperature

Innervated by sympathetic nervous

53
Q

What is a cyst

A

Fluctuant swelling containing fluid or keratin

54
Q

What is a comedone

A

Plugged sebaceous follicle

55
Q

What bloods can be done in dermatology

A 
Autoimmune screen
Coag screen
Monitoring systemic Rx
Vit D
ASOT 
Pruritus / alopecia screen
56
Q

What is patch testing for

A

Exposure allergy

57
Q

What is prick testing for

A

Systemic allergy

Dermatology (12 decks)

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