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PHTH 531 - MEAG > SKIN AND IT'S DISEASES > Flashcards

SKIN AND IT'S DISEASES Flashcards

1
Q

What is treated in the realm of dermatology

A

anything that you can access without having to penetrate the body with a scope

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2
Q

What are the 3 layers of the skin

A

Epidermis
Dermis
Subcutaneous

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3
Q

What are the 4 major types of skin lesions

A
  • Flat lesions
  • Elevated lesions
  • Fluid-filled lesions
  • Other lesions
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4
Q

What are the two subtypes of flat lesions

A
  • Macule - Small spot; not palpable, <1cm

- Patch - large spot not palpable, >1cm

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5
Q

What is a sun spot called

A

Lentigo

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6
Q

What are the two subtypes of elevated lesions

A
  • Papule - small bump; superficial, elevated, < 1cm

- Plaque - Large bump; superficial, elevated, >1cm

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7
Q

What are the subtypes of a fluid-filled lesions?

A
  • Vesicle - small bubble, fluid filled, usually superficial, <0.5 cm
  • Bulla - Large bubble, fluid-filled, can be superficial or deep, >0.5
  • Pustule - pus-containing bubble; often categorized according to whether or not they are related to hair follicles
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8
Q

What are the 4 Other lesions

A
  • Scale
  • Crust
  • Excoriation
  • Erosion
  • Ulcer
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9
Q

What is a scale

A

Accumulation or excess shedding of keratin from the stratum corneum (uppermost layer of the epidermis) - flakey

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10
Q

What is a crust

A

Dried exudate (i.e. blood, serum, pus) on the skin surface; synonymous with scab

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11
Q

What is an excoriation

A

Loss of skin due to scratching or picking

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12
Q

What is an erosion

A

superficial open wound, loss of epidermis or mucosa only

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13
Q

What is an ulcer

A

deeper open wound with partial or complete loss of dermis or submucosa

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14
Q

do erosions heal with a scar

A

no

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15
Q

do ulcers heal with a scar

A

much more likely

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16
Q

What is the extent of injury and the appearance of a 1st degree burn

A

Superficial

Erythema (redness)

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17
Q

What is the extent of injury and the appearance of a second degree burn

A

Partial thickness

Blistering

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18
Q

What is the extent of injury and the appearance of a third degree burn

A

Full thickness

Necrosis

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19
Q

Why is the rule of 9s important

A

to know the extent of the burn - influences prognosis and management during first 48-72 hours

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20
Q

What are 4 types of chronic ulcers

A
  • Pressure
  • Vascular
  • Neuropathic
  • Other
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21
Q

What causes an arterial ulcer?

A

Poor inflow of blood into area

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22
Q

What causes a venous ulcer?

A

Blood not draining properly from limb - blood pules up in the extremity and changes hydrostatic forces in skin

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23
Q

What is the presentation + treatment of a venous ulcer

A

Above ankle, swollen

Want to compress limb

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24
Q

Do you want to compress an arterial ulcer

A

no - makes it worse

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25
Q

There must be damage to which skin layer in order to have scarring

A

dermis

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26
Q

What occurs if there is just superficial injury

A

blistering and erosions only - no scarring

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27
Q

What are the 3 phases of wound healing

A
  1. inflammatory
  2. proliferative
  3. remodelling
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28
Q

What occurs in the inflammatory stage? How long is it?

A

Involves vascular effects and a cellular response that culminates in acute inflammation which is aimed at eliminating pathogens or debris and delivering the materials required for healing the wound
24h - 2 weeks

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29
Q

What occurs in the proliferative stage? how long is it?

A

Production of materials to restore a functional skin barrier.
Days to months

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30
Q

Which layers of the skin need to be repaired during the proliferative stage

A

both the dermis and the epidermis

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31
Q

What occurs in the dermis during the proliferative stage

A

Fibroplasia (from fibroblasts) and neovascularization (from endothelial cells);

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32
Q

What does early angiogenesis and fibroplasia result in?

A

granulation tissue (Friable beefy-red tissue )

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33
Q

What occurs in the epidermis during the proliferation stage

A

the wound must re-epithelialize through keratinocyte proliferation and migration - Re-epithelialization from edges to cover up wound

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34
Q

What occurs during the remodelling phase? How long does it take?

A

The wound contracts and acquires increased tensile strength; the healed wound culminates in a scar

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35
Q

What is the classification of wounds and healing based on?

A

Time, extent, repair method
Acute or chronic
Partial or full thickness
Primary or secondary intention healing

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36
Q

What is the difference from partial thickness to full thickness wounds?

A

Partial thickness = epidermis and part of the dermis

Full thickness = extends through dermis and some of the subcutaneous layer or deeper

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37
Q

What is the difference between primary and secondary intention healing?

A

Primary - wound is completely closed by a surgical excision

Secondary - wound is left to completely heal on its own

38
Q

What are two types of scars

A

Hypertropic scar

Keloid scar

39
Q

What is a hypertropic scar

A

thick scar that is in excess of the amount of tissue required to replace the damaged dermis - thick and raise

40
Q

What is a keloid scar

A

thick scar that clearly extends beyond the margins of the original wound

41
Q

Are bacterial infections superficial or deep?

A

both

42
Q

What are bacterial infections most commonly caused by

A

Streptococcus or Staphylococcus species

43
Q

Are fungal infections more commonly superficial or deep? why?

A

superficial
Because causative organisms do not invade beyond the epidermis + they eat keratin and there is much less keratin inside the body

44
Q

What are the two major types of superficial fungal infections

A

Dermatophytosis and candidiasis

45
Q

How does dermatophytosis present itself

A

Look for scarly red rings

46
Q

How does cadidiasis present itself

A

bright red patches and pustules (yeast infection)

47
Q

what type of environment do fungal infections thrive in

A

moist and warm

48
Q

How are infections by dermatophytes named

A

by the body side involved

Tinea _____

49
Q

What are the most common herpes virus infections due to

A

Herpes simplex and varicella zoster

50
Q

What is herpesvirus clinically characterized by

A

pain and that evolve to crusts

51
Q

What is herpesvirus pathologivally characterized by

A

you get primary infection on skin - this will heal - but the virus will tract along sensory nerve to dorsal root ganglion in a dormant/latent phase forever. Causes pain because it is infecting the skin and the sensory nerve ending

52
Q

What is the lay man terms for a primary varicella zoster and a secondary?

A

Chicken pox

Shingles

53
Q

What is human papillomarvirus? What occurs with this virus

A

warts

Does not activate immune system but gets into cell and causes the epidermis to grow like crazy

54
Q

How does malluscum contagiosum present

A

translucent papules with central keratotic core - white core you can squeeze out

55
Q

What two populations is molluscum contagiosum common with

A 
young children (correlated with swimming) 
Young adults (STD)
56
Q

What are two types of infestations

A

scabies and lice

57
Q

How does scabies present

A

intensely pruritic infestation; look for linear burrows on the skin

58
Q

What are the five cardinal morphologic features of psoriasis vulgaris

A
  • Plaque (raised lesions)
  • Well-circumscribed margins
  • Bright salmon red colour
  • Silvery micaceous scale
  • Symmetric distribution - bilateral
59
Q

What is the pathogenesis of psoriasis

A

a chronic immunologic disease of the skin characterized by profound cutaneous inflammation and epidermal hyperproliferation

60
Q

What is the prevalence of psoriasis

A

1-3% of population

with positive family history in up to 30% of patients

61
Q

what are 5 complications seen with Psoriasis

A
  • Physical - pruritus, fissuring, bleeding of lesions
  • Emotional/psychological feel stigmatized and socially isolated; loss of self-esteem
  • Economic - costs of medication; time away from work
  • Severe psoriasis is associated w/ Increased risk of cardiovasculaar disease and shortened lifespan
  • Psoriatic arthritis: 5-10% of patient with psoriasis will have psoriatic arthritis
62
Q

How is Psoriasis treated

A
  • Topical creams, oitments, gels, and lotions
  • Physio w/ UV light
  • Systemic therapy with immunosuppressive drugs such as methotrexate or cyclosporine
63
Q

Eczema is clinically referred to

A

dermatitis

64
Q

How does eczema (dermatitis) present?

A

Itchy, red, scaly disorders

65
Q

Eczema (dermatitis) can be ___ or _____

A

endogenous (atopic dermatitis) or exogenous (contact dermatitis)

66
Q

What is atopic dermatitis

A

comes from inside your body

- intensely pruritic inflammatory skin disorder associated with atopy: astham, hayfever, and allergic conjuctivitis

67
Q

What is the most outstanding clinical feature of atopic dermatitis? What are some other presentations?

A

pruritis

Other:
- Marked xerosis (dry, scaly skin)
- Ill-defined erythema
- Tiny coalescing edamatous papules or papulovesicles
Lichenification (thickening of skin lines)
- Excoriation
- Crusting (if secondarily infected)

68
Q

What is the treatment of atopic dermatitis

A
  • Avoid irritating factors (alcohol containing agents)
  • Aggressive restoration of the cutaneous permeability barrier with bland emolients and moisturizers
  • Topical glucocorticoids
  • Topical immunomodulators
  • Topical or systemic anti-staphylococcal antibiotics
  • Oral antihistamies
  • UV phototherapy for severe or resistant cases
69
Q

What are the two forms of contact dermatitis

A
  • Allergic contact dermatitis: immune hypersensitivity to an allergen in contact with the skin
  • Irritant contact dermatitis: Contact of the skin with something that primarily causes direct local irritation
70
Q

What is seborrheic dermatitis

Where does it occur

A

Dandruff -

Areas of higher sebaceous gland activity

71
Q

What causes seborrheic dermatits

A

excessive immune reaction to a lipophilic yeast called Pityrosporum that normally occurs on skin

72
Q

What are two associated disorders with seborrheic dermatits

A

PD and immobility due to other neurological disorders

HIV infection

73
Q

What are 3 autoimmune connective tissue disorders

A
  • Lupus erythematosus
  • Scleroderma/System sclerosis
  • Dermatomyositis/Polymyositis
74
Q

What are the skin findings of lupus erythematosus

A

Malar “butterfly rash”, localized erythema and edma, alopecia, photosensitivity, mucosal ulcers, Raynauds phenomenon

75
Q

What occurs with scleroderma/system sclerosis

A
  • Autoimmunity provokes a massive fibrotic tissue response

- Cutaneous fibrosis can be localized or widespread; may lead to joint contractures; Raynaud’s phenomenon

76
Q

What are the systemic manifestations of scleroderma/system sclerosis

A

Hypertension, pulmonary fibrosis, GI dysmotility,

77
Q

What is dermatomyositis/polymyositis

A

Autoimmune connective tissue disorder

Has inflammatory myosistis leading to muscle weakness

78
Q

What is the difference between dermatomyositis and polymyosistis

A 
derma = skin and muscle 
poly = just muscle
79
Q

What are two types of benign skin tumors

A
  • seborrheic keratosis

- Melanocytic nevi - moles

80
Q

What are 3 types of skin cancer

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Malignant melanoma
81
Q

What do cells in basal cell carcinoma look like

A
  • Basal layer of the epidermis
  • Translucent skin-colored nodules
  • May be eroded or ulcerated
82
Q

What is basal cell carcinoma likely to spread to

A

not other organs but rather along surface of skin

83
Q

What are the 3 types of basal cell carcinoma

A
  1. Nodular - big bump on skin
  2. Superficial - spreading on surface - flatter
  3. Sclerosing (looks like a scar)
84
Q

what is the appearance of squamous cell carcinoma?

A
  • Solid skin tumors
  • May often be volcano-shaped
  • Thick overlying scale
  • Lots of keratin so not translucent in appearance
85
Q

What is an actinic keratosis?

Describe its appearance

A
  • Precursor lesion to squamous cell carcinoma

- Actinic Keratosis are scaly; skin coloured, pink or red and rough in texture

86
Q

Are squamous cell carcinomas likely to spread to organs?

A

yes

87
Q

What is the most dangerous form of skin cancer

A

Malignant melanoma - highest potential for spread to other organs

88
Q

What is the least dangerous form of skin cancer

A

Basal cell carcinoma

89
Q

What is the ABCDE rule for melanoma used for

A

for detection

90
Q

What is the ABCDE rule for melanoma?

A 
A= Asymmetry 
B = Border 
C = Colour 
D = Diamete 
E = evolving or eccentric
91
Q

What are some major risk factors for skin cancer

A
  • Prior personal history of skin cancer or pre-cancer
  • Excessive prior sun exposure
  • Presence of multiple skin moles
  • Presence of abnormal looking moles
  • Family history of skin cancer
  • Chronic systemic immunosuppression

PHTH 531 - MEAG (2 decks)

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