Skin and its Pathology

Question 1

Skin functions

Answer 1

Largest organ of the body
Protective barrier against environmental insults
Temperature and water loss regulation
Sensation
Vitamin D synthesis
Appearance

Question 2

Bulla

Answer 2

Raised, clear fluid-filled lesion >0.5cm in diameter

Question 3

Vesicle

Answer 3

Raised, clear fluid-filled lesion

Question 4

Nodule

Answer 4

Solid raised lesion >0.5cm in diameter with a deeper component

Question 5

Papule

Answer 5

Solid raised lesion

Question 6

Plaque

Answer 6

Palpable scaling raised lesion >0.5cm in diameter

Question 7

Patch

Answer 7

A flat area of altered colour or texture >0.5cm

Question 8

Macule

Answer 8

A flat area of altered colour

Question 9

Benign Leisons

Answer 9

Skin tags
Moles
Cysts
Papillomas

Question 10

Fibroepithelial polyps

Answer 10

Common
Generally in middle-age and older people
Neck, trunk, face, axilla and groin
Flesh coloured bag like lesion

Question 11

Naevi

Answer 11

Proliferation of melanocytes (pigment-producing cell)
Naevus cells within the
dermo-epidermal junction (junctional naevi)
dermo-epidermal junction and dermis (compound naevi)
just in dermis (intradermal naevi)

Question 12

Sebaceous cyst

Answer 12

Clinical term encompasses 2 types of cysts
Derived from invagination of epithelium

2 types:
Epidermoid cyst
Pilar cyst

Question 13

Seborrhoeic Keratosis

Answer 13

Middle aged and older people

Arise spontaneously

Trunk, head and neck

Question 14

Haemangioma

Answer 14

Benign vascular tumours of the dermis

Tend to occur in children

Bluey red surface

Question 15

Malignant lesions

Answer 15

Basal cell carcinoma (BCC)
Squamous cell carcinoma (SCC)
Bowen’s disease
Melanoma

Question 16

Basal Cell Carcinoma

Answer 16

Most common human cancer
Slow growing tumours
Rarely metastasize
Occur at sun exposed sites

Question 17

Bowen’s Disease

Answer 17

Precursor to SCC
Epidermal dysplasia
Sun damage

Question 18

Squamous Cell Carcinoma

Answer 18

Second commonest skin tumour of sun-exposed sites in older people

Question 19

Melanoma

Answer 19

Fairly common
Arises in sun damaged skin
Can be very aggressive and spread widely
Used to be universally fatal but early diagnosis means can be removed.

Question 20

ABCDE of Melanoma

Answer 20

Asymmetry
Border - irregular
Colour - variable pigmentation in lesion
Diameter - mostly >6mm
Enlarge

Question 21

Rashes

Answer 21

Inflammatory skin reactions
Eczema
clinical term that encompasses many different conditions
literally means “to boil over”
itching, burning, rash, blisters

Question 22

Psoriasis

Answer 22

Commonly affect elbows, knees, scalp, lumbosacral area and glens penis.
Can be associated with nail changes, arthritis, myopathy, enteropathy and spondylic joint disease.
Well demarcated, salmon pink plaques with silver scaling

Question 23

Scabies

Answer 23

common and very itchy
caused by human scabies mites.
common in the young and the elderly.
Spread by direct skin-to-skin contact with someone who already has scabies.
mites are found mainly in the web spaces of the fingers and on the palms of the hands, the wrists, ankles and soles of the feet.
Burrows appear as small greyish lines on the skin

Question 24

Skin in Systemic Disease

Answer 24

Meningitis
SLE
Internal malignancy

Question 25

Meningitis

Answer 25

Unwell (headache, stiff neck, dislike of bright light) Can deteriorate rapidly (aching limbs (particularly leg pain), cold hands and feet). The majority (over 50%) with meningococcal septicaemia develop a rash of tiny ‘pink prick' spots which can rapidly develop into purple bruising. Non blanching rash