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Pharmacology > Skin Intro > Flashcards

Skin Intro Flashcards

1
Q

What are the Fitzpatrick skin types?

A

Type 1 - pale white skin, blue/green eyes, blonde/red hair - doesn’t tan, always burns

Type 2 - fair skin, blue eyes - burns easily, tans poorly

Type 3 - darker white skin - tans after initial burn

Type 4 - light brown skin - burns minimally, tans easily

Type 5 - brown skin - rarely burns, tans dark easily

Type 6 - dark brown/black skin - never burns, always tans

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2
Q

What are the functions of the skin?

A
  1. Barrier to external injury
  2. Temperature control
  3. Fluid and electrolyte balance
  4. Produces vitamin D
  5. Cosmetic function
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3
Q

What is intrinsic aging?

A

Passage of time, skin becomes finely wrinkled, exaggeration of expression lines, laxity and pallor

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4
Q

What is photo aging?

A

Alterations in skin structure from chronic sun exposure in addition to passage of time

Causes xerosis, irregular pigmentation and more pronounced wrinkling

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5
Q

What is a nodule?

A

Solid raised lesion >3mm in diameter - contains no fluid

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6
Q

What is a papule?

A

A small solid raised lesion

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7
Q

What is a macule?

A

A flat coloured lesion - not raised

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8
Q

What is a patch?

A

A large flat coloured lesion

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9
Q

What is a vesicle?

A

A small fluid filled lesion <1cm

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10
Q

What is a bulla?

A

A larger fluid filled lesion >1cm

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11
Q

What is a cyst?

A

A soft raised encapsulated lesion filled with semi-solid or liquid contents

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12
Q

What is a pustule?

A

A vesicle filled with fluid and leukocytes

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13
Q

What is a plaque?

A

A large, flat-topped raised lesion

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14
Q

What is erythema?

A

Redness of the skin due to capillary dilation

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15
Q

What is a scale?

A

A collection of cells that have departed from the epidermis

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16
Q

What is excoriation?

A

Injury caused by scratching when the epidermis and dermis are removed

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17
Q

What is lichenification?

A

Thickening of the skin characterised by accentuated skin fold marking

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18
Q

What is a crust?

A

Dried exudate of body fluids that may be yellow or red

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19
Q

What is atrophy?

A

An acquired loss of substance

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20
Q

How would you diagnose skin conditions?

A
  1. Distribution
  2. Type of primary lesion
  3. Shape of individual lesions
  4. Arrangement
    - linear - external
    - generalised - systemic
21
Q

What patient history would you need to diagnose a skin condition?

A
  1. Evolution of symptoms
  2. Associated symptoms
  3. Past/current medications
  4. Ongoing/previous illness
  5. History of allergies
  6. Presence of photosensitivity
22
Q

What are the causes and triggers for eczema?

A
  1. Environmental irritants
    - irritants
    - extremes of temp and humidity
    - abrasive fabrics
  2. Infection
  3. Environmental allergens
    - inhaled allergens
    - dietary factors
  4. Endogenous
    - stress
    - hormonal changes in women
23
Q

What are the stages of eczema?

A
  1. Acute - skin is very oedamatous producing papules or bullae
  2. Subacute - glistening of skin with redness, scaling and crusting - secondary infection is common
  3. Chronic - skin is red, dry, scaly and slightly thickened with a tendency to crack and fissure
24
Q

What are the clinical features of eczema?

A

Intense pruritis in all forms except seborrhoeic eczema

Itch - scratch - excoriation - lichenification

Epidermal barrier is disordered leading to secondary infection

25
Q

What is discoid eczema?

A

A type of eczema that occurs in circular or oval patches on the skin

26
Q

What is contact dermatitis?

A

A type of eczema that occurs when the body comes into contact with a particular substance

27
Q

What is varicose eczema?

A

A type of eczema that occurs most often on the lower legs caused by problems with the flow of blood through the leg veins

28
Q

What is seborrhoeic eczema?

A

A type of eczema where red scaly patches develop of the scalp, eyebrows, ears and sides of the nose

29
Q

What is infantile seborrhoeic eczema?

A

Often but not always affects the scalp - cradle cap

30
Q

What is pompholyx?

A

A type of eczema that causes tiny blisters to erupt across the palms if the hands

31
Q

What is atopic eczema?

A

A chronic relapsing inflammatory skin condition characterised by a red itchy rash that favours the skin creases

32
Q

What are the clinical features of atopic eczema?

A
  1. Pruritis
  2. Facial and flexural eczema in infants
  3. Flexural eczema in adults and children
  4. Chronic or relapsing dermatitis
  5. Personal or family history of atopy
33
Q

What is the diagnostic criteria for atopic dermatitis?

A

An itchy condition plus three or more:

  1. Onset of signs and symptoms before the age of 2
  2. Personal history of allergy or allergic rhinitis
  3. Personal history of dry skin over the last 12 months
  4. Personal history of flexural eczema
  5. Visible flexural eczema involving the skin creases
34
Q

What are the localised variants of atopic eczema?

A
  1. Eyelid
    - exposed to environmental allergens and irritants
    - ribbing or scratching can cause loss of eyelashes
  2. Palmar/plantar
    - glistening erythema with varying degrees of scaling and fissuring
  3. Cheilitis
    - dry scaly lips
35
Q

What are the signs and symptoms of eczema?

A
  1. Pruritis
  2. Erythema
  3. Dry skin
  4. Scaly plaque in flexural surface
  5. Lichenification that feels thick/rough and is often hyper pigmented
  6. Hyper and hypopigmentation
36
Q

How do you manages atopic eczema?

A
  1. Emollients and soap substitutes
  2. Topical corticosteroids or calcineurim inhibitors (second line) for ACUTE treatment
  3. Oral antibiotics for infections
37
Q

What lifestyle treatment can you give for eczema?

A
  1. Avoid triggers
  2. Education
  3. Mittens and filed nails
  4. Soap substitutes
38
Q

What is the fucntion of emollients?

A
  1. Improve hydration of skin
  2. Prevent scaling and cracking
  3. Restore barrier function
39
Q

What emollients are used?

A

White soft paraffin and emulsifying ointment/liquid - occlusive effect

Urea - hydrating agent

Fire risk

40
Q

How do topical corticosteroids work?

A

Used for acute control and maintenance

Control inflammation
- body site
- eczema severity
- age of patient

Use finger tip unit

41
Q

What are the guidelines for topical corticosteroids?

A
  1. Use least potent that relieves symptoms
  2. Choose correct strength for correct body area
  3. Make sure emollients are used correctly
  4. Children under 12 with atopic eczema refer to nice
42
Q

What are the potencies of topical corticosteroids?

A

Mild - hydrocortisone 0.1 - 2.5%

Moderate - clobetasone butyrate 0.05%

Potent - hydrocortisone butyrate 0.1%

Very potent - clobetasol proprionate 0.05%

43
Q

What are the side effects of corticosteroids?

A
  1. Transient burning or stinging
  2. Worsening and spreading of untreated infection
  3. Permanent striae
  4. Thinning of skin
  5. Acne vulgaris/rosacea
  6. Excessive hair growth at site of application
  7. Allergic contact dermatitis
  8. Mild depigmentation

Systemic:
1. Growth suppression in children
2. Adrenal supression
3. Cushing syndrome

44
Q

How do topical calcineurin inhibitors work?

A

Acute control or maintenance

Inhibit inflammatory cytokines transcription in active T cells and other inflammatory cells through inhibition if calcineurin

Steroid sparing effect

45
Q

What are the adverse effects of TCI?

A
  1. Burning
  2. Stinging
  3. Soreness
  4. Pruritis
  5. Skin infections
46
Q

How does pimecrolimus work.

A

1% cream that should be used early at the first sign of itching

Prevent flare progression and increase the time between flares

Can be used in children over 2 and adults

47
Q

How does tacrolimus work?

A

0.1 or 0.03% ointment

Have a rapid and sustained effect in signs and symptoms of atopic eczema

Improvement after 1 week and sustained over 12 months

Children over 2

48
Q

What is seborrhoeic eczema?

A
  1. A hyperproliferative skin disorder
  2. Sharply marginated covered with greasy looking scales
  3. Affects scalp, chest, back, face and groin
  4. Flaky, redness and dryness of skin
  5. Malassezia yeast species

Pharmacology (19 decks)

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