Skin path/tumour Flashcards
what are the two types of inflammatory skin disease
infectious or non infectious
what are the three clinical stages of eczema/dermatitis
acute - skin red, serous exudate
subacute - skin is red, less exudate, itchier, crusting
chronic - skin thick and lethargy, scratching
what is spongiosis and what is it associated with
eczema
spongiosis - intercellular oedema within epidermis which leads to chronic inflammation
what are the 4 types of eczema
atopic - type 1 hypersens - associated with asthma and rhinitis
contact irritant dermatitis - from acid detergent
contact allergic dermatitis - allergic to irritant - nickel, rubber
dermatitis of unknown cause
what is psoriasis
red oval plaques on extensor surfaces, fine silvery scale
which disease would you see auspitz sign
psoriasis
small bleeding points after removal of scale layers
what is the classic histology of psoriasis
psoriasiform hyperplasia
collection of neutrophils in scale
what is the cause of psoriasis
massive cell turnover or autoimmune
PSORS gene in MHC of chromosome 6p2
what are the two types of lupus erythematous
DLE - discoid - skin only
SLE - systemic-visceral disease - maybe skin involvement
what are the clinical features of lupus erythematous
red scalp patches on sun-exposed areas - butterfly rash on cheeks and nose (SLE)
what is the cause and histology of lupus erythmomatosus
autoimmune affecting connective tissue
mainly kidneys as well
thin atrophic epidermis with thickened basement membrane
what are the symptoms of dermatomyositis
peri-ocular oedema and erythema (heliotropic rash)
myositis - proximal muscle weakness
how do you tell the difference between LE and dermatomyositis
negative immunoflourescnce for LE band in derma
what is the definition and two types of bullous disease
formation of fluid filled blisters
pemphigus or pemphigoid
describe the two types of bullous disease
pemphigus - intra-epidermal bulla, superficial, loss of cohesion between keratinocytes
autoantibodies against intracellular membrane
pemphigoid - sub epidermal, deep - autoantibodies to glycoprotein in basement membrane - do not rupture and common in elderly
what is dermatitis herpetifromis and what is it associated with
small intensely itchy blisters on extensor surface - associated with coelliac disease
what do these 5 skin lesions look like and what systemic disease are they a sign of
dermatomyositis dermatitis herpetiformis ancanthosis nigricans necrobiosis lipodica erythema nodosum erythema marginatum
visceral cancer
coeliac disease
dark warty lesions in armpits - internal malignancy
red and yellow plaque on legs - DM
red tender nodules on shins - infection elsewhere
Rheumatic fever
what is the most common malignant tumour of the skin
basal cell carcinoma
what is the cause of basal cell carcinoma and clinical features
sun exposure - gorlins syndrome increases risk
early nodule, late ulceration - morphoeoic BCC
what are the causes of squamous cell carcinoma and clinical features
UV radiation, hydrocarbon exposure, chronic ulcers, immunosuppressed, drugs
features - ulcerated crusted surface
what can actinic keratosis lead to
squamous cell carcinoma
where do melanocytes derive from
neural crest
what is the function of melanocytes
produce melanin which is transferred to epidermal cells to protect the nucleus
what are naevi/moles and what are the types
local benign collections of melanocytes - superficial (congenital or acquired), deep - blue naevi
what is a mongolian spot
a deep mole
describe atypical mole syndrome
families with increased incidence of melanoma, multiple atypical moles
what are the risk factors of melanoma and how does it compare to BCC and SCC
much rarer and very dangerous
sun exposure, family history of atypical mole syndrome, giant congenital naevi
what are 4 types of melanoma
lentigo maligna melanoma
acral lentiginous melanoma
superficial spreading melanoma
nodular melanoma
what is the most common melanoma in the UK vs afro carribean people
superficial spreading melanoma UK
acral lentiginous melanoma - afrocarribian
what condition are BRAF mutations assisted with
superficial spreading melanoma
what is the most important factor in melanoma
breslow thickness
the thicker the mm then less the 5yr survival
what factors other than thickness are important in melanoma
BANS - back, arms, neck, scalp - have poorer prognosis
satellites - black deposits going up arm
sentinel node
how do you treat melanoma
surgery
BRAF inhibitors
