Skin & soft tissue Flashcards by Jo Nkonge

Summary of Skin & Soft tissue pathology

SSTI
- Viral, Bacterial, Fungal

Diseases of head/neck

Inflammatory conditions of skin & eye

Skin tumours
- BCC, SCC, Melanocytic naevi, Melanoma

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The skin is highly colonised. By which organisms?

S. Aureas (pathogenic potential)
Coagulase -ve Staphylococci
Corynebacterium spp
Propionibacterium

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Skin/soft tissue infections can be localised or systemic. How can a localised infection occur?

Innoculation of contaminated object

Contamination of pre-existing skin lesion

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S. Aureas in addition to causing inflammation, can release EXOTOXINS. Which ones?

EDT A/B
TSST-1
Panton-Valentine Leukocidin (PVL)

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This virus has a 1” infection of chickenpox and a 2” inection of shingles.

VZV

Type of herpes virus

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Treatment of VZV infection?

Oral/IV Aciclovir

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This virus has a 1” infection in infants as mouth lesion and 2” infection of vesicular mouth/genital lesion.

HSV

Topical/Oral Aciclovir

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Raised pearly lesions + umbilicated = ?

Molluscum Contangiosum

Common

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Name the 4 common bacteria responsible for skin infections?

S. Aureas
S. Pyrogens
H. Influenzae
Pasteurella Multocida

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Infection of epidermis + Plaque-like lesions + Yellow exudate = ?

Impetgio

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Bacteria that cause Impetigo?

S Aurea

S. Pyrogenes

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The complications of Impetigo are caused by ETA A/B. What are they?

SSSS (like burns)

Bullous Impetigo

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Infection of dermis + caused by S. pyrogenes = ?

Erysipelas

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How does Erysipelas present?

Fever
4 cardinal signs
LN involvement

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Infection of skin + subcutaneous tissue = ?

Cellulitis

Caused by ALL 4 bacteria

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Presentation of Cellulitis?

Fever
4 cardinal signs
UNILATERAL

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Cellulitis has many diffrentials e.g. Acute arthritis, hypersensitivity reaction, DVT, necrotising fasciitis. What is the treatment?

Flucloxicillin

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Infection of skin + subcutaneous tissue + 2 types = ?

Necrotising fasciitis

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Type 1: Polymicrobial
Type 2: S. pyrogenes.

What is the treatment for necrotising fasciitis?

IV antibiotics (Meropenem + Clindamycin)

Surgical debridement

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Gas gangrene is a type of anaerobic infection (uncommon). Which sites do they tend to infect?

Post-amputation site

Post-op

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Gas gangrene is caused by C. perfringens. Treatment?

Metronidazole
Surgical debidement

(anaerobic)

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List common fungal skin infections

Tinea corporis - ringworm
Tinea pedia - athlete's foot
Tinea cruris - groin
Tinea capitus - scalp ringworm
Onycomycosis

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The 2 most common risk factors for carcinoma of the oral cavity and larynx are..?

Both SCC

SMOKING

ALCOHOL

The name of the autoimmune muco-cutaneous condition that has Wickman’s striae?

Lichen planus

Vocal cord polyps are benign and see in ...?

Heavy drinkers | Singers

Nasal polyps arise from recurrent rhinitis. Large polyps can lead to..?

2" Sinusitis

Cholestastoma is ass. with chronic otitis media. What is it?

= abnormal non-neoplastic skin growth --> hearing loss

Otosclerosis = abnormal bone deposition in middle ear. presentation?

Bilateral Young (familial) slow progression --> hearing loss

Labrynthitis is inflamm of middle ear. T/F?

F = inflamm of inner ear Bacteria/Viral causes

Ear carcinomas can occur in external ear (BCC, SCC) or the ear canal (SCC). Which one is linked to sun exposure?

External ear (pinna) carcinomas

The most common tumour of middle ear which is benign but locally aggressive?

Paragangliomas

Keratitis + Conjunctivitis can be caused by..?

VZV | Chlamydia

Condition where lens become opaque + ass with DM, Down's, Rubella...

Cataracts

Retinal infections are caused by cat/dog faeces, called?

Toxoplasma | Toxocara canis

List 3 caused of retinal vascular D.

Ischaemia Hypertensive retinopathy Diabetic retinopathy

MD = damage to central part of vision. What are the 2 types?

Dry MD* - progressive Wet MD - new vessel growth under retina

Retinoblastoma & UVeal Melanoma are example of..?

Eye tumours

2 types of Dermatitis?

Atopic | Contact - Irritant, Allergic

Autoimmune + red oval plaques + silvery scale + Ausoitz sign

Psoriasis

Psoriasis causes?

FH Environmental triggers ass. with AD

L.E is an autoimmune conn tissue condition. What are the types?

Discoid LE - skin only | SLE - visceral +/- skin

Dermatomyositis can be mistaken for SLE. What is it ass with?

UNDERLYING VISCERAL CANCER ~25%

Presentation of dermatomyositis?

Peri-oribtal oedema Facial rash Muscle weakness

State 3 bullous D.

Pemphigus Bullous Pemphigoid Dermatitis Herpetiformis

Which Bullous D is small intensely itchy + ass. with Coeliac + youth?

Dermatitis Herpetiformis IgA deposition

Most common type of Porphyria = ?

PCT Porphyria Cutanea Tarda = porphyria build-up from enzyme def

Is PCT mostly congenital or acquired?

80% ACQUIRED from Hep C | Tissue damage when exposed to sun

What is the most common malignancy in the UK?

Basal cell Carcinoma (BCC)

BCC appears as nodule/ulcer often in sun-exposed sites. Risk factors?

SUN-EXPOSURE | RT, Immunosuppression, Gorlin;s

SCC = nodule with ulcerated surface. What is the pre-malignant condition?

Actinic Keratosis

Risk factors for SCC?

SUN-EXPOSURE | immunosuppression, renal transplant, drugs, chronic ulcers

Giant Congenital Naevi, Mongolian spot & Dysplastic naevus syndrome fall under the umbrella of..?

Melanocytic naevi | 2 have increased risk of melanoma

Melanocytes are from neural crest cells and protect cells from UV. T/F?

Melanoma is a dangerous malignancy. Is it more common than BCC/ SCC?

No | Rarer - rising incidence

4 risk factors of Melanoma

SUN-EXPOSURE Race - fair FH - dysplastic naevus syndrome Giant congenital naevi

The most common type of Melanoma is UK?

Superficial spreading

Skin lesions can be a sign of sytemic D. Which skin lesions?

DERMATOMYOSITIS - Visceral Cancer DERMATITIS HERPETIFORMIS - Coeliac D ACANTHOSIS NIGRANA - Internal Malignancy NECROBIOSIS LIPOIDA - Diabetes