Urticaria

Question 1

Name the term that means “increased thickness of keratin layer”

Answer 1

Hyperkeratosis

Question 2

Name the term that means “increased turnover of keratinocytes/persistence of keratin nuclei”

Answer 2

Parakeratosis

Question 3

Name the term that means “increased thickness of epithelium”

Answer 3

Acanthosis

Question 4

Define “papillomatosis” and name a condition it is present in

Answer 4

Irregular epithelial thickening

Acanthosis nigricans

Question 5

Define “spongiosis”

Answer 5

Oedema between keratinocytes

Question 6

In psoriasis, what is the basic pathology that is occuring?

Answer 6

Parakeratosis in the corneal layer

Question 7

What is meant by the Koebner phenomenon?

Answer 7

Trauma to a site of the body can stimulate skin lesions in that particular area

Question 8

Neutrophils are present in the corneal layer in psoriasis. True/False?

Answer 8

True

Unusual but true

Question 9

What is Auspitz sign in psoriasis?

Answer 9

Bleeding spots when psoriasis scales are scraped off

Question 10

Where does acne vulgaris tend to affect?

Answer 10

Sites of high sebaceous gland concn

face, neck, upper back, chest

Question 11

How does sebum, produced by sebaceous glands, lead to acne?

Answer 11

Sebum builds up in the hair follicle, increasing pressure to cause rupture

Question 12

What are comedones?

Answer 12

Keratin and sebum build up in hair follicles, producing whiteheads and blackheads

Question 13

Rosacea is commoner in males. True/False?

Answer 13

False

Commoner in females

Question 14

What are the facial features of rosacea?

Answer 14

Erythema with no comedones
Flushing
Visible blood vessels
Pustules
Thickened skin (rhinophyma)- enlarged unshapely nose

Question 15

List some triggers of rosacea

Answer 15

Alcohol
Sunlight
Spicy food
Stress

Question 16

Which mites are often present in rosacea?

Answer 16

Demodex mites

Question 17

Name 3 examples of immunobullous diseases

Answer 17

Pemphigus
Bullous pemphigoid
Dermatitis herpetiformis

Question 18

What is the most common subtype of pemphigus?

Answer 18

Pemphigus vulgaris

Question 19

Pemphigus vulgaris is an autoimmune condition. What happens?

Answer 19

IgG antibodies made in response to desmoglein 3 - this is the glue that maintains desmosomal attachments

intra-epidermal (thin roofed)

Question 20

In bullous pemphigoid, where does the blistering develop?

Answer 20

Underneath the epidermis

Question 21

Acantholysis (loss of desmosomal attachments in epidermis) occurs in bullous pemphigoid. True/False?

Answer 21

False (occurs in pemphius vulgaris)

pemphigus is intra-epidermal

Question 22

Bullous pemphigoid is an autoimmune condition. What happens?

Answer 22

IgG produces antibodies against hemidesmosomes
Causes epidermis to separate from basement membrane (at the DEJ)

is subepidermal

Question 23

Dermatitis herpetiformis is linked to which GI disease?

Answer 23

Coeliac disease

Question 24

How is dermatitis herpetiformis produced in coeliac patients?

Answer 24

IgA against wheat cross-reacts against connective tissue matrix proteins

Question 25

What is the commonest form of psoriasis?

Answer 25

Chronic plaque psoriasis (psoriasis vulgaris)

Question 26

Psoriasis is symmetrical and usually affects flexor surfaces. True/False?

Answer 26

False | Symmetrical and affect extensor surfaces

Question 27

List treatment for psoriasis

Answer 27

``` Emollients Vitamin D analogue Coal tar Steroid ointment Phototherapy Systemic therapy- methotrexate (immunosuppression) ```

Question 28

Give examples of vitamin D analogues

Answer 28

Calcipotrol (Dovonex) | Calcitrol (Silkis)

Question 29

What is the basic function of retinoids in psoriasis?

Answer 29

Reduces skin turnover (reduces parakeratosis)

Question 30

Which organism can colonise the hair follicle duct, causing acnes?

Answer 30

Propionibacterium acnes

Question 31

Open comedones are called blackheads/whiteheads | Closed comedones are called blackheads/whiteheads

Answer 31

Open comedones are called blackheads, closed comedones are called whiteheads

Question 32

List topical treatment for acne

Answer 32

 Keratolytic – Benzoyl peroxide  Retinoids (vit A derivative) - Tretinoin= drying effect  Antibiotics – Tetracycline= antibacterial and anti-inflammatory

Question 33

What does benzoyl peroxide do?

Answer 33

Keratolytic + antibacterial

Question 34

What type of drug is adapalene?

Answer 34

Topical retinoid (dries skin)

Question 35

Name an oral retinoid that can be used for systemic treatment of acne

Answer 35

Isotretinoin

Question 36

Comedones are present in rosacea. True/False?

Answer 36

False

Question 37

Outline treatment for rosacea

Answer 37

Reduce triggers Topical antibiotic- metronidazole Oral antibiotic- tetracycline Low dose isotretinoin if severe

Question 38

Bullous pemphigoid is a deep blister; pemphigus is a superficial blister. True/False?

Answer 38

True | BP goes through DEJ; pemphigus is intra-epidermal between keratinocytes

Question 39

What is Nikolsky sign?

Answer 39

Top layers of the skin slip away from the lower layers when slightly rubbed; i.e., popped blister

Question 40

Which disease - bullous pemphigoid or pemphigus vulgaris - is Nikolsky positive?

Answer 40

Pemphigus vulgaris

Question 41

Outline treatment for pemphigus and pemphigoid

Answer 41

Steroid Immunosuppressive Tetracyline in pemphigus

Question 42

What is psoriasis?

Answer 42

Chronic inflammatory skin condition defined as itchy red skin with scaly silver-white papules and plaques.

Question 43

What is psoriasis linked with?

Answer 43

Arthritis | Nails- onycholysis

Question 44

What is guttate psoriasis?

Answer 44

"Teardrop” psoriasis seen in young adults o Occurs two weeks after strep throat infection o Resolves spontaneously but recurrence is likely

Question 45

What are lichenoid disorders?

Answer 45

Conditions characterised by damage to basal epidermis and infiltraton between the epidermis and dermis

Question 46

What is lichen planus?

Answer 46

T-cell mediated inflammation Rash is characterised by small, purple flat-topped, polygonal papules that are very itchy.

Question 47

Where is lichen planus more common?

Answer 47

More common on flexors of wrists and legs Oral lesions are very common White reticular network in mouth (‘Wickham’s striae’)- lace-like pattern on surface of papules and buccal mucosa

Question 48

What is the management for lichen planus?

Answer 48

Underlying cause (drug reaction) Emollients +/- Steroids +/- Phototherapy

Question 49

What is the pathogenesis of acne vulgaris?

Answer 49

poral occlusion, bacterial colonisation of duct, dermal inflammation, sebum production

Question 50

What glands do acne come from?

Answer 50

Pilosebaceous glands