Urticaria Flashcards

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1
Q

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

A

Hyperkeratosis

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2
Q

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

A

Parakeratosis

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3
Q

Name the term that means “increased thickness of epithelium”

A

Acanthosis

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4
Q

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

A

Irregular epithelial thickening

Acanthosis nigricans

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5
Q

Define “spongiosis”

A

Oedema between keratinocytes

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6
Q

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

A

Parakeratosis in the corneal layer

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7
Q

What is meant by the Koebner phenomenon?

A

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

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8
Q

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

A

True

Unusual but true

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9
Q

What is Auspitz sign in psoriasis?

A

Bleeding spots when psoriasis scales are scraped off

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10
Q

Where does acne vulgaris tend to affect?

A

Sites of high sebaceous gland concn

face, neck, upper back, chest

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11
Q

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

A

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

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12
Q

What are comedones?

A

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

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13
Q

Rosacea is commoner in males. True/False?

A

False

Commoner in females

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14
Q

What are the facial features of rosacea?

A
Erythema with no comedones
Flushing
Visible blood vessels
Pustules
Thickened skin (rhinophyma)- enlarged unshapely nose
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15
Q

List some triggers of rosacea

A

Alcohol
Sunlight
Spicy food
Stress

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16
Q

Which mites are often present in rosacea?

A

Demodex mites

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17
Q

Name 3 examples of immunobullous diseases

A

Pemphigus
Bullous pemphigoid
Dermatitis herpetiformis

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18
Q

What is the most common subtype of pemphigus?

A

Pemphigus vulgaris

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19
Q

Pemphigus vulgaris is an autoimmune condition. What happens?

A

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

intra-epidermal (thin roofed)

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20
Q

In bullous pemphigoid, where does the blistering develop?

A

Underneath the epidermis

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21
Q

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

A

False (occurs in pemphius vulgaris)

pemphigus is intra-epidermal

22
Q

Bullous pemphigoid is an autoimmune condition. What happens?

A

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

is subepidermal

23
Q

Dermatitis herpetiformis is linked to which GI disease?

A

Coeliac disease

24
Q

How is dermatitis herpetiformis produced in coeliac patients?

A

IgA against wheat cross-reacts against connective tissue matrix proteins

25
Q

What is the commonest form of psoriasis?

A

Chronic plaque psoriasis (psoriasis vulgaris)

26
Q

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

A

False

Symmetrical and affect extensor surfaces

27
Q

List treatment for psoriasis

A
Emollients
Vitamin D analogue
Coal tar
Steroid ointment
Phototherapy
Systemic therapy- methotrexate (immunosuppression)
28
Q

Give examples of vitamin D analogues

A

Calcipotrol (Dovonex)

Calcitrol (Silkis)

29
Q

What is the basic function of retinoids in psoriasis?

A

Reduces skin turnover (reduces parakeratosis)

30
Q

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

A

Propionibacterium acnes

31
Q

Open comedones are called blackheads/whiteheads

Closed comedones are called blackheads/whiteheads

A

Open comedones are called blackheads, closed comedones are called whiteheads

32
Q

List topical treatment for acne

A

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

33
Q

What does benzoyl peroxide do?

A

Keratolytic + antibacterial

34
Q

What type of drug is adapalene?

A

Topical retinoid (dries skin)

35
Q

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

A

Isotretinoin

36
Q

Comedones are present in rosacea. True/False?

A

False

37
Q

Outline treatment for rosacea

A

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

38
Q

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

A

True

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

39
Q

What is Nikolsky sign?

A

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

40
Q

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

A

Pemphigus vulgaris

41
Q

Outline treatment for pemphigus and pemphigoid

A

Steroid
Immunosuppressive
Tetracyline in pemphigus

42
Q

What is psoriasis?

A

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

43
Q

What is psoriasis linked with?

A

Arthritis

Nails- onycholysis

44
Q

What is guttate psoriasis?

A

“Teardrop” psoriasis seen in young adults

o Occurs two weeks after strep throat infection
o Resolves spontaneously but recurrence is likely

45
Q

What are lichenoid disorders?

A

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

46
Q

What is lichen planus?

A

T-cell mediated inflammation

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

47
Q

Where is lichen planus more common?

A

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

48
Q

What is the management for lichen planus?

A

Underlying cause (drug reaction)

Emollients +/- Steroids +/- Phototherapy

49
Q

What is the pathogenesis of acne vulgaris?

A

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

50
Q

What glands do acne come from?

A

Pilosebaceous glands