Welcome + Derm basics

Question 1

Describe the six skin types

Answer 1

• Fitzpatrick
• I - Always Burns, Never Tans
• II - Always Burns, Sometimes Tans
• III - Sometimes Burns, Always Tans
• IV - Never Burns, Always Tans
• V- Dark Brown, rarely burns, fast and easy tanning
• VI- Black, Almost never burns

Question 2

Using the mnemonic SCAM - how would you describe an individual lesion?

Answer 2

• Size (and shape)
• Colour
• Associated secondary change
• Morphology (and margin)

Question 3

Using the mnemonic ABCD - how would you describe a pigmented lesion?

Answer 3

• Asymmetry (Irregular)
• Border
• Colour (two or more)
• Diameter (>6mm)

Question 4

Define: Lesion, Rash

Answer 4

• Lesion - area of altered skin
• Rash - an eruption of multiple areas of altered skin

Question 5

Define naevus

Answer 5

Localised malformation of tissue structures, commonly pigmented

Question 6

Define comodone

Answer 6

Plug in a sebaceous follicle containing altered sebum/bacteria and cellular debris.

Can be open (blackheads) or closed (whiteheads)

Question 7

Define Pruritis?

Answer 7

Itching

Question 8

What is the Koebner Phenomenon in dermatological distribution?

Answer 8

Linear eruption

Question 9

Define the following Dermatological Configuration terms:

• Discrete
• Confluent
• Target
• Annular
• Discoid
• Linear

Answer 9

• Discrete - Separate Lesions
• Confluent - Lesions merging together
• Target - Concentric rings like a dartboard
• Annular - Circle/Ring (like ringworm)
• Discoid - Coin shaped
• Linear - In a line

Question 10

Describe Erythema

Answer 10

Redness due to inflammation and vasodilation, that blanches under pressure

Question 11

Describe Purpura and the 2 types

Answer 11

Red/Purple discolouration due to bleeding into skin/mucous membrane that does not blanch with pressure. Can be

• Petichae (small pinpoint)
• Ecchymoses (large bruise)

Question 12

What is the difference between Hypopigmentation and Depigmentation?

Answer 12

• Hypopigmentation - areas of paler skin (eg Pityriasis Versicolor)
• Depigmentation - White skin due to lack of melanin (eg Vitiligo)

Question 13

Define the morphological terms: Macule, Patch and Plaque

Answer 13

• Macule - flat area of altered colour (freckles)
• Patch - larger flat area of altered colour
• Plaque - Palpable scaling raised lesion>0.5cm in diameter

Question 14

Define the morphological terms: Papule and Nodule

Answer 14

• Papule - Solid raised lesion <0.5cm (eg Xanthomata)
• Nodule - Solid raised lesion >0.5cm

Question 15

Define the morphological terms: Vesicle and Bullae

Answer 15

• Vesicle - Raised clear fluid filled lesion <0.5cm
• Bullae - Raised clear fluid filled lesion>0.5cm

Question 16

Define the morphological terms: Pustule and Abscess

Answer 16

• Pustule - Pus containing lesion<0.5cm in diameter
• Abscess - Localised accumulation of pus in dermis or subcut tissue

Question 17

Define the morphological terms: Wheal, Furuncle, Carbuncle

Answer 17

• Wheal - Transient raised lesion due to dermal oedema
• Furuncle - Staph infection in or around a hair follicle
• Carbuncle - Staph infection around adjacent follicle

Question 18

Define: Excoriation, Lichenification and Scaling

Answer 18

• Excoriation - loss of epidermis following trauma
• Lichenification - well defined roughening of skin with accentuation of skin markings
• Scaling - Flakes of Stratum Corneum

Question 19

Describe three different scar complications

Answer 19

• Atrophic - thinning
• Hypertrophic - Hyperproliferation within wound boundaries
• Keloidal - Hyperproliferation beyond wound boundary

Question 20

Define Ulcer and Fissure

Answer 20

• Ulcer - Loss of dermis and epidermis
• Fissure - Epidermal crack due to excess dryness

Question 21

What is Hypertrichosis?

Answer 21

Non androgen dependent pattern of hair growth

Question 22

Define: Koilonychia, Oncholysis, Pitting

Answer 22

• Koilonychia - Spoon depression of nail plate
• Oncholysis - Separation of distail nail from nail bed (psoriasis, fungal nail function)
• Pitting - Depression in nail plate (psoriasis, eczema)

Question 23

Describe the four different special cells of the skin

Answer 23

• Keratinocytes (protective barrier)
• Langerhans (immunological)
• Melanocytes (protects cell nuclei from UV)
• Merkel Cells (specialised nerve endings for sensation)

Question 24

Describe the four main layers of the epidermis

Answer 24

• Stratum Corneum - Keratin
• Stratum Granulosum
• Stratum Spinosum - Prickle Cell
• Stratum Basale - Actively dividing cells

Question 25

What is the ‘extra’ layer of the epidermis and where is it found?

Answer 25

Stratum Lucidum - Paler compact keratin In areas of ‘thick skin’ (eg soles of feet)

Question 26

Describe the composition of the Dermis

Answer 26

Made collagen/elastin/GAGs Contains immune cells, nerves, lymphatics and blood supply

Question 27

What are the three main types of hair?

Answer 27

• Lanugo - Fine long hair in foetus
• Vellus - Fine short hair on body’s surface
• Terminal - Coarse long hair on scalp/eyebrows/eyelashes

Question 28

What are Sebaceous Glands?

Answer 28

Produce sebum via hair follicles

Lubricates and waterproofs skin

Stimulated by androgens

Question 29

What are Sweat Glands?

State the two types

Answer 29

Innervated by sympathetic nervous system

Eccrine - Universally distributed in skin

Apocrine - located in axilla and genitalia etc and function from puberty onswards

Question 30

Which term best describes the configuration of the following images?

Answer 30

Question 31

How would you describe the colour of the following images?

Answer 31

Question 32

How would you describe the following primary lesions?

Answer 32

Question 33

How would you describe the following secondary lesions?

Answer 33