W6: Skin & Temp, Pharmacol., Skin Infections etc

Question 1

Skin structure

Answer 1

EPIDERMIS:

s. corneum
s. lucidum
s. granulosum
s. spinosum
s. basale

DERMIS: vascl, + muscles

Subcut. tissue: fat

Question 2

Flat circumscribed areas

Answer 2

Macule / Patch

Question 3

Raised areas

Answer 3

Papule / Plaque

Question 4

Palpable lesions

Answer 4

Nodule

Question 5

Fluid filled lesions

Answer 5

Vesicle / Bullae

Question 6

Pus filled lesions

Answer 6

Pustule / Abscess

Question 7

Loss of epidermis + dermis

Answer 7

Erosion / Ulcer

Question 8

Investigations

Answer 8

Charcoal swab - bacteria=> microscopy, culture

Viral Swab - PCR, throat swabs, eruptions,

Punch biopsy

Fungal scrapings - mycology

Question 9

Systemic treatments

Answer 9

ImmSupp

RETINOIDS: vit A analogues, normalise keratinocyte funct., anti-inflamm + antiCa
!monitor LFT and triglycerides

BIOLOGICS

Question 10

Skin Infections (Bacterial)

Answer 10

IMPETIGO: children, s. aureus, s. pyogenes; bullae
=> topical *fusidic acid etc.), Abx oral fluclox, erythromycin

ERSIPELAS:

CELLULITIS: “”,
=> IV Fluclox + benzylpenicillin
> Severe orbital cellulitis
OEDEMA, BLISTERS: erythemous, lower leg bilateral

LIPODERMATOSCLEROSIS: poor circulation, acute, bilateral, venous dis.
=> Tx venous disease + topical steroids

Question 11

Skin Infection (Fungal)

Answer 11

TINEA (dermatophyte)
unilateral
=> terbinafine, clotrimazole, oral antifungal
> tinea manum, capitis, cruris, corporis

CANDIDIASIS
- flexures
-pustules 
=> nysastatin
=> emollient

Question 12

Skin Infection (Viral)

Answer 12

VIRAL WARTS: hpv, children imm suppr.
=> cyrotherapy
=> wart paints }stimulate imm system

MOLLUSCUM CONTAGIOSUM: self-resolve, DNA pox virus
=> potassium hydrochloride: stim imm system

HERPES SIMPLEX: HSV1 + HSV2
herpres herpeticum: crusted, monomorphic, erosion+vesicles
=> ACICLOVIR
*herpes zooster, crusted papules + vesicles 2º dermatological reactivation = shingles

Question 13

Skin infestations

Answer 13

Hx: backpacking, hostels, camp, nursing homes

*bilateral webspaces genital, feet+ankle; faecal matter = irritation = crusted scabies (imm suprr.)

=>Permethrin
=> household/contacts