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imed3004 > Inflammatory skin Diseases 2 > Flashcards

Inflammatory skin Diseases 2 Flashcards

1
Q

What is impetigo?

A

A superficial epidermal skin condition.

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2
Q

What is bacterial folliculitis/carbuncles?

A

Infection of hair follicles and sebaceous glands

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3
Q

What is cellulitis?

A

Infection

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4
Q

What are the predisposing factors of impetigo?

A

Minor trauma

Nasal carriage of staph

School and other institutions of close contact with other people

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5
Q

What causes impetigo most commonly?

A

Staph aureus (especially in bullous subtype) but it can also be caused by streptococcus.

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6
Q

What causes staphylococcal scalded skin?

A

The exfoliative toxins produced by staphylococcus

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7
Q

What are the types of impetigo?

A

Common impetigo (school sores, thin walled vesicles or pustules that rupture to form a thick golden crust, can be solitary or clustered)

Bullous impetigo (erosions and flaccid bullae, caused by an exotoxin which results in keratinocytes falling apart and blister formation)

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8
Q

What does histology look like with impetigo?

A

Subcorneal collection of neutrophils

Can see more neutrophils migrating upwards through the epidermis

Surface crust of serum and dying neutrophils

May see bacterial colonies

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9
Q

Which part of the hair follicle is affected most commonly by folliculitis?

A

Superficial part of the hair follicle (infundibulum)

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10
Q

What kinds of infection cause superficial folliculitis?

A

Can be bacterial (staph)

Can be fungal or viral

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11
Q

What is characteristic histopathology of superficial folliculitis?

A

Neutrophils in infundibulum

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12
Q

What is pseudofolliculitis?

A

Inflammation of follicles caused by trauma and other non-infectious causes (eg shaving and waxing or a drug reaction)

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13
Q

What is a furuncle?

A

A deep infectious inflammatory process within pilosebaceous unit. It is often caused by staphylococcus aureus

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14
Q

What does a furuncle look like?

A

It begins as a painful papule with surrounding erythema and swelling, center becomes soft, yellow and may discharge pus

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15
Q

What is a carbuncle?

A

Coalescence of several furuncles

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16
Q

What are the histological features of furuncles?

A

Deep dermal abscess centered around a hair follicle with lots of neutrophils.

Surrounding inflammation bay extend to deeper tissues

Surface often shows a crust of serum and dying neutrophils

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17
Q

What are eryspiles/cellulitis?

A

An acute inflammatory process within the dermis which is usually caused by streptococcus pyogenes

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18
Q

What do erysipelas/cellulitis look like?

A

Oedematous, tender, hot, well demarcated red plaques. As well as expanding area of erythema.

Most commonly affects face, feet, hands, and lower limbs

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19
Q

Which bacteria most commonly cause erysipelas/cellulitis?

A

Streptococcus pyogenes

20
Q

What are the predisposing factors of erysipelas and cellulitis?

A

Minor trauma/breaks in the skin

Peripheral vascular disease

Diabetes

Lymphoedema

Immune suppression

Obesity

Alcohol abuse

Previous infection at same site (frequently occurs at same site)

21
Q

What does histology show in people with cellulitis and erysipelas?

A

Dermal oedema and lymphatic dilatation.

Diffuse infiltrate of neutrophils

22
Q

What is staphylococcal scalded skin syndrome?

A

Blistering disorder caused by staph aureus exotoxins.

23
Q

How does staph cause SSS?

A

Blisters are produced by exotoxins produced elsewhere that are transported to the skin where they cause blister formation. There are no bacteria in the blisters typically.

24
Q

What causes superficial fungal infections?

A

Dermatophytes:

Microsporum

Epidermophyton

Trichophyton

25
Q

What is dermatophyte infection named by?

A

Location of infection:

Tinea corporis (body)

Tinea capitis (head)

Tinea cruris (groin)

26
Q

What does histology of dermatophyte infection look like?

A

Fungi in stratum corneum

Looks like spongiotic reaction

27
Q

What are the clinical types of HPV infection?

A

Many different types:

Verruca vulgaris (classic wart)

Verruca plana (flat warts)

Verruca plantaris (sole of the foot and persist and are painful)

Condyloma acuminatum

28
Q

What is the outcome of most HPV infections?

A

Usually the warts regress

29
Q

What does histology show about HPV infections?

A

Compact corneum

Papillomatosis curving inward

Vacuolated keratinocytes

30
Q

What is molluscum?

A

Infection with pox virus causing lesions called umbilicated papules

31
Q

Who does herpes simplex commonly infect?

A

Primary infection is oral in childhood by HSV1

Genital infections in young adults and by HSV2

32
Q

What happens in subsequent infections with herpes simplex?

A

Subsequent episodes tend to be less severe

33
Q

What does histology show with herpes simplex?

A

Multinucleated giant cells

Campolytic vesicles

Peripheral marginalisation of keratinocytes

Moulding

Necrosis of epithelium

Neutrophil infiltration

34
Q

What infection does varicella zoster cause?

A

Chicken pox

35
Q

How does varicella zoster reactivate?

A

In a dermatomal distribution (shingles)

36
Q

What is scabies?

A

Infestation with sarcoptes scabiei (mite infection)

37
Q

Who is scabies most common in?

A

Children

Elderly

Crowding and poor living conditions

38
Q

What are the symptoms of scabies?

A

Very itchy rash that is worse at night

2 patterns of lesions:

Burrows or a generalized rash

39
Q

How is scabies confirmed?

A

Potassium hydroxide on a skin scrape from a lesion would allow visualization of mites.

40
Q

What does histology show of scabies?

A

The mites

Hyperkeratosis

Scybala (mite poo)

Eosinophil rich

41
Q

What is acne vulgaris?

A

An inflammatory disorder of the pilosebaceous unit (aka Pimples)

42
Q

What are the lesions that make up acne?

A

Variable and include:

Comedones

Papules

Pustules

Cysts

Sinuses

Scars

43
Q

What are comedones?

A

Comedones are widened hair follicles which are filled with keratin, other debris, bacteria and sebum

44
Q

What are closed and open comedones called?

A

Closed = whiteheads

Open = blackheads

45
Q

What causes acne vulgaris?

A

4 inter-related factors:

Abnormal follicular keratinisation with retention of keratin within the follicle

Increased sebum production (androgens)

Presence of bacteria (propionibacterium acnes)

Inflammation

46
Q

How does acne form?

A

Ongoing dilation of comedo leads to wall of follicle becoming very thin until it ruptures.

The keratin, sebum and bacteria incite an acute inflammatory response

First neutrophils invade and then granulomatous inflammation and fibrosis occur and this focus enlarges into an abscess.

47
Q

What are the types of cutaneous drug reactions?

A

Not too bad:

Morbilliform (aka exanthematous)

Can be pretty bad:

DRESS (Drug reaction with Eosinophilia and Systemic Symptoms)

SJS/TEN (Stevens Johnson Syndrome/Toxic Epidermal Necrolysis)

imed3004 (50 decks)

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