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year 2 endocrine - Robbie > Introduction to General Dermatology > Flashcards

Introduction to General Dermatology Flashcards

1
Q

what is the largest organ in the body?

A

skin

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2
Q

the skin contains what adnexal structures?

(the parts adjoining an organ)

A

Hair, nails, glands, sensory structures

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3
Q

what are important roles that skin is involved in?

A

Important role in protection, homeostasis and transmission of sensations

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4
Q

what are the layers of the skin?

A

3 main layers

Epidermis is the outermost layer and made out of keratinocytes

Melanocytes are the cells that make pigment – everyone has same amount of melanocytes but different amount of melanosomes

Have acquired and innate immune system in the epidermis

Next you have junction attaching epidermis to the dermis

Collagen matrix

No blood vessels in the epidermis and all blood vessels in the dermis

Hair follicles

Erector papillae muscle aswell – Goosebumps for temperature control

Epidermis and dermis is different in different places in your body

It changes a you get older and don’t have same collagen and this is why you get pressure sores etc

Fat layer will be different in different places in the body

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5
Q

what are the layers of the epidermis?

A
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6
Q

study this picture showing the anatomy of the nail

A
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7
Q

what are the names of the different stages in the hair cycle?

A

Anagen

Catagen

Telogen

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8
Q

what happens in the anagen stage of the cell cycle?

A

active growing phase

80-90% of hair

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9
Q

what happens in the catagen stage of the cell cycle?

A

2–3 week phase growth stops/follicle shrinks

1–3% of hairs

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10
Q

what happens in the telogen stage of the cell cycle?

A

resting phase for 1–4 months

up to 10% of hairs in a normal scalp

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11
Q

what are the functions of skin?

A

Thermoregulation - Insulation, Heat transfer

Skin immune system - Innate and Adaptive functions

Barrier:

  • Protects against Mechanical, Chemical, microorganisms, Ultraviolet light
  • Keeps in water and Electrolytes, Macromolecules

Sensation - Temperature, touch and pain

Vitamin D synthesis - UV light converts 7-dehydrocholesterol to cholecalciferol

Interpersonal Communication - Physical appearance, smell, self-identity

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12
Q

what are the statistics relating to skin disease?

A
  • 22-30% of Population affected
  • 15% of consultations in general practice
  • 6% of hospital referrals
  • 50% skin cancer/lesions
  • 25% require surgical procedure
  • 10% require patch testing
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13
Q

what percentage of people with a skin problem seek care?

A
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14
Q

Why is skin disease important?

A
  • Disfigurement
  • Discomfort
  • Disability
  • Depression
  • Death
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15
Q

what are the causes of skin disease?

A
  • External - Temperature, UV, chemical (allergen or irritant), infection, trauma
  • Internal - Systemic disease, genetics, drugs, infection
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16
Q

what are external causes of skin disease?

A

Photosensitivity:

  • Commonly caused by medications
  • Exposed sites affected
  • Can be sensitive to UVA, UVB, visible light or a combination of these

Cold Injury:

  • Frostbite, Chilblains
  • Skin Necrosis
  • Cold Urticaria (hives (urticaria) or large red welts form on the skin after exposure to a cold stimulus)

Trauma:

  • Dermatitis Artefacta - condition in which skin lesions are solely produced or inflicted by the patient’s own actions
17
Q

what are internal causes of skin disease?

A

Genetic

Drug reaction:

  • Vary in severity
  • Think of OTC drugs
  • Take a good history!

Autoimmune:

Bullous Pemphigoid (an autoimmune pruritic skin disease preferentially in elderly people, that may involve the formation of blisters (bullae) in the space between the epidermal and dermal skin layers)

18
Q

Describing skin lesions:

what is morphology?

A

Morphology is the appearance of skin lesions

Small usually means less than 5mm

19
Q

Describing skin lesions:

how do you decribe small and large circumscribed area?

A

Macule - Small circumscribed area

Patch - Larger circumscribed area

20
Q

Describing skin lesions:

how do you describe a small and large raised area?

A

Papule - Small raised area

Plaque - Larger Raised

21
Q

Describing skin lesions:

how do you describe if it is small or large fluid filled?

A

Vesicle - Small Fluid filled

Bulla - Large Fluid filled

22
Q

Describing skin lesions:

how do you describe small and large pus filled?

A

Pustule - Small Pus filled

Abscess - Large Pus filled

23
Q

Describing skin lesions:

how do you desribe if it affect the epidermis or dermis?

A

Erosion - Loss of Epidermis

Ulcer - Loss of Epidermis and dermis

24
Q

exmaples of skin conditions:

A
25
Q

more examples of skin conditions:

A
26
Q

what is dermatosis?

A

a disease of the skin, especially one that does not cause inflammation

27
Q

what does the distribution of dermatosis mean?

A

The distribution of a dermatosis refers to how the skin lesions are scattered or spread out

28
Q

Do skin lesions come as just one or multiple?

A

Skin lesions may be isolated (solitary or single) or multiple

29
Q

Do skin diseases have particular distributions?

A

The localisation of multiple lesions in certain regions helps diagnosis, as skin diseases tend to have characteristic distributions

What is the extent of the eruption and its pattern? - localised, generalised, symmetrical etc

30
Q

what are the names of some of the most common skin conditions?

A
31
Q

the skin in general medicine - cutaneous signs are useful in diagnosing many conditions such a what?

Can diagnose other conditions based off skin conditions

Look at bigger picture as don’t want to miss something else

Take a history to find out if it is just a skin condition or something bigger

A

Erythema Nodosum

Sarcoidosis

Vasculitis

Malignancy

Auto-immune conditions

32
Q

what is Acanthosis Nigricans?

A

Associated with insulin resistance, obesity, malignancy

Flexural distribution

Hyperkeratosis and Hyperpigmentation, papules

‘velvety’ appearance

Doesn’t cause problems

May have undiagnosed type 2 diabetes

33
Q

what is Thyroid Skin Disease?

A

Pretibial myxoedema

5% of Graves Disease

Same process as behind eyes – mucinosis

Other skin changes seen in both hyper and hypothyroidism

34
Q

what investigations would be done in dermatology if bacterial infection was suspected?

A
  • Charcoal swab
  • Ask for MC&S
  • Microscopy
  • Culture
  • Sensitivities
35
Q

what investigations would be done in dermatology if viral infections where suspected?

A
  • Viral swab for PCR
  • Can swab vesicle/bulla if vesicular eruption
  • If systemic illness, can take throat swab

e.g. chickenpox

36
Q

what investigations owuld be done in dermatology if fungal infection was suspected?

A
  • Skin scraping
  • Nail clipping
  • Hair sample
  • Fungal cultures
37
Q

what is a simple way to take a skin biopsy?

A

punch biopsy

Take lots of biopsies

Around 4 or 5mm

Good for pathology

year 2 endocrine - Robbie (28 decks)

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