Big Derm Flashcards by Shubham Agwan

What kind of tissue is the epidermis

stratified cellular epithelium

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What is another name for the Prickle Cell Layer

Spinous layer

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What are Blaschko’s lines

Developmental growth of skin (not following nerves, vessels or lymphatics)

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What kind of hormones can be synthesised in the skin

Hormones

e.g testosterone

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How long does it take for a keratinocyte to go from the bottom to the top of the epidermis

28 days

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Which epidermal layer is one cell thick and what shape are the cells

basal layer

cuboidal

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Which epidermal layer is made up of polyhedral cells

Prickle cell (spinous)

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Which layer of the the epidermis is highly metabolically active

Basal layer

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What is the difference in how basal cells and all other cells are connected

All other cells - desmosomes

Basal cells - hemidesmosomes

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What are langerhan’s cells

Antigen presenting cells of the skin

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What structure are Langerhans’ cells characterised by

Birbeck granule

shaped like a tennis racquet

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Which epidermal layer contains lamellar bodies

Granular layer

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What are the mechanoreceptors called and which skin layer are they found in

Merkel cells

Basal layer

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What are the 3 phases of hair growth and what do they mean

Anagen - growing
Catagen - involuting
Telogen - resting

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What is the difference between a nodule and a papule

Nodule - >0.5cm

Papule - <0.5cm

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What does Petechial suggest

pinpoint-sized macule of blood in the skin

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What is a weal

Itchy raised nettle rash due to dermal oedema

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Which glands are the smelly ones and where are they found

Apocrine

Axilla and perineum

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What are the actual sweat glands called

Eccrine

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Causes of Impetigo

Staph Aureus typically

can be strep

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Treatment of impetigo

Flucloxacillin for Staph

penicillin for strep

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How is Impetigo spread

Direct contact

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What colour is Impetigo and where is it found

Weeping, exudative area

honey coloured, typically on face, around mouth

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How does Staphylococcal scalded skin syndrome (SSSS) present

Scald-like skin appearance followed by large flaccid bulla

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What type of Impetigo can cause Staphylococcal scalded skin syndrome (SSSS)

Bullous Impetigo

What is the treatment for Staphylococcal scalded skin syndrome (SSSS)

Flucloxacillin

How can you differentiate between SSSS and TEN (toxic epidermal necrolysis)

Mucosal involvement only occurs in TEN

What are the causes of cellulitis

Beta-haemolytic streptococcus most commonly

Treatment for cellulitis

penicillin and flucloxacillin

Types of Necrotising fascitis and the difference between them

Type 1 - Mixed anaerobes | Type 2 - Strep Pyogenes

Investigation for Parovirus B19

Parovirus B19 IgM test

What is Parovirus B19 also known as

Slapped Cheek syndrome | Erythema Infectiosum

What joint pathology can Parovirus B19 cause

Arthritis

What do monomorphic punched out lesions suggest

Eczema herpeticum

What is the treatment for Eczema Herpeticum

Anti-virals

What is Shingles called after 4 weeks

Post Herpetic Neuralgia

Which types of HPV are associated with cervical cancer

16 & 18

Which types of HPV are associated with genital warts

6 & 11

What is the treatment for Molluscum Contagiosum

Self limiting

What is Orf

Disease of the sheep due to a pox virus infection

What is Tinea cruris

Dermatophyte infection of the groin

What is Tinea pedis

Dermatophyte infection of the foot (Athlete's foot)

What is Tinea manuum

Dermatophyte infection of the palms

What is Tinea unguium

Dermatophyte infection of the nails

What is the treatment for dermatophyte infections

Clotrimazole cream | Topical Anti-fungal

How is scabies spread

Prolonged close contact and sexual contact

What is a pathogmonic sign of scabies

Linear or curved skin burrows

How is scabies diagnosed

Skin scraping

Treatment for scabies

Malathion lotion overnight

What is Norwegian scabies and what sort of people does it affect

Chronic crusted form of scabies | Affects immunosuppressed

What is another name for eczema

Atopic Dermatitis

Which gene is linked to eczema

Filaggrin gene

What immunoglobulin would be seen in skin affected by Eczema

IgE | Atopy

What is the guidance on when to use which strength of steroids on skin

The face should only be treated by mild steroids In young children, the body should be treated with mild and moderately potent steroids Treatment of the palms and soles may require potent or very potent steroids as the skin is much thicker

Where does Sebhorrhoeic Eczema affect the body

Body sites rich in sebaceous glands

What does a "crazy paving pattern" indicate

Asteatotic Eczema

What is Asteatotic Eczema

Dry plate-like cracking of the skin with a red, eczematous component

What should be suspected if the eczema is in an unusual or localised distribution

Allergic or Irritant Contact Dermatitis

What type of hypersensitivity is allergic dermatitis

Type 4 (delayed)

What is Lichen Simplex

Thickened, scaly and hyperpigmented areas of lichenification

What drugs can make psoriasis worse

Lithium Anti-malarials Beta-blockers

What nail changes can accompany psoriasis

Nail Pitting | Onycholysis

What is suggested by "raindrop-like psoriasis"

Guttate Psoriasis

What are the three derm symptoms associated with allergy

Urticaria Angioedema Anaphylaxis

Order of investigations for allergy

``` History Specific IgE (RAST) Skin prick Challenge test Serum mast cell tryptase level (during anaphylaxis) ```

Three cardinal features of acne vulgaris

Comedones Pustules Inflammatory papules

What is the difference between whiteheads and blackheads

Whiteheads are closed from the air | Blackheads are open

What is acne fulminans

Severe necrotic and crusted acne lesions | Requires urgent treatment with oral prednisolone

What is the first line keratolytic used in Acne Vulgaris

Benzoyl peroxide

What topical antibiotics are given for Acne Vulgaris

Erythromycin | Clindamycin

What oral antibiotic can you give for Acne Vulgaris

Tetracycline

Antibiotic given for Acne Rosacea

Topical Metronidazole

Target lesions indicative of

Erythema Multiforme

What is Pyoderma Gangrenosum

Erythematous nodules or pustules that frequently ulcerate

Treatment for Pyoderma Gangrenosum

Very potent topical steroids | Immunosuppressants may be used in resistant cases

What drug other than immunosuppressants can be given for dermatomyositis

Hydroxychloroquine

Which systemic autoimmune disease can cause erythema nodosum

Sarcoidosis

How many cafe-au-lait spots suggest genetic disease

More than 5 | greater than 2.5cm in diameter

What is the inheritance of NF type 1

Autosomal dominant

Ash leaf pigmentation suggests what

Tuberous sclerosis

Which bullous disease has mucosal involvement

Pemphigus Vulgaris

Which is more common out of bullous pemphigus and pemphigoid

Pemphigoid

Which antibody is associated with pemphigus vulgaris

Anti-Desmoglein 3 IgG

Which GI disease is dermatitis herpeformitis associated with

Coeliac Disease

What is another name for a basal cell papilloma

Seborrhoeic keratosis

What are two precursors to squamous cell carcinoma

Bowen's disease | Actinic keratoses

What are the 4 types of malignant melanoma

Lentigo Maligna Superficial Spreading Nodular Acral

Which type of ulcer do you use compression bandaging for

Venous | *not arterial*

What is androgenic alopecia

Male pattern baldness | May occur in females following menopause

What is Alopecia areata

Immune mediated hair loss | Patches of baldness

What is Telogen effluvium

Diffuse hair loss that occurs some 3 months after pregnancy or a severe illness 'Stress' puts all the hairs into the telogen phase of hair shedding at the same time. Hair fully recovers and normal hair cycle resumes within a few months

What is hirsutism

Male pattern hair growth seen in females

What is hypertrichosis

State of excessive hair growth at any site and occurs in both sexes

Which topical therapy contains preservatives

Creams

What does erythematous bullseye lesions suggest

erythema migrans | lyme disease

What does cauliflower appearance suggest

Plantar Warts

Who is affected by Kaposi's sarcoma

HIV Patients | Immunosuppressed Patients

What is fish scale skin

Ichythosis

What does velvety thickened lesions in axillae suggest

Acanthosis nigricans

What protein defect increases risk of eczema, hay fever and asthma

Filaggrin

What kind of hypersensitivity is involved in a skin prick test

Type 1 hypersensitivity

What kind of hypersensitivity is involved in a patch test

Type 4 hypersensitivity

What is sentinel lymph node

Is the first lymph node or group of nodes draining a cancer

What is Ramsay-hunt syndrome

Vesicle and pain in auditory canal and throat | Can result in CN VII palsy, leading to facial drooping

Which skin cells are responsible for Vitamin D metabolism

Keratinocytes

What do Pancinian corpuscles sense

Pressure

What senses vibration in the skin

Meissner's corpuscles

What is acantholysis

lysis of intercellular adhesion sites

Is acantholysis seen in Pemphigus or Pemphigoid

Pemphigus | NOT seen in Pemphigoid