Body Parts Connected to the Skin Flashcards

(58 cards)

1
Q

How many telangiectasia on the body are considered to be pathological?

A

More than 5

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2
Q

If you see multiple Telangiectasia around the mouth, what condition should you consider?

A

Osler Weber Rendu

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3
Q

In what conditions do multiple telangiectasia appear?

A
  • Liver disease
  • Rheuamtoid Arthritis
  • Pregnancy
  • Various Drugs (COCP)
  • Post Radiation
  • Connective Tissue Disease (Systemic Sclerosis)
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4
Q

What are some viral causes of oral lesions?

A
  • Herpes Simplex 1 & 2 - grouped vesicles.
    • Gingivostomatitis
  • Chicken pox
  • Measles - Koplik spots
  • Coxsackie Viruses - mouth ulcers - herpangina
  • Hand Foot and Mouth - greyish mouth ulcers.
      • fever, lymphadenopathy and malise
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5
Q

This child had a sore mouth, bad breath, pain on swallowing and swollen gums.

What is this?

A

Gingivostomatitis due to HSV

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6
Q

What is this?

A

Herpangina

Usually due to coxackie virus.

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7
Q

What are these?

A

Koplik Spots

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8
Q

What is this and what are some causes of it?

A

Cheilitis

  • Atopic eczema
  • Irritant dermatitis (usually from saliva)
  • Contact dermatitis
  • Nutritional deficiencies (especially Vit C and Zinc deficiency)
  • Drug-induced cheilitis
  • Angular cheilitis
  • Actinic cheilitis
  • Granulomatous cheilitis
  • Trauma
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9
Q

In younger patients, what is the main cause of angular cheilitis?

A

Irritant contac with saliva or licking of lips

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10
Q

In older patients, what is the main cause of angular cheilitis?

A

Poorly fitting dentures.

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11
Q

If a patient has angular cheilitis, what should also be considered?

A

Secondary infection with Staph or candida.

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12
Q

What nutritional deficiencies can cause angular cheilitis?

A

Vitamin C and Zinc

(Most commonly caused by alcoholism and eating disorders)

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13
Q

What is the treatment for angular cheilitis?

A
  1. Mild to moderate topical steroid +/- antibiotic/ antifungal.
  2. Once resolved, give soft white paraffin to maintain control.
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14
Q

What are the 2 main causes of contact dermatitis on the lips?

A
  1. Agents put directly on the lips (lipstick, mouthwashes)
  2. Agents transferred to the lips fom the hands (e.g nail varnish)
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15
Q

What is this and what is the management for this?

A

Acitinic Cheilitis

  • Ablative therapy -e.g. cryotherapy; curettage and cautery; shave cautery
  • Topical agents -e.g. 5-fluorouracil (Efudix) or Imiquimod cream (Aldara)
  • Daily use of a high factor sunscreen for the lips
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16
Q

What is this and what is the treatment?

A

SCC of the lip

Excision.

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17
Q

This patient has Granulomatous Cheilitis.

What diseases is it associated with?

What investigations should be done?

A
  • Crohn’s disease
  • Sarcoidosis
  • Chronic Contact Dermatitis due to dental materials such as cinnamates.

Investigations

  • Biopsy
  • Chest X-Ray
  • Bowel investigations for crohns
  • Patch Testing.
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18
Q

What syndrome can granulomatous cheilitis be associated with?

A

Melkerson-Rosenthal Syndrome

  • Tongue swelling (Scrotal tongue)
  • Recurrent facial palsy

Usually idiopathic or associated with the aforementioned conditions on the other card.

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19
Q

What is the treatment for Granulomatous Cheilitis?

A
  • Topical steroids (usually moderately potent is enough)
  • Intralesional steroids (be careful of skin atrophy)
  • Oral immunomodulatory drugs (rarely needed)
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20
Q

What is the treatment for an apthous ulcer?

A
  • Hydrocortisone buccal tablets.
  • Chlorhexidine mouthwash.
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21
Q

What rare conditions can cause oral ulcers to form?

A
  • Behçet’s disease
  • Drugs
  • Irradiation
  • Blistering disorders
  • Systemic diseases (Crohn’s disease)
  • Metabolic deficiency diseases (vitamin C deficiency i.e. scurvy, zinc deficiency)
  • connective tissue disorders (e.g. SLE)
  • HIV
  • Other viral illnesses.
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22
Q

What is the treatment approach to apthous ulcers?

A
  • Exclude systemic disease - 10% of Crohn’s patients have recurrent apthous ulcers.
  • Exclude infection - herpes etc.
  • Advice good oral hygeine
  • Symptomatic treatment - hydrocortisone buccal tablets and chlorhexidine mouthwash.
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23
Q

What are the features of Behcet’s Syndrome?

A

Triad of:

  1. Recurrent oral ulcers
  2. Genital ulcers
  3. Uveitis
  • Other features include: arthropathy, meningo-encephalitis, colitis, neuropathies, vasculitis.
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24
Q

What test is indicative of Behcet’s disease?

A

Pathergy test - pustules at the site of venepuncture.

25
What are the causes of Behcet's Disease?
* It is **generally not known**. * **Genetic** link to **HLA B51** * **Correlated** with **Streptococcal infection** * Considered an **auto-inflammatory disorder.**
26
What ethnic group is Behcet's disease more common in?
Eastern Mediterranean and Middle Eastern.
27
What is the management of Behcet's Disease?
* **Apthous Ulcers** - treat. * **Resistant disease** - consider Prednisolone, Colchicine, Dapsone, Sulfasalazine.
28
**Which of the two will affect the oral mucosa?** Bullous Pemphigoid or Pemphigus Vulgaris?
Pemphigus Vulgaris
29
What is this? What malignancy is it associated with?
* **Paraneoplastic pemphigus** - severe and painful oral ulcerations of the lips and lateral borders of the tongue. * Associated with **B Cell Lymphoproliferative** disorders.
30
What condition is this?
Oral Lichen Planus
31
What % of patients with generalised LP have intraoral LP?
1-2%
32
Oral Lichen Planus is usually a clinical diagnosis. But what can be done if you are unsure?
A biopsy
33
What is the treatment for oral lichen planus?
Same as aphthous ulcers.
34
What is a potential problem for people with oral lichen planus?
1-5% will develop oral LP (It is more common with the erosive form)
35
What are some causes of gingival hyperplasia?
* Crohn’s disease * Pregnancy * Scurvy * Drugs * Phenytoin * Cyclosporin * Nifedipine * Myeloma.
36
What is perifolicular hyperplasia associated with?
Scurvy
37
How is atopic or contact exczema of the eyelids treated?
* Mild topical steroids. * Pimecrolimus or Tacrolimus can also be used.
38
What conditions cause thinnning of the eybrows?
* Hypothyroidism * Foolicular mucinosis * Secondary Syphilis * Leprosy
39
What conditions can cause loss of the eyebrows?
* Seborrhoeic dermatitis * Discoid lupus erythematosus
40
What can cause periorbital swelling?
* **Local** * Eyelid infections * Contact dermatitis * Orbital tumours * Chalazion (granulomatous reaction in a Meibomian gland). * **Systemic** * Angio-oedema * Dermatomyositis * Renal disease * Cardiac failure * Thyroid disease * Superior vena caval syndrome * Bacterial, viral or parasitic/protozoal infections.
41
What is this?
Syringiomas | (A Form of benign lesion)
42
What are these?
Milia
43
What is the most common form of cancer around the eye?
BCC (70% of malignant eyelid tumours are BCCs)
44
What are some postoperative problems of BCC eyelid surgery?
* Tear flow problems * Recurrent infections * Local Reocurrence of the tumour is common.
45
What is this?
Sebaceous carcinoma of the lower eyelid. it can mimic a chalazion.
46
What is this?
BCC of the lower eyelid
47
Bleparitis is associated with what condition?
Seborrheic dermatitis
48
90% of oral cancers are what type of cancer?
Squamous Cell Carcinomas
49
What oral areas are most commonly affected?
The Lips (30%) The Tongue (25%)
50
How do intra-oral neoplasia usually present?
* Persistent **erythroplasia** * Persistent **ulceration** especially with fissuring or raised margins * **Persistent lump** * Fixed **induration** * **Leukoplakia** * Unexplained **local lymphadenopathy**.
51
What are the causes of intra-oral neoplasia?
* **Smoking** * **Chewing tobacco** * **Alcohol** * Poor **oral hygeine**. * **Chronic inflammation** from **Lichen planus** * **Rare: Plummer-Vinson Syndrome**
52
What is this and what should you do?
This is leukoplakia. It needs to be biopsied.
53
What is this?
**Oral hairy leukoplakia** * Caused by the **Epstein**-**Barr virus** * Common in **HIV patients** if poorly controlled.
54
What is this?
Chondrodermatitis nodularis Helicis
55
Who is CNH (Condrodermatitis nodularis helicis) more common in?
Middle-aged or elderly patients
56
What causes CNH/
It is a form of pressure sore It is commonly misdiagnosed as a BCC, SCC or SK.
57
What are the treatment options for CNH?
* Topical steroids * Cryotherapy * Excision of the nodule and a portion of the inflammed cartilage.
58
What can commonly cause contact dermatitis in the ear?
* Hair products * Plastic or rubber ear appliances * Objects used to blean the ear (hairpins, matches) * Topical medication * Neomycin * Propylene glycol.