common skin conditions Flashcards by Eilidh Edmiston

what is hyperkeratosis

increased thickness of keratin

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what is parakeratosis

persistence of nuclei in the keratin layer

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what is acanthosis

increased thickness of epithelium

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what is papillmatosis

irregular epithelial thickening

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what is spongosis

oedema between squames, will increase prominence of intercellular prickles

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what is puritus

a unpleasant, poorly localised, non-adapting, sensation that provokes the desire to scratch

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where is the itch sensation processed

parts of the forebrain and hypothalamus

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what are the 4 types of itch, give examples

pruritoceptive = something triggers itch e.g. eczema, dry skin, psorasis

neuropathic = damage to nerves e.g. MS

neurogenic = no evidence of damage to the CNS but it has been affected e.g. opiates

psychogenic = pyschological cause with no CNS damage e.g. delusion

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what is the treatment for itch

determine and treat underlying cause
antihistamine
emollients
antidepressants 
phototherapy
opiate antagonists

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what is the most common type of psoriasis

chronic plaque psoriasis aka psoriasis vulgaris

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describe psoriasis

symmetrical
Commonly affects the extensors, scalp, sacrum, hands, feet, trunk and nails
Sharply demarcated, scaly, erythematous plaques which are reversible

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what are auspitz signs, what condition are they associated with

removal of surface scale reveals tiny bleeding points

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what is the kobner phenomenon

psoriasis develops in areas of skin trauma e.g. scratch marks or scars

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describe nails found in psoriasis

pitting
dystrophy
sublungal hyperkeratosis
onycholysis

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what is the buzzword description for psoriasis

Sharply demarcated, scaly, erythematous plaques which are reversible

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what is psoriasis associated with

arthritis
crohns
cancer
depression
uvetitis
obesity/hypertension/dibetes/lipid abnormalities

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what is the management of psoriasis

emollients = 1st line 
steroid ointments =2nd line
vitamin D analogues
coal tar
dithranol
can combine with phototherapy
last line = systemic treatments

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give examples of vitamin D analogues

Calciptriol

calcitrol

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what is Guttate psoriasis

small lesions over the upper trunk and proximal extremities classically trigged by a bacterial infection usually a URT infection

aka eruptive

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what is palmoplantar pustular psoriasis

chronic condition affecting the soles and palms, can occur without psoriasis

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what is eruthrodemic psoriasis

this is a rare aggressive, inflammatory form of psoriasis. Symptoms include a peeling rash across the entire surface of their body. The rash can itch or burn intensely and it spreads quickly.

aka widespread pustular

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what is acne vulgaris

chronic inflammatory disease of the pilosebaceous unit

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what is the cause of acne (3)

increased androgens at puberty = increased sebum
keratin plugging of pilosebaceous units = blockage
infection with anaerobic bacteria “corynebacteium acnes” = infection

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describe the appearance of acne

Study These Flashcards

relates to sites with the most sebaceous glands
comedones: open = blackheads, closed = whiteheads
pustules, papules, and cysts
erythema
secondary features include:
   scars
   texture change
   hypertrophic changes

what are the gradings of acne

mild, moderate and severe

describe mild acne

scattered papules, pustules and comedones

describe moderate acne

numerous papules, pustules and mild atrophic scarring

describe severe acne

cysts, nodules, and significant scarring

what i the treatment of acne

``` most will spontaneously resolve with time benzoyl peroxide vitamin A derivatives antibiotics (topical or oral) isotrentinoin (oral) ```

what is rosacea

prominent facial flushing exacerbated by sudden change

what commonly affects rosacea

spicy foods alcohol change in temperature

describe rosacea

``` located on chin, cheeks, and forehead papules, pustules but no Comedones erythema = visible blood vessels thickening of skin (rhinophyma) = enlarged, unshapely nose conjunctivitis/gritty eyes ```

what is the management of rosacea

``` reduce aggravating factors metronidazole ivermectin = reduces mite numbers tetracycline (long term) isotretinon at low dose if severe ```

treatment of telangiectasia

vascular laser

treatment of rhinophyma

surgery.laser shaving

what is lichen planus

type of lichenoid eruption which is characterised by damage and infiltration between the epidermis and dermis Itchy, non-infectious rash

describe the appearance of lichen planus

Violaceous (pink/purple), flat-topped shiny papules | Wickham’s striae = fine, lace-like pattern on surface of papules and buccal mucosa

what is the treatment of lichen planus

generally lasts 12-18 months before disappearing on its own | topical or oral steroids

what is vasculitis

group of disorders in which there are inflamed blood vessels

what are the symptoms of vasculitis

wide range: pain sudden onset purpuric rash/pustules necrotic

what is a chronic leg ulcer

open lesion between the knee and the ankle joint that remains unhealed for at least 4 weeks

what are the causes of leg ulcers

``` venous (60-80%) arterial (22%) mixed venous and arterial (10-20%) rheumatoid arthritis (9%) diabetes (5%) ```

describe a venous leg ulcer

lower leg shallow edged shallow base may have other venous pathologies (e.g. varicose veins)

describe a arterial leg ulcer

punched out appearance deep very painful may have other arterial pathologies (e.g. pale, hairless, shiny, cool to the touch)

what are the symptoms of leg ulcers

``` pain leakage smell Lipodermatosclerosis/ hyperpigmentation infection ```

what are the investigations of leg ulcers

``` ABPI bloods patch testing duplex scan swab ```

what would a ABPI tell you

if the ulcer was arterial

what is the normal range for ABPI

what range suggests vascular disease in ABPI

<0.8

what range suggest calcification in ABPI

>1.5

when would you do a patch test for a leg ulcer

if there is associated eczema or an allergy/irritant is suspected

when would you take a swab of an leg ulcer

if infection is suspected

what is the treatment of leg ulcers

``` non-adherent dressing de-sloughing compression application compression stockings leg elevation pain relief ```

what must you consider if normal treatments aren't working with leg ulcers

malignancy

what treatment should be considered for psoriasis of the scalp

greasy ointments tar shampoo steroid shampoo vit D analogues

what treatment should be considered for psoriasis of the axilla

calcineurin inhibitor

what is the buzzword for lichen planus

Irregular sawtooth acanthosis

where does lichen plans typically affect

Typically effect volar wrists/forearms, shins and ankles

what is the histology of lichen planus

Hypergranulosis = thicken granular layer orthohyperkeratosis = hyperkeratosis with no nuclei Band-like upper dermal infiltrate of lymphocytes

common skin conditions Flashcards

covers itch, psoriasis, acne, rosacea, lichen planus (59 cards)