CP 63 - inflammatory skin diseases Flashcards Preview

Skin Pathology > CP 63 - inflammatory skin diseases > Flashcards

Flashcards in CP 63 - inflammatory skin diseases Deck (71):
1

what the 2 types of chlamydia

a] Trachoma is a tropical disease which infects the corneum and conjuctiva. Common cause of blindness.

b] Mild disease due to Chlamidia types d-k, aquired during birth from infection in genital tract

2

what can cause retina infections

toxoplasma - cat poo
toxocara canis - dog poo

3

what is macular degeneration

Damage to macule, the central part of vision.

-dry - age related
-wet - new vessel growth beneath retina

4

what can cause cataracts

senil degeneration
rubella
down's syndrome
irradiation
Diabetes
Uveitis

5

what conditions can happen in the retina?

ischaemia
hypertensive retinopathy
diabetic retinopathy

6

what tumours can arise from the retina?

retinoblastoma - genetic, occurs in retina,

Melanoma - arise from melanocytes of Uveal tract (Iris, ciliary body or choroid)

7

what is leprosy?

chronic granulomatous infection which can involves nerves, loss of sensation

8

what causes leprosy?

mycobacterium leprae

9

what are some of the common fungal infections

ringworm - tinia pedis (athelete's foot), tinea cruris (groins) - infectiob by trichophuton species

trush - candida infection

10

what is another name for eczema?

dermatitis

11

what are the 3 clinical stages of dermatitis

1 - acute dermatitis (skin red, weeping serous exudate +/- small vesicles.)

2- subacute dermatitis (skin is red, less exudate, itching ++, crusting.)

3 - chronic dermatitis (skin thick and leathery secondary to scratching)

12

what are the microscopy of the different stages of dermatitis

1 - spongiosis (intercellular oedema within epidermis)

2 - Chronic inflammation - predominantly superficial dermis.

3 - Epidermal hyperplasia and hyperkeratosis - mild in acute dermatitis, marked in chronic dermatitis

13

what can atopic eczema be associate with?

asthma and hay fever

14

what kind of reaction id eczema?

type 1 hypersensitivity to allegen

15

what is contact irritant dermatitis

direct injury to skin by irritant, eg acid, alkali, strong detergent, etc

16

what is contact allergic dermatitis

- nickel, dyes, rubber. Act as haptens which combine with epidermal protein to become immunogenic.

17

what is seborrhoeic dermatitis ?

affect areas rich in sebaceous glands: scalp, forehead, upper chest

18

what is nummular dermatitis

coin shaped lesions

19

what is psoriasis?

well defined, red oval plaques on extensor surfaces - knee elbows, sacrum

fine silvery scale, Auspitz sign

20

what is the distinct psoriasiform hyperplasia

regular elongated club shaped rete ridges

thinning of epidermis over dermal papillae

parakeratotic scale

collections of neutrophils in scale

21

what is the pathogenesis of psoriasis

massive cell turnover

22

what is the aetiology of psoriasis

problems in the MHC on chromosome 6p2 (same area involved in other autoimmune disorder)

required environmental trigger factors

23

what does patients with psoriasis have increased risk of?

non-melanoma skin cancer

24

what types of different lupus erythmatosus are there?

discoid - skin only
systemic - visceral disease +/- skins

25

how is lupus erythematosus present clinically?

Red scaly patches on sun-exposed skin +/- scarring, scalp involvement causes alopecia

26

what would butterfly rash on cheek and nose indicate?

SLE

27

what sort of condition is lupus erythematosus

Auto-immune disorder primarily affecting connective tissues of the body

28

what are the microscopical feature of lupus erythematosus

thin atrophic epidermis, . Inflammation and destruction of adnexal structures.

LE band - IgG deposit in basement membrane

29

what are presentation of dermatomyositis

peri-ocular odema and erythema (heliotropic rash)

30

what does dermatomyositis indicate in some population?

In adults 25% associated with underlying visceral cancer

31

what does the bullous disease

Formation of fluid filled blisters

32

what does intra-epidermal bulla represent?

pemphigus

33

what does sub-epidermal bulla represent?

pemphigoid

34

what is pemphigus

Group of disorders characterised by loss of cohesion between keratinocytes resulting in an intraepidermal blister.

35

how does pemphigus manifest?

Autoantibodies, directed against intercellular material

36

how does bullous pemphigoid manifest?

Autoantibodies to glycoprotein in basement membrane.

37

what is deematitis herpetiformis

Small intensely itchy blisters. Extensor surfaces

38

what can dermatitis herpetiformis indicate?

coeliac disease

39

what is acanthosis nigricans

darty warty lesions in armpits

40

what can acanthosis nigricans indicate

internal malignancy

41

what can xanthoma indicate

hyperlipaemis

42

what can porphyria indicate

problem with production of haem

43

what can porphyria be presented?

acute abdo pain, psycho problem, peripheral neuropathy, urine goes dark on light exposure

44

what is the most common form of porphyria?

porphyria cutanea tarda

45

what can cause porphyria cutanea tarda

20% FH, 80% acquired through Hep C

46

what is the most common malignant skin tumour?

basel cell carcinoma

47

aetiology for BCC?

sun exposed site (face), occasionally radiotherapy

48

what are some of the clinical presentation for BCC?

early - nodule, late - ulcer
microscopically - tumour composed of islands of basaloid cells with peripheral palisade

49

what can cause squamous cell carcinoma?

UV irradiation (sun exposed)
radiotherapy - treatment of melonoma
chemical exposure - tars, mineral oils
chronic scars/ulcers
immunosuppression - renal transplant patients at increased risk
drugs (new drugs for melanoma)

50

what are some of the clinical presentation of SCC?

Nodule with ulcerated, crusted surface

51

is SCC particularly invasive

no really (still more invasive for BCC) -

52

what is actinic keratosis

dry scaly patches of skin caused by damage from years of sun exposure - patches can be pink brown in colour

pre-malignant disease of SCC

53

what is the cause of actinic keratosis

dysplasia to squamous epithelium

54

what is the function of melanocytes

to form melanin which is transferred to epidermal cells to protect the nucleus from UV radiation

55

what are the benign tumour arise from melanocytes?

naevi (moles)

56

what are the malignant tumour arise from melanocytes?

melanoma

57

what is naevi?

local benign collections of melanocytes

58

what is naevus syndrome

families with increased incidence of melanoma, multiple clinically atypical moles, increased risk of developing melanoma

59

what is the acronym for identifying naevus and melanoma

melanoma -

asymmetrical
borders uneven
colour variation
diameter >6mm

60

what is the causes of melanoma

sun exposure (especially short intermittent severe exposure)

race - celtic with red hair
FH - dysplastic naevus syndrome

61

what is lentigo maligna

elderly ppl have face patches which is slow growing, flat, pigmented patches

62

what is the microscopic feature of lentigo maligna

Proliferation of atypical melanocytes along basal layer of epidermis. Skin also shows signs of chronic sun damage.

63

will lentigo maligna become invasive?

might do later on in the disease, melanocytes may invade dermis with potential to metastasis

64

where does acral lentigenous melanoma affect the most?

palms and soles, occasionally subungula

65

which race is acral lentigenous melanoma affect the greatest?

afro-caribbeans

66

what is the superficial spreading melanoma

commonest type in Britain

67

where does superficial spreading melanoma

Early: flat macule. Late: blue/black nodule

68

what is nodular melanoma

Starts as pigmented nodule. +/- ulceration. Poor prognosis.

69

what is the microscopic features of nodular melanoms

invasive atypical melanocytes invade dermis to produce nodules of tumour cells

70

what is breslow thickness

measure on microscope from granular layer of epidermis to base of tumour

71

what is the treatment of melanoma

surgery
BRAF inhibitors 60% melanoma have mutation in b-raf gene