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Derm Flashcards

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1
Q

Main cell type in epidermis

A

Keratinocytes

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2
Q

Epidermis layers

A 
Stratum:
Germinativum
Spinosum
Granulosum
Lucidum(palms/soles)
Corneum
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3
Q

What is the dermis mainly made of

A

Collagen(fibroblasts)

Immune cells

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4
Q

Afferent nerves

A

Merkel cell(epidermis): light touch, pressure

Meissner’s corpuscle: light touch, vibration
Ruffini corpuscle: stretch
Pacinian corpuscle: pressure/vibration

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5
Q

Psoriasis pathology

A

Chronic, immune-mediated

Stressed keratinocytes release DNA
Immune complexes form
Cytokine release
Inflammation

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6
Q

Psoriasis symptoms

A

Extensor surface erythematous plaques

Psoriatic arthritis

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7
Q

Psoriasis management

A

Vit D analogues
Topical corticosteroids
Phototherapy

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8
Q

Atopic eczema pathology

A

Intensely pruritic chronic inflammation

Impaired protection against microbes

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9
Q

Eczema symptoms

A

Flexor surface erythematous plaques that itch

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10
Q

Eczema management

A

Emollients
Topical corticosteroids
Phototherapy
Biological therapy

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11
Q

Lupus skin symptoms

A

Red scaly patches

Butterfly rash on face

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12
Q

What to do if an infant has red rash

A

Test ECG in case infant has neonatal lupus(50% have heart block)

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13
Q

Dermatomyositis skin symptoms

A

Photodistributed rash:
Heliotrope rash(eyes)
Shawl sign(upper chest)
Gottron’s papules

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14
Q

Dermatomyositis antibodies

A

Anti-p155: malignancy

Anti-MDA5: digital ulcers->interstitial lung disease

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15
Q

Dermatomyositis investigations

A

Antinuclear antibodies
Creatinine kinase
LFT: ALT raised
Biopsy

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16
Q

Vasculitis presentations

A

GI bleed
Abdominal pain
Macular purpura

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17
Q

What is sarcoidosis and features

A

Granulomas, commonly lungs
Highly variable presentation
Diagnosis of exclusion
Lupus pernio

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18
Q

Graft vs host disease symptoms

A

Face involvement
Acral involvement
Diarrhoea

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19
Q

DRESS syndrome/SJSTEN causes

A

Antibiotics
Anticonvulsants
NSAIDs

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20
Q

DRESS syndrome presentations

A

Head/neck oedema
Rash
Fever
Lymphadenopathy

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21
Q

Result of itching

A

Nodular prurigo

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22
Q

Causes of itch without rash

A 
Uraemia
Cholestasis
Iron deficiency/overload
HIV
Cancer
Drugs
Psychogenic
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23
Q

Scurvy presentations

A

Spongy gingivae
Corkscrew hair
Petechiae

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24
Q

Kwashiorkor presentations

A

Hepatomegaly
Loss of muscle mass
Soft, thin nails

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25
Vit B3 deficiency presentations
Photodistributed erythema | Casal’s necklace
26
Steven-Johnson-Syndrome/Toxic Epidermal Necrolysis classification
BSA detachment: <10% -> SJS 10-30% -> SJS/TEN >30% -> TEN
27
SJSTEN pathology
Emergency | Flu like symptoms followed by skin lesions->blisters emerge->skin detaches
28
CKD cutaneous presentations
Prurigo Xerosis(dryness) Half and half nails Calciphylaxis
29
Liver disease presentations(derm)
Jaundice Muerhcke’s lines(nails) Terry’s nails Clubbing
30
S. Aures infections
``` Folliculitis Cellulitis Impetiginisation SSSS, toxic shock syndrome Blistering distal dactylitis Erysipelas Necrotising fasciitis ```
31
S. Pyogenes infections
``` Cellulitis Ecthyma Blistering distal dactylitis Erysipelas Scarlet fever Necrotising fasciitis ```
32
Pseudomonas aeruginosa infections
Folliculitis | Ecthyma gangrenosum
33
Animal-related infections
Erysipeloid: raw fish/meat Borreliosis(Lyme): tick bite Tularaemia: handling animals, tick/deerfly bites
34
What is a carbuncle
Furuncle(deep follicular abscess) affecting adjacent follicles
35
Which part of skin affected in cellulitis
Lower dermis and subcutaneous tissue
36
Oedema causing infections
Cellulitis | Erysipeloid
37
Necrotising fasciitis management
Prompt diagnosis Broad spectrum antibiotics and surgical debridement Blood/tissue culture
38
Borreliosis presentations
1-30 days: fever, headache, secondary lesion | Neuroborreliosis: facial palsy, aseptic meningitis
39
Syphilis primary presentation and treatment
Chancre: painless ulcer, firm border | Painless lymphadenopathy
40
Syphilis progression
Secondary: Malaise, fever, pruritus Lues maligna(if immunosuppressed) Tertiary: Gumma skin lesions Neurosyphilis
41
Leprosy types
Lepromatous leprosy: multiple lesions, sensation&sweating normal Tuberculoid leprosy: few lesions, anhidrotic&numb
42
Herpes simplex virus types
HSV-1: saliva and secretions | HSV-2: sexual contact
43
HSV presentations
Burning/tingling-> urinary retention Lymphadenopathy, malaise Painful vesicles on erythematous base
44
What is roseola infantum
6th disease HHV6 Commonly children
45
Most common fungal infection
Trichophyton rubrum
46
Scabies presentations
Flesh-coloured pruritic papules | Burrow of fine white scale
47
Types of lice
Head louse: pediculous humanus capitis Body louse: pediculous humanus corporis Pubic louse: crabs
48
Infestation treatment
Permethrin | Ivermectin
49
Melanoma pathology
``` Most common skin cancer Melanocyte malignancy MAPK pathway CDKN2A loss of function CTLA-4 inhibits costimulatory signal for CD8 T cell to kill tumour cell ```
50
Melanoma subtypes
Superficial spreading: horizontal&vertical Nodular: only vertical growth Lentigo maligna: commonly face Acral lentiginous: commonly palms/soles
51
Melanoma diagnosis(ABCDE)
``` A: asymmetry B: border irregularity C: colour variation D: diameter >5mm E: evolving ```
52
Melanoma management and major prognostic factor for metastasis
Primary excision, 2mm peripheral margin Sentinel lymph node biopsy LDH: major prognostic factor(metastasis) Immunotherapy: CTLA-4 or PDL-1 inhibition Oncogene: BRAF or MAPK inhibition
53
Types of keratinocyte dysplasia
Basal cell carcinoma Squamous cell carcinoma Actinic keratoses Bowen’s disease
54
Basal cell carcinoma pathology
Loss of function mutation->sonic hedgehog signalling pathway p53 mutation Almost never metastasises
55
Basal cell carcinoma treatment
Standard excision Radiotherapy Vismodegib->inhibits SHH pathway
56
Squamous cell carcinoma features
CDKN2A, p53 mutations | Rapidly growing
57
Squamous cell carcinoma treatment
Excision | Radiotherapy
58
Keratoacanthoma
Rapidly growing papule that resolves after months Neck snd sun exposed areas Difficult to distinguish from SCC
59
Types of cutaneous T cell lymphoma
Mycosis fungoides Sezary syndrome
60
Mycosis fungoides features and treatment
Common Takes years to diagnose Topical corticosteroids, phototherapy, radiotherapy Chemotherapy if advanced
61
Sezary syndrome triad of symptoms and treatment
Triad of: erythroderma, generalised lymphadenopathy, neoplastic T cells Extracorporeal photophoresis Topical corticosteroids
62
Kaposi sarcoma virus
HHV8
63
Merkel cell carcinoma virus and treatment
Polyomavirus Treat with surgery, radiotherapy Anti PDL1
64
PVL S. Aureus features
Painful More than 1 site Recurrent Present in close contacts Higher morbidity, mortality, transmissibility
65
Viral infections derm
``` HSV Varicella zoster virus HFMD(coxsackievirus) Erythema infectiosum(parvovirus B19) Rosella infantum(6th disease) Orf(parapoxvirus sheep/goats) Warts(HPV) ```
66
Sarcoidosis
Systemic granulomatous disorder(lungs common) Diagnosis of exclusion Lupus pernio
67
Carcinoid syndrome
Metastasis of malignant carcinoid tumour Flushing, wheezing, diarrhoea, dizziness 5-HT secretion

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