Derm notes Flashcards by Shubham Agwan

Name 4 appendages of skin

Nails
Hair
Glands
Mucosa

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Name 2 diseases where there is a loss of control of epidermal turnover

Skin cancer

Psoriasis

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In which epidermal layer is the keratinocyte nucleus lost

Granular layer

origin of the cornified envelope

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In which structure in the melanocytes does conversion of tyrosine to melanin take place

Melanosome

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How are full melanosomes transferred to adjacent keratinocytes

Via dendrites

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What is Merkel cell cancer caused by

Viral infection

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What type of hypersensitivity is bullous pemphigoid

Type 2 hypersensitivity

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What are the 4 parts of a hair follicle

External root sheath
Internal root sheath
Cortex
Medulla

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What is sebum made up of and which glands is it secreted from

Squalene, wax esters, triglycerides & free fatty acids

Secreted by sebaceous glands

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What is acute skin failure clinically known as

Toxic Epidermal Necrolysis

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What are 3 structurally important proteins in the keratin layer

Filaggrin
Involucrin
Keratin

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What are the main type of T cells found in the epidermis and the dermis

Epidermis - CD8+ cells

Dermis - CD4 & CD8+ cells

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What types of Th cells are involved in psoriasis and atopic dermatitis

Psoriasis - Th1 & Th17

Atopic Dermatitis - Th2 & Th17

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Where are T cells sensitized

Thymus

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Which T cell type can kill cells directly

CD8+ cells (Cytotoxic)

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What are the two types of dendritic cells in the dermis

Dermal

Plasmacytoid

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What is the difference between dermal and plasmacytoid dendritic cells

Dermal Dc’s involved in antigen presenting

Plasmacytoid Dc’s produce IFN-alpha (found in diseased skin)

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When is an Arthus reaction seen

Skin testing in type 3 hypersensitivity

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What is the scale used to classify the colour of people’s skin

Fitzpatrick scale

Skin types I - VI

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Which Staph species is associated with foreign objects

Staph Epidermidis

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What should you suspect in a female with multi-system involvement and hypotension

Toxic Shock Syndrome

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Give an example of a toxic (non-allergic) reaction

Scombroid Fish toxin

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What are the chemistry related factors which make a drug more likely to cause a drug eruption

High Molecular weight

B-lactam compounds, NSAID’s

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What type of reaction is a Xanthematous drug eruption

Type 4

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How do emollients work

Enhance rehydration of epidermis

How do calcineurin inhibitors work and give an example

Tacrolimus Suppress Lymphocyte activation Can be used topically in eczema

What is the treatment for Pityriasis Versicolor

Ketoconazole

How does Capsaican work and what is it used for

Depletes substance P | used as an anti-pruritic

What is the treatment for genital warts

Podophyllin

What are the 4 treatment options for MRSA

Doxycycline Co- trimoxazole Clindamycin Vancomycin

Which staph. can cause urinary tract infections in women of child-bearing age

Staph Sacrophyticus

What is the treatment for a dermatophyte infection of the scalp (Not clotrimazole)

Terbinafine or Itraconazole Orally

What is Vagabond's disease

Pediculus Corporis (Body Louse)

Which organism which can cause pneumonia can also cause Erythema Multiforme

Mycoplasma Pneumoniae

What is aplastic crisis and which derm disease can cause it

A drop in haemoglobin due to cessation of RBC production | Slapped cheek disease (Parvovirus B19)

How is Lyme disease diagnosed

Antibody blood test

The dermis contains which types of collagen

Type 1 and 3

What is ground substance made up of

Hyaluronic acid & Chondroitin Sulphate

What is the epidermal basement membrane made up of

Laminin & Collagen type 4

Define Hyperkeratosis

Increased thickness of keratin layer

Define Parakeratosis

Persistence of nuclei in keratin layer

Define Acanthosis

Increased thickness of epithelium

Define Papillomatosis

Irregular thickening of epithelium

Define Spongiosis

Oedema fluid between squames

Define psoriasiform disease

Elongation of rete ridges

Define lichenoid disease

Basal layer damage

Define vesiculobullous disease

Blistering

What are Munro micro-abscesses

Complement attracts neutrophils to keratin layer | seen in psoriasis

Which gene is associated with dermatitis herpetiformis

HLA-DQ2

What is rhinophyma

A large red bullous nose

What are the 4 types of itch

Pruritoceptive Neuropathic Neurogenic Psychogenic

What is the Leser-Tralet sign

Eruptive appearance of many lesions | suggests Internal malignancy

What is the pathology of erythema nodosum and what is the treatment

Inflammation of subcutaneous fat | No active treatment

Which class of antibiotics can be implicated with Toxic Epidermal Necrolysis

Penicillins

What is Keratoderma Blenorrhagia and which MSK syndrome is it associated with

Waxy yellow papules on soles of feet | Reiter's syndrome

What is alopecia areata and what is a drug which can be given

Autoimmune hair loss (spots) | Minoxidil

Which GI and endocrine pathologies are associated with acanthosis nigricans

GI malignancies | Type 2 diabetes mellitus

Name a GI disease and an MSK disease which are associated with pyoderma gangrenosum and the treatment for it

Crohn's disease Rheumatoid Arthritis --> Oral steroid

What is a port wine stain and what is the treatment

Flat capillary malformation seen at birth | No treatment

Pearly white papules with a central umbilication | What should you suspect

Molluscum Contagiosum

What is Pityriasis Versicolor and what is the treatment

Infection caused by Malassezia fungus | Ketoconazole shampoo

Which hair growth can chronic malnutrition cause

Lanugo hair

Someone on the pill presents with a central red papule with capillaries, on their upper body What should you suspect

Spider Naevus

What pathology is described as premalignant white hard spots on the mucous membranes of the mouth

Leukoplakia

What are the 1st and 2nd line treatments for psoriasis

Emollient | Topical steroid + Topical Calcipotriol

What is the treatment for moderate and severe Impetigo

Moderate - Topical Fusidic acid | Severe - Oral Flucloxacilin

What is hyperhidrosis and what is the treatment

Excessive sweating | Topical Aluminium Chloride

What is Guttate Psoriasis preceded by

Strep Infection 2-4weeks prior

What do papules with a white lace pattern suggest and what is the treatment

Lichen Planus | Topical steroids

How would you describe the pathology of Bowen's disease

Intra-epidermal squamous cell carcinoma

Why should you immediately admit a child who presents with new onset purpura

To rule out meningococcal disease and acute lymphoblastic leukaemia

Which derm disease tends to spare the nasolabial folds

Acne Rosacea

Which derm disease presents with a Herald patch

Pityriasis Rosea

Which condition is characterised by melanin-stimulating hormone being produced in excess by the pituitary

Nelson's syndrome