Dermatology

Question 1

HSV 1 causes

Answer 1

primary herpes simplex(herpetic gingovstomatitis)

Question 2

HSV.1 causes what in choldren

Answer 2

gingivostomatitis

Question 3

signs and symptoms of HSV1

Answer 3

• often asymptomatic or very mild in presentation
• fever, restlessness and excessive dribbling
• drinking and eating painful
• halitosis
• gingiva red swollen and bleed easily
• white vesicles rupture to form ulcers on the tongue, throat palate and inside the cheeks
• local lymph nodes often enlarged and tender

Question 4

management of HSV1

Answer 4

o self limiting
o fever subsides after 3-5 days and recovery complete within 2 wks
o rest, fluids and antipyrexials/analgesics
o oral lesions may require chlorhexidine mouthwashes, difflam for pain

Question 5

recurrent HSV1

Answer 5

cold sore

Question 6

signs and symptoms of recurrent hsv 1

Answer 6

• itching or burning
• followed by irregular clusters of small closely grouped umbilicated vesicles
• most frequently affect the lips (HS labialis)AKA cold sore
• heal in 7-10 days w/o scarring

Question 7

herpes simplex on skin

Answer 7

herpetic whitlow-
Swelling, reddening and tenderness of finger.
- Clear vesicles develop that later rupture leaving open sores.
- Very painful.

Question 8

herpes zoster can also cause

Answer 8

chicken poz leading to shingles

reactivated in dorsal root ganglia nerve cells

Question 9

zoster

Answer 9

• Pain precedes skin signs by 1-3 days.
• 1-3 days after the onset of pain the characteristic rash appears.
• Starting with a crop of red papules which progress to blistering vesicles which burst and then crust confined to the local distribution of affected nerve.
• Common sites include, chest, neck, and lumbar/sacral regions.

Question 10

complications of shingles

Answer 10

herpes zoster of opthalmicus
5th C involved
unilateral rash in distribution of trigeminal nerve
Hutchinson’s sign
- skin involvment of the tip of the nose indicates nasocilary nerve involvment

Question 11

skin infection caused by pox virus

Answer 11

molluscum contagiosum
reacitonary epithelial hyperplasia
- Flesh-coloured to pink, umbilicated, pearly surface, approximately 1–5 mm in- diameter.

Question 12

cellulitis

Answer 12

bacterial infection affecting lower dermis and SC tissues of the ksin
SC pyrogens or SC aureus
red inflamed skin, painful TPP, warm to touch
managed with Ab

Question 13

erysipelas

Answer 13

superficial form of cellulitis
SC pyogens
well defined raised border
butterfly distribution 
treated with Ab

Question 14

Acne vulagris

Answer 14

inflamm disease of the pilosebaeous follicle

Question 15

cause of blockages of pilosebaceous follicle

Answer 15

1) increased sebum production,
2) keratin plugging,
3) colonisation by (C. acnes) bacteria,
4) local inflammation

Question 16

atopic dermatitis - ezema

Answer 16

chronic itchy skin condition
associated with atopic tendency
• Itchy, erythematous, dry scaly patches.
• Acute lesions become erythematous, vesicular and weepy.
• Chronic lesions become excoriated and lichenified.

Question 17

aetiology of atopic dermatitis

Answer 17

1. Inherited abnormalities in the skin barrier
   - fillogrin expression
   - binds to keratin in epidermal cells
2. Immune factors
   - abnormal balance in TH1 and 2, TH2 elevated
   - high IgE Ab
3. Imbalances in the microbial microflora of the skin.
4. External factors that make the skin dry
   - eg hard water
5. Skin irritants
6. Stress

Question 18

psoriasis

Answer 18

• Characterised by clearly defined, red and scaly plaques.

plaque from hyper proliferation of keratinocytes and secondary inflammatory infiltration

Question 19

management of psoriasis

Answer 19

• Psoriasis Area and Severity Index (PASI) score used in assessment.
• Avoiding precipitating factors i.e. alcohol consumption.
• Emollients to soften scale.
• Topical – vitamin D analogues, topical steroid creams, coal tar, dithranol, salicylic acid, topical retinoids.
• Phototherapy – UVB or psoralen combined with UVA.
• Systemic – methotrexate, retinoids, cyclosporin, mycophenolate

Question 20

melanotic naevi

Answer 20

mole
hyperplasia of melanocytes
acquired or congenital

Question 21

subtypes of melanin naevi

Answer 21

junctional naevu - melanocytes found just below the basement membrane of epidermis
dermal naevus - melanocytes found in dermis
compound naevu - Mel…within dermis and at BM of epidermis
combined naevus - 2 diff types of mole within same lesion

Question 22

ABCDE - for skin lesions not emergency lol

Answer 22

• (Asymmetry, Border irregularity, Colour variation, Diameter > 6 mm).

Question 23

seborrhoetic keratosis

Answer 23

• Highly variable.
• Stuck on appearance.
• Flat or raised papule or plaque.
• 1 mm to several cm in diameter.
• Grey, light brown, dark brown, black or mixed colours.
• Smooth, waxy or warty surface.

unknonw cuase

Question 24

spider telangiectasis

Answer 24

acquired vascular malformation
Central red papule (spider body) from which fine red lines (spider legs) extend radially.
dilaton enhance by increased estroenic blood levels

Question 25

progenic granuloma

Answer 25

benign reactive proliferation of capillary blood vessels - Red, brownish, blue-black exophytic growth on the skin. If left untreated they often reach 1–2 cm in size. often occur @ pregnancy

Question 26

chondrodermatitis nodular helicis

Answer 26

Benign inflammatory condition affecting the skin and cartilage of the ear (helix) pressure on ear - Helix or antihelix of the ear. - Solitary, firm, oval-shaped nodule, around 4–6 mm in diameter. - May have a central crust and surrounding erythema. - located on the sleeping side. i.e. unilateral

Question 27

cysts

Answer 27

closed sac distinc membrane develop abnormally in a cavity or structure of the body

Question 28

epidermoid cyst

Answer 28

do not involved sebaceous glands and don't contain sebum occluded pilosebaceous unit mutiple can occur in Garner syndrome - Normal or slightly pink overlying skin colour. - Fixed to the skin surface but mobile over deeper layer. - Has a central punctum. - Bad smelling cheesy debris can be expressed from the central punctum. - If secondarily infected - acute pain, swelling , redness, and discharge.

Question 29

sun damage skin conditions

Answer 29

solar lentigo | actinic elastosis

Question 30

solar lentigo

Answer 30

patch of darkened skin surrounded by normal skin UV causes local hyperplasia of melanocytes (proliferation above the BM, not like moles which are miltilayre)

Question 31

actinic elastosis

Answer 31

accumulation of abnormal elastic in the dermis of the skin | UV stimulates fibroblast to produce excess collagen and elastin

Question 32

actinic keratosis

Answer 32

precancerous condition abnormal keratinocyte development due to DNA damage by short wavelength UVB • Flat or thickened papule or plaque. • Tan, pink, red colour with a scaly surface. • The patch often feels dry or rough to touch. - may get a cutaneous horn

Question 33

types of malignant skin disease

Answer 33

melanoma vs non melanoma

Question 34

basal cell carcima

Answer 34

locally invasive tumours malignant

Question 35

risk factors for basal cell carcinoma

Answer 35

UV previous skin cancer solar elastosis and actinic keratosis

Question 36

subtypes of BCC

Answer 36

nodular (smooth surface, skin coloured nodule) superficial (scaly irr plaque, thin translucent rolled border) morphemic (waxy scare like plaque w/ indistinct borders)

Question 37

squamous cell carcinoma

Answer 37

invasive malignant tumour of epithelial keratinocytes | risk factors - UV exposure, fiztpartrick skin 1 and 2 types, premalignant conditions

Question 38

SCC signs and managment

Answer 38

``` ill defined nodule lesions grow ulcerated or necrotic centre, surface crust staged with TNM surgical, radio, chemo ```

Question 39

malignant melanoma

Answer 39

tumour of epidermal melanocytes | risk.- UV Fitzpatrick 1/2, atypical moles, fam history

Question 40

diagnosis

Answer 40

examination biopsy breslow thickness for invative melanomas TNM classiication