Dermatology

Question 1

What are the layer of the skin?

Answer 1

• epidermis
• dermis
• hypodermis

Question 2

What is the largest organ of the body?

Answer 2

The skin (1.5-2.0m^2)

Question 3

What is the function of skin?

Answer 3

• anatomical barrier
• heat regulation
• sensory input
• storage for lipids and water
• drug absorption and waste excretion

Question 4

How does oily skin differ from ‘normal’ skin?

Answer 4

• more secretion from sebaceous glands (sebum)
• more bacterial colonisation
• skin becomes heavier and thicker
• more risk of pore black age
• more spots and pimples
• less likely to wrinkle

Question 5

What are comedones?

Answer 5

Blackheads
- build up of keratin and sebum

Question 6

What are examples of bacterial infections of the skin?

Answer 6

• acne
• impetigo
• furuncles and carbuncles
• erysipelas

Question 7

What are furuncles?

Answer 7

Pockets filled with pus
- caused by staph aureus
- red painful and swollen

Question 8

Who is most likely to suffer from acne?

Answer 8

teenagers

Question 9

What are the causes of acne?

Answer 9

• follicular sensitivity to testosterone

Question 10

What can make acne worse?

Answer 10

• contraceptive pills (progesterone)
• systemic steroid treatment
• anticonvulsant drugs

Question 11

How can acne be managed locally?

Answer 11

• reduce excess skin oil (using cleanser)
• benzoyl peroxide
• retinoids
• antibiotic lotions

Question 12

If local treatments for acne fail, what systemic management is used?

Answer 12

• antibiotics (tetracycline based)
• retinoids (isotretinoin)
• hormone manipulation (anti-androgens)

Question 13

What microorganism causes Erysipelas?

Answer 13

streptococcus pyogenes

Question 14

How is erysipelas managed?

Answer 14

• oral/IV antibiotics

Question 15

What can erysipelas progress to?

Answer 15

• necrotising fasciitis
• septic shock

Question 16

What is Impetigo?

Answer 16

Highly infection skin disease caused by
- staphylococcal
- streptococcal

Has a crust red blister appearance

Question 17

What are examples of viral skin infection?

Answer 17

• herpes simplex
• shingles
• warts
• molluscum contagiosum

Question 18

What can cause activation of the Herpes simplex virus?

Answer 18

Trauma
- physical
- chemical
- UV light

Question 19

How is Herpes Simplex treated?

Answer 19

Aciclovir

Question 20

What causes Molluscum Contagiosum?

Answer 20

MCV (pox virus)

Question 21

What causes warts?

Answer 21

Human Papilloma Virus (types 1-3)

Question 22

How are warts treated?

Answer 22

• keratolysis
• cryosurgery
• excision

Question 23

What are examples of fungal skin infection?

Answer 23

• Athletes foot
• Ringworm
• Intertrigo

Question 24

How can athletes foot be prevented?

Answer 24

• keep skin dry
• keep skin damage free

Question 25

How is athletes foot treated?

Answer 25

Miconazole (topical)

Question 26

What is intertrigo? How is it treated?

Answer 26

Fungal infection due to chafing in moist body folds. Treat with topical antifungal: - clotrimazole - miconazole

Question 27

How is Pityriasis Versicolor treated?

Answer 27

Topical or systemic antifungal - topical ketoconazole - systemic itraconazole

Question 28

What are examples of skin infestations?

Answer 28

- scabies - lice

Question 29

How is scabies spread?

Answer 29

skin-to-skin contact

Question 30

How does Scabies present?

Answer 30

- itching (severe at night) - rash on trunk and limbs - burrows appear on skin

Question 31

How is scabies treated?

Answer 31

- benzyl benzoate - permethrin - malathion

Question 32

How are lice transmitted?

Answer 32

close contact with an infected individual or shared items

Question 33

How are lice treated?

Answer 33

- personal and clothing hygiene - chemical insecticides (permethrin)

Question 34

What are examples of inflammatory skin disease?

Answer 34

- eczema - occupational dermatitis - psoriasis

Question 35

What are the 2 types of eczema?

Answer 35

- atopic - contact

Question 36

What is eczema?

Answer 36

Inflammation of the skin - becomes itchy, dry, flakey - occasionally weeps

Question 37

What is the commonest form of eczema?

Answer 37

atopic eczema - develops in childhood - usually improves with age

Question 38

What are triggers for eczema?

Answer 38

- stress - mensuration - illness - changes in weather

Question 39

How is eczema managed?

Answer 39

- cotton clothing - emollients - soap substitutes - corticosteroids

Question 40

What is contact dermatitis?

Answer 40

reaction to an environmental agent resulting in a rash with an intense itch

Question 41

How is contact dermatitis treated?

Answer 41

Remove source - topical steroids can help

Question 42

What is psoriasis?

Answer 42

Dysregulated epidermal proliferation - skin surface builds up & thickens

Question 43

How is psoriasis treated?

Answer 43

- emollients - topical steroids - tar - dithranol - vitamin A derivatives - PUVA (activated by UV light)

Question 44

What systemic drugs can be used to treat psoriasis?

Answer 44

- methotrexate - cyclosporin - aitretin - infliximab

Question 45

What are examples of immunological skin diseases?

Answer 45

- blistering conditions (pemphigoid) - lichen planus - connective tissue diseases (scleroderma, raynauds)

Question 46

How do immunological skin diseases occur?

Answer 46

- auto-antibody attack on skin components causing loss of cell to cell adhesion - split forms in skin (fills with inflammatory exudate and forms vesicle/blister)

Question 47

What are examples of vesiculobullous diseases?

Answer 47

- pemphigoid - pemphigus - epidermolgysis bullosa - linear IgA disease - dermatitis herpetiformis

Question 48

What is Pemphigoid?

Answer 48

presents as thick walled blisters

Question 49

How is pemphigoid managed?

Answer 49

Immunosuppressants - steroids - ‘steroid sparing’ drugs

Question 50

What is pemphigus?

Answer 50

Fatal disease without treatment - oral lesions usually seen before skin - intra-epithelial blister

Question 51

What problems are associated with Epidermolysis Bullosa?

Answer 51

- infection - fluid loss - scarring