Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SPINE Semester 2 > Dermatology > Flashcards

Dermatology Flashcards

(113 cards)

Start Studying
1
Q

What are the two main types of skin lesions?

A
  1. Melanocytic - tend to be pigmented
  2. Epidermial (keratinocyte derived) - not pigmented
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the four basic tumours of epidermal lesions?

A

Basal cell papilloma
Basal cell carcinoma
Solar/Actinic keratosis
Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main features of squamous skin tumours?

A

Sqaoumous cells (everything above the basal layer) - produce keratin
Results in scaly/keratinised lesions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main skin lesions affecting basal cells?

A

Benign = basal cell papilloma = seborrheic keratosis
Malignant = basal cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the main skin lesions affecting squamous cells?

A

Benign = solar/actinic keratosis
Malignant = sqaoumous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common skin tumour?

A

Basal cell papilloma = seborrheic keratosis (benign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of skin lesions is this describe?

A

A seborrheic keratosis
Appears pigmented (although is epidermal in origin)
Raised lesions (from increased amount of keratinocytes)
Warty appearance (lumps and bumps within surface)
Patchy and variable pigmentation
Norm on torso

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the histological features of seborreica keratosis?

A

Cerebrous or warty appearance (bumpy surface)
Containing cysts of keratin - these can be seen on the surface (patchy pigementation)

Looks like a hot cross bun

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the histological features of basal cell carcinoma?

A

Grow downwards in islands - however remain attached to overlying abnormal epidermis
Avascular as outgrowths push down blood vessels.
New branching blood vessels may begin to form between outpouching.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the gross features of a basal cell carcinoma?

A

Avascular - pearly or translucent quality
Attempt to grow blood supply - visible larger blood vessels growing in and branching (arborising telangiectasia)
Rolled edges
Central depression/ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a development of a basal cell carcinoma?
What is the prognosis?

A

Ulceration due to avascular centre
The most common cancer in humans.
Does not metastasis
Gradually enlarged locally over the years/months = slow growing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What skin lesion is seen in this image?

A

Ulcerated BCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does Actinic keratosis look like histologically?

A

Dysplasia of the epidermis
It remains above the basement membrane, with no signs of invasion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the gross appearance of actinic keratosis?

A

Dysplastic cells produce abnormal keratin - feel hard and spiky.
Looks like green/yellowly scab.
Commonly on areas of maximum sun exposure (back of hands, scalp, temporal, lower lip, top of ears)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Bowens Disease?

A

When epidermal cells are very dysplastic - unable to make keratin - triggers immune response against dysplastic cells.
Grade 3 dysplastic AK lesions - deep lesions
No keratin plaque.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a keratin horn?

A

Feature of a squamous cell skin tumour
The build-up of keratin from dysplastic squamous cells is deposited in a horn-like shape.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does a cutaneous horn indicate/prognosis?

A

A squamous tumour of the skin
Typically an benign AK develops into a malignant squamous cell carcinoma (more likely when swelling underneath the horn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the prognostic features of a squamous cell carcinoma of the skill?

A

Can metastasise
Well differentiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the key diagnostic features of a sqaoumous cell carcinoma on a gross level?

A

A keratin horn with a lump/swelling underneath - indicated invasion of nearby tissue
Tend to be more rapidly growing - 3 months ish
May be ulcerated
Malignant potential depends on site, histology and size.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How to differentiate between an AK horn and a SCC?

A

AK - lack of lump - role around between fingers
SCC - lump underneath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does a poorly differentiated SCC present?

A

Nodule of dysplastic cells
Disordered cellular structure - poor blood supply - can ulcerate.
More likely to metastasize than a well differentiated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the main melanocytic tumour of the skin?

A

Malignant melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the prognosis like for malignant melanoma?

A

Poor prognosis - particularly is deep in skin
No fixed chemotherapy or radiotherapy
One of the largest killers of young people after accidents and suicide.
Metastatic potential depends on Breslow thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What features are concerning of malignant melanoma?

A

New dark flat mole
Young person with many moles - some of which look different
Tends to be pigmented/red
Asymmetrical
Irregular borders
Myriad of colours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the key prognostic indicators for Malignant melanoma?
Breslow thickness - for 5yr survival up to 0.75mm - 98% 5yr 1mm over 90% 5yr 1-3mm 70% 5yr over 3mm 40% 5yr
26
What are the key features of malignant melanoma?
Larger moles (compared to others on patient) Typically a dark black colour (although can become amelanotic) Asymmetrical - particularly around the edge ABCD - asymmetry, border, colour and diameter.
27
What is the difference between a lesion and a rash?
Lesion = one abnormality in one area of the skin Rash = process, widespread or can affect several areas. Typically red, pimply and itchy.
28
What is the basic history for a lesion?
Where How long Preceding abnormality Pain etc UV exposure - pre-cancerous or cancerous lesions:
29
What is a key part of the UV exposure history?
Tendency to tan/burn - fair/dark skin, freckling Sun lover or hater Lived/worked abroad - armed services Sunbed use
30
What is the important part of the rash history?
Where did it begin? How has it evolved? Previous skin diagnosis? Sun exposure worsen (lupus) or improve (eczema/psoriasis). Contact with substances - allergic contact dermatitisis Occupation/hobbies - allergic Drugs, when started - drug erruption Symptoms - itch, pain, weeping (this tends to be eczema) PMH - atopy (eczema), family (psoriasis or eczema), itchy contacts (scabies)
31
What are the different levels of the skin?
Epidermis Dermis Sub-cutaneous fat
32
What are the key features of a dermal pathology?
Skin stays smooth Raised surface
33
What are the key features of an epidermal pathology?
May or may not be raised Thickened layers Surface change - scaly, crusting on surface, fluid seeping through
34
What are some key terms to use when describing lesions?
Macule - flat and little Patch - flat and big Papule - raised and little Nodule - raised dome shapedand big Plaque - raised flat
35
What is a papule?
Raised little lesion
36
What is a macule?
A flat little lesion
37
What is a nodule?
A raised large lesion Dome shaped
38
What is a patch?
A large flat lesion
39
What is meant by a vesicle?
Papule (small raised lesion) that is filled with fluid
40
What is a bulla?
A large raised dome-shaped lesions filled with fluid.
41
What is a pustule?
A typically small individual skin lesion containing pus.
42
What is meant by a crust in dermatology?
Dried serum Orange/yellow colour May be confused with keratin (normally white/yellow) Crust must always be removed to reveal underlying pathology as can obscure tumour features.
43
What is meant by scale in dermatology?
Abnormality of stratum corneum Accumulation of abnormal keratin Hyperkeratotic Build often white, dry deposits Can be flaked off
44
What is meant by lichenification & warty process?
Lichenification - scratching of skin causes epidermal thickening - accentuated skin markings (peaks and valleys) Wart process - rocking up of skin is the warty chain.
45
What is the difference between erosion, ucler and excoriation?
Erosion - superficial skin loss - exudate visible as crust in surrounding areas Ulcer - deep loss, all of epidermis and parts of dermis lost Excoriated - typically from patient scratching
46
What is meant by purpura in a rash?
Blood leakage in the skin causes a non-blanching dusk purple colour.
47
How does tissue viability affect the colour of a rash?
Necrosis -> green to black
48
How does pigment affect the colour of a rash?
Melanin induced - blue or black colour Pigment due to degraded blood product - hemosiderin - pale brown
49
Describe this rash? What is it?
palpable, painful purpura - non-blanching rash. Cutaneous vasculitis Tends to be painful and palpable. May grow to cover larger area and lead to necrosis (due to lack of blood supply to the overlying skin)
50
Where does psoriasis commonly occur?
Extensors
51
Where does eczema commonly occur?
Flexural
52
Why are rashes pimply?
Typically collect lymphocytes/extracellular substances under the epidermis - raise epidermis to form a pimple
53
What substances can infiltrate the skin and cause a rash?
Inflammatory cells - the majority - lymphocytes, eosinophils and neutrophils. Extracellular substances - such as pre-tibial myoxoedema.
54
What does lichen mean related to a rash?
Small bumps on the skin
55
What are the main types of epidermal rashes?
Eczematous Psoriasiform Lichenoid Vesiculobullous/blistering
56
What are the different types of dermal rashes?
Vasculopathic Granulomatous Tissue deposition.
57
How does an eczematous rash appear?
Small vesicles in the epidermis - clear cavities on histology (spongiosis) - start small often merge together - variable size blisters. Keratin may fracture and break off - scaling and dryness Weeping.
58
What does a psoriasiform rash?
Vast thickening of epithelium - folds or projections down into dermis Rough/dry - abnormal keratin - hyperkeratosis/scale
59
What is a lichenoid rash?
Autoimmune destruction of the bottom of the epidermis Tend to appear purple grossly Dermis tends to be replaced by lymphocytes - infiltrate and kill epidermal cells producing colloid bodies Loss of boundaries between epidermis and dermis
60
What does a vesiculobullous rash look like?
Fluid-filled swelling Epidermis separates from dermis - fluid filled space between them
61
What do vasculopathic rashes look like?
Raised smooth lesions = (hives/urticaria) Blood vessels - damageed - leaking - blood or fluid - cause purpura or oedema Histology - band of paleness under epidermis represents oedema.
62
What do granulomatous rashes look like?
Histology - vast lymphocytes and degrading collagen, granuloma (macrophages arround a centre ring) Gross - ring-shaped, spread outwards over months, tend to be found on extensor surface of the knuckle.
63
What does a tissue deposition rash look like?
Scarring and deposition of substance within the dermis. Collagen proliferation Gross - brown and waxy appearance, waxy feel on palptation.
64
What is the basic process of eczema?
Not a disease - a reaction pattern to an insult - any skin at any point External insults - overwashing, scratching Internal - skin barrier/cutaneous immune system disorder
65
What is the typically histological appearance of eczema?
Minute vesicles in the epidermis This is called spongiosis May not be visible grossly.
66
How does eczema present grossly?
Micro vesicles forming larger vesicles on the surface Vesicles rupture onto surface can burst causing weeping (shininess), large volumes of water loss = dehydration, can dry on surface causing crusts. Displacement of keratin from underlying vesicles can cause abnormal dryness/flakiness as drops off. Spectrum from dryness/hyperkeratosis to vesicular (red and weeping)
67
Where does eczema tend to occur?
On thicker skins -palm of the hands, antecubital fossa, knees
68
How to tell the difference between the dryness/hyperkeratosis in eczema and psoriasis?
Psoriasis - clear boundary Eczema - unclear borders, tends to fade in and out of the skin.
69
What are the different ways of classifying eczema?
Exogenous v endogenous Acute (weepy) v chronic (dry and scaly) - does not relate to time frame.
70
What are the different causes of exogenous eczema?
1. Contact dermatitis (irritant - chemical in any person such as nappy rash and allergic) 2. Photosensitive 3. Lichen simplex (scartching) 4. Asteatotic - crazy paving (due to dryness of the skin)
71
What are some different types of contact dermatitis irritant eczema?
Nappy rash - symmetrical, sparing of the creases Ileostomy - releasing gastric enzymes around stoma - clearly defined circular border Lip licking eczema - repeated wetness and drying - well defined around mouth (same idea on hands from wetting/drying of hands, shower gels, shampoo, fabric softener, hand soap)
72
What are some common types of allergic contact eczema?
Elastoplasts Ear piercing - nickel Cosmetics and perfume
73
What are the ways of investigating eczema?
Patch testing
74
How is patch testing done for eczema? Why?
Patches of substances on back - what for few days Tests for Type 4 delayed hypersensitivity Identifies an allergic contact eczema.
75
How is the prick test used for skin allergies?
Tests for type 1 immediate hypersensitivity Immediate response Produces a urticaria rash
76
What drugs can predispose patients to photosensitive eczema?
Quinine - used to treat cramp Thiazide diuretics
77
What are the different causes of endogenous eczema?
1. Atopic eczema - genetic component - e.g filagrin - affects keratin cross-linking. 2. Discoid eczema 3. Eczema due to venous insufficiency (varicose or venous)
78
What is discoid eczema?
Legs of older men Circular-shaped eczema areas - varying in size
79
What are the key features of atopic eczema?
Thicker skin - elbow flexures, knee, neck Blistering on palms Scaliness Crusting from weeping - notes golden crusts indicate staph. aureus infection. Glycenation - thickening of skin - increased clarity of skin markings.
80
What is eczema herpeticulum?
Golden crusts - golden discharge - impetigo Also many blisters - many popped Blisters are monomorphic - all the same size Widespread Patient often feels very unwell. Caused by herpes infection.
81
What is erythroderma?
When more than 95% of the skin is involved in a rash of any kind May be eczea, psoriasis, drugs, lymphomas, leukaemia or idiopathic. Serious sign of acute deterioration requires hospital admission
82
What is a plaque in dermatology?
A flat raised lesion - large (over 1cm)
83
What is a wheal in dermatology?
Swelling of the skin into red or skin coloured welts with well defined edges.
84
What is atrophy in dermatology?
Dimpling/inversion of the skin Skin still intact. Localised shrinking of the skin - appears thinner, shiny and wrinkled.
85
What is meant by a burrow in dermatology?
Commonly seen in scabies Hole/place of entry Followed by a red line just under the skin - may be able to see the mite.
86
What is koebnerization?
Appearance of new lesions that look like patients existing skin disease - often in areas of damage such as scratching.
87
When handing over what acronym should be used to describe a rash?
Site Size and shape Colour Associated symptoms Margin & morphology SCAM
88
How do you measure breslow thickness for malignant melanomas?
Measured from the epidermis's granular layer to the tumour's base.
89
What is the typical treatment for a basal cell carcinoma?
Excision with 4mm margin
90
What is the general treatment for a sqaoumous cell carcinoma?
Excision with 4mm margin
91
What is the general treatment for a malignant melanoma?
Excision with a 2mm margin, followed by a wider excision +/- SLNB.
92
What are the different types of skin infection?
Bacterial Viral Fungal Infestations
93
Give some examples of bacterial infections of the skin
Cellulitis - deeper subcutaneous layer Erysipelas - typically just epidermis/dermis Impetigo Menigococcal rash Chancre
94
What is the treatment for cellulitisis?
Look for portal of entry Swabs +/- bloods Analgesia, fluid, elevation Manage co-morbs Oral antibiotics If severe/systemic - IV antibiotics Prolonged course may be required.
95
What is a chancre?
Small painless ulcer First sign of syphylis Typically develops on genitals - can also be in the mouth or anus. Typically followed by red/smallish spots on the palms and soles of the feet.
96
What are the different viral infections that occur on the skin?
Viral exanthem - widespread, face or trunk alongside generally unwell Herpes simplex - small vesicle on upper lip Eczema herpeticulum - infected ulcerated eczema Zoster virus = shingles Varicella zoster = chickenpox
97
What are the different superficial fungal infections that occur on the skin?
Dermatophytes (tinea) Candida Other types of yeasts
98
What does tinea corporis look like?
Fungal infection Circular, clearly defined, raised scaly edge Itchy Trunk or limbs
99
What do different tinea infections look like in dermatology?
Dry scaly lesions May have mild eryhthema Hair loss if relevant Tine capitis - on the scalp Tinea pedis - on the foot Tinea versicolour - loss of pigmentation (asymmetrical - vertiligo is symetrical)
100
What is onychomycosis?
Tinea unguium Funal nail infection Thicker, discoloured and fragmented nail
101
What is candida intertrigo?
A red itchy rash Occurs in skin folds when infected by yeast.
102
What is seborrhoeic dermatitis?
Chronic inflammatory skin disorder Rash of scaly patches with underlying yellow or white pigments. - erythematous base Areas of lots of sebaceous glands - around the nose,
103
What are some infestations that can affect the skin?
Scabies - presents as burrows Pubic lice Head lice Insect bite reaction
104
What is the treatment for scabies?
5% permethrin cream applied all over skin and left for 8-10hrs Oral ivermectin 200mcg/Kg Repeat a week later to kill newly hatched mites Identify and treat contacts Launder bed linines, towels and clean rooms Seal items that cannot be washed in plastic bag for a week Itching may persist up to 6 weeks.
105
What are the different types of emollients?
Ointments Creams Lotions
106
What are the pros and cons of creams?
+ Easy to rub in + Dont stain clothes + will rub into weepy skin - Not the best moisturisers - contain preservatives - can cause contact allergy
107
What are the pros and cons of lotions as emollients?
Mainly water based - poor moisturisers + easy to apply to hairy areas
108
What are the pros and cons of ointments as emollients?
Better moisturisers than creams Better for eczema/dry skin Dont rub in easily Can be more unwieldy Can make clothes/sheets messy Greasy form a waterproof barrier
109
What are the pros and cons of topical steroids in eczema?
+ range of potencies + essientla for all but mildest eczema + effective and safe with appropriate use - toxicity including atrophy (with strong steroids over prolonged periods at the face and skin creases), acne, rarely adrenal suppression.
110
What are some topical steroids from least to most potent?
Hydrocortison Eumovate Betnovate Dermovate
111
What is the medical terminology for a mole? What is this?
A naevus A local proliferation of melanocytes - congenital or acquired Develop any time from infancy to early adulthood - more worrying in adults.
112
What are the different types of moles?
Junctional naevus - melanocytes at DEJ - flat and pigmented Compound neavus - melanocytes at the DEJ and dermis - central raised areas surrounded by a flat patch Intradermal naevus - dermis only - raised
113
How should pigmented lesions be assessed?
ABCDE Asymmetrical Borders - uneven? Colour - two or more? Diameter - larger than 1/4 inch Evolving - change size/shape/colour etc

SPINE Semester 2 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions