Dermatology Flashcards
Define basal cell carcinoma.
Commonest form of skin malignancy, most commonly occurring on the face, that often invades surrounding tissue but seldom metastasizes.
- Also known as a rodent ulcer
What is Gorlin’s syndrome?
A condition that affects many areas of the body and increases the risk of developing various cancerous and noncancerous tumors.
- Strongly linked to basal cell carcinoma
What are the risk factors for basal cell carcinoma?
o Pprolonged sun exposure or UV radiation
o Photosensitising pitch
o Tar
o Arsenic
What are the presenting symptoms of basal cell carcinoma?
o A chronic slowly progressive skin lesion
o Usually found on the FACE but sometimes the scalp, ears or trunk
What are the types of basal cell carcinoma?
o Nodulo-ulcerative (most common)
o Morphoeic
o Superficial
o Pigmented
What are the signs of nodulo-ulcerative on examination?
o Small glistening translucent skin over a coloured papule
o Slowly enlarges
o Central ulcer with raised pearly edges
o Fine telangiectasia over the tumour surface
o Cystic change in larger lesions
What are the signs of morphoeic basal cell carcinoma on examination?
o Expanding, yellow/white waxy plaque with an ill-defined edge
o More aggressive than nodulo-ulcerative
What are the signs of superficial basal cell carcinoma on examination?
o Most often on trunk
o Multiple pink/brown scaly plaques with a fine edge expanding slowly
What are the signs of pigmented basal cell carcinoma on examination?
o Specks of brown or black pigment may be present in any BCC
What are the appropriate investigations for basal cell carcinoma?
o Diagnosis is mainly on clinical suspicion
o Biopsy is rarely necessary
Define contact dermatitis.
An inflammatory skin reaction in response to an external stimulus, acting either as an allergen or an irritant.
What are the two types of contact dermatitis?
o Allergic - a delayed type IV hypersensitivity reaction, which occurs after sensitisation and subsequent re-exposure to the allergen
- cosmetics, metals, topical medications, textiles
o Irritant - an inflammatory response that occurs after damage to the skin, usually by chemicals
- detergents/soaps, solvents, powders
What are the presenting symptoms of contact dermatitis?
o HANDS are the most frequently affected but can occur anywhere
o Redness of skin
o Vesicles and papules in the affected area
o Crusting and scaling of skin
o Itching of an affected area
o Fissures
o Hyperpigmentation
o Pain or burning sensation
o Make sure you do a thorough occupational history
What are the appropriate investigations for contact dermatitis?
o No investigations necessary most of the time
o Some may need patch testing
Define eczema.
A pruritic papulovesicular skin reaction to endogenous and exogenous agents.
What are the risk factors for eczema?
o Exogenous = irritants (e.g. nappy rash), contact (delayed type 4 hypersensitivity reaction to an allergen), atopic
o Endogenous = atopic, seborrhoeic, pompholyx (a type of eczema that affects the hands and feet), varicose veins, lichen simplex
What are the presenting symptoms of eczema?
Itching
Heat
Tenderness
Redness
Weeping
Crusting
Ask about occupational exposure to irritants (e.g. bleach)
Ask about personal/family history of atopy (e.g. asthma, hay fever)
What are the signs of acute eczema on examination?
Poorly demarcated erythematous oedematous dry scaling patches
Papules
Vesicles with exudation and crusting
Excoriation marks
What are the signs of chronic eczema on examination?
Thickened epidermis
Skin lichenification
Fissures
Change in pigmentation
What is the usually presentation of atopic eczema?
- mainly affects face and flexures
What is the usually presentation of seborrhoeic eczema?
o Yellow greasy scales on erythematous plaques
o Commonly found on eyebrows, scalp, presternal area
What is the usually presentation of pompholyx eczema?
o Vesiculobullous eruption on palms and soles
What is the usually presentation of nummular eczema?
o Coin shaped on the legs and trunk
What is the usually presentation of asteatotic eczema?
o Dry, crazy paring pattern
