2 types of thermo-receptors?
central and peripheral
centra and peripheral thermoreceptors detect ?
central detect - core body temp.
peripheral detect - environmental temp.
temp. regulating centre in brain?
hypothalamus
heat stroke?
body temp raised above 40 degrees
what happens to set point in hypothalamus in fever?
set point is shifted and raised in hypothalamus
pharmacokinetics?
effect of body on drug
pharmacodynamics?
effect of drug on body
3 things to consider about a drug?
distribution
metabolism
excretion
vehicle of drug means?
examples
stable substance that carried active drug to correct area of action
solution
cream
ointment
shampoo
factors that affect topical absorption?
conc of med temp thickness of skin chemical properties o drug vehicle skin site
unit used to measure how much topical med to use?
finger tip unit
0.5g = 1 unit
retinoids?
for?
side effects?
vit A
good for skin - epidermis treating
has side effects - dry skin and lips
immunosuppressants?
e.g.
for inflammatory skin disorders
oral steroids
biologics?
treat inflammation conditions
genetically engineered proteins
- mab
- cept
-mab biologics means?
indicates monoclonal Ab
-cept biologics means?
indicates a receptor fusion
impetigo?
causes -2
contagious skin infection - superficial skin
red sores and blisters - cornflakes stuck to skin
bacterial - aureus and street. pyogens
gram positive cocci
erysipelas?
causes
bacterial infection of top layer of skin - bright red rash on skin
strept. pyogenes
staph aureus
cellulitis?
infection of bacteria getting into deeper layers of skin - swollen area of skin
lipidermatosclerosis?
changes in lower legs skin - inflamed fat under skin
tinea?
feature of it
examples
group od fungal infections
unilateral and localised
ringworm
athletes foot
candidiasis
yeast infection
thrush
nystatin?
anti fungal cream
intertrigo?
rash that facts folds of skin - due to friction causing inflammation
viral warts due to?
due to HPV virus
molluscum contagioscum?
due to?
DNA pox virus
small raised papule spots on skin
herpes HSV = 1 and 2 difference?
present as?
1 - cold sores - oral transmission
2 - STD - genital herpes
herpes zoster virus?
prognosis
shingles - chicken pox
it is self limiting
scabies?
contagious skin condition due to tiny mites that burrow into skin
erythroderma?
widespread inflammation skin condition
SJS?
skin condition due to reaction o drug - lead to painful rash an blisters
TEN?
skin condition due to adverse drug reaction -lead to skin peeling and blistering
SJS vs TEN?
SJS is mild
TEN is more sever end of sam spectrum
erythema multiforme?
trigger?
presentation
hsv trigger
infection hypersensitivity reaction
round rashes on palms, limbs etc
DRESS?
drug allergy to variety of meds
drug induced hypersensitive reaction - includes abnormal blood cell levels
and includes rashes, facial swelling, organ damage,
phemigus?
where
autoimmune condition
group of conditions that cause blisters and pus filled bumps -
on epidermis outside f skin
blisters easily ruptured - fragile
pemphigoid?
autoimmune conditin
lower skin layer affected -
creating tense blisters that don’t break easily
two forms of psoriasis ?
erythrodermic - inflammation of skin - intense burning and itching
pustular - pus filled blisters formed on skin
eczema herpeticum?
cause
hsv caused
with poorly controlled eczema
SSSS?
caused?
SKIN CONDITION covers wide area of skin - upper layer causing blisters and peeling
bacteria caused staphylococcal aureus
urticaria?
hives
outbreaks of swollen, itchy rashes that appear suddenly due to reaction to allergens - food, bites or chemicals
acute and chronic urticaria?
treatment options
acute - less than 6 weeks
chronic - more than 6 weeks
anti-histamines
biologic - omalizumab
emollients? do what
replace barrier - rehydrates - moisturiser
psoriasis? what is happening here?
common sites?
causes skin cells to multiply 10x faster than normal
common areas of bumpy red patchy lesions
knees, elbows, scalp
causes of psoriasis?
issue in immune system
that causes inflammation and triggers overproduction of skin cells -
genetic - run-in families
environmental
eczema? what is it
skin condition where patches of skin get itchy and red
types of ecsema?
contact dermatitis
atopic ecsema
irritant contact dermatitis
allergic contact dermatitis explain type?
type 4 hypersensitivity
eczema
T cell mediated
allergic contact dermatitis type of hypersensitivity?
type 4 hypersensivity reaction
irritant contact dermatitis due to?
skin injured by hand washing, friction, environmental factors - cold, chemicals etc
patch test?
testing for allergies
sedborrhoeic dermatitis?
caused by?
skin condition on scalp - scaly red itchy patches
can be immune system abnormality
yeast - malassezia
discoid ecesma?
dermatitis that cause skin to go red, swollen in circular oval patches
pompholyx eczema?
eczema that causes you to get tiny itchy blisters on hand and palms of hands
asteatotic eczema?
dermatitis due to dry skin - cracked scaly appearance -
venous ecsema?
due to?
in lower legs due - common in people with varicose veins -
due to increase pressure in veins
Calcineurin inhibitors?
used to suppress immune system
topical
pimecrolimus
tacrolimus
immunosupression examples?
used for?
azathioprine
ciclosprorin
types of non-melanoma?
basal cell cancer and squamous cell cancer
causes of non-melanoma skin cancer?
uv radiation hpv immunosuppression carcinogens familial
basal cell carcinoma?
more common
slow
develop in basal cells - deepest part of epidermis
mohs surgery? used when?
special type of excision of skin cancer - to help keep as much healthy skin left -
for high excision areas
photodynamic therapy?
use of light to kill skin cancer cells as treatment
vismodegib?
drug used to treat basal cell carcinoma
squamous cell carcinoma ?
cells involved?
explain
keratinising squamous cells
faster growing
non- metastasise
keratoacanthoma?
skin cancer tumour BENIGN - looks like a crater -
what to look at when looking at skin lesions?
ABCDE rule asymmetry border colour diameter evolution
dermoscopy for?
to look at skin lesions closely - increase clinical accuracy
non-melanoma skin cancer meaning?
melanoma skin cancer meaning?
- cancer in upper layers of skin
- more serious and can spread to other organs
different types of melanoma?
superficial spreading malignant
nodular
lentigo maligna
immunotherapy of melanoma cancer?
-mab
-nib
meds
breslow thickness?
used how?
depth of melanoma from outer skin layer to deepest melanoma cell
used to assess the prognosis of patient
cutaneous lymphoma?
classification of it?
cancer of wbc - that involve the skin - abnormal proliferation of lymphocytes
B cell lymphoma
T cell lymphoma
mycosis fungicides?
stages?
common form of T cell cutaneous lymphoma
patch on skin(red, flat)
plaque - thickened
tumour - irregular lump
metastatic - infiltrate into lymph nodes
Sézary syndrome?
red man syndorme
form of T cell cutaneous lymphoma
affect all body -
total skin electron beam therapy?
type of radio consisting of small charged particles
to superficial layers - sparing deeper layers
treat cutaneous lymphoma
extracorporeal photophoresis?
treat cutaneous lymphoma
draw blood – collect blood and make T cells sensitive to uv
and damage the diseased cells by uv radiation
seborrhoea keratoses?
benign - warty growths stuck on
cryotherapy?
liquid N
like a thermal burn to remove skin lesions
cysts?
encapsulated lesion containing fluid material
dermatofibroma?
benign fibrous firm nodules
under the skin
angioma?
non cancerous benign lesions - made up of small blood vessels - overgrowth of blood vessels in skin
pyogenic granuloma?
appearance like?
rapidly enlarging growth - due to proliferation of bv
like an red lump - raspberry like ons surface
curettage?
scraping of the lesion
Bowens disease?
early form of skin cancer - dysplasia
affects outermost layer squamous cells
actinic keratoses?
treated by? 3
rough sclaly patches on sun damaged skin
curette
cryotherapy
topical iquimod
layers of skin?
and brief composition of each
top epidermis - outer keratinocytes dermis - bv, glands, muscles, hair hypodermis - fat etc bottom
layers of skin?
describe each one with their cell type?
come lets get some beers
stratum corneum - horny layer
stratum lucidum - flat cells
stratum granulosum - diamond shaped cells
stratum spinosum - prickle cells
stratum basale -columnar epithelial cells
hair cycle?
stage s
hair follicles go through growth, shrinkage and shredding cycle
anagen - growing phase
catagen - growth/shrinks
telogen - shed
function of skin? 3
thermoregulation -
skin immune system
barrier
sensation
macule?
small flat circumcised
patch?
larger flat cirucumcised
papule?
small raised area
plaque?
large raised area
small lesion means?
less than 5cm
vesicle?
small fluid filled
bulla?
large fluid filled
pustule?
abscess?
small pus filled
large pus filled
erosion?
ulcer?
loss of epidermis - superficial
loss of epidermis and dermis - deeper
rosacea?
reness in face and visible blood vessels
how to take skin biopsy?
punch biopsy - punch through skin and sample all layers
what cells are responsible for hypersensivity reaction in skin?
mast cells
delayed hypersensvitiy reaction due to what cells?
T cells
4 risk factors for skin cancer?
fam history of skin cancer previous skin cancer subbed use previous radiation exposure to carcinogens
name some benign skin lesions?
viral warts cysts lipoma dermatofibroma vascular lesions
side effects of topical steroids?
telangiectasia glaucoma atrophy cataracts bruising hirsutism
what do retinoids do?
normalise keratinocyte function
anti inflam effects
what need to do with immunosuppressants?
regular blood monitoring - as risk of malignancy etc
acne vulgaris?
includes
disease of psu - face, chest, back
comedones pustules papules cysts scars
psu?
pilo-secaceous unit
structure consisting of hair and glands and skin
comedones?
skin coloured papule - blocked follicles
closed and open comedones?
open - blackhead
closed - whitehead
acne treatment ?
FIRST LINE AND SECOND LINE
1ST LINE - topical
AB:clindamycin
erythromycin
topical retinoids/benzoyl peroxide
2ND LINE - systemic meds
AB: tetracyclins
erythromycin
combined oral contra. pill
isotretinoin
UVB
isotretinoin?
for?
issue?
for severe acne
accutane
retinoid med
multiple side effects
side effects of isotretinoin?5
dry skin brittle hair mood disturbance headaches liver function derangement
how to treats scarring?
treat inflammation first and wait 1 yr if on isotretinoin
chemical peels laser excision steroid dermabrasion - exfoliate
acne rosacea?
redness of skin leading to more visible sign of bv
or pus filled pustules/bumps
facial most likely
can have a few triggers for a flare up
difference between rosacea and acne vulgaris?
no comedones in rosacea
treatment of rosacea?
first line
second line - name the AB
first line - topical MEDS
second line - systemic meds AB: Tetracyclins erythromycin isotretinoin laser light base treatment - uvb
macula changes what?
not texture just colour