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Flashcards in Inflammatory Skin Disease + Infection Deck (134)
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1
Q

what type of topical treatment is a semisolid emulsion of oil in water?

A

cream

2
Q

what type of topical treatment is a semisolid grease/oil?

A

ointment

3
Q

what type of topical treatment is a suspension/solution of medication in water, alcohol or other liquid?

A

lotion

4
Q

what type of topical treatment is a semi-solid, thickened, aqueous lotion containing high molecular weight polymers?

A

gel

5
Q

what is the purpose of an emollient?

A

enhances rehydration of epidermis

6
Q

in what type of skin conditions are emollients prescribes?

A

dry/scaly conditions

7
Q

in what type of skin conditions are wet wrap therapies prescribed?

A

very dry (xerotic) skin

8
Q

compare the routes of antiviral administration for herpes simplex (eg cold sore or genital wart), eczema herpeticum, herpes zoster (shingles)?

A

HSV (cold sore/wart)- topical antiviral

eczema herpeticum- oral antiviral

herpes zoster- oral antiviral

9
Q

what is hyperkeratosis?

A

increased thickness of keratin layer

10
Q

what is parakeratosis?

A

persistence of nuclei in the keratin layer?

11
Q

what is acanthosis?

A

increased thickness of epidermis

12
Q

why does parakeratosis occur?

A

cells turn over more quickly, no time for nuclei to disappear

13
Q

what is papillomatosis?

A

a type of acanthosis (increased thickness of epidemis) where you get wiggly epidermis (ie irregular)

14
Q

what is spongiosis?

A

oedema between keratinocytes

15
Q

why does spongiosis occur?

A

water has leaked out of keratinocytes because of inflammation

16
Q

is papillomatosis a feature of eczema?

A

no

17
Q

is spongiosis a feature of eczema?

A

yes

18
Q

what happens to the dermatitis/eczema plaques in the chronic phase? (ie after itching)

A

thicken (lichenification) and become elevated

19
Q

what is the pathogenesis of the contact allergic type of dermatitis?

A

delayed type 4 hypersensitivity reaction

20
Q

what is the pathogenesis of the contact irritant type of dermatitis?

A

non-specific trauma

21
Q

what is the pathogenesis of the atopic type of dermatitis? (eczema)

A

genetics + environmental factors causing inflammation

22
Q

what is the pathogenesis of the drug-related type of dermatitis?

A

type 1 (IgE mediated) or type 4 (delayed) hypersensitivity reaction

23
Q

what is the pathogenesis of the photo-induced/photosensitivity type of dermatiits?

A

reaction to UV light

24
Q

what is the pathogenesis of the lichen simplex type of dermatitis?

A

physical trauma to scratching the skin

25
Q

what is the pathogenesis of stasis dermatitis?

A

physical trauma to hydrostatic pressure

ie can be caused by immobility- hydrostatic pressure within blood vessels causes oedema then dermatitis

26
Q

when the cause of contact allergic dermatitis is not clear, what test can be done?

A

patch testing

27
Q

describe the plaques of atopic eczema?

A

ill-defined red and scaly

28
Q

what type of distribution is seen in atopic eczema?

A

mainly flexural distribution

in the very young it can be on extensor surfaces

29
Q

what is excoriation?

A

breaks in skin caused by scratching

30
Q

what is the most common cause of secondary infection of atopic eczema? (ie after excoriation)

A

staph aureus

31
Q

what is a typical sign of staph aureus secondary skin infection? (ie after excoriation)

A

crusting

32
Q

what is the classic feature of eczema herperticum?

A

monomorphic punched out lesions

33
Q

what does monomorphic mean?

A

each lesion is of the same size

34
Q

what is discoid eczema?

A

eczema with well-defined lesions

35
Q

what is the most common contact allergen in the UK?

A

nickel

36
Q

what is pompholyx eczema?

A

eczema restricted to hands and feet

37
Q

is pompholyx eczema acute or chronic?

A

always acute

38
Q

compare Staph aureus to all other Staph species in terms of presence of coagulse?

A

Staph aureus = coagulase positive

all other staph = coagulase negative

39
Q

what species of Staph is known as golden Staph?

A

Staph aureus

40
Q

what is the function of coagulase?

an enzyme which Staph aureus contains

A

clots plasma

41
Q

what type of Staph causes UTIs in women of child bearing age/

A

Staph. saprophyticus

42
Q

what are the 2 important categories of beta-haemolytic strep?

A

group A strep (strep pyognes)

group B strep

43
Q

what are the 2 important categories of alpha-haemolytic strep?

A

strep pneumoniae

strep viridans

44
Q

where do non-haemolytic Strep commonly cause infection?

A

urinary tract infections

45
Q

where in the body are non-haemolytic Strep commensals?

A

bowel

46
Q

what are the 2 most common pathogens causing impetigo?

A

Staph aureus

GAS (strep pyogenes)

47
Q

what population does Staphylococcal scalded skin syndrome usually occur in?

A

neonates

48
Q

what pattern of redness does erysipelas give?

A

butterfly pattern

49
Q

why can’t you tell whether the cause of erysipelas is Staph or Strep?

A

blood cultures are usually negative, no swabs available

50
Q

what type of characteristic pain is seen with necrotising fasciitis?

A

pain disproportionally high to what can be clinically seen

51
Q

what is the antibiotic of choice for treating sensitive strains of Staph aureus?

A

flucloxacllin

52
Q

in addition to antibiotics, what else is required for the treatment of necrotising fasciitis?

A

immediate surgical debridement

53
Q

what are the 2 types of necrotising fasciitis?

A
  1. caused by mixed anaerobes and coliforms

2. GAS

54
Q

when does type 1 necrotising fasciitis tend to occur?

A

post abdominal surgery

55
Q

what is a dermatophyte infection?

A

a fungal infection (ringworm)

56
Q

what is tinea capitis?

A

ringworm (fungal) infection of the scalp

57
Q

what is tinea barbae?

A

ringworm (fungal) infection of the beard

58
Q

what is tinea corporis?

A

ringworm (fungal) infection of the body

59
Q

what is tinea manuum?

A

ringworm (fungal) infection of the hand

60
Q

what is tinea unguium?

A

ringworm (fungal) infection of the nails

61
Q

what is tinea cruris?

A

ringworm (fungal) infection of the groin

62
Q

what is tinea pedis?

A

ringworm (fungal) infection of the foot

63
Q

what is tinea pedis more commonly known as?

A

athlete’s foot

64
Q

what type of skin do dermatophytes enter?

A

abraded or soggy skin

65
Q

what type of tissues do dermatophytes infect?

A

keratinised only

eg skin, hair, nails

66
Q

why can dermatophye lesions give a ‘ring’ appearance?

A

lesion grows outwards and heals in the centre

67
Q

what is the main species of ringworm (dermatophyte) that infects humans?

A

trichophyton rubrum

68
Q

what virus causes both chickenpox and shingles?

A

varicella zoster virus

69
Q

which type of nerve roots does varicella virus remain latent within?

A

sensory nerve roots

70
Q

is the reactivation distribution of herpes zoster virus dermatomal or myotomal?

A

dermatomal

71
Q

what 2 groups of patients tend to get herpes zoster virus?

A

elderly

immunocompromised

72
Q

compare the onset of pain to the onset of the rash with herpes zoster?

A

pain usually comes 1/2 days before the rash

73
Q

what is post herpetic neuralgia?

A

pain associated with herpes zoster, greater than 4 weeks after getting infection

74
Q

what is Ramsay Hunt syndrome?

A

herpes zoster virus associated with 7th cranial nerve causing facial palsy and also irritation of 8th cranial nerve

75
Q

what type of vaccine is the vaccination for chickenpox?

A

live attenuated

76
Q

what is herpetic whitlow?

A

HSV infection where the nail meets skin

77
Q

what cranial nerve does the HSV virus remain dormant in/ can reactivate from?

A

trigeminal ganglion

78
Q

compare HSV type 1 and type 2 in terms of oral/genital herpes?

A

type 1: main cause of oral herpes. 50% of genital herpes cases

type 2: rare cause of oral herpes. 50% of genital herpes cases

79
Q

which type of HSV is more severe and more likely to recur?

A

HSV type 2

80
Q

aciclovir is a HSV/VZV antiviral, why does it not eliminate latent virus?

A

it only affects replicating virus

81
Q

what are the classic lesions of erythema multiforme?

A

target lesions with erythema

82
Q

what causes erythema multiforme?

A

many triggers

  • drugs
  • infections
83
Q

what types of HPV are most common in warts and veruccas?

A

1, 2, 3, 4

84
Q

what types of HPV are most common in genital warts?

A

6, 11

85
Q

what types of HPV are most associated with cervical cancer?

A

16, 18

86
Q

compare the original HPV vaccine to the new HPV vaccine?

A

original protected against types 16 and 18

new protects against 6, 11, 16 and 18

87
Q

what is herpangina?

A

blistering rash at the back of the mouth

88
Q

what viruses cause herpangina?

A

enteroviruses

not herpes

89
Q

what viruses cause hand foot and mouth disease in humans?

A

enteroviruses

90
Q

what population are occupationally exposed to Orf?

A

farmers

91
Q

Orf is a zoonosis from what animals?

A

sheep

92
Q

what bacteria causes syphilis?

A

treponema pallidum

93
Q

how do you diagnose primary syphilis?

A

swab of chancre for PCR

94
Q

how do you diagnose secondary or tertiary syphilis?

A

blood test

95
Q

where is the secondary syphilis rash prominent?

A

on palms of hands and soles of feet

96
Q

in secondary syphilis, what can be seen on mucous membranes?

A

snail trail ulcers

97
Q

what bacteria causes lyme disease?

A

borrelia burgdorferi

98
Q

what is the treatment of lyme disease?

A

doxycycline or amoxicillin

99
Q

what is the most common genodermatoses?

A

neurofibromatosis

100
Q

what is the second most common genodermatoses?

A

tuberous scelrosis

101
Q

what is the earliest cutaneous sign of tuberous sclerosis?

A

ash-leaf macule

102
Q

is an ash leaf macule hyperpigmented or depigmented?

A

depigmented macule

103
Q

what parts of the genes (exons or introns) are removed during transcription and splicing?

A

introns

104
Q

what are the 3 types of epidermolysis bullosa?

A

simplex
junctional
dystrophic

105
Q

compare epidermolysis bullosa simplex, junction and dystrophic in terms of where pathology lies?

A

simplex- pathology in epidermis
junctional- pathology in DE junction
dystrophic- pathology in dermis

106
Q

1/2 cafe au lait macules can be normal, what does more than 5 suggest?

A

genetic disease

107
Q

what is the ground substance within dermis made of?

A

hyaluronic acid and chondroitin sulphate

108
Q

what are the 4 main subtypes of inflammatory skin diseases?

A
  • spongiotic
  • psoriasiform
  • lichenoid
  • vesiculobollous
109
Q

what happens to the epidermis in psoriasiform inflammation?

A

acanthosis due to elongation of rete ridges

110
Q

what happens in lichenoid inflammation?

A

basal layer damage

111
Q

what happens in vesiculobullous inflammation?

A

blistering

112
Q

what subtype of inflammatory skin disease does eczema, contact allergic dermatitis and photosensitivity come under?

A

spongiotic inflammation

113
Q

what subtype of inflammatory skin disease does psoriasis come under?

A

psoriasiform inflammation

114
Q

what subtype of inflammatory skin disease does lichen planus and lupus come under?

A

lichenoid inflammation

115
Q

what subtype of inflammatory skin disease does pemphigoid pemphigus and dermatitis herpetiformis come under?

A

vesiculobullous inflammation

116
Q

what is koebner phenomenon? (in relation to psoriasis)

A

when new psoriatic lesions arise at sites of trauma

117
Q

describe psoriatic lesions?

A

well demarcated, erythematous, scaly plaques

118
Q

describe the distribution of psoriasis?

A

extensor surfaces

119
Q

there are 4 types of pemphigus, which is most common?

A

pemphigus vulgaris

120
Q

what is acantholysis?

A

break down of intracellular adhesion sites

121
Q

compare bullous pemphigoid and pemphigus in terms of acantholysis?

A

pemphigus has acantholysis

pemphigoid doesn’t

122
Q

compare bulloud pemphigoid and pemphigus in terms of the target of autoantibodies?

A

pemphigoid- antigens in hemidesmosomes

pemphigus- antigens in desmosomes

123
Q

what disease is dermatitis herpetiformis strongly associated with?

A

coeliacs disease

124
Q

what is the treatment od dermatitis herpetiformis?

A

gluten free diet

125
Q

compare the type of autoantibodies of pemphigus, pemphigoid and dermatitis herpetiformis?

A

pemphigus- IgG
pemphigoid- IgG
dermatitis herpetiformis- IgA

126
Q

describe whiteheads and blackheads in terms of comedones?

A

whitehead- closed comedone

black head- open comedone

127
Q

is angioedema pitting or non-pitting?

A

non- pitting

128
Q

in what type of allergic reaction are serum tryprase levels raised?

A

anaphylaxis

129
Q

what type of nerve fibres transmit itch?

A

C fibres

unmyelinated

130
Q

what are the 4 causes of itch?

A

pruritoceptive
neuropathic
neurogenic
psychogenic

131
Q

what causes a pruritoceptive itch?

A

something in skin triggers itch

132
Q

what causes a neuropathic itch?

A

damage of any sort to central or peripheral nerves causing itch

133
Q

what causes a neurogenic itch?

A

no evident CNS damage, but itch caused by effects on CNS receptors

134
Q

what type of itch do systemic diseases with associated pruitus usually cause?

A

neurogenic itch