Inflammatory Skin Disease + Infection Flashcards
(134 cards)
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
what is the pathogenesis of stasis dermatitis?
physical trauma to hydrostatic pressure
| ie can be caused by immobility- hydrostatic pressure within blood vessels causes oedema then dermatitis
26
when the cause of contact allergic dermatitis is not clear, what test can be done?
patch testing
27
describe the plaques of atopic eczema?
ill-defined red and scaly
28
what type of distribution is seen in atopic eczema?
mainly flexural distribution
| in the very young it can be on extensor surfaces
29
what is excoriation?
breaks in skin caused by scratching
30
what is the most common cause of secondary infection of atopic eczema? (ie after excoriation)
staph aureus
31
what is a typical sign of staph aureus secondary skin infection? (ie after excoriation)
crusting
32
what is the classic feature of eczema herperticum?
monomorphic punched out lesions
33
what does monomorphic mean?
each lesion is of the same size
34
what is discoid eczema?
eczema with well-defined lesions
35
what is the most common contact allergen in the UK?
nickel
36
what is pompholyx eczema?
eczema restricted to hands and feet
37
is pompholyx eczema acute or chronic?
always acute
38
compare Staph aureus to all other Staph species in terms of presence of coagulse?
Staph aureus = coagulase positive
all other staph = coagulase negative
39
what species of Staph is known as golden Staph?
Staph aureus
40
what is the function of coagulase?
| an enzyme which Staph aureus contains
clots plasma
41
what type of Staph causes UTIs in women of child bearing age/
Staph. saprophyticus
42
what are the 2 important categories of beta-haemolytic strep?
group A strep (strep pyognes)
group B strep
43
what are the 2 important categories of alpha-haemolytic strep?
strep pneumoniae
| strep viridans
44
where do non-haemolytic Strep commonly cause infection?
urinary tract infections
45
where in the body are non-haemolytic Strep commensals?
bowel
46
what are the 2 most common pathogens causing impetigo?
Staph aureus
| GAS (strep pyogenes)
47
what population does Staphylococcal scalded skin syndrome usually occur in?
neonates
48
what pattern of redness does erysipelas give?
butterfly pattern
49
why can't you tell whether the cause of erysipelas is Staph or Strep?
blood cultures are usually negative, no swabs available
50
what type of characteristic pain is seen with necrotising fasciitis?
pain disproportionally high to what can be clinically seen
51
what is the antibiotic of choice for treating sensitive strains of Staph aureus?
flucloxacllin
52
in addition to antibiotics, what else is required for the treatment of necrotising fasciitis?
immediate surgical debridement
53
what are the 2 types of necrotising fasciitis?
1. caused by mixed anaerobes and coliforms
| 2. GAS
54
when does type 1 necrotising fasciitis tend to occur?
post abdominal surgery
55
what is a dermatophyte infection?
a fungal infection (ringworm)
56
what is tinea capitis?
ringworm (fungal) infection of the scalp
57
what is tinea barbae?
ringworm (fungal) infection of the beard
58
what is tinea corporis?
ringworm (fungal) infection of the body
59
what is tinea manuum?
ringworm (fungal) infection of the hand
60
what is tinea unguium?
ringworm (fungal) infection of the nails
61
what is tinea cruris?
ringworm (fungal) infection of the groin
62
what is tinea pedis?
ringworm (fungal) infection of the foot
63
what is tinea pedis more commonly known as?
athlete's foot
64
what type of skin do dermatophytes enter?
abraded or soggy skin
65
what type of tissues do dermatophytes infect?
keratinised only
| eg skin, hair, nails
66
why can dermatophye lesions give a 'ring' appearance?
lesion grows outwards and heals in the centre
67
what is the main species of ringworm (dermatophyte) that infects humans?
trichophyton rubrum
68
what virus causes both chickenpox and shingles?
varicella zoster virus
69
which type of nerve roots does varicella virus remain latent within?
sensory nerve roots
70
is the reactivation distribution of herpes zoster virus dermatomal or myotomal?
dermatomal
71
what 2 groups of patients tend to get herpes zoster virus?
elderly
| immunocompromised
72
compare the onset of pain to the onset of the rash with herpes zoster?
pain usually comes 1/2 days before the rash
73
what is post herpetic neuralgia?
pain associated with herpes zoster, greater than 4 weeks after getting infection
74
what is Ramsay Hunt syndrome?
herpes zoster virus associated with 7th cranial nerve causing facial palsy and also irritation of 8th cranial nerve
75
what type of vaccine is the vaccination for chickenpox?
live attenuated
76
what is herpetic whitlow?
HSV infection where the nail meets skin
77
what cranial nerve does the HSV virus remain dormant in/ can reactivate from?
trigeminal ganglion
78
compare HSV type 1 and type 2 in terms of oral/genital herpes?
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
which type of HSV is more severe and more likely to recur?
HSV type 2
80
aciclovir is a HSV/VZV antiviral, why does it not eliminate latent virus?
it only affects replicating virus
81
what are the classic lesions of erythema multiforme?
target lesions with erythema
82
what causes erythema multiforme?
many triggers
- drugs
- infections
83
what types of HPV are most common in warts and veruccas?
1, 2, 3, 4
84
what types of HPV are most common in genital warts?
6, 11
85
what types of HPV are most associated with cervical cancer?
16, 18
86
compare the original HPV vaccine to the new HPV vaccine?
original protected against types 16 and 18
new protects against 6, 11, 16 and 18
87
what is herpangina?
blistering rash at the back of the mouth
88
what viruses cause herpangina?
enteroviruses
| not herpes
89
what viruses cause hand foot and mouth disease in humans?
enteroviruses
90
what population are occupationally exposed to Orf?
farmers
91
Orf is a zoonosis from what animals?
sheep
92
what bacteria causes syphilis?
treponema pallidum
93
how do you diagnose primary syphilis?
swab of chancre for PCR
94
how do you diagnose secondary or tertiary syphilis?
blood test
95
where is the secondary syphilis rash prominent?
on palms of hands and soles of feet
96
in secondary syphilis, what can be seen on mucous membranes?
snail trail ulcers
97
what bacteria causes lyme disease?
borrelia burgdorferi
98
what is the treatment of lyme disease?
doxycycline or amoxicillin
99
what is the most common genodermatoses?
neurofibromatosis
100
what is the second most common genodermatoses?
tuberous scelrosis
101
what is the earliest cutaneous sign of tuberous sclerosis?
ash-leaf macule
102
is an ash leaf macule hyperpigmented or depigmented?
depigmented macule
103
what parts of the genes (exons or introns) are removed during transcription and splicing?
introns
104
what are the 3 types of epidermolysis bullosa?
simplex
junctional
dystrophic
105
compare epidermolysis bullosa simplex, junction and dystrophic in terms of where pathology lies?
simplex- pathology in epidermis
junctional- pathology in DE junction
dystrophic- pathology in dermis
106
1/2 cafe au lait macules can be normal, what does more than 5 suggest?
genetic disease
107
what is the ground substance within dermis made of?
hyaluronic acid and chondroitin sulphate
108
what are the 4 main subtypes of inflammatory skin diseases?
- spongiotic
- psoriasiform
- lichenoid
- vesiculobollous
109
what happens to the epidermis in psoriasiform inflammation?
acanthosis due to elongation of rete ridges
110
what happens in lichenoid inflammation?
basal layer damage
111
what happens in vesiculobullous inflammation?
blistering
112
what subtype of inflammatory skin disease does eczema, contact allergic dermatitis and photosensitivity come under?
spongiotic inflammation
113
what subtype of inflammatory skin disease does psoriasis come under?
psoriasiform inflammation
114
what subtype of inflammatory skin disease does lichen planus and lupus come under?
lichenoid inflammation
115
what subtype of inflammatory skin disease does pemphigoid pemphigus and dermatitis herpetiformis come under?
vesiculobullous inflammation
116
what is koebner phenomenon? (in relation to psoriasis)
when new psoriatic lesions arise at sites of trauma
117
describe psoriatic lesions?
well demarcated, erythematous, scaly plaques
118
describe the distribution of psoriasis?
extensor surfaces
119
there are 4 types of pemphigus, which is most common?
pemphigus vulgaris
120
what is acantholysis?
break down of intracellular adhesion sites
121
compare bullous pemphigoid and pemphigus in terms of acantholysis?
pemphigus has acantholysis
pemphigoid doesn't
122
compare bulloud pemphigoid and pemphigus in terms of the target of autoantibodies?
pemphigoid- antigens in hemidesmosomes
pemphigus- antigens in desmosomes
123
what disease is dermatitis herpetiformis strongly associated with?
coeliacs disease
124
what is the treatment od dermatitis herpetiformis?
gluten free diet
125
compare the type of autoantibodies of pemphigus, pemphigoid and dermatitis herpetiformis?
pemphigus- IgG
pemphigoid- IgG
dermatitis herpetiformis- IgA
126
describe whiteheads and blackheads in terms of comedones?
whitehead- closed comedone
| black head- open comedone
127
is angioedema pitting or non-pitting?
non- pitting
128
in what type of allergic reaction are serum tryprase levels raised?
anaphylaxis
129
what type of nerve fibres transmit itch?
C fibres
| unmyelinated
130
what are the 4 causes of itch?
pruritoceptive
neuropathic
neurogenic
psychogenic
131
what causes a pruritoceptive itch?
something in skin triggers itch
132
what causes a neuropathic itch?
damage of any sort to central or peripheral nerves causing itch
133
what causes a neurogenic itch?
no evident CNS damage, but itch caused by effects on CNS receptors
134
what type of itch do systemic diseases with associated pruitus usually cause?
neurogenic itch
