Rash Morphology

Question 1

Layer of the epidermis

Answer 1

Epidermis
Dermis
Hypodermis
Basement membrane
Subcutaneous Fat

Fibroblasts produce collagen

4 major cells types = keratinocytes, langerhans cells, melanocytes, Merkel cells

Question 2

Layers of the epidermis

Answer 2

come lets get some beer

corneum = dead keratinocytes 
lucidum = palms and soles, extra skin layer, more resilient skin 
granulosum = lipids and lamellar granules
spinosum = langerhan cells (APC),
basale = melanocyte, where keratinocytes are produced (journey takes 30 days to go up the layers), Merkel cells

Question 3

morphology into size

Answer 3

Question 4

Answer 4

middle = fissures

top right = lichenification (thickening, seen in eczema)

bottom right = excoriations (scratch marks, seen in eczema)

left = ulcer (epidermal loss)

Question 5

zmacule

Answer 5

flat lesion <1cm, without elevation or depression

BLEEDING = petechia, purpura (macula or palpable), ecchymosis

VASCULITIS

ix = clotting screen, FBC for anaemia, LFT

Question 6

patch

Answer 6

larger than 1cm, flat

Question 7

What morphology is this?

Answer 7

maculopapular nodule

Question 8

what are these?

Answer 8

HSV on the left (vesicle)

acne on the right (pustule)

Question 9

Answer 9

bullous pemphigoid

Question 10

vesicle, bullae and pustule

Answer 10

Question 11

plaques

Answer 11

Question 12

abscess, wheal and papilloma

Answer 12

abscess = localised collection of pus in a cavity, more than 1cm in diameter

wheal = elevated compressible fading area (dermal oedema)

papilloma = small projection of skin

Question 13

configuration (shape)

Answer 13

annular means leading red edge

Question 14

Answer 14

erythema multiforme

• hypersensitivity reaction
• common culprit: HSV (1 >2)
• other: mycoplasma pneumonia
• hands/palms > upper limbs > trunks (within 24 hours)
• acute, often self-resolving

Question 15

EM → SJS → TEN

Answer 15

Question 16

SJS/TEN

Answer 16

Term emergency (rare)

prodromal: flu-like

abrupt onset of lesions on trunk > face/limbs

macules, blisters, erythema = atypical features

blisters merge = sheets of skin detachment

Nikolsky +ve

extensive full thickness mucocutaneous necrosis <2-3 days

Question 17

Hoe to describe term lesion

Answer 17

Question 18

SJS/TEN

Answer 18

Question 19

scale, crust and fissure

Answer 19

Question 20

what is name for risk stratification score for pressure ulcers

Answer 20

Waterlow score

Question 21

ulcer, scar, atrophy

Answer 21

keloid scar

hypertrophic scar

With hypertrophic scars, the extra connective tissue that forms within the original wound stays within that area. With keloid scars, the extra connective tissue that forms extends beyond the original wound area.

Question 22

different types of scales

Answer 22

Question 23

secondary skin changes

Answer 23

lichenification = seen in chronic dermatitis, thickened and shiny skin

Question 24

Where on the body

Answer 24

acral = palms and soles of feet, distal extremities

Question 25

blascho lines

Answer 25

Question 26

Answer 26

**A process in which injury to the skin causes further formation of psoriasis**. (elbows and knees)

Question 27

Shape descriptions

Answer 27

Question 28

Colour descriptions

Answer 28

**dilated or broken blood vessels located near the surface of the skin or mucous membranes**.

Question 29

Ddx sieve VITAMINE DEC

Answer 29

Question 30

Ddx sieve VITAMINE DEC

Answer 30

Question 31

Ddx of scale/papules/plaques

Answer 31

Question 32

Herald patch

Answer 32

Question 33

Ddx of blister

Answer 33

Question 34

Ddx by site on body

Answer 34

Question 35

Ddx by shape

Answer 35

Question 36

SJS

Answer 36

Question 37

Toxic epidermal necrolysis

Answer 37

Question 38

Drug causes of SJS/TEN

Answer 38

Question 39

Answer 39

If the test result is positive, the very thin top layer of skin will shear off, leaving skin pink and moist, and usually very tender. A positive result is **usually a sign of a blistering skin condition**. People with a positive sign have loose skin that slips free from the underlying layers when rubbed.