Session 4: Dermatology

Question 1

History of presenting complaint in dermatological disease.

Answer 1

Initial appearance and then its evolution.

Symptoms such as itch or pain.

Aggravating factors and relieving factors

Previous and current treatments

Question 2

Past medical history in a patient with dermatological disease.

Answer 2

Systemic diseases

History of atopy

History of skin cancer or pre-cacner

History of sunburn/sunbathing/sun-bed use

Skin type

Social history

Drug history

Question 3

How is a pigmented lesion described? (ABCD)

Answer 3

Asymmetry

Border (irregular or blurred/defined or ill-defined)

Colour

Diameter

Question 4

How is a skin complaint described? (SCAM)

Answer 4

Site and distribution/Size and shape

Colour

Associated changes

Morphology

Question 5

How is this described?

Answer 5

Generalised

Question 6

How is this described?

Answer 6

Flexural

Question 7

How is this described?

Answer 7

Extensoral

Question 8

How is this described?

Answer 8

Photosensitive

Question 9

How is this described?

Answer 9

Discrete

Question 10

How is this described?

Answer 10

Confluent

Question 11

How is this described?

Answer 11

Linear

Question 12

How is this described?

Answer 12

Target

Question 13

How is this described?

Answer 13

Erythematous

Blanching

Question 14

How is this described?

Answer 14

Purpuric

Non-blanching

Question 15

How is this described?

Answer 15

Hyperpigmentation/pigmented

Question 16

How is this described?

Answer 16

Hypopigmentation

Question 17

How is this described?

Answer 17

Scaly

Due to build up of keratin

Question 18

How is this described?

Answer 18

Crust

Due to dried exudate

Question 19

How is this described?

Answer 19

Excoriation

Erosion from scratching

Question 20

How is this described?

Answer 20

Erosion/Ulceration

Question 21

Answer 21

Macule

Question 22

Answer 22

Papule

Question 23

Answer 23

Patch

Question 24

Answer 24

Plaque

Question 25

Answer 25

Nodule

Question 26

Answer 26

Vesicle | (filled with serous/water)

Question 27

Answer 27

Pustule | (filled with pus)

Question 28

Answer 28

Bulla | (just a large vesicle \> 1 cm)

Question 29

Describe appearance

Answer 29

Annular

Question 30

Describe appearance

Answer 30

Wheal

Question 31

Answer 31

Discoid/nummular

Question 32

Answer 32

Comedone (Either closed or open) Open = blackhead Closed = whitehead

Question 33

Answer 33

Patchy alopecia

Question 34

Answer 34

Diffuse alopecia

Question 35

Answer 35

Hypertrichosis

Question 36

Answer 36

Hirsutism

Question 37

Answer 37

Koilonychia

Question 38

Answer 38

Pitting

Question 39

Answer 39

Onycholysis

Question 40

Answer 40

Clubbing

Question 41

Name condition

Answer 41

Erythroderma

Question 42

Functions of the skin

Answer 42

Protective barrier against environmental insult Temp reg Sensation Vit D synthesis Immunosurveillance Cosmesis

Question 43

Complications of erythroderma

Answer 43

It is described as a total skin failure where there will be impairments of each function of the skin: Hypothermia Infection Renal failure (insensible loss) High output cardiac failure due to dilated skin vessels Protein malnutrition because there is a high turnover of skin

Question 44

Causes of erythroderma

Answer 44

Psoriasis Eczema Drugs Cutaneous T cell lymphoma

Question 45

Symptoms of erythroderma

Answer 45

Pruritus Fatigue Anorexia Feeling cold

Question 46

Signs of erythroderma

Answer 46

Erythematous Thickened skin Inflamed skin Scaly skin No sparing skin

Question 47

Cell types of epidermis

Answer 47

Keratinocytes (protective) Langerhan cells (APCs) Melanocytes (protection against UV) Merkel cells (sensation)

Question 48

Layers of the epidermis

Answer 48

Straum basale Stratum spinosum Stratum granulosum Stratum corneum And also stratum lucidum in thick skin.

Question 49

Turnover time of skin

Answer 49

30 days

Question 50

Composition of dermis

Answer 50

Collagen Elastin Glycosaminoglycans This provides strength and elasticity to the skin. It also contains immune cells, nerve cells, skin appendages, lymphatics and blood vessels.

Question 51

Explain the properties of the sebaceous glands.

Answer 51

Produce sebum through hair follicles. This is done in order to lubricate the skin and will first become active after puberty. They are stimulated by the conversion of androgen to DHT.

Question 52

Give an example of a condition that can arise from too much sebum production.

Answer 52

Acne vulgaris

Question 53

Function of the eccrin and apocrine glands.

Answer 53

Regulate body temp.

Question 54

Innervation of the glands.

Answer 54

Sympathetics

Question 55

Where can eccrine glands be found?

Answer 55

Widespread throughout the body

Question 56

Where can the apocrine glands be found?

Answer 56

After puberty at and around axillae, areolae, genitalia and anus.

Question 57

3 main types of hair.

Answer 57

Lanugo Vellum Terminale

Question 58

Growth cycle of hair.

Answer 58

Anagen Catagen Telogen

Question 59

What is this?

Answer 59

Melanonychia Can be malignant melanoma