Skin

Question 1

What is Mealses

Answer 1

Viral respiratory infection that can also present with a rash, can show tiny white spots intra-orally

Question 2

What is Rubella

Answer 2

(German measles), viral infection that presents with rough-feeling spotty rash

Question 3

What is the associated Risk with Rubella

Answer 3

High risk to unborn children + pregnant women, will cause foetal abnormalities with 90% mother->child transmission rate

Question 4

what is chickenpox

Answer 4

Varicella zoster virus, highly contagious vial infection

Question 5

Describe the presentation of chickenpox

Answer 5

Small red spots, which become very itchy blisters
first appear on face, back and chest

Question 6

how can you differentiate chickenpox and measles

Answer 6

Measles is respiratory so will see a runny nose, sore throat, hacking cough
chickenpox, the red spots will turn into itchy blisters

Question 7

In an adult pt, what is the progression of chickenpox from the spots?

Answer 7

Virus will retreat to CNS, will lay dormant until a trigger can reactivate it (e.g becoming unwell, temp immunocompromised) and can cause shingles

Question 8

where is shingles most commonly associated?

Answer 8

will affect skin in a dermatome area, frontal division of trigeminal on face

Question 9

What is the treatment for HSV-1

Answer 9

Acyclovir (prevents viral DNA replication)

Question 10

What are oral manifestations of HSV-1

Answer 10

primary herpetic gingival stomatitis - clusters of vesicles/ulcers in mucosa and tongue

Question 11

What is herpetic whitlow

Answer 11

Herpes in the fingers, vesicles form and burst on the fingers,
painful, red, swell

Question 12

What is the aetiology of warts

Answer 12

Human papilloma virus (describes a group of viruses to include HPV),

Question 13

what is the Tx for warts

Answer 13

Cryotherapy, salicylic acid cream

Question 14

what is the association with HPV

Answer 14

Cervical cancer, screening is present to all women aiming to identify intra-epithelial neoplasia

Question 15

Outline Folliculitis

Answer 15

Bacterial infection around a single follicle on the skin

Question 16

Describe a Boil

Answer 16

bacterial infection, extending redness with liquefaction of tissue, creating a painful lump filled with pus

Question 17

What is a carbuncle

Answer 17

An extension of a boil - undermining the skin, bacterial infection involving multiple sites to form a dome for a cluster of boils

Question 18

What is Erysipelas and how does it present

Answer 18

Infection of stept. into dermis layer of skin
Presents as a large, very red swelling forming a clear margin > needs A&E w./ antibiotics

Question 19

What is impetigo and how does it present

Answer 19

Highly contagious infection from either Strept. or Staph.
Will form a vesicle with surrounding area of redness, will rupture to form a yellow crust
involves the outer keratin layer

Question 20

What causes Eczema

Answer 20

Type 1 hypersensitivity reaction, IgE-mediated inflammation

Question 21

Where does Eczema normally present?

Answer 21

moist skin, flexor surfaces, will be incredibly itchy

Question 22

What is the management for eczema?

Answer 22

moisturise the skin, avoid strong soaps that’ll wash off natural oils, topical antihistamine and corticosteroids

Question 23

what is the presentation of psoriasis

Answer 23

white, scaly patches of itchy skin, normally extensor surfaces

Question 24

Name the differences between psoriasis and eczema

Answer 24

(both immunologically mediated)
Eczema = Flexor surfaces, Psoriasis = Extensor surfaces
Psoriasis not type 1 hypersensitivity reaction

Question 24

Name the differences between psoriasis and eczema

Answer 24

(both immunologically mediated) Eczema = Flexor surfaces, Psoriasis = Extensor surfaces Psoriasis not type 1 hypersensitivity reaction Eczema = broken red skin, Psoriasis = scaly white skin

Question 25

What is SLE?

Answer 25

Systemic Lupus Erythematosus, Systemic autoimmune condition that affects skin, joints, liver, kidney, GI Unknown aetiology, SLE is most common type of lupus

Question 26

How does SLE present?

Answer 26

'Butterfly rash' across the nose and cheeks

Question 27

Management for SLE

Answer 27

Depends on severity and what body systems are involved Steroids, biological response modifiers, methotrexate (antimetabolite)

Question 28

What is DLE

Answer 28

Discoid Lupus Erythematosus, a milder form of systemic LE that affects the skin (can progress into systemic LE)

Question 29

Describe the presentation of DLE

Answer 29

Round sores, as disks of skin break down to form vesicles

Question 30

What is Raynaud's phenomenon, and what is it associated with

Answer 30

- Descreased blood flow to the fingers, causing them to go white and cold - Scleroderma (thickening, hardening of the skin)

Question 31

What is the aetiology behind lichen planus

Answer 31

Cause unknown, immunologically mediated T cell infiltrate

Question 32

Describe oral presentation of lichen planus

Answer 32

- typically bilateral - Whickham's striae >spiderweb appearance of lacy white lines - erosive: oral ulcers, persistent areas of redness, covered in yellow slough

Question 33

Management of Oral Lichen planus

Answer 33

- Benzydamine hydrochloride mouthwash - SLS free toothpaste - topical and systemic steroids

Question 34

What is the difference between Pemphigus and pemphigoid

Answer 34

(both auto-immune conditions that produce vesicles of bullae in oral mucosa) - Pemphigus is auto-immune against desmosomes, pemphigoid is auto-immune against hemidesmosomes - Pemphigus produce easily broken intra-epithelial vesicles, pemphigoid produce sub-epithelial lesions which are less delicate

Question 35

what is a desmosome and which skin condition is associated with it

Answer 35

Structure involved in holding epithelial cells together, which are auto-immune attacked in Pemphigus

Question 36

What is a hemidesmosome, and which skin condition is associated with it?

Answer 36

Hemidesmosome connects the cells to the basal lamina, associated with pemphigoid

Question 37

What oral condition can disguise itself as a cyst?

Answer 37

Chronic discharging dental sinus (can put in a gp point and radiograph it to track it back to tooth causing the issue)

Question 38

Categories for describing skin lesions

Answer 38

Where is it Size and shape Does it move Consistency Compressable, pulsatile, any associated lymphadenopathy/sinus/nerve issues

Question 39

Describe what telangiectasia is and how it presents

Answer 39

Vascular lesion, very small clusters of red spots, can be associated with nose bleeds

Question 40

Describe what spider navi is and how it presents

Answer 40

common lesions, red 'spiderweb' expanding form a point Associated with liver failure (hepatitis, cirrhosis)

Question 41

Describe appearance of Sturge-weber syndrome

Answer 41

Vascular lesion, causes 'port wine staining' (big swathe of dark red across skin) unilateral distribution along trigmenal nerve can present alongside epilepsy

Question 42

What are the managements for vascular lesions

Answer 42

-refer to GP - laser treatment - surgical resection - beware intra-oral > can bleed excessively

Question 43

Where are melanocytes in the skin structure?

Answer 43

Basal Layer of epidermis

Question 44

7-point checklist for melanoma:

Answer 44

- change in size (panic if larger than pencil end) - irregular pigmentation - irregular border - itch, altered sensation - larger than other lesions - inflammation - oozing

Question 45

What is the difference in basal and squamous cell carcinoma?

Answer 45

Affect different cell types, Squamous is more likely to metastasize, more aggressive than BCC

Question 46

How are skin cancers Diagnosed

Answer 46

biopsy