Skin

Question 1

Functions of the skin

Answer 1

protective barrier against environmental insults
temp and water loss regulation
sensation
Vit D synthesis
appearance

Question 2

Structure of normal skin

Answer 2

epidermis
dermis
subcutaneous tissue

Question 3

Flat skin terminology

Answer 3

macule: flat area of altered colour <0.5cm
patch: flat area of altered colour and texture >0.5cm

Question 4

Raised skin terminology

Answer 4

papule: solid raised lesion <0.5cm
nodule: solid raised lesion >0.5cm (deeper)
plaque: palpable scaling raised lesion >0.5cm

Question 5

Blistered skin terminology

Answer 5

vesicle: raised, clear fluid filled lesion <0.5cm
bulla: raised, clear, fluid filled lesion >0.5cm

Question 6

Fibro epithelial polyps

Answer 6

benign lesion
"skin tags"
middle aged/older people more common
neck, face, trunk, axilla and groin
flesh coloured, bag like lesion
histology: fibrous core, epidermis on a stalk

Question 7

Naevi

Answer 7

benign lesion
“moles”
proliferation of benign melanocytes (pigment-producing cell)
> dermo-epidermal junction (junctional- just in epidermis)
> dermo epidermal junction and dermis (compound - epidermis and dermis)
> just in dermis (intradermal)

Question 8

Sebaceous cysts

Answer 8

benign lesion 
2 types
> epidermoid (granular layer)
> pilar (no granular layer)
lined with stratified squamous epithelium

Question 9

Seborrhoeic keratosis

Answer 9

benign lesion
middle aged/older people
arise spontaneously
trunk, head and neck

Question 10

Haemangioma

Answer 10

benign lesion
vascular tumour of the dermis
tends to occur in children
blue/red surface

Question 11

Basal cell carcinoma

Squamous cell carcinoma

Answer 11

Malignant lesion
most common human cancer
slow growing, rarely metastasise
occur at skin exposure sites’

Bowen’s disease = precursor to SCC, due to sun damage

Question 12

Melanoma

Answer 12

malignant lesion
arises in sun damaged skin
can be very aggressive and spread widely
used to be universally fatal, but early diagnosis = removal
5 things to look out for:
asymmetry 
border - ? irregular
colour - ? variable pigmentation in lesion
diameter - mostly >6mm
enlarged ?

Question 13

Rashes

Answer 13

inflammatory skin reactions

eg. eczema - itching, burning, blisters

Question 14

Psoriasis

Answer 14

commonly affects elbows, knees, scalps, lumbosacral area, glens penis
associated with nail changes, arthritis, myopathy (disease of muscle), enteropathy (disease of intestines)and spondylic joint disease
salmon pink plaques with silver scaling

Question 15

Scabies

Answer 15

caused by human scabies mites = itchy
spread by direct skin to skin contact with someone who has it
burrows appear as small grey lines on skin

Question 16

Meningitis

Answer 16

unwell (headache, stiff neck, dislike to bright lights)
can deteriorate rapidly (aching limbs, cold hands and feet)
majority develop a rash of tiny ‘pin prick’ spots developing into purple bruising
non-blanching rash!!