Skin

Question 1

What is a macule?

Answer 1

A flat lesion <5mm

Question 2

What is a patch?

Answer 2

A flat lesion >5mm

Question 3

What is a papule?

Answer 3

A raised solid lesion <5mm

Question 4

What is a nodule?

Answer 4

A raised solid lesion >5mm

Question 5

What are target lesions and what causes them?

Answer 5

Red concentric rings, caused by erythema multiforme

Question 6

What is Koebners phenomenon and what causes it?

Answer 6

Skin lesions appearing on lines of trauma - caused by lichen planus

Question 7

What is erythroderma?

Answer 7

Erythema and scaling that affects the entire body, which can lead to heart failure and dehydration

Question 8

What does monomorphic mean and what is it characteristic of?

Answer 8

A cluster of same-sized vesicles, caused by eczema herpeticum

Question 9

What is the difference between an ulcer and an erosion?

Answer 9

Ulcer - break in dermis and epidermis

Erosion - break in epidermis

Question 10

What is eczema?

Answer 10

AKA dermatitis - red, itchy, dry, scaly skin caused by dehydration

Question 11

What are the exogenous causes of eczema?

Answer 11

• Irritant
• Allergic
• Photodermatitis

Question 12

What are the 7 endogenous causes of eczema and describe them?

Answer 12

• Atopic - absence of filaggrin
• Seborrhoeiac - affects the scalp, hormone related
• Discoid
• Pompholyx - vesicles that burst on hands and feet
• Varicose - dilated lichenified veins in legs
• Asteatotic - elderly, lack of sebum, very dry
• Lichen simplex - very itchy and thick, neck and ankle

Question 13

Where does atopic eczema affect?

Answer 13

Young children - extensor surfaces

Everyone else - flexor surfaces

Question 14

How is eczema treated?

Answer 14

Emollients
Topical steroids - hydrocortisone, betamethasone
Topical tacromilus

Question 15

What is eczema herpeticum?

Answer 15

A disseminated viral infection characterised by fever and itchy blisters (from chronic eczema)

Question 16

What is psoriasis?

Answer 16

Well-defined scaly plaques due to fast turnover of skin cells

Question 17

What are the 7 types of psoriasis?

Answer 17

Guttate - teardrop shaped on trunk, Group A strep
Plaque - elbows and knees
Scalp 
Nail - pitting
Flexural - groin, buttocks, elbows
Pustular - hands and feet
Erythrodermic

Question 18

How is psoriasis treated?

Answer 18

Emollients
Topical steroids - hydrocortisone, betamethasone
Vitamin D3 analogues - calcipotrol (reduces cell turnover)
Salicyclic acid
Dithranol
Coal tar preparations

Question 19

If eczema and psoriasis still persist from treatment, how can they be managed?

Answer 19

Phototherapy, methotrexate (anti-inflammatory)

Question 20

What are the characteristics of a basal cell carcinoma?

Answer 20

Rolled, nodular, pearly edge, telangiectasia, slow-growing, erosions, locally invasive, sun-exposed areas

Question 21

How is a BCC managed?

Answer 21

Excision
Cryotherapy
Topical flurouracil or imiquimod

(NOT 2WW)

Question 22

What are the characteristics of a squamous cell carcinoma?

Answer 22

Ulcerated, firm, keratotic with hard raised edges, sun-exposed areas

Question 23

How is an SCC managed?

Answer 23

2WW - Excision and radiotherapy

Question 24

What is a malignant melanoma, and what is the criteria for diagnosis?

Answer 24

ABCDE
Asymmetry
Border - irregular
Colour - non-uniform
Diameter - >7mm
Elevation

Ask about changes in shape, size, colour, bleeding

Question 25

What are the 2 main types of malignant melanoma, and name 2 others?

Answer 25

Superficial spreading - grow slowly Nodular melanoma - invade deeply, metastatize early, often amelanotic Others include - lentigo maligna, acral melanoma (palms,soles)

Question 26

How is malignant melanoma managed?

Answer 26

2WW (even if just one change) - surgical excision, chemotherapy

Question 27

What is Breslows thickness?

Answer 27

The length from the granular layer of the epidermis to the base of the skin cancer, correlating with approximate survival time

Question 28

What are solar (actinic) keratosis?

Answer 28

Premalignant tumour - Crumbly yellow crusts on sun-exposed areas that can become SCCs after years

Question 29

How are actinic keratosis treated?

Answer 29

Cryotherapy | Topical fluorouracil or imiquimod

Question 30

How do fluorouracil and imiquimod work?

Answer 30

They cause erythema --> vesiculation --> erosion --> ulceration --> necrosis --> healing Warn patients of expected inflammatory reaction

Question 31

What is Bowen's disease?

Answer 31

Premalignant tumour - Slow-growing red scaly plaque (carcinoma in situ) that can become SCCs after years

Question 32

How is Bowens disease treated?

Answer 32

Cryotherapy Topical fluorouracil Photodynamic therapy

Question 33

What is lentigo maligna?

Answer 33

Premalignant melanoma in situ that consists of malignant cells but does not show invasive growth - can become malignant melanoma

Question 34

What is extramammary Paget's disease?

Answer 34

Chronic eczema-like rash around the genitals that can be associated with underlying cancer

Question 35

What is seborrheic keratosis?

Answer 35

Benign skin-growth that resembles malignant melanoma