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Dermatology > Skin > Flashcards

Skin Flashcards

(57 cards)

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1
Q

What is the layers of the skin (biggest organ of the body)

A

Epidermis
Dermis
Hypodermis = subcutaneous tissue which anchos skin to fascia (useful in insulation)

Skin appendages = derived from skin cells

  • Hair
  • Nails
  • Sebaceous glands
  • Sweat glands
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2
Q

What is the epidermis made up of and what pathology can affect

A

Striatum cornea (thick top layer made up of keratin)
- Thickest in palms and soles
- Thin at eyelids
Keratonocytes - produce keratin
Melanocytes - produce melanin
Lagerhan’s - immune (process antigen and migrate to LN)
Average turnover = 30 days

Pathology

  • Change in turnover e.g. psoriasis
  • Change in surface or loss of epidermis e.g. scales / ulcer
  • Change in pigmentation
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3
Q

What is the dermis made up of

A 
Collagen = mainly 
Fibroblasts synthesis elastin 
Dendiritc cells for immune
Nerves + blood vessels 
Adrenal structures - hair / glands / sensory

Pathology

  • Change in contour / loss of dermis
  • Disorder of skin appendages - hair / acne (Sebaceous gland)
  • Change lymphatics / blood vessel - erythema, urticaria, purpura
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4
Q

What are nails made up of

A 
Nail plate (hard keratin) which arises from nail matrix at posterior nail fold and rests on nail bed 
Nail bed contains capillaries which give colour
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5
Q

What is the stages of the hair cycle and types of hair

A

Lanugo - fine long hair in fetus
Vellus - fine short hair on all areas
Terminal - coarse long hair on scalp, eyebrows, eyelash and pubic

Hair shaft - keratinised tube
Hair bulb - actively dividing cells and melanocyte which gives pigment

Anagen = active growing
Catagen = growth stops + follicle shrinks
Telogen = resting phase
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6
Q

What are the functions of the skin

A 
Thermoregulation - insulation / sweat / blood flow 
Immune system - innate and adaptive 
Barrier
Sensation
Synthesis of Vitamin D
Personal communication
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7
Q

What causes skin disease

A

Photosensitivity - often medication
Temperature - frost bite / necrosis / cold urticaria
Trauma - dermatitis artefacts
Genetics - eczema / psoriasis / acne / neurofibroma
Autoimmune - bullous pemphigoid
Infection
Systemic

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8
Q

What is a macule

A

Small flat circumscribed area <5mm of altered colour

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9
Q

What is a patch

A

Larger flat area of altered colour >5mm

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10
Q

What is a papule

A

Small raised area <0.5cm

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11
Q

What is a plaque

A

Large raised area >0.5cm

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12
Q

What is a vesicle

A

Small fluid filled lesion <0.5cm

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13
Q

What is a bullae

A

Large fluid filled

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14
Q

What is a pustule

A

Small pus

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15
Q

What is an abscess

A

Large pus in dermis or subcutaneous tissue

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16
Q

What is wheal

A

Transient raised lesion due to localised oedema

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17
Q

What is an erosion

A

Superficial loss of epidermis

Heals without scarring

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18
Q

What is an ulcer

A

Loss of epidermis and denims

Heals with scarring

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19
Q

Why can skin regenerate

A

Has stem cells

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20
Q

What causes purpura in children

A 
Thrombocyotpenia 
Meningococcal septicaemia - non-palpable 
ALL
Congenital bleeding disorder 
ITP
HSP - tend to be palpable 
NAI
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21
Q

What should you do to all children with new onset purpuric rash

A

Always admit to exclude life threatening
Ax prior to transfer to hospital as may be due to menigococcal septicaemia
Clotting screen and platelet to exclude coagulation disorder

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22
Q

What causes purpura in adults

A 
Vasculitis
Bone marrow failure
ITP
Drugs
Nutrition
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23
Q

What can distribution of skin disease be

Study These Flashcards
A

Localised
Generalised
Symmetrical

24
Q

How can you investigate skin disease

Study These Flashcards
A 
Charcoal swab - bacterial and fungal 
Viral swab - vesicular eruption
Skin scraping
Nail scraping 
Dermoscopy
25
What do you send swab for
MC+S if charcoal PCR if viral Biopsy
26
Do you swab in cellulitis
No as will have pyrexia so need blood culture
27
What do you do if fungal suspect
Skin scraping Nail clipping Hair sample Fungal culture
28
What is important in HPC of skin problem
``` Duration Initial appearance and evolution Symptoms - itch / pain Aggravating and relieving factors Previous and current Rx Recent contact / stress / travel Hx sunburn or sunbeds Skin type ```
29
What else is important
``` PMH - atopy / skin cancer FH - skin disease SH - occupation / do skin lesions improve DH QOL ```
30
How do you examine skin lesion
Inspect Describe Palpate Systematic check
31
What do you look for on inspetion
Site and number of lesions | Pattern of distribution
32
How do you describe each individual lesion
``` SCAM Site Shape Colour Associated secondary change Morphlogy / Margin ```
33
What are you feeling for on palpation
``` Surface Consistency Mobility Tenderness Temperature ```
34
What systemic check do you do
Examine nail, scalp, hair and mucous membrane
35
General terms and meaning
``` Pruritus = itch Lesion = area altered skin Rash = eruption Naevus = localised malformation Comedone = plug in sebaceous follicle containing sebum and bacteria - If open = black head - If closed = white head ```
36
How do you describe distribution
Generalised = all over body Extensive = widespread Localised = one area of skin Flexural = body folds Extensor Pressure area - sacrum / buttock / ankle / heel Dermatome - supplied by single spinal nerve Photosensitive - affects sun exposed area Koebner - linear eruption arising at site of trauma
37
What can colour of lesions be
Erythema - redness due to inflammation which blanches Purpura - red or purple due to bleeding which doesn't blanch - Petechiae = small pinpoint macules - Ecchymoses = large bruising patches Hypo-pigmentation DE-pigmentation due to lack of melanin Hyperpigmentation
38
How do you describe morphology/ structure of lesion
See above
39
How do you describe secondary morphology that arises from primary
See below
40
Excoriation
Loss of epidermis following trauma
41
Lichenification
Well-defined roughening of skin
42
Scaling
Flakes of stratum corneum
43
Crusting
Rough surface consisting of dried serum, blood, bacteria that has exude through eroded epidermis
44
Scar
New fibrous tissue post wound healing - Atrophic = thinning - Hypertrophic = within boundary - Keloid - beyond boundary
45
Fissure
Epidermal linear split
46
Striae
Linear areas from purple-pink-white | Associated execessive steroid / growth / pregnancy
47
Hair terms
``` Alopecia = loss of hair Hirsutism = androgen dependent hair growth in female Hypertrichosis = non-adorgen dependent hair growth ```
48
Nail terms
``` Clubbing = Loss of angle between posterior nail fold and plate Koilonychia = spoon shaped depresion Onycholysis = separation of distal nail plate from nail bed Pitting = punctate depression ```
49
What is onycholysis associated with
Trauma Psoriasis Fungal Hyperthyroid
50
What is pitting associated with
Psoriasis Eczema ALopeia acreana
51
What do sebaceous glands do
Produce sebum via hair follicles (pilosebaceous unit) Lubricates and waterproofs skin Become active at puberty
52
What do sweat glands do
Regulate body temperature | Innervated by sympathetic nervous
53
What is a cyst
Fluctuant swelling containing fluid or keratin
54
What is a comedone
Plugged sebaceous follicle
55
What bloods can be done in dermatology
``` Autoimmune screen Coag screen Monitoring systemic Rx Vit D ASOT Pruritus / alopecia screen ```
56
What is patch testing for
Exposure allergy
57
What is prick testing for
Systemic allergy

Dermatology (12 decks)

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