Skin

Question 1

What are the main functions of skin?

Answer 1

Protection
Thermoregulation 
Metabolic function 
Psychosocial
Sensation

Question 2

What are the main layers of the skin?

Answer 2

Epidermis
Dermis - Splits into the Papillary and the Reticular
Hyper-dermis

Question 3

What are the layers of the epidermis?

Answer 3

Stratum Corneum 
Stratum Granulosum 
Stratum Spinosum 
Stratum Basale 
(Run from superficial to deep)

Question 4

What is the rough lifespan of a epidermal cell?

Answer 4

45-60 days

Question 5

Name 3 things that happen as cells mature

Answer 5

Increase in keratin granules and filaments
Increase in lamella bodies (glycophospholipids)
Cells become flattened and more tightly packed

Question 6

How does cell life span change in people with psoriasis?

Answer 6

Normal life span is only 7 days

Over proliferation of skin cells, resulting in an excess and therefore dry and flaking patches

Question 7

Name 4 types of epidermal cell

Answer 7

Keratinocytes
Melanocytes
Langerhans cells
Merkel cells

Question 8

Which epidermal layer would you find Keratinocytes in? What is their function?

Answer 8

All layers - Corneum, Granulosum, Spinosum, Basale
90% of all epidermal cells
Makes Keratin

Question 9

Which epidermal layer would you find Melanocytes in? What is their function?

Answer 9

Basale layer

Produce melanin

Question 10

Which epidermal layer would you find Langerhans cells in? What is their function?

Answer 10

Spinosum
Present antigens
Results in hypersensitivity reactions - Type 4 rash
Associated with nickel sensitivity and contact dermatitis

Question 11

Which epidermal layer would you find Merkel cells in? What is their function?

Answer 11

Basale layer

Light touch sensory function

Question 12

What does the dermis contain?

Answer 12

Blood vessels
Nerves
Hair follicles
Collagen and Elastin

Question 13

What makes up a Pilosebaceous unit?

Answer 13

Hair follicle
Sebaceous gland
Arrector pili muscle

Question 14

Name the 2 types of sweat glands and state where they are found

Answer 14

Eccrine - All over the body (Thermoregulation)

Apocrine - Armpit and groin

Question 15

How does skin aid thermoregulation?

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Answer 15

AV anastomoses
Found in the top and bottom of the dermis
Can cause shutdown at different levels

Question 16

What is a macule?

Answer 16

Flat small skin lesion

Question 17

What is a patch?

Answer 17

Flat large skin lesion

Question 18

What is a papule?

Answer 18

A raised solid small skin lesion

Question 19

What is a nodule?

Answer 19

A raised solid large skin lesion

Question 20

What is a plaque?

Answer 20

A raised solid very large skin lesion (psoriasis)

Where the area is greater than the height

Question 21

What is a vesicle?

Answer 21

Raised, fluid filled, small and clear skin lesion

Question 22

What is a Bolla?

Answer 22

Raised, fluid filled large and clear skin lesion

blister

Question 23

What is a Pustule?

Answer 23

Raised, fluid filled, pus filled skin lesion

Question 24

What is a large Pustule called?

Answer 24

An abscess

Question 25

What are the risk factors for a basal cell carcinoma?

Answer 25

UV exposure, genetic predisposition (pale skin), immunosuppression

Question 26

Which is the most common skin cancer?

Answer 26

Basal Cell Carcinoma

Question 27

What is the prognosis for basal cell carcinoma?

Answer 27

Good. Doesn't metastasise Just chop the affected skin out

Question 28

What is the second most common type of skin cancer?

Answer 28

Squamous cell carcinoma

Question 29

What are the risk factors for squamous cell carcinoma?

Answer 29

UV exposure, being male, immunosuppression, fair skinned, occupational exposure

Question 30

What does the prognosis for squamous cell carcinoma depend on?

Answer 30

Depends on lesion thickness | Does metastasise

Question 31

What are the risk factors for Melanoma?

Answer 31

UV exposure, lots of dysplastic or niave lesions, history of melanoma Least common type of skin cancer

Question 32

What is the prognosis for Melanoma?

Answer 32

Poor | Based on deepness of invasion

Question 33

What histological changes would you see in cancerous cells?

Answer 33

Hyperchromatic Loss of normal architecture High nuclear to cytoplasmic ratio Pleomorphism (cells don't all look the same)

Question 34

What is the A to E approach for assessing lesions?

Answer 34

``` A = Asymmetry = bad if not symmetrical B = Border = bad if jagged border C = Colour = bad if not all the same colour D = Diameter = bad if big E = Evolution = bad if crusty, bleeding, itchy...anything it wasn't previously ```

Question 35

What does TNM staging stand for?

Answer 35

Tumour size No of nodes Metastasis

Question 36

What are the boundaries for removal of a lesion?

Answer 36

Elliptical 3:1 cm length:width Incision should be parallel to tension lines in skin