Skin and integument Flashcards
(199 cards)
1
Q
what do desmosomes do
A
Provide mechanical strength and contribute towards the water barrier
2
Q
Different layers of the skin from outermost to innermost
A
stratum corneum stratum lucidum stratum granulosum stratum spinous (prickle cell layer) stratum basale (basement membrane)
(come lets grow some bananas)
3
Q
What glands are in the skin
A
sudoriferous (sweat), sebaceous, ceruminous, mammary
4
Q
What are Langer’s lines
A
skin tension lines (also called cleavage lines)
parallel to natural collagen fibres in the skin
5
Q
What are Blashcko lines
A
lines of normal cell development in the skin
invisible under normal conditions
6
Q
Anatomy layers of scalp (five)
A
Skin Collagen fibres Aponeurosis loose areolar periosteum
7
Q
Why does skin elasticity change
A
Skin loses ability to stretch and bounce back with ageing
things that accelerate: sun exposure, smoking
8
Q
Typical skin distribution of psoriasis
A
Extensor surfaces
9
Q
Typical skin distribution of eczema
A
flexor surfaces
10
Q
Four uses of skin
A
Physical barrier
chemical barrier
immune barrier
microbiome barrier
11
Q
Describe microbiome barrier of the skin
A
commensal bacterial in and on skin compete with potential pathogens
12
Q
Things that affect the microbiome nature of the skin
A
host physiology environment immune system hosts genotype lifestyle pathobiology
13
Q
what is meant by host physiology
A
age
sex
site
14
Q
what is meant by environment (microbiome)
A
climate
geographical location
15
Q
what is meant by immune system (in microbiome skin)
A
previous exposure
inflammation
16
Q
what is meant by hosts genotype (microbiome)
A
susceptibility genes such as flaggarin
17
Q
what is meant by lifestyle (microbiome)
A
occupation
hygiene
18
Q
what is meant by pathobiology (microbiome)
A
underlying conditions such as diabetes
19
Q
describe immune barrier nature of the skin (epidermis)
A
keratinocytes and resident immune cells protect against potential pathogens langerhans cells (antigen presenting cells that activate T cells that provide an immune response)
20
Q
Name cells present in immune barrier nature of the skin (dermis)
A
mast cells macrophages dendritic cells B&T cells NK cells plasma cells
21
Q
Describe chemical barrier nature of the skin
A
skin has an acidic pH (maintained by sweat conversion of triglycerides to fatty acids)
alters to this pH (i.e. more acidic) alters the microbiome function
lipids that require trans-epidermal water loss are produced by enzymes that require an acidic pH
22
Q
Name a couple of effects that vitamin D synthesis has on the skin
A
differentiation and proliferation anti-microbial effects sebaceous gland regulation photo-protection adaptive immunity wound healing hair follicle cycling deficiency linked to (hair loss, cancer, atopic dermatitis..)
23
Q
What receptors are located superficially in the skin
A
Meissner’s corpuscles and Merkel’s discs
24
Q
What are Meissner’s corpuscles
A
cutaneous nerve ending responsible for transmitting fine, discriminative touch and vibration
25
What are Merkel's discs
widely distributed (in fingertips and lips)
slow adapting and unencapsulated
respond to light touch (discriminative)
26
What receptors are located deeply in the skin
Pacinian corpuscles and Ruffini endings
27
What are pacinian corpuscles
detect pressure and vibration from being compressed which stimulates their internal dendrites
28
What do Ruffini endings detect
detect stretch
deformation within joints
warmth
29
What are the rapidly adapting receptors
pacinian corpuscles, Meissner's corpuscles and hair follicle afferents
(all sense vibration)
30
Do superficial receptors have large or small receptive fields
small - sense fine details and textures
31
what is glabrous skin
skin without hair (palms, soles of feet)
32
Paraesthesia
burning or prickling sensation, often accompanied by numbness, usually felt in hands or feet
33
Transient (short-lived; passing; not permanent) factors of paraesthesia
pressure-induced, hyperventilation, viral infection, hyperthermia
34
Chronic factors of paraesthesia
vascular disorders, metabolic disorders (diabetes), malnutrition, neuropathy, arthritis, autoimmune (MS)
35
What is tactile hyperesthesia
increased tactile (touch) sensitivity due to peripheral neurological disorders (peripheral neuropathy)
36
What is tactile hypoesthesia
(numbness) Decreased tactile sensitivity due to damage of afferent nerves (ischaemia due to vascular disorders, decompression sickness, thiamine deficiency)
37
Three types of cutaneous pain sensation receptors
polymodal nociceptors
mechano-cold receptors
mechanically insensitive nociceptors
38
what do polymodal nociceptors detect
mechanical, thermal and chemical stimuli
39
What do mechano-cold receptors detect
mechanical and cold stimuli
40
what do mechanically insensitive nociceptors detect
chemical and possible thermal stimuli
41
What fibres does fast pain run along
| what do this fibres produce
A𝛅 fibres produce initial and well localised pain (sharp/.pricking)
42
what fibres does slow pain run along
| and what pain do they give
C fibres more prolonged aching pain
43
What fibres do pressure blocks block
myelinated A𝛅 fibres
44
What fibres does a local anaesthetic block
unmyelinated C fibres
45
What is hyperalgesia
excessive response to noxious (painful) stimuli
| over-reaction to painful stimuli
46
what is allodynia
production of pain by non-noxious stimuli (not painful)
| being stroked by a feather causes a pain response
47
Describe primary hyperalgesia include sensitising agents
Primary hyperalgesia is characterized by increased responsiveness to both heat and mechanical stimulation in the area of injury.
sensitising agent: An agent which, when added to a biological system, increases the amount of damage done by a subsequent dose of radiation.
chemically mediated sensitisation of nociceptors results in increased firing rate
sensitising agents including bradykinin, prostaglandins, and cytokines
48
Describe secondary hyperalgesia
occurs without an increase in the firing rate of nociceptors - increased responsiveness of central pain circuit
secondary hyperalgesia is generally associated with increased responses to mechanical but not heat stimuli.
49
What reflex does pain cause
flexion withdrawal reflex
50
what reflex does itching cause
scratching behaviour
51
What causes an acute itch
insect bite/allergen
52
what causes a chronic itch
inflammatory dermatoses (psoriasis, eczema)
systemic disorders (renal failure)
neuropathic (MS)
psychological (OCD)
53
What does nociceptor activity cause release of and what does this do
substance P from axon collaterals which increases blood flow and inflammatory agents (histamine causing redness heating and swelling of efferent nerve)
54
Layers of the scalp
```
pneumonic SCALP
Skin (& dense connective tissue)
Connective tissue
Aponeurosis
loose areolar connective tissue
periosteum
```
55
What does Zosteriform mean
stays in one dermatome and doesn't cross the midline
56
What are lines of Blaschko thought to represent
lines of normal cell development in the skin. These lines are invisible under normal conditions. They become apparent when some diseases of the skin or mucosa manifest themselves according to these patterns.
thought to represent pathways of epidermal cell migration and proliferation through development of foetus
57
What is a vesicle
fluid-filled raised sac/lesion, 5mm or less in diameter
58
what is a bulla
fluid-filled raised sac/lesion, greater than 5mm in diameter
59
what is a blister
common term used interchangeably with vesicle and bulla
60
what is a pustule
pus-filled raised sac/lesion
61
5 types of psoriasis
```
vulgar psoriasis
psoriatic erythroderma
guttate psoriasis
inverse psoriasis
pustular psoriasis
```
62
Why don't you treat psoriasis with potent steroids
can turn into pustular psoriasis -which is resistant to a lot of treatment
63
What are the associated comorbidities of psoriasis
DVT/PE and cardiovascular disease
64
Signs of rosacea
facial redness
bumps and pimples
skin thickening (rhinophyma - of the nose)
eye irritation (bloodshot, burning and/or stinging)
65
ABCDE model for melanoma
```
asymmetrical
border (irregular border)
Colour (several colours)
Diameter (>6mm)
Evolution (how it has changed over time)
```
66
Difference between neuropathic, vascular and arterial leg ulcers
neuropathic - diabetes, usually over pressure point
arterial - painful, usually over medial malleolus
vascular - spread out, superficial, background venous changes on the legs (varicose veins, darkened patches)
67
5 different dermatology investigations
```
skin swab
fungal scrapes/nail clippings
punch biopsy
superficial sample
excision
```
68
Define homeotherms
(mammals) that have physiological mechanisms that can regulate temperature
69
Define poikilotherms
(fish) temperature varies with that of external environment
70
define the meaning of core in terms of temperature
The core houses vital organs (temperature only varies a little here)
71
Define the meaning of shell in terms of temperature
temperature can vary more as a result of regulatory responses to preserve core temperature
72
what is the optimal core temperature
37 degrees celsius
73
Describe the receptors near the central thermoreceptors near the midbrain, medulla and spinal cord)
More warm receptors than cold receptors
74
describe the peripheral receptors temperature
more cold receptors than warm receptors
75
how is sodium and calcium involved in body's set temperature
if sodium increases then the set temperature increases
| if calcium increases then set temperature decreases
76
What are the five ways you can clinically measure temperature?
rectal (representative of core temp.)
sublingual (representative of core temp. but can deviate if you have eaten or drunk anything)
axillary (useful for children - can come up cold)
Forehead (cooler than core temp.)
external auditory meatus (ear)
77
what does cholinergic mean
nerve cells where acetylcholine acts as a neurotransmitter
78
what is acetylcholine? what does it do?
main neurotransmitter of parasympathetic nervous system
| contracts smooth muscle, dilates blood vessels, increases bodily secretions, and slows heart rate
79
Three causes of hyperthermia
heat exhaustion
heat stroke
malignant hyperthermia
80
Run down of heat exhaustion (caused by? Symptoms?treatment?)
caused by: strenuous activity, dehydration, alcohol use, overdressing
symptoms: dizziness, fatigue, faintness, increased HR, decreased BP, cramps, nausea, headache
treatment: stop activity and rest, move to cooler place, rehydrate
81
Run down of heat stroke (what is it? Symptoms? treatment?)
failure to regulate core temperature
symptoms (heat stroke ++): racing HR, hot skin, confusion, agitation, loss consciousness, coma
Treatment: ice packs, cooling blankets, IV fluids, support injured organ system
82
Run down of malignant hyperthermia (what is it? Treatment?)
aberrant (not normal) response to volatile general anaesthetics (halothane and suxamethonium)
aberrant cellular ca handling leads to increased metabolic rate (& therefore increase in temperature)
treatment: dantrolene sodium immediately
83
what is hyperhidrosis?
excessive sweating
axillary and palmoplantar (sometimes face)
occurs in 2-3% population
onset after adolescense
84
primary hyperhidrosis cause
idiopathic (arises spontaneously and unknown cause)
85
secondary hyperhidrosis cause
hyperthyroidism, some medications, diabetes, and obesity
86
Treatment options for hyperhidrosis
aluminium based antiperspirants (block sweat glands)
anticholinergics (decreases sweat production)
botox
surgery (remove sweat glands)
87
define pyrexia
fever
88
how does a fever occur
occurs as result of an infection
this produces toxins
which increases WBCs that release pyrogens (fever causing substance)
pyrogens act on neurons which set temperature in the hypothalamus (they then increase the set point)
89
how does body temperature change with a menstrual cycle
Your body temperature naturally changes a tiny bit throughout your menstrual cycle. It's lower in the first part of your cycle, and then rises when you ovulate. For most people, 96°– 98° Fahrenheit is their typical temperature before ovulation.
90
6 ways in which skin can be damaged
```
trauma
surgery
burns
tattoos
skin disorder
disease
```
91
4 steps of coagulation
1) Constriction of the blood vessel. 2) Formation of a temporary “platelet plug." 3) Activation of the coagulation cascade. 4) Formation of “fibrin plug” or the final clot.
92
what is a keloid scar
thick raised scar
93
difference between arterial and venous ulcers
Arterial ulcers develop as the result of damage to the arteries due to lack of blood flow to tissue. Venous ulcers develop from damage to the veins caused by an insufficient return of blood back to the heart.
Arterial ulcers have a distinct “punched out” appearance and are typically circular with a red, yellow, or black coloration. They are usually extremely painful. Venous ulcers are often painless unless they are infected.1
94
define haemostasis
process to prevent and stop bleeding, involving coagulation
95
define wound exudate
fluid leaking from a wound
96
What happens with high wound exudate
healing can be delayed, surrounding skin may be macerated and excoriated
97
What is normal exudate compared to not
thin and watery is normal
| thick and sticky can indicate infection
98
define autolysis
breakdown of all or part of a cell or tissue by self-produced enzymes
99
define granulation tissue
vascularised tissue that forms as chronic inflammation involves
(new capillaries make the tissue appear pink)
100
3 phases of wound healing
inflammatory phase
proliferation phase
maturation phase
101
what happens in the inflammatory phase of wound healing
| what signs can you see? what cells at work?
blood vessels contract and blood clot is formed
when haemostasis is achieved blood vessels then dilate for essential cells (antibodies, WBC, growth factor, enzymes and nutrients to reach wounded area)
can see signs of erythema, heat, oedema, and functional disturbance
predominant cells at work are phagocytic cells (neutrophils, macrophages)
102
what happens in the proliferation phase of wound healing
wound is rebuilt with new granulation tissue
(comprised of collagen and extracellular matrix)
(angiogenesis occurs here)
epithelial cells then resurface the wound (called epithelisation)
103
what is healthy granulation tissue dependent on?
fibroblasts receiving sufficient levels of oxygen and nutrients supplied by the blood
should be uneven in texture, does not bleed easily and is pink in colour
104
what is dark granulation tissue an indicator of
an indicator of poor profusion, ischaemia, and/or infection
105
what happens during the maturation phase of wound healing
final phase
occurs once the wound has closed
involved remodelling of collagen from type III to type I
Cellular activity reduces and the number of blood vessels in the wounded area regresses and decreases
106
how many types of skin in the Fitzpatrick skin type scale
6
107
Define bulla
raised, fluid-filled lesion larger than a vesicle
108
define fissure
crack or break in the skin
109
define macule
flat, coloured spot
110
define nodule
solid, raised lesion larger than a papule, usually indicative of systemic disease
111
define papule
small, circular, raised lesion at the surface of the skin
112
define plaque
a small, abnormal patch of tissue on a body part or an organ.
113
define pustule
raised lesion containing pus, often in a hair follicle or sweat pore
114
define ulcer
lesion resulting from destruction of the skin and perhaps subcutaneous tissue
115
define vesicle
small, fluid filled, raised lesion; blister or bleb
116
define wheal
smooth, rounded, slightly raised area often associated with itching; seen in urticaria such as resulting from an allergy
117
what is sebbhoreic keratosis
highly variable appearance
flat or raised papule or plaque
1mm to several cm in diameter
can be skin coloured, yellow, grey, light brown, dark brown, black or mixed colour
smooth, waxy or warty surface
appear to stick on skin surface like barnacles
118
describe basal cell carcinoma (BCC)
slow growing lesion
classically a nodule with a central crust and telangiectasia
high risk area of the T-zone (should be referred to secondary care within two weeks)
119
define telangiectasia
spidery in appearance blood vessels, sharp and demarcated to the tip of the lesion
120
describe keratin horn
prevents you from identifying an underlying lesion
50% have a benign base
should be referred as risk of malignancy
121
describe squamous cell carcinoma (SCC)
```
keratinocyte tumour
more common in elderly male
increased risk of other skin cancers
larger lesions carry worse prognosis
quick onset
usually painful
```
122
what is a BCC a tumour of
the basoloid epithelium
123
what is a keratoacanthoma
```
rapidly growing volcanic like lesion
can form on sites of trauma
tend to resolve spontaneously
not malignant
difficult to differentiate between SCC
```
124
what is a actinic keratosis
very common (usually on protruding bits and mens scalps)
pre-cancerous
(rare to progress to SCC but can increase with the more you have)
prevention better than cure
a rough, scaly patch on the skin that develops from years of sun exposure.
125
treatment options for actinic keratosis
```
nothing
emollient
topical chemotherapy agents
cryotherapy
surgical removal
```
126
what are sebaceous cysts and how are they treated
benign lesions
surgical removal required when not inflamed
have to make sure entire sack is removed otherwise it will be recurring
on skin its called an epidermal cyst, on scalp its a pilar cyst
127
What is Hutchinson sign a sign of and what does it look like
a malignant lesion (subungal melanoma)
| looks like longitudinal brown-black pigmentation on nails
128
What is Fitzpatrick sign a sign of and what does it look like
a benign lesion (dermatofibroma)
| looks like:dimple sign, sign in which lateral pressure on the skin produces a depression.
129
what is a lipoma
benign fatty lumps
they are mobile under the skin
can be painful if traumatised/or on bony prominence
130
what is a dermatofibroma and how does it look
benign fibrous nodule
probable reactive process
skin looks shiny and stretched
hard to touch
131
describe keloid scar
firm smooth growth secondary to trauma
the worst site - necklace to navel
more common in people of colour
132
what is a cherry angioma
noncancerous (benign) skin growth made up of blood vessels
(increase in number over the age of 40)
(can be linked to pregnancy and rarely malignant)
133
what is a Moe's surgery
they take the lesion out and a histologist sits with you and you remove layer by layer
134
what is erythema multiforme
symmetrical, red, raised skin areas that can appear all over the body.
usually noticeable on hands and feet
most common cause: Herpes simplex virus
spontaneously resolves within 4 weeks
135
what does periorbital mean
around the eyes
136
what is cellulitis
deep inflammation of subcutaneous and dermis
presents as unilateral - hot, tender leg
(occasionally has blisters)|
137
risk factors for cellulitis
```
defective barrier
diabetes/immunosuppresion
chronic lymphedema
peripheral vascular disease
previous cellulitis
```
138
what is lipodermatosclerosis
what does it typically look like
what is it linked to
how do you treat it
results from chronic inflammation and fibrosis of the dermis and subcutaneous tissue of the lower legs
in acute phase may be painful and red
(no systemic upset)
linked to obesity
Inverted champagne flute (tight around ankle then flares out towards calves)
compression for treatment
139
what is paronchyia
| acute treatment?
acute infection around nail (usually bacterial)
usually vey painful
treatment: warm soaks, topical antiseptic if localised, antibiotics if not localised
140
what is erytheroderma and its causes
severe and potentially life-threatening inflammation of most of the body's skin surface
causes: dermatitis, psoriasis, drugs, leukaemia, idiopathic
141
what to look for in erythroderma
```
Pustules (infection or pustular psoriasis)
Superficial blisters (acute dermatitis)
Keratoderma
Nail changes
Lymphadenopathy
```
142
treatment for erythroderma
stop all non-essential drugs
emollients
treat underlying infection
fluid balance and control
143
what is pyoderma gangrenosum
rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs.
• Neutrophilic dermatosis (lots of neutrophils causing inflammation)
144
what is necrotising fasciitis
bacterial infection of soft tissue and fascia
Pain out of proportion to how it looks (agony)
Most common site is lower leg
Severe pain and systemically unwell
Needs surgical debridement
145
what is SJS
Steven - johnson syndrome
146
what is TEN
toxic epidermal necrolysis (Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the skin. This disorder can be caused by a drug reaction—often antibiotics or anticonvulsives.)
147
what is Eczema herpeticum
small punched out ulcers
| common in children with atopic eczema
148
what is generalised pustular psoriasis
rare
sterile pustules on an erythemous background
can occur in response to stopping steroids, pregnancy, drugs
149
how is skin colour determined
melanocytes in the stratum basale
(all skin types have the same number of melanocytes)
melanosomes produce melanin
(melanin is carried by the keratinocytes up the epidermis layer)
150
where do you look for jaundice
in the eyes
151
where do you look for cyanosis
nail beds
less obvious around the mouth
under the tongue
152
how to look for urticaria in skin of colour
feel the skin (should be raised)
| won't see the erythema as clearly
153
what is Mongolian blue spot (skin of colour)
flat bluish- to bluish-gray skin markings commonly appearing at birth or shortly thereafter
lumbosacral dermal melanocytosis
Caused by entrapment of melanocytes in dermis of developing embryo
usually resolves by four years of age but can last forever
154
what is ochranosis
the bluish black discoloration of certain tissues
from hydroquinone deposition in the skin (people of colour use it to lighten their skin)
usually on face when related to hyroquinone
155
what can secondary hypopigmentation be due to
corticosteroid injection
| • More common if injections are instilled subcutaneously or intradermally
156
what is vitiligo
acquired depigmentation syndrome
(loss of melanocytes)
its an autoimmune condition
more cosmetically significant in people of colour
157
what is Dermatosis papulosa nigra
benign
• Multiple smooth black/brown papules on the face and neck
most common in black females
(histology same as sebbhoreic keratosis)
158
what is melanonychia
is brown or black discolouration of a nail
benign
common in darker skin types
look for multiple lines to confirm diagnosis (check toes too)
159
what is an aural melanoma
type of melanoma arising on the palms or soles.
(in darker skins this is the most common)
not related to sun exposure
malignant
160
what is a subungal melanoma
presents as brown-black discolorations of the nail bed. It can present as either a streak of pigment or irregular pigmentation. The discoloration can progress to thickening, splitting, or destruction of the nail with pain and inflammation.
161
what is traction alopecia
caused by repeated trauma to hair follicles or from pulling your hair back into tight hairstyles
encourage less traction on hair
apparent in darker skin type hairstyles
162
what is Acanthosis nigricans
| when does it usually appear
It causes thicker and darker patches or streaks, usually in skin creases and folds, such as the sides and back of the neck, armpits, elbow pits, and groin. But it can show up anywhere on the body.
can appear in people with ovarian cysts, underactive thyroids or problems with the adrenal glands.
163
what is a regional flap in plastic surgery
conducted when tissue is transferred from a part of the body in or near the head and neck region and rotated into the surgical defect.
164
what is a local flap in plastic surgery
when your surgeon takes tissue from 1 part of your body (called the donor site) and moves it to the surgical site that needs to be covered (called the recipient site). Local flaps can be used for reconstructing different areas of the body.
165
what is a free flap in plastic surgery
involves the transfer of a patient's own tissue from a donor site to a recipient site, which is typically the site of a defect. The donor site usually has a distant location with respect to the recipient site.
166
what are two skin substitutes (plastic surgery)
integra (synthetic skin replacement used to reconstruct wounds after elective planned surgery)
matriderm (acellular dermal substitute with porous membrane three-dimensional structure composed of collagen and elastin from bovine ligament and dermis, applicable for full-thickness skin defects.)
167
how should you go about describing a rash
• Site, distribution, colour, shape, border
168
true/false: IgE levels are raised in cases of eczema
true
169
6 different types of emollients
lotions - thin
creams - thicker but can be greasy
ointments - thick and greasy
sprays - for sensitive and hard to reach places
bath additives (little to no area to support evidence)\
bleach baths
170
discoid/ nummular eczema discussion
defined by scattered, well-defined, coin-shaped and coin-sized plaques of eczema
resistant to treatment
important differential - fungal infection (eczema has all over scale whereas fungal is usually just the outside with central sparing)
171
varicose eczema discussion
really common
eczema on lower legs
linked to varicose veins
Haemosiderin - brown appearance, blood has leaked out and is sat in the skin
can be called stasis or gravitational eczema
172
Dyshidrotic/pompholyx eczema discussion
```
is a skin condition where you get itchy blisters on your hands and feet.
intensely itchy
skin looks bubbly at surface
responds well to topical steroids
associated with stress
```
173
Asteatotic eczema discussion
a type of eczema that is more common in older people. It usually affects the shins but sometimes affects other areas such as the thighs, arms, tummy and back.
use loads of emollients
common in hospitals because peoples legs get dry
174
what is intertrigo
inflammation caused by skin-to-skin friction, most often in warm, moist areas of the body, such as the groin, between folds of skin on the abdomen, under the breasts, under the arms or between the toes
175
what is tinea pedis
fungal skin infection that usually begins between the toes. It commonly occurs in people whose feet have become very sweaty while confined within tight-fitting shoes. Signs and symptoms of athlete's foot include an itchy, scaly rash.
176
what is tinea versicolour
common fungal infection of the skin. The fungus interferes with the normal pigmentation of the skin, resulting in small, discolored patches. These patches may be lighter or darker in color than the surrounding skin and most commonly affect the trunk and shoulders.
177
what is tinea cruris
fungal infection that causes a red and itchy rash in warm and moist areas of the body. The rash often affects the groin and inner thighs and may be shaped like a ring. Jock itch gets its name because it's common in athletes
178
what is alopecia areata
Smooth patches of hair loss with exclamation mark hairs(short broken hairs) around edge
strong link to autoimmune condition
179
what is scabies
| treat with?
very itchy skin condition caused by tiny mites burrowing into your skin.
• Looks on wrists and between finger web spaces for signs of burrows
• Treat with dermal lyclear cream twice 7 days apart (for eggs that havent hatched)
• Treat everyone who has been in contact
• Itch may persist for weeks after treatment (eczema from burrows)
180
what is molluscum contagiosum
usually a harmless infection that causes small dimpled spots to appear on the skin.
small, firm spots that have a dimple in the middle. They can be itchy.
goes over a matter of months
widespread in an adult - think HIV
181
what is rosacea
| what do you treat the symptoms with?
common skin condition that causes blushing or flushing and visible blood vessels in your face.
can occur with papules and pustules
can cause rhinopehyma - change in nose shape due to papules and pustules
• Treat flushing with vasoconstrictors
• Treat papules and pustules with metronidazole gel
• Treat rhinophyma with surgery or laser
182
what is hypodermis
subcutaneous tissue
183
non-epithelial cells in epidermal layer
melanocytes
langerhan's (dendritic) cells - type of macrophage
Merkel cells - sensory receptors to touch
184
where do melanocytes sit in epidermis
basement membrane
185
how thick is the stratum basal (basal layer) in epidermis
one cell thick
186
how do sebaceous glands develop
as an outgrowth of the hair external root sheath
187
describe eccrine glands
```
all over body
simple secretory coil in epidermis with pore opening on surface via duct
secrete watery hypotonic solution
thermoregulation
pH 4-6 reduces fungal growth
lubrication
```
188
describe apocrine glands
straight narrow ducts running parallel to hair follicles
secretory portion is located in the dermis and/or hypodermic
ductal portion similar to eccrine ducts
thick secretion into adjacent hair follicle
involved in pheromone secretion
under hormonal control
189
what is parakeratosis
presence of nucleated keratinocytes in the stratum corneum
○ Thought to be due to accelerated keratinocytic turnover
○ Scaly appearance
○ Can occur in benign and malignant skin conditions
190
what is JACCOL
```
jaundice
anaemia
clubbing
cyanosis
oedema
lymphadenopathy
```
191
what to do in a skin examination
1. Inspect
2. Describe
3. Palpate
4. Systemic check
192
what does it mean if lesions are discrete
individual lesions are separate and distinct
193
what does it mean if lesions are grouped
they are clustered together
194
what does it mean if lesions are confluent
they merge so discrete lesions are not visible or palapable
195
what does it mean if lesions are linear
they form a line
196
what does it mean if lesions are annular
they are arranged in a single ring or circle
197
what does it mean if lesions are polycyclic
they are arranged in concentric circles
198
what does it mean if lesions are arciform
they form arcs or curves
199
what does it mean if lesions are reticular
they form a mesh like network
