Skin Conditions II

Question 1

What is actinic cheilitis?

Answer 1

It is otherwise known as Farmer’s lips. A precancerous rash that develops on the lips, usually as a scaly patch.

Question 2

What are the 3 terms that refers to bleeding in the skin?

Answer 2

Petechiae, Purpura and Ecchymoses.
Petechiae refers to smaller red or purple dots.
Purpura refers to larger purple lesions seen on the skin.
Ecchymoses resembles bruises.

Question 3

Which condition will present with mucocutaneous dark freckles on the lips, oral mucosa, palms and soles of feet?
Other signs include multiple haemartomatous polyps.

Answer 3

Peutz-Jegher’s syndrome, an autosomal dominant mutation of tumour suppressor gene STK11

Question 4

What is Leser-Trélat sign and what does it indicate?

Answer 4

Leser-Trélat sign is the sudden appearance of multiple seborrhoeic keratoses that rapidly increases in size and number. It is most significant in individuals < 30yo.

It is caused by an associated cancer, especially adenocarcinoma of the stomach and colon, and often occurs with malignant acanthosis nigricans.

Question 5

What skin conditions can gastric carcinoma present with?

Answer 5

The presentation of gastric carcinoma can include Leser-Trélat sign, Virchow node, Sister Mary Joseph nodule and Krukenberg tumour.

Question 6

Define acanthosis

Answer 6

Acanthosis is diffuse hyperplasia (increased thickness from increased number of cells).

Question 7

What is intraepithelial neoplasm?

What is it also known as?

Answer 7

A neoplasm confined to the epidermis, and did not pass through the basal layer. It is also known as Squamous cell carcinoma in-situ.

Question 8

Define hyperkeratosis

Answer 8

Hyperkeratosis is hyperplasia of stratum corneum (keratinocytes)

Question 9

“Peripheral Palisading cells” often refer to which skin condition?

Answer 9

Basal Cell Carcinoma. Peripheral palisading cells is a histological description.

Question 10

Which cells are abnormal in Actinic Keratosis?

Answer 10

Keratinocytes confined to the basal layer of the epidermis are abnormal in actinic keratosis.

Question 11

Does Actinic Keratosis progress into SCC or BCC?

Answer 11

SCC

Question 12

What is the common presentation of a SCC? Describe the lesion

Answer 12

An erythematous crateriform nodule with a rolled border and a central keratotic core.
OR
A keratotic nodule

Question 13

Honey-coloured crusts on the chin. What is a possible differential diagnosis?

Answer 13

Impetigo, most commonly due to bacterial infection by Staphylococcus Aureus or Streptococcus Pyogenes (Group A Streptococci).

Question 14

What is the most common cause of erysipelas?

Answer 14

Erysipelas is most commonly caused by Streptococcus Pyogenes (Group A Streptococci)

Question 15

Which antibiotic is used first line against impetigo?

Answer 15

Flucloxacillin

Question 16

In Angina, the ST segment is elevated or depressed

Answer 16

Depressed

Question 17

How can lumps found on the skin be classified into?

Answer 17

Intradermal (cannot draw the skin over it) or subcutaneous (able to manipulate it independently from the skin)

Question 18

What are the 6 ‘S’ in the physical examination of lumps

Answer 18

Site, Size, Shape, Surface, Smoothness, Surrounding

Question 19

What are the examples of intradermal lumps?

Answer 19

Sebaceous cysts, Abscess, Dermoid cysts, Granuloma

Question 20

What are the examples of subcutaneous lumps?

Answer 20

Lipoma, Ganglion, Neuroma, Lymph node

Question 21

Which bacteria is a common cause of Furuncles and Carbuncles?

Answer 21

Furuncles and Carbuncles are commonly caused by Streptococcus Pyogenes (Group A Strep)

Question 22

Which bacteria is a common cause of erysipelas and cellulitis?

Answer 22

Erysipelas and Cellulitis are commonly caused by Staphylococcus Aureus.