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Dermatology > Skin pathology > Flashcards

Skin pathology Flashcards

(65 cards)

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1
Q

Virilisation

A

female facial hair due to excess androgen from a tumour

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2
Q

Alopecia areata

A

autoimmune hair loss

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3
Q

Merkel cell cancer

A

Rare. Caused by the merkel cell virus, No vaccine and high mortality

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4
Q

Blister

A

connection between epidermis and dermis is loose, so water flows in giving a blister

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5
Q

Intra-epidermal blistering

A

presents as moist skin (exudative fluid) as blisters within the prickle cell layer burst

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6
Q

Warts

A

HPV infects keratinocytes which leads to a stimulation of hyperkeratisation giving raised warts

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7
Q

Loss of filaggrin predisposes to…

A

eczema

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8
Q

What is the most common form of skin cancer?

A

Basal cell carcinoma

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9
Q

Where do Basal cell carcinomas originate from?

A

hair follicle cells

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10
Q

What are inherited diseases of the DEJ? Give some examples

A

Skin fragility conditions due to a mutation in one of the proteins in the DEJ
Epidermolysis bullosa simplex (EBS) or dystrophic (EBD)

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11
Q

What are acquired diseases of the DEJ? Give some examples

A

Auto-antibodies to proteins in the DEJ

Dermatitis herpetiformis, pemphigoid

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12
Q

What is photoaging?

A

Long term sun exposure –> loss of elastin and collagen –> loss of skin texture –> wrinkles

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13
Q

What is a port wine stain?

A

Angioma = fixed dilation of blood vessels in the skin

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14
Q

What is allergic contact dermatitis?

A

Inflammatory reaction (dermatitis) with pruritic erythema, oedema and often vesicles at the site of chemical contact

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15
Q

When does allergic contact dermatitis occur?

A

after many repeated sub-threshold exposures that do not initially induce signs of systems (afferent stage)
Gradually the patient develops the efferent/elicitation stage and symptoms occur

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16
Q

What is the standard diagnostic test for alergic contact dermatitis?

A

patch test

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17
Q

What triggers psoriasis?

A

triggered by environmental factors in genetically susceptible individuals

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18
Q

Describe a typical psoriatic plaque.

A

itchy, well defined circular-to-oval bright red/pink elevated lesions (plaques) with overlying white or silvery scale
distributed symmetrically over extensor body surfaces and the scalp

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19
Q

In psoriasis, activated T cells are attracted to the dermis by chemokines and secrete IL -17A/17F/22. What does this stimulate?

A

Keratinocyte proliferation, AMP release and neutrophil-attracting chemokines

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20
Q

What is icthyosis vulgaris?

A

Common dry skin

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21
Q

What is the earliest sign of tuberose sclerosis?

A

ash-leaf macule

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22
Q

How is tuberose sclerosis inherited?

A

autosomal dominant

new mutations are common

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23
Q

What tumours can manifest with tuberose sclerosis?

A

perungual fibroma (nail)
facial angiofibromas
Hamartomas
Bone cysts

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24
Q

How can epidermolysis bullosa be inherited?

A

dominant, recessive, new mutation or acquired

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25
What is the difference between the 3 forms of EB?
EB Simplex - more superficial blistering EB Junctional - split in lamina lucida, most severe form EB Dystrophic - deeper blistering
26
What is the most common genetic condition associated with cafe au lait macules?
Neurofibromatosis type 1
27
What else can neurofibromatosis type 1 present with?
``` neurofibromas plexiform neuroma axillary or inguinal freckling optic glioma distinctive bony lesion 2 + Lisch molecules ```
28
What are the classifications of psoriasis in terms of body involvement?
Mild - 10% affected
29
A bacterial infection on top of eczema/dermatitis would be suggested by what?
crusting, weeping, pustulation and/or surrounding cellulitis with erythema of otherwise normal looking skin sudden worsening of the condition
30
Give 5 points about eczema herpeticum?
``` Areas of rapidly worsening eczema clustered blisters consistent with early stage cold-sores "monomorphic punched out lesions" possible fever, lethargy or distress admit urgently! ```
31
Candida intertrigo.
Candida of the skin folds
32
Define leg ulcer.
Any break in the skin of the lower leg above the ankle that has been present for more than 4 weeks.
33
What questions need to be asked with regards to a leg ulcer?
``` Duartion of ulcer Had previous ulcer? Pain? Disturbing sleep? Affecting mobility? PMH - DVT, varicose veins, PVD, arterial disease, DM Position of ulcer meausre surface area can take photograph ```
34
Where do venous ulcers tend to develop?
around the medial or lateral malleoli
35
Are venous ulcers deep or superficial?
Superficial | tend to have a shallow edge
36
What are venous ulcers charaterised by?
lipodermatosclerosis (chronic skin cahnge with chronic venous insufficiency) hyperpigmentation
37
What investigations are required for a leg ulcer?
``` ABPI Wound swabs - if look infected/ smelly Bloods Patch testing Duplex scan if indicated ```
38
What kind of dressing is required for a venous ulcer?
non-adherent 4 layer compression bandaging system
39
With compression bandaging, what length of time is aimed for the ulcer to be healed by?
12 weeks
40
What ABPI is normal and what indicates disease?
1.5 = calcification
41
What is the typical description of an arterial ulcer?
sharp, cliff-like edges "punched out" typically painful and deep
42
Where do arterial ulcers tend to appear on the body?
foot or mid-shin
43
Where do pressure ulcers present?
Sacrum, heels, ischea and greater trochanters
44
With ulcers around the ankle, what should be done to help maintain joint mobility?
ankle exercises
45
Where are melanocytes derived from?
neural crest
46
What is the correct term for freckles?
Ephilides
47
What are ephilides?
Patchy increase in melanin pigmentation but notumber of melanocytes occur after UV exposure and fade again
48
What are actinic lentigines/ solar lentigines/ liver spots?
macules created after UV exposure but increased number of basal melanocytes so do not fade after UV exposure usually darker and larger than ephilides
49
How do melanocytic naevi form?
Due to melanocytes whihc have failed to mature or igrate in-utero
50
Are all melanocytic naevi congenital?
No can be acquired | Congenital melanocytic naevi tend to be larger and slightly raised
51
How many simple melanocytic naevi do people tend to have?
20-30
52
How do melanocytic naevi present?
moles, macules, papules, plaques, nodules
53
If a person had a giant (>20cm) congenital naevus, what is the risk of melanoma?
10-15%
54
What are the 3 kinds of naevi?
Junctional naevus compound naevus Intradermal naevus
55
What does a dysplastic naevi look like?
>6mm in diameter variegated pigment border asymmetry relative risk of malanoma increased with number of melanocytic naevi
56
How is familial dysplastic naevi inherited?
autosomal inheritance
57
What is a halo naevus?
peripheral halo of depigmentation (AI reaction) around a naevus showing inflammatory regression
58
What is a blue naevus?
Entirely dermal and consist of pigment rich dendritic spindle cells Often on backs of hands and wrists
59
Give some info on a Spitz naevus?
very rare usually occur <20 years old consist of large sindle and/or epitheloid cells most are entirely benign but may mimic MM closely very pink as many stromal blood cells
60
What are seborrheic keratoses?
benign proliferation of epidermal keratinocytes
61
What do seborrheic keratoses look like?
brown/blak greasy "warty" lesion with stuck on appearance but may be flat with regular border often on trunk and face
62
How can seborrheic keratoses be treated?
reassurance cryotherapy curettage shave excision
63
What is a dermatofibroma?
deep (dermal) brown/grey firm nodule | possibly due to insect bites
64
What is a subcorneal haemartoma and how does it present?
"talon noir" or black heel large indurated discoid black patch caused by trauma
65
Give some drugs that can cause an allergic dermatitis type reaction after exposure in the sun?
``` Trimethoprim Tetracyclines NSAIDs Diuretics Vit A derivatives Anti-fungals ```

Dermatology (11 decks)

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