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Dermatology > Background > Flashcards

Flashcards in Background Deck (21)
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1
Q

history

A

occupation important
HPC: duration, location, initial appearance, evolution, associated symptoms (itch, pain, bleeding), treatments tried

RF: age, sunburn, occupation, smoking, travel

impact/ICE: psychosocial important

2
Q

examination

A

DCM: rashes/eruptions
ABCDE; 5S: site, size/shape, symmetry, surface. surrounding
‘SCAM’: size/shape, colour, associated change, morphology/margin

palpate: surface, consistency, mobility, tenderness, temp , illumination, LN

check hair, nails, oral mucosa

3
Q

skin anatomy

A

epidermis:
- corneum: horny cells; keratin
- lucidum: thick skin only; pale compact keratin
- granulosum: keratohyaline granules and lipids; looser
- spinosum: ‘prickle cells’; differentiation
- basale: dividing cells
dermis: papillary and reticular; appendages, nerves, elastin/collagen, BV
subcutis: fatty CT

keratinocytes, Langerhan’s (APC), melanocytes, Merkel’s (nerve endings)

4
Q

skin function

A
protection (Barrier)
temperature
sensation
vitamin D synthesis
immunosurveillance
appearance/cosmesis
5
Q

hair

A

modified keratin; shaft, bulb, and melanocytes

lanugo: fine; fetus/AN
vellus: fine short hair; all surfaces
terminal hair: course, long; scalp, eyebrows, eyelashes, pubic, pits, legs, face

anagen (grow), catagen (Regress), telogen (shed/rest)

6
Q

nails

A

nail plate (keratin)
matrix
proximal nail fold
nail bed (Capillaries)

7
Q

glands

A

sweat: SANS, temp reg; eccrine and apocrine (smelly, EAM, areola)
sebaceous: sebum from hair follicles; lubricate + waterproof; androgens

8
Q

wound healing

A

haemostasis: constriction, platelets, fibrin clot
inflammation: dilatation, NP/MP migration, phagocytosis
proliferation: granulation (fibroblast), angiogenesis, re-epithelialisation (migration)
remodelling: collagen reorganisation, scar maturation

9
Q

rash description

A

DCM

10
Q

pigmented lesion

A

ABCDE + compare to other lesions

asymmetry
border: smooth, reg, reg irreg, irreg
colour: uniform, gradient/change, random
diameter
evolution and elevation
11
Q

individual lesion

A

5S: site, size/shape, symmetry, surface, surroundings

SCAM: size/shape, colour, associated change, morphology/margin

12
Q

erythema DDx

A
psoriasis: extensors, scaly, plaques
drugs incl. EM/SJS/TEN
eczema: excoriation, flexures
mycosis: annular, scaly rim, central clearing
pityriasis rosea: herald patch, scaly
lymphoma: LN palpable
idiopathic
infection: erythrasma, candidiasis, cellulitis
13
Q

purpura DDx

A

thrombocytopenic:

  • meno septicaemia: acute, Sx, petechiae, bruise, hge, necrosis
  • DIC: trauma/Ca/obstetric/liver, bleeding, pet/ecc, hge, necrosis
  • ITP: ?HSM, well, preceding viral

nonTP:

  • drugs
  • vasculitis/CTD: systemic upset, dependent areas, palpable painful purpura
  • aged skin: sun-damaged, non-palpable purpura, systemicall well
14
Q

pruritus DDx

A

derm:

  • coeliac: dermititis herpetiformis (pap/ves)
  • eczema: dry, erythema, vesicles, exudate
  • scabies: burrows and rubbery nodules
  • lichen planus (purple + lacy white), lichen sclerosis (white thinning)
  • urticaria: pink wheals; round/annular/polycyclic, triggers
  • chicken pox: vesicles

non-derm:

  • cholestatic jaundice
  • drugs: aspirin, alcohol, morphine, codeine
  • pregnancy
  • uraemia
  • DM/thyroid
  • malignancy (e.g. blood Ca)
  • iron deficiency, PRV
  • xerosis
  • psych
15
Q

depigmentation DDx

A
vitiligo
inflammatory depigmentaion
DLE (lupus)
pityriasis abla
piebaldism
Addison's (hyperpigment contrast)
pityriasis versicolour
16
Q

Koebner’s

A
psoriasis
lichen planus
viral warts
molluscum contagiosum
sarcoidosis
17
Q

blisters DDx

A
impetigo
insect bites
HSV/HZV
acute contact dermatitis
pompholyx: tiny blisters
burns
bullous pemphigoid: hge tense blisters; IgG in hemidesmo/BM
pemphigus vulgaris: superfical 'shedded' blisters; IgG desmosome (epidermis), Nikolsky sign (shedding)
18
Q

red swollen leg DDx

A

cellulitis: painful, trauma/ulcer, diffuse edge, systemic upset
erysipelas: painful, spreading, trauma/ulcer, defined, systemic upset
DVT: painful, RFs, may be cyanotic, systemically well, tender
chronic venous insufficiency: heavy/ache, better with move; blue/purple, oedema, varicose veins, LDS, eczema, venoux ulcer
necrotising fasciitis: extremely painful, systemic upset, rapid spread

19
Q

anaphylaxis

A
lip/tongue swelling
bronchospasm
hypotension
angioedema
urticaria: itchy wheals

Rx: adrenaline (0.5ml 1:1000), antiH (10-20mg), CST (100mg)

20
Q

acne DDx

A
Rosacea: no comedones
peri-oral dermatitis: no comedones
folliculitis: no comedones
DLE
drug eruption
endocrine: sudden, severe, hyperandro, menstrual
21
Q

erythema multiforme DDx

A

infection: strep (Ag hypersensitivity
HZV (65% of cases)
drugs: penicillin, sulphonamides, phenytoin, allopurinol
urticaria: 2 colours (annular wheal),