MCI SCREENING EXAM STUFF: skin

Friday, 16 March 2012

skin


 
Layers of epidermis
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale

 Wood’s lamp examination
disease
appearance
T. vesicolor
Golden yellow
P. aeruginosa
Aqua green
Porphyria cutanea tarda
Pink-orange
Leprosy
Blue-white
Hypopigmentation
Pale white
Hyperpigmentation
Purple brown
Vitiligo
Bright-white/ blue-white
Albinism
Bright-white/ blue-white
Erythrasma
Coral red, pink
T. schonlenii
Pale green
Microsporum
Yellow green
Tuberous sclerosis
Blue white
Pseudomonas infection
Greenish white or pale blue
Porphyria cutanea tarda
Pinkish red –urine
Pityriasis versicolor
Golden yellow fluorescence
Tinea capitis
Green fluorescence


Special types of Acne
Acne conglobata
Severe cystic acne with comedones, abscesses, sinuses and nodules.
Acne fulminans
Inflammatory nodules, cysts plaques, fever, constitutional symptoms, treated with steroids.
Acne venerata
Caused by contact with comedogenic chemicals
Acne cosmetica
Caused by contact with comedogenic cosmetics
Tropical acne
Acne on back, buttocks, thigh because of high humidity of tropical climate.
Acne excoriae Picker’s acne
Seen in females caused by compulsive picking of  the lesions


Occlusion tetrad
Nodulocystic acne
Dissecting cellulites of scalp
Hydradenitis suppurativa
Pilonidal sinus


Phases of growth of hair
Anagen
growing phase
Telogen
resting phase
Catagen
transitional phase


TYPES OF ALOPECIA
Alopecia areata
Patches of smooth area with loss of hair.
At the periphery of patches are exclamation hair ( attenuated bulb with splayed pigmented distal end)
Alopecia totalis
Total loss of scalp hair
Alopecia universalis
When hair has been lost over the entire body
 
Graypatch            
Characterized by scaly gray patches with stubs of broken hair and easy pluckability of hair.
Caused by ectothrix   fungi.
Shows greenish yellow fluorescence under woods lamp.
Black dot
Areas of alopecia studded with black dots representing hair broken off at surface of the scalp, caused by endothrix fungi.
Kerion celsii
Is a boggy indurated area exuding pus.
May be followed by scarring and permanent alopecia
Favus/ Witkop
Affects scalp, glabrous skin, nails.
Concave Sulphur yellow crusts / scutulae form around loose wiry hair, atrophy leads to smooth glossy thin paper/ scars.


*Atopic dermatitis, infantile eczema/ neurodermatitis Also called Besnier’s prurigo

Signs of atopy
Dennie Morgan folds
(Extra fold beneath the eyelid is called the Denny Morgan fold)
Extra crease line just below the lower eyelid, exceeding midline(pupil)
Keratosis pilaris
Follicular papules on the extremities
Hertoghe’s sign-
Thinning of lateral eyebrows
White dermographism-
Tripler response o is replaced by blanching of skin

pemphigus
pemphigoid
Nikolsky sign present
Absent
Bullae are intraepidermal and flaccid
Bullae are subepidermal and tense
Mucosa involved
Mucosae are not involved
Acantholysis present
Absent
Involves upper part of body
Lower part of body
Age-40-60
Age 60-80
Prognosis poor
Prognosis good

Nikolsky sign
Sliding of superficial layers of skin on the deeper layers when a tangential force is applied with the pulp of thumb, especially over bony prominences
Positive in
Staphylococcal scalded skin syndrome-
Toxic epidermal necrolysis
Pemphigus
Epidermolysis bullosa congenital
Pemphigus

 
*Butcher’s wart / Anatomists wart- Cutaneous tuberculosis / verrucosa cutis
Slowly progressive asymptomatic lesion that follows penetrating trauma
Treated with akt.

*Pseudofolliculitis barbae-
Seen in blacks. Caused due to close shaving of curved hair, which pierce the skin.
Treatment is to stop shaving.
 
*Pityriasis versicolor
Hypopigmented or hyperpigmented perifollicular finely scaly macules coalescing to form patches seen on upper arm, neck, trunk, underarms.
Caused by Malassezia furfur.

*Ping pong scabies- mite is transmitted from one house member to another.

*Inguinal bubo appears 2- 4 weeks after genital ulceration.

*Bull’s eye lesion or iris lesion or target lesion
Seen in erythema mutiforme

*Miyagawa’s granulocorpuscles are found in lymphogranuloma venereum, when smears are stained with Giemsa

*Commonest cause of photoallergic dermatitis in India is Parthenium

*Impetigo of Bockhart
Acute superficial folliculitis
Pustules heal without scarring.

*Lyell’s disease-Toxic epidermal necrolysis.

*Pastia’s line-
Linear petechial lesions found in scarlet fever in antecubital and Axillary folds.

*Desert sore / Veldt sore is a superficial ulcer caused by corynebacterium diphtheriae.

*Meleney’s gangrene-
Caused by peptostreptococcus and staphylococcus aureus or enterobacteriaceae.

*Hot tub folliculitis
Caused by pseudomonas  aeruginosa. Occurring 1-4 days after bathing in hot tubs, swimming pool or whirlpool.

*Rose spots of salmonellosis occur between umbilicus and nipples.

*Chicken pox
Rash is described as dew drops on rose petals
Centripetal distribution.







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