What cells are present in the epidermis?
keratinocytes (produces keratin – hair, nails), melanocytes (melanin pigment), Langerhans cells (immunity)
Cells in the dermis?
fibroblasts (produces connective tissue – collagen, elastin), sebaceous and sweat glands, hair follicles, Meissner’s corpuscle (light touch) and Pacinian corpuscle (coarse touch/vibration)
Cells in the subcutis/hypodermis?
subcut. fat
Functions of the skin?
Sensation Temperature regulation Vitamin D synthesis Immunosurveillence Protective barrier Fluid/electrolyte balance (sweating) 7) Structural (body shape) 8) Waterproofing 9) UV barrier
How is acne vulgaris caused?
Colonisation of the pilosebaceous duct with Propionibacterium acnes
How do u treat mild acne?
closed comedones. Topical retinoids or benzoyl peroxide
Name some topical retinoids
tretinoin, isotretinoin, or adapalene
How do u treat moderate acne? (papules and pustules)
Combined therapy of topical retinoids. and topical antibiotic (clindamycin and erythromycin) or oral abx
Name oral abx?
tetracycline
or doxycycline
name a topical abx?
clindamycin and erythromycin
Where is atopic eczema normall seen?
asthma or hay fever
possible asthma triggers?
Soaps and detergents, animal dander, house-dust mites, extreme temperatures, rough clothes, pollen, some foods and stress
PAthophysiology of eczema?
Abnormalities in epidermal barrier protein fillagrin poor barrier function and dry skin allows antigen penetration into epidermis hyperreactivity, induction of IgE antibodies
treaments for eczema?
Avoid triggers and scratching. emollients.
mild/ potent topical corticosteroid for immunosuppression (eg hydrocortisone mild)
potent corticosteroid (clobetasone butyrate)
Severe - antihistamines - cetirizine
severe - oral CS - prednisolone
How do you treat infected ecsema>?
Localised areas – topical antibiotic
Generalised areas – oral antibiotic (flucloxacillin or erythromycin)
What is psoriasis?
A systemic, immune-mediated, inflammatory skin disease - typical relapsing-remitting course
What are nail changes in psoriasis?
Nail pitting, discolouration, onycholysis (detachment from the nail bed)
treatment for psoriasis?
emollient,
a potent topical corticosteroid
plus a topical vitamin D preparation (calcipitriol)
coal tar preparation
Describe a venous ulcer?
Large, exudative, non painful, sloping and gradual. medial gaiter region. covered with slough
Describe an arterial ulcer?
Mainly in toe, heel and ankle region. punched out well defined and painful, small, covered with slough and necrotic tissue
Risk factors nd signs for venou ulcers?
DVT, varicose veins. signs are leg oedema, normal peripheral pulses,. MX with compression bandaging
Artierl ulcer RF and signs?
Arterial disease, smoking, LDL, cholesterol, DM. Treateted with vascular reconstruction.
Signs of Artierl ulcer?
Cold skin, loss of hair, shiny pale skin, abscent peripheral pulses. leg pain worse when elevated
What is cellulitis?
caused by infection of the dermis and subcutaneous fat, typically affects the lower leg or arm and may spread proximally
