Summary DERMATOLOGY MLA MAPPING - for Medical Exams and Finals
8 views 0 purchase
Course
Medicine (MLA)
Institution
The University Of Manchester (UOM)
One page summaries for topics listed in the MLA Topic Map associated with dermatology
Contents include: Scarring; Eczema; Psoriasis; Folliculitis; Acne Vulgaris; Cellulitis; SJS/TEN; etc.
All MLA topics are covered within my shop - see other documents for more
Each topic covers approx. one page ...
Basal Cell Carcinoma
Definition & DDx DDx
Originating from basal keratinocytes - SCC
usually 2º to DNA damage by UV radiation - Melanoma
- Invasion of basement membrane - Seborrhoeic keratosis
- Most common skin cancer - Actinic keratosis
- Most common western cancer - Dermatofibroma
Classification Anatomy & Risks
Nodular Risk factors
- Most common subtype - FHx/PMH
- Raised, shiny, pink/translucent - Genetic syndromes e.g., Gorlin
nodule Syndrome
- With central ulceration/crusting o AD loss of tumour
Other suppressor gene function
- Sclerosing PTCH
- Keratotic - Fitzpatrick type I/II skin
- Pigmented (rare) - High level sun/UV exposure e.g.,
- Superficial (often mistaken for occupational, sunburn, sunbeds
eczema/psoriasis - Immunosuppression
- Chronic inflammation e.g., burn
site
- Smoking
- Old age
- Male
Investigations
Diagnosis via excision biopsy with 4mm
margin
- Rx and diagnosis based on clinical
suspicion
Symptoms & Complications - Occasionally, punch biopsy
- Very slow growing completed first
- Local destruction (rare metastasis) 6mm margin for high-risk lesions
- Usually asymptomatic - 2cm diameter
- Central ulceration - Location on
- Sun-exposed areas ear/lip/face/hands/feet/genitals
- Central depression - Immunosuppressed
- Pearly surface/rolled edge - Recurrent disease
- Telangiectasia
Treatment/Management & Side effects
As above; sometimes Mohs micrographic surgery used
- Tissue removed and examined under microscope in real time
Lifestyle advice to prevent further lesions e.g., suncream
,Squamous Cell Carcinoma
Definition & DDx
Locally invasive malignant tumour of Investigations
epidermal keratinocytes Poor prognosis
Risk factors - Poorly differentiated
- Excessive sun exposure - ≥2cm diameter
- AK/Bowen’s disease - >4mm deep
- Immunosuppression e.g., - Immunosuppression
transplant, HIV
- Smoking Treatment/Management & Side effects
- Long-standing leg ulcers Surgical excision
- Genetic conditions e.g., xeroderma - <2cm diameter = 4mm margin
pigmentosum excision
- ≥2cm diameter = 6mm margin
Symptoms & Complications excision
- Sun exposed sites Mohs micrographic surgery may be used in
- Rapidly expanding; may bleed high-risk patients and cosmetically
- Painless/Ulcerated nodules important sites
- ‘Cauliflower-like’ appearance AK Rx = 5-fluorouracil/NSAIDS
Malignant Melanoma
Definition & DDx Anatomy & Risks
Skin cancer arising from melanocytes Risk factors
Subtypes - FHx/PMH
- Superficial spreading - Genetic syndromes
- Lentigo maligna - Fitzpatrick I/II
- Acral lentiginous (involves - Immunosuppression
palms/soles) - High levels of sun/UV
- Subungual - Presence of atypical melanocytic
- Amelanotic naevi
Symptoms & Complications - Smoking
ABCDE - Advanced age
- Asymmetry - Male
- Border irregularity Investigations
- Colour variation - Check for distant metastases
- Diameter ≥7mm o PET/CT may be necessary
- Elevation/evolution over time - Excisional biopsy with 2mm margin
Can also include itchiness and bleeding - If Breslow thickness >1mm =
sentinel LN biopsy
Treatment/Management & Side effects
Breslow thickness determined histologically = most important prognostic indicator
- Mm from top of granular layer to deepest point of tumour
- Breslow thickness in mm x10 = further excision outside 2mm margin required
May also require adjuvant immunotherapy/chemotherapy in mets/Stage III/IV
- Pembrolizumab
50% 5-yr survival if Breslow thickness ≥4mm:
- Best prognosis in <0.75mm
, Pressure Sores
Anatomy & Risks
Develop in pts unable to move parts of body due to illness, paralysis or advancing age
Risk factors
- Malnourishment
- Incontinence
- Lack of mobility
- Pain (leading to reduction in mobility)
Symptoms & Complications
Waterlow score (screening); includes:
- BMI
- Nutrition status
- Skin type
- Mobility
- Continence
Investigations
Grading 1-4
I. Non-blanchable erythema of intact skin
II. Partial thickness skin loss involving epidermis/dermis; superficial abrasion/blister
III. Full thickness skin loss; damage/necrosis of SC tissue; not through fascia
IV. Extensive destruction/necrosis/damage to muscle/bone/structures +/- full
thickness skin loss
Treatment/Management & Side effects
- Moist wound environment encourages ulcer healing
o Hydrocolloid dressings/hydrogels
o Avoid soap to stop drying out
- Only use abx if evidence of surrounding cellulitis
- Consider referral to tissue viability nurse
- Surgical debridement may be beneficial for selected wounds
Other skin lesions
Seborrhoeic keratosis
‘Stuck on’ warty plaque with fissured keratin surface
Melanocytic naevi
Can be junctional/compound/intradermal
Dermatofibroma
Small firm nodule <1cm; slow growth; asymptomatic
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller EtheMedic. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.07. You're not tied to anything after your purchase.
