1
What type of hypersensitivity reaction occurs in atopic eczema?
Type 1 (IgE mediated)
What is lichenification?
thickened/ hardened area of skin
Name the assessment that measures the thickness of tumours
Breslow's
What is pruritus?
itching
What is the atopic triad?
The atopic triad is a term used to describe the coexistence of atopic dermatitis (i.e., eczema), asthma and allergies e.g. rhinitis and conjunctivitis (hay fever).
Give an example of a very potent (Class 1) topical glucocorticoid
clobetasol propionate, diflucortolone valerate
Give 3 risk factors for developing skin cancer
Excessive UV light exposure, history of sunburn, degree of skin pigmentation, use of tanning beds, aeroplane workers, having many moles or unusual moles, weakened immune system, genetics, age, radiotherapy
What is the most common type of skin cancer?
basal cell carcinoma
Give 2 adverse effects of using topical steroids
adrenal suppression, ocular adverse effects (cataract and glaucoma), tinea incognito (fungal skin infection), rosacea, perioral dermatitis, folliculitis, striae (dermal scarring- stretch marks), cutaneous atrophy and telangiectasia
What is the mechanism of action of clobetasone?
It inhibits the migration of macrophages and leukocytes into areas of inflamed skin by reversing vascular dilation and permeability. It also induces inhibitory proteins, thus leading to decreased activity of prostaglandins, kinins, histamine, liposomal enzymes and other endogenous mediators of inflammation
What are TCI's and give one example
topical calcineurin receptor e.g. tacrolimus or pimecrolimus
What do the letters ABCDE stand for in the assessment for malignant melanoma?
asymmetry of the mole, border irregularity, colour variegation, diameter >6mm, elevation
Blockage of which main 2 IL pathways are targeted when treating eczema
IL-4 (causes raised IgE) and IL-31 (key mediator of itch)
What are the 4 clinical types of malignant melanoma?
Lentigo maligna melanoma
Superficial spreading malignant melanoma
Nodular malignant melanoma
Acral lentiginous malignant melanoma
60% of human melanomas have an activating mutation in a gene that codes for a protein kinase. What is the name of this mutation?
BRAF V600E (valine replaced by glutamic acid-E)
Describe the 4 main routes of metastasis
-Lymphatic spread - Allows transport of tumour cells to lymph nodes and ultimately, to other parts of the body (most common route for carcinomas)
-Hematogenous spread - Because of their thinner walls, veins are more frequently invaded than are arteries, and metastasis tends to follow the pattern of venous flow (favoured by sarcomas and some carcinomas)
-Transcoelomic - Cancer cells seed onto peritoneal, pleural, pericardial, or subarachnoid spaces and membranes
-Transplantation or implantation - Carriage of fragments of tumour cells via needles or surgical instruments to other parts of the body during surgery and diagnostic procedures