Skin Disorders IIa

48 flashcards · Other · by Jared Blackwell

  1. DRESS - morbilliform (reactive/drug rxn) Drug rxn with eosinophilia and morbilliform rash. Organ involvement - systemic, fever. 2-8 weeks after drug.

  2. Uticaria (reactive/drug rxn) IgE on mast cells Wheals surrounding pallor Dermal edema Neutrophils and eosinophils

  3. Erythema nodosum (reactive/drug rxn) Painful, inflammatory lesions of subcutaneous fat. Lower legs Idopathic or coccidiomycosis, estrogen.

  4. Erythema multiforme (blister disorder) Palms, soles, hands Caused by infection, commonly HSV. Langerhans inflammatory cascade.

  5. Steven-Johnson Syndrome (blister disorder) Fever, bulla and necrosis Dermal-epidermal junction; + Nikolsky Mucus membranes Drug interactions, CD8+ trigger. *Clindamycin, Sulfamethoxazole, Nystatin.

  6. Dermatitis Herpetiformis Pruritic papules, vesicles, bulla. IgA at DE junction. Celiac disease Knees, elbows, butt

  7. Pemphigus Vulgaris Diffuse flaccid blisters, oral. Nikoslky sign Type II hypersensitivity Desmosomes falling apart = acantholysis IgG attacks desmosomes.

  8. Bulllus Pemphigoid Type II hypersensitivity - IgG IgG attack hemidesmosomes. Linear fluorescence TENSE blisters, don't break easily. Elderly

  9. What are the pigment disorders?

    Albinism - autosomal recessive Melasma - "Raccon mask of pregnacy" Vitiligo- white patches. Lentigo- Simple or solar. Increased melanocyte at DE junction.

  10. Angioma (Benign neoplasm) Port wine stains Telangiectasia of face. Has to do with blood vessels.

  11. Nevus - means birthmark. Derived from neural crest melanocytes. Common mole. Melanoma may arise. Junctional = FLAT, melancoytes at DE junction. Intradermal = papular, more benign. Melanocytes in dermis.

  12. Seborrheic Keratosis Flat, greasy, pigmented, look "stuck" Head, trunk Benign, common in elderly.

  13. Basal Cell Carcinoma Waxy, pink nodules Palisading nuclei Mitotic figures PTCH mutation

  14. Squamous Cell Carcinoma Firm scaly red lesions. Keratin pearls. Mutant p53

  15. Keratoacanthoma Dome shaped nodule. Rapid growing "volcano like"

  16. Melanoma ABCDEs Mutant p53 and BRAF kinase. Pagetoid migration CDKN2A and CDK4 familial melanoma.

  17. Describe Porphyria Cutanea Tarda

    Porphyria Cutanea Tarda results from enzyme defect in heme synthesis. Vesicles on dorsal hands. Photosensitive, sunburn.

  18. Pityriasis Rosea Herald patch w/ eruption on trunk; Christmas tree pattern. Begins as single lesion. Epidermal spongiosis with parakeratotic caps. Children, idiopathic. Resolves spontaneously in 2 months.

  19. Lichen Planus Purple, polygonal, pruritic, planar. Wickham Striae - white lesion in mouth Hypergranulosis. Band like lymphocytic infiltrate at DE junction. Treat w/ steroids. Common on ventral wrist. May be autoimmune, Hep C.

  20. Psoriasis Silvery patch Auspitic sign - bleed with scrape. HLA B27s Treat w/ immunosuppresant *Increased spinosum. Prominent rete ridges *Decreased granular layer. Acanthosis (thickening of epidermis) Neutrophils in epidermis

  21. SSSS Staph, children w/ infection. Widespread blisters Destroys dermal-epidermal junction. Exotoxin destroys keratinocyte attachment to granulosum. + Nikolsky Treat with IV vancomyocin

  22. What is this and how would you treat this?

    Telangiectasia of nose and cheek. Treat with laser. Steroid cream thins skin showing more blood vessels; worse. Steroids may cause telangiectasia.

  23. What is this and how would you treat this?

    Impetigo caused by staph. Honey colored crust Common in children Subcorneal neutrophils with bacteria. Staph or Strep. Mild cases = Topical Antibiotics Severe Cases = Oral Antibiotics Clindamycin Doxycline (tetracyclines under 8yr stains teeth) Nafcillin, pencillinase-resistance. Ciproflaxin, a fluoroquinone

  24. What is this and how would you treat this?

    Tinea capitis (ring worm) Arm treat with Fluconazole, Ketoconazole "-azoles" Topical antifungals - azole Head treat with Griseofulvin Oral antifungal NO Nystatin, ONLY works for yeast (gut, vaginal) NO steroids - Fungi LOVE topical steroids. KOH shows fungal infections.

  25. What is this and how would you treat this?

    Herpes Simplex Oral acyclovir (guanosine analog)

  26. What is this and how would you treat this?

    Remove SCC, bipsosy others. Actinic keratosis on forehead treat with topical cream 5 fluorouracil.

  27. What is this and how would you treat this?

    Dynamic rhytides (wrinkling) Treat with bleaching creams, exfoliants, botox.

  28. What is this and how would you treat this?

    Psoriasis Systemic therapy - immunosuppressants, monoclonal antibodies.

  29. What is this and how would you treat this?

    Tuberous sclerosis Treat with m-TOR inhibitors which shrink them.

  30. What is this and how would you treat this?

    Left- Poison ivy, contact dermatitis to nickel Treat with steroids.

  31. What is this and how would you treat this?

    Wart treated with chemical lead to chemical burn Treat chemical burn topical antibiotics, then wart with topical antibiotic.

  32. What are the classes of topical Corticosteroids?

    Class I: Super HIGH Clobetasol Class II: High Flucinoide Mometasone Class III - V: Medium Mometasone Triamcinolone Class VI - VII: Low Fluocinolone Desonide Hydrocortisone **DON'T use Class I on face.

  33. What is this and how would you treat this?

    Necrobiosis Lipoidica Diabeticorum Treat the diabetes

  34. What is this and how would you treat this?

    Belief in parasitosis (delusion of bugs on skin) Fix infection, scars, psychiatric help.

  35. Tinea (pityriasis) versicolor Blotches, hypopigmented slightly scaly macules. Children and teens, hot humid weather. Diagnose with KOH.

  36. Rosacea Overgrowth of Demodex mites associated with bacterial infection. Rhinophyma is overgrowth of dermis and sebaceous glands of nose.

  37. SLE Butterfly macular erythema. Anti-nuclear Ab for SLE Granular IgG at basemement membrane. "bubbly" basal layer *Spares nose (unlike seborrheic dermatitis). DISCOID LUPUS Inflam. infilitrate at DE junction. Thick BM.

  38. Human Papilloma Virus Verruca vulgaris - common warts. Genital warts Epidermal hyperplasia with viral change. Cervical carcinoma

  39. Molluscum contagiosum Translucent papules caused by poxvirus. Umbilicated lesion. Eosinophil invasion compress and obscure nucleus.

  40. Erysipelas Infection upper dermis, S. pyogenes - Group A Strep. Face or legs. Well-defined, raised demarcation between infected and normal skin

  41. What organism causes abcess? What causes Necrotizing fascitis?

    Staph aureus. Group A Strep (also causes erysipelas & cellulitis).

  42. Eczema "itch that rashes" Spongiosis, lymph exocytosis. Atopic dermatitis in children, as result of asthma, allergic reaction. Face and extensor surfaces.

  43. What is an abscess and treatment?

    Pus in dermis. First line treat with incision and drain.

  44. Describe Syphilis

    Primary 1-3 weeks after infection. Painless chancre of genitalia. Secondary 2-8 weeks after primary. Non-itchy rash hands and feet. Tertiary 5-10 years after secondary. Cardio and neuro complications.

  45. Difference in Keloid and Hypertrophic scar?

    Hypertrophic scars are "Primarily fine, well-organized, wavy type III collagen oriented parallel to epidermis surface with abundant nodules. Keloids histologically are “disorganized, large, thick, type I and III. BLACK PEOPLE.

  46. Acanthosis Nigricans

    Obesity, insulin resitance. Velvet brown plaques. Neck.

  47. Xanthoma Yellow papules, nodules, plaques. Dyslipidemia. Lipid in dermal histiocytes. Yellow plaques around eyes.

  48. Angiofibroma Facial papules with fibrous core. Upper dermis, If multiple papules = Tuberous Sclerosis, benign CNS tumors, renal cysts, seizures.