18: Dermatopath 2

Question 1

Acute vs chronic inflammatory dermatoses

Answer 1

1. Acute: days-weeks, inflammatory infiltrates of lymphocytes and macrophages
2. Chronic: months-years, changes in epidermal growth or dermal fibrosis

Question 2

Angioedema: what layers of skin is the edema in

Answer 2

Deeper dermis, subq fat

Question 3

Three conditions that can cause erythema multiforme

Answer 3

1. Interface dermatitis
2. Stevens-Johnson
3. Toxic epidermal necrolysis

Question 4

Interface dermatitis

Answer 4

Dermal edema, lymphocytes along dermoepidermal junction

Question 5

Stevens Johnson syndrome**

Answer 5

Extensive erythema multiforme in child related, with oral mucosa, conjunctiva, and genitals affected -> can lead to sepsis

Question 6

Toxic epidermal necrolysis

Answer 6

Diffuse necrosis and sloughing of epithelia resembing 3rd degree burns

Question 7

Koebner phenomenon

Answer 7

Psoriatic lesions induced by local trauma bc it starts perpetuating a local inflammatory response

Question 8

Two common treatments for psoriasis pts

Answer 8

TNF inhibitors + IL-17 inhibitors

Question 9

What is the most common chronic inflammatory dermatosis

Answer 9

Seborrheic dermatitis (more than psoriasis)

Question 10

How does Parkinson’s cause seborrheic dermatitis

Answer 10

Dopamine deficiency -> increased sebum production -> seborrheic dermatitis (can be tx with levodopa and improves)

Question 11

Tx for pemphigus

Answer 11

Immunosuppressive

Question 12

Five types of pemphigus and describe them

Answer 12

1. Pemphigus vulgaris: most common
2. Pemphigus vegetans: large moist warts and pustules in flexural surfaces
3. Pemphigus foliaceus: mostly in Brazil
4. Pemphigus erythromatosus: localized to malar area of face
5. Paraneoplastic pemphigus: assoc with NHL and lymphoid neoplasms

Question 13

Four factors that play into acne vulgaris

Answer 13

1. Keratin blocks sebum flow
2. Hypertrophy of sebaceous glands in puberty
3. Propionibacterium colonizes hair follicles
4. Secondary inflammation of follicles

Question 14

Acne conglobate

Answer 14

Severe acne with sinus tract formation and dermal scarring

Question 15

Treatment for the bacteria propionibacterium acnes

Answer 15

13-cis-retinoic acid

Question 16

Panniculitis

Answer 16

Inflammatory reaction in subq adipose

Question 17

Five potentially life threatening disorders that have skin rash as a primary feature

Answer 17

1. Pemphigus vulgaris
2. Steven’s Johnson syndrome
3. Toxic epidermal necrolysis
4. Toxic shock syndrome
5. Staph scalded skin syndrome

Question 18

Dysplastic nevus syndrome

Answer 18

AD with 50+% chance for developing melanoma by age 60

Question 19

Genetic mutation in dysplastic nevus syndrome

Answer 19

CDKN2A or CDK4