28. endocrine

Question 1

Inflammatory dermatosis include

Answer 1

Acute and Chronic

Question 2

Acute inflammatory dermatosis include

Answer 2

Atopic dermatitis
Contact dermatitis

Question 3

Chronic inflammatory dermatitis include

Answer 3

Psoriasis
Lichen planus

Question 4

Atopic eczematous dermatitis
Define
Where
Type of hypersensitivity
Mutation

Answer 4

Type I hypersensitivity reaction
•Pruritic, erythematous, oozing rash with vesicles and edema
•On the cheeks, trunk and extensor surfaces in neonates, and moves to the flexor creases as the child aged
•Often associated with a personal or family history of AD, allergic rhinitis, and asthma; 35% of infants with AD develop asthma later in life
•Affect 15 to 20% of children

Defects in the keratinocyte barrier due to mutations in the filaggrin (filament aggregating protein) gene (FLG) is seen in

Question 5

Contact dermatitis divided into

Answer 5

Allergic CD
Irritant CD

Question 6

Allergic contact dermatitis (ACD)
Define
Subtype

Answer 6

Type IV hypersensitivity reaction against poison ivy, oak, nickel and chemicals found in the household cleaners, cosmetics, fabrics, dyes, medications (penicillin) and rubber products
•Photoeczematous dermatitis is a type of ACD that is caused by ultraviolet (UV) light reacting with drugs (e.g:- tetracycline, sulphonamides and thiazides).

Question 7

Irritant Contact Dermatitis (ICD)

Answer 7

The most common type of eczematous dermatitis
•Non immunologic reaction due to the local toxic effect of a chemical on the skin (e.g, detergents in soaps and diaper dermatitis )
•The hands are the most important sites of ICD

Question 8

CHRONIC INFLAMMATORY DERMATOSES

Answer 8

Psoriasis
Lichen planus

Question 9

Psoriasis
Define
Cause
Also involves
Histologically
What sign is shown

Answer 9

Well-circumscribed, salmon-colored plaques with silvery scale, usually on extensor surfaces and the scalp.

Associated with HLA haplotypes Cw6, B13 and B17

Nail and psoriasis arthritis

Acanthosis
Parakeratosis
Munro abscess
Kojog pustules

Auspitz sign

Question 10

Cause of silver color in psoriasis

Answer 10

Parakeratosis
Keratinocyte nuclei retention

Question 11

What are Munro abscess

Answer 11

Neutrophil collection in corneum

Question 12

What are kojog pustules

Answer 12

Neutrophil collection in sub corneum

Question 13

Why auspitz sign seen

Answer 13

Because there is acanthosis
Capillaries dilates
And when scale is picked is bleeds

Question 14

Lichen planus (LP)
Where
Male or female
Linked to
Patho genesis
6 ps
Histology
Clinically it shows

Answer 14

Skin and mucous membrane
Female more
Linked to hepatitis C

Cytotoxic T cell and memory cells response to change in antigen of basal cells

Plaque polygonal planar Pruritic papules

Hyperkeratosis no parakeratosis
Acanthosis saw tooth appearance

Wickham strae and kobener phenomenon linear

Question 15

Vesicular and Bullous Disease
Include

Answer 15

Pemphigus

Bulluois pemphihoid

Dermatitic herpesform

Erythema multi forms

Question 16

Pemphigus
Anti what?
Type what
Histology
What sign
Immunoflourence

Answer 16

Superficial soft blisters which ruptured easily
IgG antibody against desmosomes Type 2

Intraepidermal lesion
Basal cell attached to BM look like Tomb stones

Nikolsky sign - easily upper lid removed

Fish net appearance

Question 17

Bullous pemphigoid
Anti what
Age and place
IgG
Histology

Answer 17

Older individuals oral mucosa spared
•Anti bullous pemphigoid-antigens 1 and 2 (a part of the keratinocyte hemidesmosome) IgG
•Deep tense bullae

IgG antibody against BM collagen

Subepidermal fluid
Eousinophil dominant in vesicle

No nikolsky sign

Question 18

Dermatitis herpetiformis
Associated with
Place
Anti what antibody / what
Vesicle form when
Histology

Answer 18

Autoimmune deposition of IgA at dermal papillae

Associated with celiac sprue

•Itchy grouped vesicles and occasional bullae on the extensor surfaces

•IgA antibodies directed against gliadin and other antigens deposit in the tips of the dermal papillae and result in subepidermal blister formation

Papillary micro abscess

Question 19

Erythema Multiforme (EM)
Patho genesis type ?
Bullous character and where
EM with fever and infection

Answer 19

An acute, self-limiting and commonly recurrent type IV hypersensitivity reaction to infections (Mycoplasma pneumoniae, herpes simplex) or drugs (sulfonamides, penicillin, barbiturates, phenytoin)
•Vesicles, bullae, and Symmetrically distributed of targetoid lesions often involving palms and soles
•EM with oral mucosa/lip involvement and fever is termed Stevens-Johnson syndrome (SJS)

Question 20

Why targetoid appearance

Answer 20

Due to central necrosis

Question 21

Toxic epidermal necrolysis
And how we say TEN

Answer 21

Severe form of SJS with sloughing off of skin
If greater than 30% of skin is affected

Question 22

Pigment disorders include

Answer 22

Hypo
Vitiligo
Albinism
Post inflammatory depigmentation

Hyper
Freckle Ephelis
Melasma
Lentigo
Nevus

Question 23

Vitiligo

Answer 23

Idiopathic possibly autoimmune destruction of melanocytes
Affected areas are devoid melanocytes

Question 24

Albinism

Answer 24

Normal № of melanocytes, deficiency of tyrosinase

Question 25

Freckle (ephelis);

Answer 25

melanocytes hyperreactivity to UV light. Change with seasons.
Increased melanosome not melanocytes

Question 26

Lentigo

Answer 26

;↑ № of melanocytes. Do not change with sunlight.

Question 27

Melasma;

Answer 27

associated with sun exposure, oral contraceptive use, and pregnancy (“mask of pregnancy”) and may

Question 28

Melanocytic nevi (mole)
Types
And other

Answer 28

Two groups:
•Congenital nevi (birthmarks) present at the time of birth
•Acquired nevi appear at puberty, become more prominent during adult life, and then involute

Can be precursor to melanoma

Question 29

Acquired nevi types

Answer 29

First as junctional nevi
Then to compound nevus by extension to dermis
Then Intradermal nevus

Question 30

Tumors of skin

Answer 30

Fibro epithelial polyp
Acanthosis nigricans
Seborrheic keratosis
Cysts