4. Acute Inflammatory and eczematous dermatoses

Question 1

Urticaria is commonly known as what?

Answer 1

hives

Question 2

What is hives associated with?

Answer 2

mast cell degranulation
dermal microvascular hyperpermeability

Question 3

What is acute hives

Answer 3

<6 weeks and associated with food and other allergens

Question 4

What is chronic hives

Answer 4

> 6 weeks and associated with autoimmune disorders, thyroid dysfunctions, etc.

Question 5

What are the causes of the increased vascular permeability associated with hives?

Answer 5

(5)
Contraction of endothelial cells
Retraction of endothelial cells
Direct injury of endothelial cells
Endothelial injury mediated by leukocytes
normal endothelial cell-to-cell binding
Transcytosis or vesiculovacuolar pathway

Question 6

How long does it take hives to resolve?

Answer 6

1-4 days

Question 7

What type of sensitivity is associated with erythema multiform and Steven Johnson Syndrome/Toxic Epidermal Necrosis?

Answer 7

Type IV

Question 8

How can erythema multiforme be classified?

Answer 8

major and minor

Question 9

What is erythema multiforme major?

Answer 9

Typical targets or raised, edematous papules distributed acrally with involvement of one or more mucous membranes; epidermal detachment involves less than 10% of total body surface area (TBSA)

Question 10

What is erythema multiforme minor?

Answer 10

Typical targets or raised, edematous papules distributed acrally

Question 11

SJS/TEN presents with

Answer 11

erythematous macules and mucous membrane erosion

Question 12

What are the levels of epidermal detachment?

Answer 12

Steven-Johnson syndrome: < 10% Epidermal detachment

Toxic epidermal necrolysis: > 30% Epidermal detachment

Overlapping SJS/TEN: 10-30% epidermal detachment

Question 13

Erythema multiforme can be classified by what characteristic compared to SJS/TEN?

Answer 13

infectious

Question 14

SJS/TEN can be classified by what characteristic compared to Erythema multiforme?

Answer 14

drug induced

Question 15

What cells release cytokines in the epidermis to mediate epithelial apoptosis and inflammatory reaction?

Answer 15

CD8+ T Cells

Question 16

What cells release cytokines in the dermis to mediate epithelial apoptosis and inflammatory reaction?

Answer 16

CD4+ T Cells

Question 17

What type of cytokine response is seen in the pathophysiology of erythema multiforme?

Answer 17

Transient TH1

Question 18

What is the oral involvement of erythema multiforme?

Answer 18

shallow ulcerations localized to the inferior tongue and bilateral posterior mucosa

Question 19

What type of hypersensitivity is associated to endogenous or exogenous stimuli in acute eczematous dermatitis?

Answer 19

Type IV

Question 20

What is spongiosis?

Answer 20

widened intracellular spaces

Question 21

What is allergic contact stomatitis?

Answer 21

dermatitis that occurs at the site of contact and includes itching and burning

Question 22

what type of hypersensitivity is allergic contact dermatitis?

Answer 22

type IV hypersensitivity

Question 23

what are the clinical features of allergic contact dermatitis?

Answer 23

Pruritic papules and vesicles on an erythematous base

Question 24

what are the pathological features of allergic contact dermatitis?

Answer 24

extensive spongiosis

May have intraepidermal vesicles, perivascular lymphocytic infiltrates in the upper dermis, also numerous eosinophils

Question 25

what is the pathogenesis of atopic dermatitis?

Answer 25

skin barrier defects: (FLG) Filaggrin and SPINK5 mutation

Question 26

Atopic dermatitis in adults can be clinical seen as what?

Answer 26

brown macular ring around the neck

Question 27

Pathological features of atopic dermatitis includes

Answer 27

acute to chronic spongiosis dermatitis

Question 28

What may be used to rule out other conditions from atopic dermatitis

Answer 28

biopsy and lab test to see IgE levels