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Bloc F - Defense > Apr12 M2-Hair and Nails > Flashcards

Apr12 M2-Hair and Nails Flashcards

1
Q

nail anatomy

A

proximal nail fold = base
lateral nail fold = skin on both sides
nail plate = nail part near lateral fold
onychodermal band = nail part near finger tip
lunula = whiter part near base
cuticle = tissue on base
matrix = most important part under the lunula. produces the nail

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2
Q

most important part of the nail and location

A

nail matrix. white tissue (see that it’s white if remove nail) under the lunula.

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3
Q

nail bed def

A

bed on which the nail rests, extending from lunula to hyponychium (which is the skin under the nail on the finger tip)

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4
Q

3 year old with sudden onset of shedding of nails and separation of nail plate from bed: different possible causes

A
  • trauma (manicure, onychotillomania)
  • eczema, erythroderma
  • severe systemic conditions
  • high fever
  • viral illness
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5
Q

3 year old with sudden onset of shedding of nails and separation of nail plate from bed: name of the condition and important related cause

A

onychomadesis

-hand foot and mouth disease caused by enteroviruses

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6
Q

tx of onychomadesis

A

nail will grow back

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7
Q

nail pitting (holes in the nail) means what

A

can be associated with

  • psoriasis
  • eczema
  • alopecia areata
  • trauma
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8
Q

swelling and redness around nail + painful erythmatous and purulent swelling of nail folds dx

A

acute paronychia

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9
Q

cause of acute paronychia

A

staph aureus

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10
Q

chronic paronychia looks like what

A
  • rednes and swelling around thumb, inflammed folds, dystrophic plate, not purulent
  • candida and irritation caused by saliva
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11
Q

group of pustules (pustular vesicular lesions) on fingernail and finger tip: name of that

A

herpetic whitlow

  • HSV1 or 2 infection of fingertip and perionychium
  • pain edema and erythema (and the pustular grouped vesicles**)
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12
Q

(imp?) brown line on the nail is what

A

melanonychia

  • think of melanoma refer to dermatology
  • nail matrix nevus or lentigo
  • subungal melanoma
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13
Q

racial melanonychia is what

A
  • melanonychia involving several nails

- benign

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14
Q

thick yellow toenails + debris under the nails: name of this SYMPTOM

A

subungal hyperkeratosis

nail plate separated from nail bed

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15
Q

disease where you see subungal hyperkeratosis and cause

A

onychomycosis

caused by fungal infections

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16
Q

most common type of onychomycosis

A

distal subungual onychomycosis

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17
Q

(imp?) distal subungual onychomycosis charact

A
  • onycholysis (bed-plate separation)
  • subungual hyperkeratosis
  • invasion of inferior plate
  • yellow brown discoloration
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18
Q

white superficial onychomychosis charact

A
  • superficial infection of nail plate

- well demarcated opaque friable plaque on dorsal plate (outer)

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19
Q

dx of onychomycosis

A
  • KOH coloration and smear
  • fungal culture
  • PAS stain (periodic acid Schiff)
20
Q

tx of onychomycosis

A

oral antifungal for 4 months

21
Q

diff parts of the hair

A
  • hair shaft = above scalp
  • hair root= in scalp
  • hair follicle = hole of the root
  • hair bulb = matrix cells making bottom of hair root
  • sebaceous glands to make sebum and keep hair and skin waterproof
22
Q

3 phases of hair growth

A
  • anagen
  • catagen
  • telogen
23
Q

anagen phase charact

A
  • lasts 1000 days

- matrix cells geown and become keratinized

24
Q

catagen phase charact

A

matrix cells suddenly stop proliferating

25
Q

telogen phase charact

A

100 days

-hair shedding phase, goes out of the follicle

26
Q

alopecia def and 2 things to check

A

means hair loss

  • localized vs diffuse
  • cicatricial or non cicatricial (scarring)
27
Q

cicatricial vs non cicatricial hair loss

A

cicatricial = lack of follicular ostia (holes) + shiny atrophic skin
non cicatricial = see hair follicles

28
Q

(important) alopecia areata def

A

autoimmune disease of patchy, non itchy, non scarring, non edematous hair loss

29
Q

tinea capitis def

A

circular patches of hair loss, itchy and scaly. broken hair

30
Q

cause of tinea capitis

A

dermatophyte fungi

31
Q

tinea capitis kerion def

A
  • inflammatory mass surrounded by follicular pustules
  • fever and local lymphadenopathy
  • severe and reactive infection. form of tinea capitis
32
Q

cause of tenia capitis kerion

A

fungal infection

33
Q

specific fungus that often causes tinea capitis

A

T. tonsurans

34
Q

dx of tinea capitis

A
  • scraping
  • KOH
  • culture
35
Q

(IMPORTANT) tx of tinea capitis

A

ORAL anti fungal

topical therapy is just to reduce infectivity

36
Q

trichotillomania def

A
  • habitual compulsive plucking of hair
  • broken hairs
  • frontotemporal or parietotemporal regions
37
Q

3 important things in trichotillomania

A
  • have access to this area of hair
  • pattern of hair loss
  • hair of different length
38
Q

tx of trichotillomania

A
  • stop habbit

- psychiatric evaluation

39
Q

androgenetic alopecia charact

A
40
Q

androgenetic alopecia in men vs women

A 
men = vertex (top of scalp) then bitemporal then both join
women = diffuse central thinning of the crown with preservation of the frontal hair line
41
Q

androgenetic alopecia cause

A
  • testosterone is transformed to DHT by 5 alpha reductase (enzyme in hair follicles)
  • have more levels of 5a reductase = have more androgen receptors
  • DHT leads to thinning and miniaturization of hair
42
Q

AGA (androgenetic alopecia) how androgen levels are diff from other people

A

NORMAL ANDROGEN LEVELS

just more 5a reductase and more androgen Rs

43
Q

DHT exact effect

A

-shortens growth phase from 3-6 years to a few weeks or months

44
Q

telogen effluvium charact

A

-premature shift of hair follicle to the telogen phase caused by some triggers (surgery, bad disease, fever, etc.)

45
Q

(imp?) triggers of telogen effluvium

A

SEND
Stress (psychosocial, surgery, systemic disease)
Endocrine (hypo, hyperthyroidism)
Nutritional (iron deficiency, etc.)
Drug (acitretin, anticoagulant, allopurinol)

46
Q

telogen effluvium evolution

A
  • shedding for 3-4 months after initiating cause

- 6-12 months for hair density to go back to normal

Bloc F - Defense (57 decks)

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