B6-024 Inflammatory Skin Pathology Flashcards
epidermal inflammatory diseases [5]
psoriasis
eczema
lupus erythematosus
lichen planus
erythema multiforme
beefy red plaques with silvery scales
tend to be around:scalp, knees, elbows, sacrum, and genitals
psoriasis
psoriasis
caused by contact with external allergen
allergic contact eczema
linear streaks of eczema can be a clue to […] derived allergic contact eczema
plant
endogenous reaction to relatively minor allergens often occurring in infancy
atopic eczema
lichenification indicates
chronic atopic eczema
acute eczema
anti-DNA antibodies
+ ANA
lupus erythematosis
butterfly malar erythema
no rash in areas protected by sunlight
lupus erythematosis
dead reds
melanin drop-out
lupus erythematosis
pruritic
purple
polygonal papules
lichen planus
Wickham striae in buccal mucosa
often a symmetric distribution
lichen planus
Hepatitis C is associated with
lichen planus
lichen planus
acute eruption
often occurs with HSV, mycoplasma
erythema multiforme
target lesions
erythema multiforme
normal corneum
erythema multiforme
blistering skin diseases [3]
pemphigus vulgaris
bullous pemphigoid
dermatitis herpetiformis
cutaneous erosions/oral ulcers of upper trunk/head
painful not itchy
pemphigus vulgaris
positive Nikolsky sign
(top layer of skin shears off when rubbed)
pemphigus vulgaris
pemphigus vulgaris
chicken wire pattern of IgG deposition in lower epidermis
pemphigus vulgaris
desmoglein 3
pemphigus vulgaris
pemphigus vulgaris is a […] hypersensitivity reaction
type II
tense blisters and vesicles on lower abdominal, thighs, forearms
severe pruritus
bullous pemphigoid
negative nikolsky sign
bullous pemphigoid
what should be on your differential in an elderly patient with severe itching without obvious cause?
bullous pemphigoid
**can form urticarial plaques
occurs where epidermis meets dermis
eosinophils
bullous pemphigoid
linear deposition of IgG and C3
bullous pemphigoid
BPAG1/BPAG2 on hemidesmosomes
bullous pemphigoid
bullous pemphigoid is a type […] hypersensitivity reaction
2
grouped pruritic papules at nape of neck, knees, elbows, sacrum, scalp
dermatitis herpetiformis
associated with HLA-DQ2 and DQ8
dermatitis herpetiformis
> 90% of patients have celiac disease
dermatitis herpetiformis
dermatitis herpetiformis is treated with [2]
dapsone
gluten free diet
dermatitis herpetiformis
granular deposition of IgA within dermal papillae
dermatitis herpetiformis
IgA complexes with gliadin and transgluatminase
dermatitis herpetiformis
dermatitis herpetiformis is a type […] hypersensitivity reaction
3
dermal/SQ inflammatory disease [5]
acne
rosacea
urticaria
leukocytoclastic vasculitis
erythema nodosum
papules, pustules, nodules, or comedones on face/back/chest
follicular occlusion by keratin debris
acne vulgaris
related to increased sebum production
acne vulgaris
acne vulgaris
redness and dilated blood vessels on nose, cheeks, forehead, chin
gritty sensation in eyes
telangiectasias on biopsy
rosacea
transient plaques, annular (ring shaped)
pruritic and edematous
urticaria
urticaria is a type […] hypersensitivity reaction
1
treatment for urticaria
antihistamines
palpable purpura in lower extremities/pressure points
leukocytoclastic vasculitis
leukocytoclastic vasculitis is a type […] hypersensitivity reaction
3
what additional test should you order for leukocytoclastic vasculitis?
UA
**can have kidney involvement
leukocytoclastic vasculitis
tender nodules on the shins of young women
erythema nodosum
erythema nodosum is a type […] hypersensitivity reaction
4
erythema nodosum
keratotic papules commonly seen on the hands, feet, face of kids/young adults
verruca vulgaris
associated with human papillomavirus
verruca vulgaris
“halo cell” koilocyte
verruca vulgaris
umbilicated papules on face, neck, axillae, trunk, thighs, buttocks, genitalia seen in children, YA, and HIV+ patient
molluscum contagiosum
due to direct transmission of a pox virus
molluscum contagiosum
molluscum contagiosum
erosions/vesicles with honey colored crusts on the faces/extremities of kids/YA
impetigo
crusted lesions often caused by S. aureus or S. pyogenes
impetigo
patients with impetigo caused by S. pyogenes can develop
poststreptococcal glomerulonephritis
impetigo
commonly caused by trichophyton rubrum
tinea
annular plaques with pustules, active border
can be found on scalp, foot, body, toenails, or groin
tinea
tinea
papules, nodules, necrosis occurring at sites of trauma, often in immunocompromised patients
can disseminate from lung infection
aspergillosis
treatment of aspergilloisis
systemic antifungals STAT and surgical debridement
**very high mortality rate in disseminated disease
aspergillosis
epidermal vesicles with deep inflammation
insect bite
pruritic papules classically in the finger webs
worsening itchiness at night
scabies
scabies
linear IgA deposition
dermatitis herpetiformis
dermatitis herpetiformis is a type […] hypersensitivity
III
treatment for dermatitis herpetiformis [2]
dapsone
gluten free diet
beefy red plaques with silvery scale
psoriasis
test tube acanthosis
neutrophils in the stratum corneum
psoriasis
itchy lesions in web spaces, especially at night
scabies
treatment for scabies
topical permethrin
bilateral palpable purpura usually in lower extremity
leukocytoclastic vasculitis
check a UA if diagnosis is
leukocytoclastic vasculitis
septate with acute angle branching with blue cytoplasm
aspergillosis
deep fungal infections typically occur in […] patients
immunocompromised
tense blisters with negative Nikolskys
bullous pemphigoid
subepidermal blister with eosinophils, linear C3, and IgG
bullous pemphigoid
autoantibodies to hemidesmosomes
BP180 antibodies
bullous pemphigoid
red scaly plaques, dyspigmentation, scarring in a photodistribution
lupus erythematosus
carpet tack scale
smudged DEJ
deep inflammation
lupus erythematosus
grouped papules
across nape of neck, knees, lower back, elbows
dermatitis herpetiformis
pruritic papules at ankles and wrists
lichen planus
linear papules at hands, nipples, waistline, and genitalia
scabies
scaly, annular, pustular rash
tinea
blisters caused by suprabasal acanthylosis
pemphigus vulgaris
subepidermal blisters
bullous pemphigus
dermatitis with squamatization, hypergranulosis, and orthokeratosis
lichen planus
band like infiltrate of lymphocytes at DEJ
saw tooth pattern squamatized epidermal hyperplasia
wedge-shaped hypergranulosis
lichen planus
neutrophils in tips of papillae without parakeratosis
dermatitis herpetiformis
spongiosis
eczema
scabies is caused by
sarcoptes scabei
gram positive bacteria producing lipase which forms irritating fatty acids within occluded hair follicles
propionibacterium
bacteria causing acne vulgaris
propionibacterium
treatment for acne vulgars
benzoyl peroxide
doxycyline if refractory
causes deep, potentially fatal infections in immunocompromised patients
manifests with necrotizing papules and plaques
aspergillus
genus of mites that infect the skin and produce itching that is worse at night
sarcoptes
linear burrows across finger webs and genitalia
scabies
genus of fungi that produce tinea
trichophyton
annular scaling rashes with pustules
trichophyton
umbilicated papules without comedones
molluscum
type […] hypersensitivity reactions are mediated by antibodies
II
type […] hypersensitivity reactions are mediated by antigen-antibody complexes
III
type […] hypersensitivity reactions are cell-mediated responses independent of antibodies
IV
type […] hypersensitivity reactions occur when antibodies bind to cell surface receptors
V
**graves disease
type […] hypersensitivity reactions are mediated by mast cells and IgE
I
allergic rhinitis is associated with
atopic dermatitis
inflammatory arthritis is associated with
psoriasis
sarcoidosis is associated with
erythema nodosum
every patient with leukocytoclastic vasculitis should have a urianalysis to evaluate for
renal failure
IgG and C3 deposits between keratinocytes in “fishnet” pattern
pemphigus vulgaris
granular IgA deposits
dematitis herpetiformis
linear deposits of IgG in basement membrane
bullous pemphigoid
beefy red plaques with silver scales
psoriasis
ill-defined erythematous plaques which ooze, crust, scale, and itch
eczema
target lesions with “bullseye” appearance and no scale
erythema multiforme
pruritic violaceous polygonal papules and Wichham’s striae
lichen planus
butterfly malar rash
acute SLE
dispigmented plaques and “carpet tack” scales
discoid SLE
patients with severe muco-cutaneous erythema multiforme may have
mycoplasma pneumonia
all hospitalized patients with erythema multiforme should be tested for
IgG and IgM to mycoplasma pneumoniae
anti-transglutaminase antibodies are seen in
dermatitis herpetiformis
mucocutaneous rash
acanthylosis
intraepidermal blistering with tombstone basal keratinocytes
pemphigus vulgaris
