Chapter 11

Question 1

Diagnosis

Answer 1

Small Plaque Parapsoriasis

Question 2

Primary Morphology and MC location in Small Plaque Parapsoriasis?

Answer 2

Hyperpigmented or yellowish red scaling patches, round to oval with sharply defined borders, 1-5cm

Trunk

{MC gender = Male}

Question 3

Digitate SPP morphology?

Answer 3

yellowish tan, elongated, fingerprint-like along cleavage lines on flank

Question 4

Early stage small pages of cutaneous T cell lymphoma morphology seen in what dz?

Answer 4

large erythematous to purplish red lesions and poikiloderma

seen in SPP

Question 5

What dz is SPP associated with?

Answer 5

liposarcoma

SPP –> resolves once tumor is removed

Question 6

Histopath of SPP?

Answer 6

type of spongiotic dermatitis

infiltrate in superficial dermis of lymphocytes

Question 7

How do you treat SPP?

Answer 7

may be refractory to steroids alone!

phototherapy alone or in combo with steroids

{UVB, NBUVB, natural sunlight +/- steroids}

Question 8

Other information about SPP?

Answer 8

1. Rarely progresses to mycosis fungoides
2. hypOpigmented varient may progress to hypOpigmented MF
3. untreated rarely progresses to lymphoma

Question 9

Diagnosis?

Answer 9

Confluent and Reticulated Papillomatosis

Question 10

Primary morphology & location of CARP?

Answer 10

Intermammary & Upper lateral trunk

Slightly scaly macules that spread

White pts: skin colored, faintly red, hyperpigmented

Pigmented pts: hyperpigmented or nonpigmented with fine white scale

Question 11

CARP symptoms and associated dz?

Answer 11

severe itching or asymptomatic

hypothyroidism

Question 12

What is pseudoatrophoderma colli?

Answer 12

1. Papillomatous, pigmented atrophic glossy lesions with delicate wrinkling
2. assoc condition with CARP
3. occurs on neck

Question 13

CARP treatment?

Answer 13

Minocycline BID x 6 wks

Question 14

Other treatments for CARP?

Answer 14

1. oral fusidic acid
2. clarithromycin, erythromycin, azithromycin
3. amoxicillin
4. topical mupirocin
5. topical/oral retinoids alone or combined c topical lactic acid, urea, alcohol
6. if assoc c PCOS = birth control pills

Question 15

Diagnosis?

Answer 15

Pityriasis Rosea

Question 16

Diagnosis

Answer 16

Palmoplantar keratoderma

type - Keratoderma climactericum

Question 17

Diagnosis?

Answer 17

Pityriasis Rubra Pilaris

Question 19

Diagnosis?

Answer 19

Pityriasis Rubra Pilaris

1. Gooseflesh
2. Classic juvenile type = limited plaques on extensor surfaces with adjacent ‘nutmeg-grater papules’

Question 20

Diagnosis?

Answer 20

Pityriasis Rubra Pilaris

Question 21

What is the morphology of acrokeratoelastoidosis?

Answer 21

1. Location : dorsal hands, knuckles, lateral margins of palms and soles
2. Morph: small, round, firms papules
3. translucent to erythematous papules at margins of the palms

Question 22

What age does acrokeratoelastoidosis affect?

Answer 22

early childhood/adolescent in inherited cases and progress slowly

Sporatic or autosomal dominant

Question 23

Acrokeratoelastosis is typically asymptomatic but can require a workup of __?

Answer 23

dermal elastorrhexis

*NO alteration of collagen or elastin

Question 24

Morphology for collagenous and elastotic marginal plaques of hands?

Answer 24

slowly progressive lesions at the margins of the palms

Question 25

Histopath for collagenous and elastotic marginal plaques of hands

Answer 25

thick collagen bundles admixed with elastic fibers and amorphous basiphilic elastotic material

*altered collagen & elastin

Question 26

Morphology of Focal Acral Hyperkeratosis?

Answer 26

crateriform keratotic papules and plaques along the borders of hands and feet

marginal hyperkeratotic papules often with a central dell

on both hands & fingers

Question 27

Who does Focal Acral Hyperkeratosis affect?

Answer 27

Autosomal dominant & sporatic forms

MC in AA

Question 28

What is important to know about Focal Acral Hyperkeratosis?

Answer 28

1. There is NO alteration in collagen or elastic on biopsy
2. differs from [Acrokeratoelastosis] and [Collagenous and Elastotic Marginal Plaques of Hands] bc it lacks above mentioned underlying dermal changes

Question 29

Who and where does Mal de Meleda affect?

Answer 29

1. affects individuals from island of Meleda
   - rare, autosomal recessive
2. NOT confined to palms - commonly found on extensor surfaces of arms

Question 30

What lab findings are associated with Mal de Meleda?

Answer 30

1. mapped to - Chromosome 8q
2. mutations in - ARS component B gene
3. mutations in - SLURP-1 gene

Question 31

What is Nagashima- type Keratosis?

Answer 31

1. nonprogressive
2. autosomal recessive palmoplantar kd
3. resembles [mal de meleda]