Chapter 23 - Skin Flashcards
Acute inflammatory dermatoses
urticaria, acute ecxematous dermatitis, erythema multiforme
chronic inflammatory dermatoses
psoriasis, lichen planus, lichen simplex chronicus
macule
flat discoloration
papule
elevated done
plaque
flat-topped elevation
scale
dry, horny, platelike growth
vesicle, bulla
fluid filled area…. >5 mm is bulla
wheal
raised area of edema, AKA hive
acantholysis
acanthosis
Hyperkeratosis
loss of keratinocyte adhesion
epidermal hyperplasia
hyper stratum corneum
type I hypersensitivity---mast cell degranulation multiple wheal (isolated or diffuse)
Urticaria—Hives
IgE dependent urticaria is assoc with
IgE independent with
common allergens
medications (opiates, antibiotics)
ex cessive complement activation
trauma, menstratuion, stresss, —-
various meds, viral infxn
hereditary angioedema
various stimuli, multipla appearancess
Acute: red, nblisters, oozing, crusts
Chronic: raised scaling plaque
Acute eczematous dermatitis
eczema
eczema is a mix of hypersensitivities
Type I and type IV
itchy—-scratching may cause trauma
MC type of ezcema
allergic contact dermatitis
CD 4+ T cell sensitization
limited to contact site
inherited risk of hypersensitivity
—atopic triad : dermatitis, asthma, rhinitis
Onsets in childhood, improves with age
Atopic dermatits (atopic eczema)
Type 4 hypsersensitivity–rare, selt-limited
infectious
drug reaction
Erythema Multiforme
how does erythema multiforme present itself
red macule, pale eroded center
targetoid lesion
post infxn, milder
erythema multiforme minor
drug related, aggressive
sloughing of epidermis, fluid loss, infection
erythema multiforme Major
autoimmune–unknow antigens, t cells in epidermis
lifelong
2% of population—
psoriasis
epidermal hyperplasia, itchy
MC in extremities—Wickham’s striae in oral cavity
lichen planus
idiopathis
repetitive trauama
epidermal hyperplasia & dermal scarring–raised itchy scale
lichen implex chronicus
S. aureus 80%… strep pyogenes
contagious
“honey-colored” crust or abscess ( when deeper)
Impetigo
Children!—mouth, nose
Neutrophils battle
what is pus?
dead WBC, edema, idk
how is impetigo transferred?
direct contact—-think wrestling
Deeper infxn, puncture wounds or burn site
Pseudomonas aeruginosa
what percent of blood do you need to lose in order for shock?
20%
Intense itchiness, Superficial or deep layers of skin or nail bed—-almost could be psoriasis
mycosis, dermatophytosis, tinea “ringworm”
Fungal, immunodeficiency
Angioinvasive: lungs-to-blood
aspergilloma
Aspergillus fumigatus
what is tinea corporis
non hairy skin area where you will get fungal infxn
what is tinea barbae?
beard (hair follicle)
pediatrics, warts
most are self-limited
HPV infxns 6 and 11\
HPV-16 and HPV-18
HPV carries e6 and e7
e6 makes p53 into tp53
e7 makes Rb into RB
blistering disorders (bullous)
pemphigus
bullous pemphigoidj
dermatitis herpetiformi
Autoimmune, rare
Middle aged/ elderly women
Type 2 hypersensitivity IgG anitbodies
Fish-net like pattern
pemphigus
most commnon type of pemphigus
Skin & mucosa—face, scalp, axillae, groin
Blisters are suprabasal
Pemphigus vulgaris
skin only—no mucosa
blisters are corneal
pemphigus foliaceus
what is acantholysis?
separation of cells
skin and mucosa of tho forearm, axilla, groin
Blisters are subepidermal
Autoimmune, older adults
Bullous pemphigoid
“tense bullae”
outer epidermis is fully intact
location—torso, gluteal, elbows, knees
autoimmune—10% of celiac patients
males, 20-40
dermatitis herpetiformis
dark, flat, round, “coin-like”, “stuck on”—Leser-Trelat sign
More
seborrheic keratosis
benign skin lesions in oily areas of body–head/neck
slow growing
nearly flesh tone
sebaceous adenoma
dysplastic (pre-cancer)—-atypia
sun-exposed areas
small, tan/broqn, “sandpaper like” lesions
tx. local eradication
actinic keratosis
2nd MC skin cancer
older adultsm sun-exposed skin
Squamous cell carcinoma
Risks, Total UV, males, burnsm ionizing rad, tar/oil, arsenic, chronic ulcers
squamous cell carcinoma
MC skin cancer older adults, sun-exposed Risks UV, mutated tumor suppressor genes PTCH (hedgehog path) TP53
Basal Cell carcinoma
What is the atopic triad?
think back to atopic dermatitis
atopic dermatitis, asthma, and allergic rhinitis
what can appear alongside erythema multiforme?
antecedent infxns include HSV and those caused by mycoplasmas and some fungi
you will see this skin condition in 10% of patients with arthritis
psoriasis
Psoriasis induced by local trauma in susceptible persons is termed whaat
Koebner phenomenon—a local inflamm response that promotes lesion development
what is auspitz sign
multiple bleeding points assoc with psoriasis
what is wickham striae
white dots or lines hightlighting the papules of lichen planus
