Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology ANDREWS > Chapter 6 Contact Dermatitis > Flashcards

Chapter 6 Contact Dermatitis Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

What is irritant dermatitis? Allergic contact derm?

A
  1. Inflam rxn in skin resulting from exposure to substance that causes eruption in most people who come in contact with it
  2. Acquired sensitivity to various substances that produce inflam rxn only in those persons who have been previously sensitized
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F atopic patients are predisposed to irritant hand dermatitis

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F acids penetrate and destroy deeply because they dissolve keratin

A

False - alkalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acid that produces burns that are less deep and more liable to form blisters

A

Hydrochloric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acid that produces brownish charring of skin beneath which is an ulceration that heals slowly

A

Sulfuric

- handled by brass and iron workers, also with copper and bronze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acid that is a powerful oxidizing substance that causes deep burns, stains yellow

A

Nitric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acid used widely in rust remover, semiconductor industry, germicides, dyes, plastics and glass etching
Strongest inorganic acid capable of dissolving glass

A

Hydrofluoric acid

  • hypocal hypomag hyperkal dysrhythmias
  • neutralized with hexafluorine solution -> 10% Ca gluc or mag oxide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acid that may produce paresthesia of fingertips with cyanosis and gangrene, yellow discoloration of nails

A

Oxalic

- neutralize with limewater or milk of magnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acud used in manufacture of pigments

A

Titanium hydrochloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acid that is protoplasmic poison that produces white eschar

A

Phenol / carbolic acid

  • neutralize with 65% ethyl or isopropyl alcohol
  • large amount -> GN, arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acid in electroplating and dye production, extensive tissue necrosis and renal damage

A

Chromic

- excision to fascia rapidly, HD to remove within 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is irritant dermatitis? Allergic contact derm?

A
  1. Inflam rxn in skin resulting from exposure to substance that causes eruption in most people who come in contact with it
  2. Acquired sensitivity to various substances that produce inflam rxn only in those persons who have been previously sensitized
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F atopic patients are predisposed to irritant hand dermatitis

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F acids penetrate and destroy deeply because they dissolve keratin

A

False - alkalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acid that produces burns that are less deep and more liable to form blisters

A

Hydrochloric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acid that produces brownish charring of skin beneath which is an ulceration that heals slowly

A

Sulfuric

- handled by brass and iron workers, also with copper and bronze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acid that is a powerful oxidizing substance that causes deep burns, stains yellow

A

Nitric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acid used widely in rust remover, semiconductor industry, germicides, dyes, plastics and glass etching
Strongest inorganic acid capable of dissolving glass

A

Hydrofluoric acid

  • hypocal hypomag hyperkal dysrhythmias
  • neutralized with hexafluorine solution -> 10% Ca gluc or mag oxide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Acid that may produce paresthesia of fingertips with cyanosis and gangrene, yellow discoloration of nails

A

Oxalic

- neutralize with limewater or milk of magnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acud used in manufacture of pigments

A

Titanium hydrochloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Acid that is protoplasmic poison that produces white eschar

A

Phenol / carbolic acid

  • neutralize with 65% ethyl or isopropyl alcohol
  • large amount -> GN, arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acid in electroplating and dye production, extensive tissue necrosis and renal damage

A

Chromic

- excision to fascia rapidly, HD to remove within 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx of airbag dermatitis

A

Topical steroids

Debridement and grafting for full thickness burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Applied on flexural areas to prevent fiberglass dermatitis

A

Talcum powder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

May completely relieve burning of capsaicin irritation

A

Acetic acid / white vinegar

Antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Skin lesion of chloracne, histology, treatment

A

Small straw colored follicular plugs and papules, on malar crescent, retroauricular earlobes neck shoulders scrotum

Loss of sebaceous glands, formation of cystic structures

Isotretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Symptoms of crude petroleum dermatitis

A

Generalized itching folliculitis or acneiform eruptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Insoluble neat cutting oils dermatitis result to

A

Follicular acneiform eruption on hands forearm face thigh back of neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Soluble oils and synthetic fluids in metalworking -> dermatitis result to

A

Eczematous dermatitis on dorsal hand and forearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

May occur from exposure to mineral oils and low grade petroleum from creosote asphalt other tar

A

Melanoderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Follicular keratosis and pigmentation resulting from crude petroleum tar oils and paraffin

A

Acne corne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Chlorinated hydrocarbon solvent and degreasing agent when inhaled may produce exfoliative erythroderma, mucous membrane erosions, eosinophilia, hepatitis

A

Trichloroethylene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most common relevant allergens in childhood

A

Nickel cobalt fragrance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is babboon syndrome or SDRIFE

A

Deep red violet eruption on buttocks genital inner thighs and axillae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

T/F contact urticaria to a substance may concomitantly have a type IV delayed sensitization and eczema from same allergen

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Body part used for patch test

A

Upper back
Patch removed after 48h or sooner, sites evaluated at day 4/5 or even up to 7 days
Erythematous papules and vesicles with edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why is the oral mucosa more resistant to irritants?

A

Keratin layer more readily combines with haptens to form allergens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How to do provocative use test

A

Material rubbed to skin of inner aspect of forearm several times a day for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How to do photopatch test

A

Patch applied for 48h, exposed to 5-15J/m2 of UVA, read after 48h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Toxicodendron dermatitis includes dermatitis from what plant family

A

Anacardiaceae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Symptoms of toxicodendron derm

A

Pruritus followed by inflammation vesicles bullae, linearity of lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tx of severe extensive plant derm

A

40-60mg prednisone OD tapered in 3wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Allergenic substance in poison ivy abd vesicant oil

A

Uroshiol

Cardol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Houseplant frquently causing contact derm

A

Money plant or philodendron crystallinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most common flower causing allergic contact derm in florists

A

Peruvian lily

- tulip fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Acid causing sensitization by lichens

A

D-usnic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

2 antigens of pollens in ragweed

A

Protein - respiratory symptoms of asthma, hay fever

Oil soluble - contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Chief sensitizer derived from plants found in oleoresin fractions

A

Essential oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Most common cause of clothing dermatitis

A

Fabric finishers
Dyes
Rubber additives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Diagnostic point in shoe dermatitis

A

Normal skin between toes

- most frequently caused by rubber accelerators mercaptobenzothiazole, carbamates, tetramethylthiuram disulfide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Metal dermatitis most frequently caused by

A

Nickel and chromates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Most common causes of allergic derm in rubber manufacturing

A

Accelerators - disulfiram, thiuram

Antioxidant - propyl-p-phenylenediamine

53
Q

Components of epoxy resins

A

Resin 90% of allergic rxn

Hardener 10%

54
Q

Leading cause of cosmetic dermatitis

A

Fragrance followed by preservatives then p-phenylenediamine in hair dye

55
Q

Primary irritants in hair bleach

A

Peroxide
Persulfate
Ammonia

56
Q

Allergen of acid perm

A

Glyceryl monothioglycolate - persists for at least 3mos in hair

57
Q

Substance in chemical depilatories causing irritant dermatitis

A

Calcium thioglycolate, sulfides, sulfhydrates

58
Q

Frequent cause of eyelid and neck derm in nail lacquers

A

Tosylamide/formaldehyde resin

59
Q

Most common sunscreen allergen

A

Oxybenzone

60
Q

Allergy to PABA may cause dermatitis from cross rxns to

A 
Thiazide 
Sulfonylureas 
Azo dyes 
P-aminosalicylic acid 
Benzocaine
PPDA
61
Q

Drug transdermal patch with highest rate of allergic rxn

A

Clonidine

62
Q

Drugs that may cause anamnestic/recalled eruption or systemic contact derm

A

Antihistamines
Sulfonamides
Penicillin

63
Q

topical anesthetic that is the Most common sensitizer

A

Benzocaine

64
Q

T/F white petrolatum is as effective in wound healing as antibiotic ointment in clean surgical procedures

A

True

65
Q

What are the occupations with the highest incidence of occupational skin disease?

A 
Agriculture
Forestry 
Fishing 
Manufacturing 
Healthcare
66
Q

T/F nonimmunologic is the most common contact urticaria

A

True

67
Q

How to do open patch test

A

Substance applied to 1 cm sq area on forearm and observed for 20-30min for erythema wheal and flare

68
Q

Secretion of T cells in the dermis in acute gen exanthematous pustulosis (AGEP)

A

IL-8 neutrophil attacking chemokine

69
Q

Secretion of T Cells in drug rash with eosinophilia and systemic symptoms

A

IL-5
Eotaxin
Recruiting eosinophils

70
Q

Type of rxn when T cells stimulate IFN-y production and Th1 response (contact derm)

A

Can be bullous but without extensive epidermal necrosis

71
Q

Type of rxn when T cells activated to function in a Th2 manner, stimulate eosinophil

A

Morbilliform and urticarial

72
Q 
Type of rxn when T cells activate CD8+ T cells, secrete perforin/granzyme B and Fas ligand, result in keratinocyte apoptosis
(CD8 cells attack all MHC class I cells hence more severe rxn)
A

Bullous rxn

73
Q

Type of rxn in T cells through cytokine production recruit neutrophils

A

Pustular exanthem

AGEP

74
Q

T cells reduced in severe bullous drug eruptions such as TEN

A

CD4/CD25/Foxp3 regulatory T cells or Tregs

75
Q

Drugs most commonly causing morbilliform/maculopapular rxn

A

TMP-SMX

Penicillins

76
Q

Characteristics of DIHS And DRESS

A

Rash developing >3wks after starting drug
Lasting symptoms >2wks after discontinuation
Fever >38deg
Multiorgan development
Eosinophilia >1500
Lymphocytosis, atypical lymphocytosis, lymphadenopathy
Frequent activation of HHV6 HHV7 EBV CMV

77
Q

Most common anticonvulsant causing DRESS

A

Carbamazepine

78
Q

T/F allopurinol hypersensitivity syndrome typically occurs in preexisting liver failure

A

False - renal

79
Q

Most common mucosal surfaces eroded in SJS

A

Oral mucosa

Conjunctiva

80
Q

Percentage of skin lesion in SJS and TEN

A

SJS/TEN overlap >10% skin surface

TEN >30%

81
Q

Internal involvement in SJS/TEN

A

Eosinophilia
Hepatitis
Worsening renal function

82
Q

What is SCORTEN for SJS/TEN

A

Predict mortality (age malignancy tachycardia renal failure hyperglycemia low bicarbonate)
1 pt for each
3.2% mortality for 0-1pt
90% for 5/more

Respiratory excluded

83
Q

Mechanism of keratinocyte death in SJS/TEN

A

Cytotoxic T cells, NK cells produve granulysin, perforin, granzyme B
Binding of soluble Fas ligand to Fas (death receptor / CD95)

84
Q

Most promising drug to treat SJS/TEN

A

Cyclosporine

85
Q

Survivors of SJS/TEN average time for epidermal regrowth,

Most common complication / sequelae

A

3 weeks

Ocular scarring and vision loss

86
Q

Drugs associated with radiation induced EM

A

Phenytoin
Amifostine
Phenobarbital
Levetiracetam

87
Q

HIV patients increases risk for development of ADR at what Th cell count

A

25-200

88
Q

Nevirapine hypersensitivity syndrome presents with

A

Fever hepatitis rash

First 6wks treatment

89
Q

FDR/E most commonly occurs where

A

Oral and genital mucosa

- with refractory period

90
Q

Skin lesion of FDE

A

Red patch evolving to iris/target lesion similar to EM and may eventually blister and erode

91
Q

Histology of FDE

A

Interface dermatitis with subepidermal vesicle formation
Necrosis of keratinocytes
Superficial and deep infiltrates of neut eo and mononuclear cells

92
Q

Pathognomonic skin layer changes in FDE

A

Normal stratum corneum and chronic dermal changes

93
Q

When and how to do oral provocation test in FDE

A

2wks from last eruption

Initial challenge 10% of standard dose AND do not challenge if with Widespread SJS/TEN

94
Q

Most common cause of AGEP

A

Drugs 90%

95
Q

Most common systemic involvement in AGEP

A

Respiratory

96
Q

Most common drug induced pseudolymphoma

A

Cutaneous T cell lymphoma

Anticonvulsant sulfa drugs dapsone antidepressants vaccination herbals

97
Q

Drugs Most common cause of non immunologic urticarial lesions

A

Aspirin
NSAIDs
(Alter PG metabolism enhancing degranulation of mast cells)

98
Q

Immunologic urticaria most often associated with

A

Penicillin

Related beta lactam

99
Q

T/F Second gen cephalosporins less likely to induce rxn in penicillin allergic pt than first or third

A

False - third

100
Q

Angioedema is a known complication of which drugs

A

ACEI and ARBs

ACEI - block kininase II increase kinin

101
Q

Most medication related photosensitivity triggered by what UV range

A

UVA

  • absorption spectra of most drugs and short range 315-430
  • penetrates into dermis where drug is present
  • NSAID TMPSMX thiazides sulfonylureas quinine quinidine phenothiazine tetracycline
102
Q

Drug most frequently causing pseudoporphyria

A

Naproxen

103
Q

Patient features predisposed to anticoagulant induced skin necrosis

A

Obese postmenopausal

  • 3-5d after therapy, red painful plaques then petechiae then bulla then necrosis
  • histo: non inflam thrombosis with fibrin in subcutaneous and dermal vessels
  • tx: stop warfarin, give vit K, LMWH, giving purified protein C rapidly reverses
104
Q

IV drugs related to injection site rxn

A

Chemo
Calcium salts
Radiocontrast
Nafcillin

105
Q

Syndromes in IM injection site rxn

A

Embolis cutis medicamentosa
Livedoid dermatitis
Nicolau syndromes- periarterial injection leading to arterial thrombosis

106
Q

Minocycline induced pigmentation with 2 types - describe

A

Type I blue black discoloration in areas of prior inflammation often acne or surgical scar
Type II similar but on anterior shin
Type III gen muddy brown hyperpigmentation accentuated in sun exposed areas

Histo: pigment granules within macrophages in dermis and at times fat resembling tattoo
Stain for both iron and melanin

107
Q

Presentation of amiodarone induced hyperpigmentation

A

Slate gray in areas of photosensitivity

After 3-6mos

108
Q

Drug inducing hyperpigmentation in Hansens disease

A

Clofazimine
Pink then reddish blue or brown in Hansens lesions
Drug induced lipofuscinosis

109
Q

Most common heavy metal induced pigmentation

A

Silver
Local and systemic argyria
- binding to sulfur or selenium, activates tyrosinase increase pigmentation

110
Q

Drug that can induce true leukocytoclastic vasculitis

A

Propylthiouracil

111
Q

Skin gland that is a unique target for adverse rxn to antineoplastic agents

A

Eccrine gland

112
Q

Tx of chemo induced acral erythema

A

Cold compress
Elevation
Cooling hands
Modification of dose schedule

113
Q

Tx of hand foot skin rxn in multikinase inhibitors

A

Topical tazarotene, 40% urea, Heparin ointment fluorouracil cream

114
Q

Component of mushroom causing toxicodermia or shiitake flagellate dermatitis

A

Lentinan

115
Q

Chemo drug causing gen or localized dyspigmentation, inability to tan, ‘photosensitivity’

A

Imatinib
- proposed mechanism inhibition of stem cell factor

*sunitinib causing depigmentation of hair after 5-6wks of treatment

116
Q

Chemo drug causing exudative hyponychial dermatitis

A

Docetaxel

117
Q

Primary lesion in side effect of EGFRI

A

Follicle papule or pustule with few or no comedones

Tx: topical metronidazole, clindamycin, hydrocortisone, pimecrolimus, tretinoin

118
Q 
Cutaneous side effect of 
Imatinib, sunitinib
Dasatinib
Bevacizumab
Sorafenib
A

Facial edema with periocular predilection
Lobular panniculitis
Bleeding, wound healing complications, ulceration of striae distensae
Keratoacanthomas or SCC, eruptive melanocytic lesions

119
Q

Exacerbation of leukocytoclastic vasculitis associated with what drugs
Exacerbation of psoriasis associated with

A

G-CSF and GM-CSF

IFN-alpha, IFN-y, G-CSF

120
Q

Skin Presentation of injection site rxn fron TNFi

A

Erythematous mildly swollen plaques 1-2d after injection

121
Q

Paradoxic appearance of psoriasis or psoriasiform dermatitis occurs more commonly in which TNFi

A

Infliximab
Etanercept
Adalimumab

Mechanism: overactivity of Th1 cells or inc IFN-alpha production by skin-resident plasmacytoid dendritic cells

Tx: topical corticosteroids, UV photoThx, topival vit D analogs, methotrexate, acitretin, cyclosporine

122
Q

Pathognomonic characteristic of acrodynia or mercury poisoning

A

Painful swelling of hands and feet sometimes associated with itching

  • diffuse symmetric erythematous morbilliform eruption in flexors and proximal extremities within a few days of exposure

Tx: succimer, seafood free diet

123
Q

Drugs causing drug induced lupus

A 
Hydralazine 
Isoniazid 
Penecillamine 
Procainamide
PTU 
Quinidine 
Captopril 
Minocycline 
Carbamazepine 
Sulfasalazine 
Statins
124
Q

Drugs most commonly causing subacute cutaneous lupus

A

HCT
Diltiazem and other ccb
Terbinafine

125
Q

Linear IgA bullous dermatosis especially associated with which drug

A

Vancomycin

Tx: stop drug, dapsone 100-200mg OD

126
Q

Explanation for LT receptor antagonist associated churh strauss syndrome

A

Unopposed LT B4 activity - chemoattractant for eo and neutro

127
Q

Skin changes most frequently seen after corticosteroid use

A 
Atrophy
Striae 
Telangectasia
Skin fragility 
Purpura
  • steroid should be substituted by pimecrolimus or tacrolimus
128
Q

T/F atopic children with >50% BSA involvement have short stature

A

True

Dermatology ANDREWS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions