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CK Flashcards

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Dermatology Board Prep flashcards
1
Q

skin cancer - types and MC

A
  1. basal cell carcinoma (BCC) (MC)
  2. Squamous cell carcinoma
  3. Melanoma
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2
Q

basal cell carcinoma (BCC) of the skin is found in (area of the body and classic location) / behavior

A

sun exposed areas / classic location: upper lip

  1. locally invasive
  2. RARELY metastasizes
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3
Q

basal cell carcinoma (BCC) of the skin - macroscopic appearance

A
  • PINK, pearly nobules, commonly with telengectasias, rolled borders, central crusting or ulceration
  • nonhealing ulcer with infiltrating growth or as a scaling plaque (superficial BCC)
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4
Q

basal cell carcinoma (BCC) of the skin - Histology

A

clusters of darkly staining basaloid cells with a palisade

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5
Q

Squamous cells carcinoma (SCC) of the skin is associated with (risk factors)

A
  1. excessive exposure to sunlight
  2. immunosuppression
  3. arsenic exposure
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6
Q

Squamous cells carcinoma (SCC) of the skin commonly appears on

A
  1. face 2. lower lip 3. ears 4. hands
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7
Q

Squamous cells carcinoma (SCC) of the skin - behavioural

A
  • locally invasive
  • may spread to lymph nodes
  • metastasize: uncommon
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8
Q

Squamous cells carcinoma (SCC) of the skin - macroscopic appearance / associated with

A

ulcerative red lesions with frequent scale.

- chronic drainage sinus

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9
Q

Squamous cells carcinoma (SCC) of the skin - precursor lesion and appearance

A

Actinic keratosis
scaly plaque, hyperkeratotic
(small, rough, erythematous or brownish papules or plaques)

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10
Q

keratoacanthoma - definition

A

keratoacanthoma is a variant (well differentiated squamous cell carcinoma that develops rapidly (4-6 weeks) and may regress spontaneously over months

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11
Q

keratoacanthoma - present as a

A

cap-shaped tumor filled with keratin debris

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12
Q

melanoma - risk factors

A
  1. sunlight exposure

2. fair-skinned persons are at high risk

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13
Q

melanoma - some subtypes (MC?)

A
  1. superficial spreading (MC)
  2. nodular
  3. lentigo maligna
  4. acral lentiginous
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14
Q

superficial spreading melanoma - growth / prognosis

A

radial

good prognosis

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15
Q

lentigo maligna melanoma - prognosis / growth

A

good prognosis

radial growth

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16
Q

nodular melanoma - growth / prognosis

A

early vertical

poor prognosis

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17
Q

acral lentiginous melanoma - special feature

A

it is not related with UV light exposure

PALMS AND SOLES

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18
Q

Basal vs squamous cell carcinoma according area of the lips

A

SCC -> lower lip

BCC –> upper lip

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19
Q

skin layers:

A
  1. epidermis
  2. dermis
  3. subcutaneous fat (hypodermis or subcutis )
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20
Q

epidermis layers - from surface to base (only the names)

A
  1. stratum corneum
  2. stratum lucidum
  3. stratum granulosum
  4. stratum spinosum
  5. statum basale
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21
Q

hyperkeratosis - definition + example

A

increased thickness of stratum corneum

psoriasis / calluses

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22
Q

parakeratosis - definition / examplie

A

hyperkeratosis with retention of nuclei in stratum corneum

psoriasis

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23
Q

spongiosis - definition / example

A

epidermal accumulation of edematous fluid in inter-cellular spaces
eczematous dermatitis

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24
Q

acantholysis - definition

hypergranoulosis - definition

A

acantholysis: seperation of epidermal cells
hypergranoulosis: increased thickness of stratum granulosum

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25
Q

acantholysis example

hypergranoulosis - example

A

acantholysis: pemphigus vulgaris
hypergranoulosis: liches planus

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26
Q

acanthosis - definition

A

epidermal hyperplasia (increased spinosum)

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27
Q

patch - definition

A

flat lesion with well-circumscribed change in skin color, more than 1 cm (macule but more than 1cm)

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28
Q

macule -definition

A

flat lesion with well-circumscribed change in skin color less than 1 cm

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29
Q

papule - definition

A

elevated solid skin lesion

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30
Q

plaque - definition

A

elevated solid skin lesion more than 1cm (papule but more than 1cm)

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31
Q

vesicle - definition

A

small fluid containing blister less than 1 cm

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32
Q

bulla - definition

A

large fluid containing blister more than 1cm

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33
Q

wheal - definition

A

transient smooth papule or plaque

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34
Q

pustule - definition

A

vesicle containing pus

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35
Q

scale - definition

A

flaking off of stratum corneum

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36
Q

pigmented skin disorders - types

A
  1. Albinism
  2. Melasma
  3. Vitiligo
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37
Q

albinism - mechanism

A

normal melanocyte number with decreased production of melanin

  1. decreased tyrosinase activity
  2. defective tyrosine transport
  3. failure of neural crest cell migration during development
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38
Q

vitiligo is caused by

A

autoimmune destruction of melanocytes

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39
Q

vascular tumors - types

A
  1. angiosarcoma 2 kaposi 3. bacillary angiomatosis
  2. Cystic hygroma 5. Glomus tumor 6. Pyogenic granuloma 7. Strawberry hemangioma
  3. Cherry hemangioma
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40
Q

angiosarcoma - typical occurs in (areas) / age

A

SUN EXPOSED AREAS: head, neck, breast

usually in elderly

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41
Q

angiosarcoma is associated with

A

radiation therapy

chronic postmastectomy lymphadema

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42
Q

hepatic angiosarcoma is associated with

A
  1. vinyl chloride

2. arsenic exposures

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43
Q

angiosarcoma - course

A

very aggressive and and difficult to resect due to delay in diagnosis

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44
Q

Bacillary angiomatosis - definition / RF / caused by

A

Bening CAPILLARY skin papules found in AIDS patiens
Bartonella henselae
AIDS patients

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45
Q

Cherry hemangioma - definition / natural history

A

bening CAPILLARY hemangioma of the elderly
do not regress
increased freq with age

46
Q

cystic hygroma - definition / RF

A

CARVENOUS lymphangioma of the neck

Turner

47
Q

Glomus tumor / definition / area / arises from

A

Benign, painful, red blue tumor under fingernails

- modified SMCs of the thermoregulatory glomus bodies

48
Q

Bacillary angiomatosis vs kaposi sarcoma

A

Bacillary angiomatosis has neutrophilic infiltrate

Kaposi sarcoma has lymphocytic infiltrate

49
Q

Pyogenic granuloma

A

polipoid lobulated CAPILLARY hemangioma that can ulcerate and bleed

50
Q

Pyogenic granuloma is associated with

A

trauma and pregnancy

51
Q

Strawberry hemangioma

A

bening capillary hemangioma of infancy

52
Q

Strawberry hemangioma- age (when appears) / frequency

A

infancy
appears in first few weeks of life
1/200 births

53
Q

Strawberry hemangioma natural history

A

appears in first few weeks of life

grows rapidly and regress spontaneously by 5-8 years old

54
Q

vascular tumors from capillaries

A
  1. Bacillary angiomatosis
  2. Cherry hemangiomas
  3. Pyogenic granuloma
  4. Straberry hemangioma
55
Q

acne - found in / treatment

A

face and trunk

treatment: treatment: retinoids, benzoyl peroxide, antibiotics

56
Q

atopic dermatitis (eczema) - appearance / area of the body / often associated with

A

pruritic eruption / skin flexures

other atopic diseases (asthma, allergic rhinitis, food alergies)

57
Q 
atopic dermatitis (eczema) usually starts .... 
thereafter
A

on the face in infancy and often appears in antecubital fossae thereafter

58
Q

Melanocytic nevus - course

A

benign, but melanoma can arise in congenital or atypical moles

59
Q

Melanocytic nevus - types according location (and where)

A
  • junctional nevus (junction between the epidermis and dermis) –> flat
  • intradermal nevi (in the dermis) –> papular
60
Q

psoriasis appearance / area

A

papules and plaques with silvery scaling

- knees and elbows

61
Q

Auspitz sign? (and when)

A

psoriasis - pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off

62
Q

rosacea - macroscopic appearance

A

erythematous papules and pustules, but no comedones

63
Q

rosacea is an …. disorder

A

inflammatory FACIAL skin disorder

64
Q

rosacea may be associated with

A

facial flushing in response to external stimuli (eg. alcohol, heat)

65
Q

rosacea - chronic inflammatory changes may result in

A

rhinophyma

66
Q

varrucae (warts) on genitals

A

condyloma acuminatum

67
Q

Seborrheic keratosis - cyst?

A

keratin filled cysts (horn cysts)

68
Q

Leser-Trelat sign

A

sudden appearance of multiple Seborrheic keratosis,

69
Q

skin infections are divided to

A
  1. bacterial skin infections

2. viral skin infections

70
Q

viral skin infections - types

A
  1. herpes
  2. molluscum contagiosum
  3. varicella zoster virus
  4. hairy leukoplakia
  5. verrucae (warts)
71
Q

herpes include (types)

A
  1. herpes labialis (lip)
  2. herpes genitalis
  3. herpes whitlow (finger)
72
Q

Molluscum contagiosum is caused by / appearance / ages

A
  • poxvirus
  • umbilicated (depressed) papules
  • frequently in children
  • it may be sexually transmitted in adults
73
Q

Hairy leukoplakia - appearance / caused by

A
  • irregular, white painless plaques on tongue that cannot be scrapped off
  • its EBV mediated
    occurs in HIV + or organ transplant recipients
74
Q

hairy leukoplakia vs thrush

A

thrush is scrapable

75
Q

hairy leukoplakia vs oral leukoplakia

A

oral leukoplakia is precancerous

76
Q

bacterial skin infections - types

A
  1. impetigo
  2. cellulitis
  3. erysipelas
  4. abscess
  5. Necrotizing fascitis
  6. staphylococcal scalded skin syndrome
77
Q

impetigo? caused by / appearance

A
  • very superficial skin (bacterial) infection
  • usually S. aureus or S. pyogenes
  • honey colored crusting
  • it is highly contagious
78
Q

cellulitis? caused by

A
  • acute, painful, spreading infection of deeper dermis and subcutaneous tissues
  • usually S. aureus or S. pyogenes
  • with a break in skin from trauma or another infection
79
Q

erysipelas is caused by / appearance

A

S. pyogenus

well-defined demarcation between infected and normal skin

80
Q

skin abscess - is caused by

A

almost always S. aureus which is frequently methcillin resistant

81
Q

necrotizing fascitis - definition and causes / appearance

A
  • deeper tissue injury, usually from anaerobic bacteria or - S. pyogenes
  • bullae and purple color to the skin
  • CREPITUS
82
Q

staphylococcal scalded skin syndrome - mechanism / symptoms

A

exotoxin (exofliative) destroys keratinocytes attachments in stratum granulosum ONLY

symptoms: 1. fever
2. generalized erythematous rash with sloughing of the upper layers of the epidermis that heals completely

83
Q

staphylococcal scalded skin syndrome - seen in

A
  1. newborns
  2. children
  3. adults with renal insufficiency
84
Q

toxic dermal necrolysis vs staphylococcal scalded skin syndrome according mechanism

A

staphylococcal scalded skin syndrome –> exotoxin destroys keratinocytes attachments in stratum granulosum
toxic dermal necrolysis –> destroys epidermal dermal junction

85
Q

blistering skin disorders - types

A
  1. pemphigus vulgaris
  2. Bullous pemphigoid
  3. dermatitis herpetiformis
  4. Erythema multiforme
  5. Steven-Johnson syndrome
86
Q

pemphigus vulgaris - appearance

A

Flaccid intraepidermal bullae caused by acantholysis

ORAL MUCOSA ALSO INVOLVED

87
Q

pemphigus vulgaris - sign

A

Nikolsky sign + : separation of epidermis upon manual stroking of skin

88
Q

bullous pemphigoid - appearance

A

tense bilsters (CONTAINING

89
Q

bullous pemphigoid - Nikolsky sign

A

negative

90
Q

pemphigus vulgaris vs bullous pemphigoid - immunofluorescense

A

pemphigus vulgaris –> reticular (net like)

bullous pemphigoid –> linear pattern

91
Q

dermatitis herpetiformis - appearance / - associated with / mechanism

A

pruritic papules, vesicles and bullae (often found on elbows)

  • celiac disease
  • deposits of IgA at tips of dermal papillae (associated with celiac disease)
92
Q

pemphigus vulgaris vs bullous pemphigoid - according course

A

pemphigus vulgaris –> potentially fatal

bullous pemphigoid –> less severe

93
Q

pemphigus vulgaris vs bullous pemphigoid - according mechanism

A

pemphigus vulgaris –> IgG against desmoglein

bullous pemphigoid –> IgG against hemidesmosomes

94
Q

Erythema multiforme is associated with

A
  1. infection 2. drugs 3. cancers 4. autoimmune diseases
95
Q

Erythema multiforme - infections?

A
  1. Mycoplasma pneumoniae

2. HSV

96
Q

Erythema multiforme - drugs?

A
  1. sulfa drugs
  2. β-lactams
  3. phenyntoin
97
Q

Erythema multiforme - target lesions?

A

look like targets with multiple rings and dusky center showing epithelial disruption

98
Q

Steven - Johnson syndrome is symptoms

A
  1. fever 2. bullae formation 3. necrosis

4. sloughing of skin 5. targetoid lesions may appear

99
Q

Steven - Johnson syndrome - skin manifestations

A
  1. bullae formation 2. necrosis

3. sloughing of skin 4. targetoid lesions may appear

100
Q

toxic epidermal necrolysis - characteristic

A

more severe form of Steven - Johnson syndrome

>30% of the body surface

101
Q

Steven - Johnson syndrome with 10%-30% of the body surface

A

Steven - Johnson syndrome-toxic epidermal necrolysis

102
Q

Actinic keratosis appearance

A

scaly plaque, hyperkeratotic

small, rough, erythematous or brownish papules or plaques

103
Q

causes of Erythema nodosum

A
  1. idiopathic 2. sarcoidosis 3. coccidioidomycosis 4. histoplasmosis 5. TB 6. streptococcal infections 7. leprosy 7. Inflammatory bowel disease
104
Q

sunburn can lead to

A
  1. impetigo

2. skin cancers

105
Q

pityriasis rosea - skin manifestations

A

Herald patch followed days later by other scaly erythematous plaques, often in a Christmas tree distributions
Multiple plaques with collarette scale

106
Q

pityriasis rosea - treatment

A

self-resolving in 6-8 weeks

107
Q

Lichen planus - skin manifestation / associated with

A

mneominc 6Ps
1. Pruritic 2. Purple
3. Polygonal Planar Papules 4. Plaques
HCV

108
Q

Liches Planus - histology

A

Sawtooth infiltrate of lymphocytes at dermal - epidermal junction

109
Q

Liches Planus - mucosa involvement as

A

Wickham striae (reticular white lines)

110
Q

dermatitis herpetiformis - treatment

A
  1. gluten free diet

2. dapsone

111
Q

strawberry hemangioma - complications (and treatment of complications)

A
  1. ulceration / scarring
  2. vision impairment if near eye
  3. life-threatening if near airway
    propranolol –> to constrict vessels

dermatology (9 decks)

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