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MHD > Clinical Dermatology > Flashcards

Clinical Dermatology Flashcards

1
Q

Compare the skin lesions seen in Dermatomyositis and Lupus

A

Dermatomyositis:

  • Involves the knuckles (Gottron’s papules)
  • More epidermal atrophy
  • Heliotrope Rash
  • Shawl sign
  • Very itchy

Lupus:

  • Spares the knuckles
  • Malar rash sparing the nasolabial folds
  • Discoid lesions are scarred, depressed plaques with a hypopigmented center
  • Scarring alopecia
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2
Q

Dermatomyositis

What may be associated with increased risk of malignancy?

A

P155/p140 (TIF-y)

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3
Q

What are Gottron’s papules?

A

Violaceous erythema overlaying the knuckles
May also be on elbows or tendons

Seen in dermatomyositis

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4
Q

What is a heliotrope rash?

A

Violaceous rash around eyes (upper lid common)

Seen in dermatomyositis

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5
Q

What is a shawl sign?

A

Lavender erythema in a shawl pattern on back, may be surrounded by flagellate erythema

Seen in dermatomyositis

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6
Q

Describe the Malar rash of Lupus

A

Comes across bridge of nose and both cheeks, sparing the nasolabial folds

Can be somewhat scaly
Transient

Most highly associated with SLE

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7
Q

Someone with a malar rash sees you in the office. They should NOT leave without doing a…

A

Urinalysis

Worried about underlying kidney disease in lupus

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8
Q

Describe the lesions in Discoid lupus

A

Scarring depressed plaques

Hyperpigmented rim and hypopigmented center

Commonly located on head, neck, ears

causes SCARRING ALOPECIA on the scalp (hair will NOT grow back in that area)

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9
Q

A patient comes in whose skin demonstrates tenting. You are worried about what disease?

A

Scleroderma = systemic sclerosis

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10
Q

Symptoms of CREST Syndrome

A 
Calcinosis Cutis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
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11
Q

CREST Syndrome is associated with what antibody?

A

Anti-centromere antibody

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12
Q

What is Lichen Sclerosis? What does it look like and where might it appear?

A

White-atrophic appearing plaques

Cigarette paper scale, most commonly in female genital area

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13
Q

Sarcoidosis

  • Histology
  • Serology
  • Skin path
A

Non caseating granulomas, often in areas of scars or trauma

Elevated serum ACE

Erythema nodosum (ill-defined tender plaques on ant legs)

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14
Q

Necrobiosis Lipoidica

Appearance and cause

A

Yellow-pink atrophic plaques on pretibia

Caused by diabetes, even if well controlled

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15
Q

Pyoderma Gangrenosum

Cause

A

Autoinflammatory disease causing ulcers in the skin

Very painful
NOT infected

Associated with underlying systemic disease (Crohn’s, arthritis, heme disorders)

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16
Q

Pyoderma Gangrenosum

Appearance

A

Often appears infected with yellow necrotic debris in center

Overlaying ledge of blue/gray skin

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17
Q

Calciphylaxis

  • Cause
  • Appearance
A

Retiform (stellate) shape due to relation to blood supply

Calcium deposition in the vessels, causes ischemia in tissues perfused by that vessel

High mortality, often associated with end stage renal disease

18
Q

Purpura

How do you know a lesion is purpura?

A

It doesn’t blanch with pressure!

19
Q

Purpura
Palpable vs Non-palpable
What does it tell you?

A

Palpable – think inflammation, often due to vasculitis

Non-palpable– vasculopathy, thromboembolic cause

20
Q

Leukocytoclastic Vasculitis

Caused by…

A

Type III HSR (immune complex)

PMN infiltrate around superficial vessels, leaks blood into skin

Assoc with infection, connective tissue disease, meds

21
Q

Leukocytoclastic Vasculitis

Appearance

A

Small pruritic papules

22
Q

Venous Stasis Dermatitis

Appearance

A

Chronic edema and leaking of blood into skin causes orange-brown color (hemosiderin deposition)

Bilateral

Acutely, may cause inflammation from skin stretching and weep fluid

23
Q

Venous ulcers are commonly seen where?

A

Ankle (side, near the malleolus)

24
Q

AV malformation

Locations, what is it?

A

Commonly on face

Congenital vascular anomaly that may flare up in puberty

25
Q

Coxsackie Virus

Where are the lesions seen?

A

Hand-foot-mouth disease

Vesicles on plams and soles

26
Q

Parvovirus B19

Appearance of skin

A

Slapped cheeks virus

Reticulated lacy erythematous eruption on extremities

27
Q

Parvovirus B19

Fetal infection could cause…

A

Anemia
Hydrops fetalis
Death

28
Q

Urticaria = Wheals

Appearance

A

Pruritic edematous non-scaly plaques

Transient

Orange skin appearance

29
Q

Urticaria = Wheals

Cause

A 
Allergy
Autoimmune
Drugs
Infection
Idiopathic
30
Q

Urticaria Pigmentosa

What is seen in histology? Gross?

A

Red-brown papules

MAST CELL disease with tons of mast cells in the dermis

31
Q

Allergic Contact Dermatitis

Describe the lesion pattern. What might be the cause?

A

“Outside-in” pattern

Cause by….ABX (topical), topical cleansers, nickel, plants

32
Q

Morbilliform Rash

Caused by….

A

Drug or a virus

Starts 7-10 days after initiation of the drug

33
Q

Morbilliform Rash

Location and Appearance

A

Common in skin folds and on torso

Many pink papules coalescing

34
Q

DRESS Syndrome

What is it? How is it different than morbilliform?

A

Drug
Reaction
Eosinophilia
Systemic Symptoms

Morbilliform rash doesn’t make people feel sick. DRESS Syndrome causes peripheral eosinophilia and systemic symptoms

35
Q

DRESS Syndrome

Treatment

A

Stop the offending drug and avoid it from that point forward

36
Q

DRESS Syndrome

Common culprits

A

Anticonvulsants
Allopurinol
ABC
Sulfonamides

37
Q

Erythema Multiforme
Cause
Appearance

A

Targetoid lesions

Most commonly caused by infection (HSV)

38
Q

Steven Johnsons Syndrome
Cause
Location

A

Cause: drug
Atypical target lesions often in trunk and face
Severe mucus membrane involvement

Less than 10% detachment

39
Q

TEN
Cause
Lesions
How much of body involved?

A

Cause: drug
Lesions are painful and epidermolytic

Over 30% of skin involved

40
Q

SPF stands for…? What does it refer to?

A

Sunlight Protection factor

Refers to amount of protection against UVA-B light

MHD (57 decks)

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