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MSCT > Cutaneous Signs of Systemic Disease > Flashcards

Cutaneous Signs of Systemic Disease Flashcards

1
Q

Acanthosis nigricans clinical presentation

A

Hyperpigmented velvety plaques on posterior neck fold and axillae, with or without acrochordons (skin tags)

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2
Q

Acanthosis nigricans associated systemic disease

A

Diabetes, sign of insulin resistance

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3
Q

Acanthosis nigricans malignancies

A

Unusual locations or sudden onset, tripe palms, associated with gastric adenocarcinoma

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4
Q

Acanthosis nigricans histology

A

Hyperkeratosis, papillomatosis of spinous layer, hyper pigmentation of basal layer

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5
Q

Sign of Leser-Trelat associated disorders

A

Malignant acanthosis nigricans

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6
Q

Sign of Leser-Trelat histology

A

Same as seborrheic keratosis, string sign

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7
Q

Sign of Leser-Trelat histology

A

Same as seborrheic keratosis, string sign, horn cysts

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8
Q

Dermatitis herpetiformis clinical characteristics

A

Extremely itchy papules/vesicles, can be erosions from scratching so much, found on elbows, knees, back, buttocks

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9
Q

Dermatitis herpetiformis diagnosis

A

Biopsy and direct immunofluorescence necessary

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10
Q

Dermatitis herpetiformis age of onset

A

Young adulthood

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11
Q

Dermatitis herpetiformis age of onset

A

Young adulthood

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12
Q

Dermatitis herpetiformis histology

A

IgA found in dermal papillae, neutrophils recruited, subepidermal cleft filled with neutrophils

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13
Q

Dermatitis herpetiformis DIF

A

Granular deposits of IgA in the dermal papillae

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14
Q

Dermatitis herpetiformis treatment

A

Gluten-free diet, immunosuppression

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15
Q

Dermatitis herpetiformis increased risk

A

Hypothyroidism or intestinal lymphoma

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16
Q

Vitiligo clinical characteristics

A

Depigmented macules and patches, favors areas of trauma

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17
Q

Vitiligo cause

A

Autoimmune attack on melanocytes

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18
Q

Vitiligo increased risk

A

Increased risk of other autoimmune disorders

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19
Q

Vitiligo histology

A

Melanocytes lost, but no inflammation seen

20
Q

Vitiligo treatment

A

Can heal on its own, or use topical anti-inflammatories, phototherapy, cosmetic camouflage

21
Q

Systemic lupus erythematosus cause

A

Chronic inflammatory disease, autoimmune disorder

22
Q

Systemic lupus erythematosus clinical characteristics

A

Pleural effusions, heart problems, lupus nephritis, arthritis, Raynaud’s phenomenon, butterfly rash

23
Q

Systemic lupus erythematosus epidemiology

A

Most common in women, African American, Hispanic, and Asian populations, and young adulthood

24
Q

Systemic lupus erythematosus histology

A

Dyskeratinized cells, lymphocytes around vessels, follicles, increased mucin within the dermis

25
Q

Subacute cutaneous lupus erythematosus clinical characteristics

A

Scaly erythematous plaques that are annular/polycyclic and psoriasiform, favors photodistribution and flares with sun exposure

26
Q

Subacute cutaneous lupus systemic involvement

A

Arthralgias, rare arthritis, Sjogren syndrome with dry mouth and eyes, possible presentation of systemic disease

27
Q

Discoid lupus erythematosus clinical characteristics

A

Chronic form of cutaneous lupus, erythematous to violaceous scaly plaques, follicular plugging, hypo/hyperpigmentations, with or without scarring or atrophy, might occur with systemic lupus

28
Q

Dermatomyositis clinical characteristics

A

Heliotrope (flower) rash on the eyelids, posterior neck, top of shoulders/chest/back (shawl sign), Gottrons papules on hands/elbows, erythamatous to dusky iliac patch-plaques with minimal scale

29
Q

Dermatomyositis definition

A

Autoimmune inflammatory myopathy with characteristic skin finding

30
Q

Dermatomyositis associated symptoms

A

Calcinosis cutis (calcification of skin in children), proximal muscle weakness, muscle fatigue, muscle tenderness, fever, malaise, possible involvement of lungs and heart

31
Q

Dermatomyositis and malignancy

A

In adults, dermatomyositis can be associated with malignancy, typically ovarian, breast, melanoma, colon, non-Hodgkins lymphoma, or nasopharyngeal (especially in Asian populations)

32
Q

Erythema nodosum clinical characteristics

A

Acute, tender, nodular eruption, typically on shins, inflammation in the fat (panniculitis), bilateral

33
Q

Erythema nodosum cause

A

Hypersensitivity reaction

34
Q

Erythema nodosum prognosis

A

Usually self-limited and will heal in weeks, rarely is chronic or recurrent

35
Q

Erythema nodosum histology

A

Widened septae, inflammation deep into subcutis, septal panniculitis, loose granulomas, septal fibrosis

36
Q

Erythema nodosum associations

A

Infections (such as strep, yersinia, salmonella, EBV, bartonella, etc), medications (oral contraceptives, sulfa antibiotics), pregnancy, systemic disease (sarcoidosis, IBD, Bechet disease)

37
Q

Erythema nodosum treatment

A

Rest, ice, elevation, NSAIDs, treatment of underlying problem if indicated

38
Q

The “other” erythemas

A

Erythema marginatum rheumatic fever, erythema multiforme (HSV), erythema ab igne (chronic heat), erythema migrans (Lyme disease)

39
Q

Pyoderma gangrenosum clinical characteristics

A

Scarring, painful deep ulcers with “gun metal” rolled borders (necrotic), ulceration will have surrounding erythema, base is covered with granulation tissue and may extend to fat or muscle

40
Q

Pyoderma gangrenosum cause

A

Uncommon neutrophilic disease process, typically in patients with systemic disease

41
Q

Pyoderma gangrenosum histology

A

Ulceration evident, inflammation is increased underneath, if no ulcer is evident there is tunneling inflammation present

42
Q

Pyoderma gangrenosum associated diseases

A

IBD, arthritis, HIV, malignancy, leukemia, drug reactions

43
Q

Pyoderma gangrenosum classifications

A

Para-inflammatory (IBD triggered), paraneoplastic (malignancies), hematologic (anomaly in blood production), drug-induced (look for new Rx), idiopathic (no known cause)

44
Q

Cutaneous T-cell lymphoma clinical characteristics

A

Chronic, non-responsive erythematous scaly plaques on the trunk or sun-protected areas, may progress to mushroom-like tumors

45
Q

Cutaneous T-cell lymphoma cause

A

Proliferation of abnormal lymphocytes

46
Q

Cutaneous T-cell lymphoma histology

A

Atypical epidermotropic lymphoid infiltrate, no spongiosis, hyper chromatic, large, atypical lymphocytes, these collect into microabsecesses in the epidermis

MSCT (28 decks)

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