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Derm Flashcards

1
Q

comparison of epidermis PT, FT, adult and significance

A

PT < FT < adult

increased permeability and water loss

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2
Q

comparison of dermis PT, FT, adult and significance

A

less collagen elastic fibers
PT < FT < adult

greater elasticity and tendency to blister

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3
Q

comparison of melanosomes PT, FT, adult and significance

A

PT < FT < adult
increased photosensitivity

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4
Q

comparison of eccrine glands PT, FT, adult and significance

A

PT = anhidrosis
FT = decreased activity for 1-7 d and neuro control at 3 years

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5
Q

comparison of sebaceous glands PT, FT, adult and significance

A

PT < FT < adult

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6
Q

comparison of hair PT, FT, adult and significance

A

PT = lanugo
FT = decreased terminal hair

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7
Q

comparison of SFA:volume PT, FT, adult and significance

A

PT > FT > adult
water loss
increased transcutaneous penetration

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8
Q

erythema toxicum confirmation

A

eosinophils on Wright staining
some have peripheral eosinophilia

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9
Q

stages of neonatal pustular melanosis

A
  1. small non inflammatory without erythema; birth
  2. ruptures with surrounding hyperpigmented macule
  3. hyperpigmented macule (up to 3 months)
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10
Q

neonatal pustular melanosis confirmation

A

neutrophils by wright staining

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11
Q

miliaria confirmation

A

sparse squamous cells and lymphocytes by wright staining

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12
Q

what causes milia

A

small epidermal inclusion cysts - retension of keratin and sebaceous material

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13
Q

pathogenesis of neonatal acne

A

previously 2/2 androgens
now maybe malassezia

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14
Q

pathogenesis of infantile acne

A

sebaceous gland hyperplasia - androgen stimulation

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15
Q

onset of neonatal and infantile acne

A

2-3 weeks vs 3-4 months

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16
Q

treatment of neonatal and infantile acne

A

neonatal - none

infantile - may require treatment to prevent scarring; may need to evaluate for CAH

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17
Q

epidemiology of neonatal and infantile acne

A

neonatal 20%; M > F

infantile M>F

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18
Q

bullous impetigo

A

first few days
honey crusting
s. aureus
Tx = antibiotics

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19
Q

SSSS

A

exotoxin s.aureus (group 2 phage)
+ nikolsky
+/- conjunctivitis and nasal congestion
fluid is sterile
culture nasopharynx, conjunctiva, skin and blood
antibiotics
NO scarring

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20
Q

histology of bullous impetigo vs SSSS

A

BI =
intradermal bullae with PMNs

SSSS = no inflammatory cells on histology
separation of granular layer

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21
Q

types of epidermolysis bullosa

A

junctional
simplex = epidermolytic
dystrophic = dermolytic

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22
Q

comparison of scarring in EB types

A

J = atrophic
S = without
D = yes

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23
Q

etiology of EB types

A

J = dermal-epidermal junction
S = intra-epidermal blisters
D = intradermal blisters (type 7 collagen decreased; increased collagenase)

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24
Q

genetics of EB types

A

J = AR
S = AD
D = AR or AD

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25
Q

clinical presentation of EB types

A

J = birth, short life span, BMP abnormal, pyloric stenosis

S = brith, heal quickly, mild course

D- birth, AR type more severe, cyles of blistering, infection and scarring, hair loss, anemia, dysphasgia

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26
Q

incontinentia pigmenti genetics

A

XL Dominant; lethal for males in utero

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27
Q

stages of incontinentia pigmenti

A
  1. linear inflammatory vesicles (eosinophils) birth - 4 mos
  2. pigmented warts on red base
  3. hyperpigmented streaks and whorls trunk and limbs first year
  4. linear hypopigmented streaks - atrophic
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28
Q

associated defects in incontinentia pigmenti

A

cns
eye - retinal vascular proliferation
dentitia

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29
Q

classification of vascular tumors vs vascular malformations

A

tumors - proliferating endothelium
malformation = normal endothelial turnover; error in vasculogenesis (slow or fast flow)

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30
Q

infantile hemangioma epi

A

F > M
PT > FT
90% by second month
face MC location

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31
Q

evolution of infantile hemangioma

A

increase between 1-5 months
stable
decrease by 1 year
50% gone by 5
75% by 7

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32
Q

PHACES

A

Posterior fossa brain malformation (Dandy Walker complex or cerebellar hypoplasia)
Hemangiomas on face
Arterial abnormalities in cerebral artery
Cardiac (often aorta)
Eye (posterior segment abnormality, persistant fetal vessel, retinal
Sternal clefting

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33
Q

PHACES epi

A

F > M

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34
Q

nevus flammeus simplex

A

aka salmon patch (capillary malformation)
may darken with crying
a/w beckwith wiedenmann

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35
Q

port wine stain

A

similar to nevus flammeus
unilateral
Sturge Weber, Klippel Trenaunay Weber, Beckwith Weidemann, Cobb (cutaneomeningospinal angiomatosis)

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36
Q

blue-rubber bleb nevus syndrome

A

multiple venous malformations
risk of coagulopathy

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37
Q

cutis marmorata

A

a/w tri 18, 21, cornelia de lange, hypothyroid
cold stress
diffuse reticulated erythematous patter
resolve with warming (cutis marmorata telangiectatica congenital does not resolve wiht warming)

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38
Q

harlequin color change

A

dependent side turns red lasting few seconds to 30 minutes
temperature imbalance

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39
Q

hypopigmented lesions a/w

A

pku
chediak higashi
albinism
TS
hypomelanosis of ito

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40
Q

albinism pathophysiology

A

AR if complete; partial aka piebaldism is AD

deficiency of tyrosinase thus limited melanin production

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41
Q

hypomelanosis of ito

A

aka incontinentia pigmenti achromians

not genetic like IP

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42
Q

waardenburg

A

AD
lateral canthus
confluent eyebrows
congenital deafness
white forelock

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43
Q

cafe au lait a/w

A

NF
mccune albright (bone dysplasia, endocrine)
LEOPARD
TS
Silver-Russell

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44
Q

congenital dermal melanocytosis a/w

A

3% remain into adulthood
a/w gangliosidosis type 1 and hunter syndrome

45
Q

nevus of ota vs ito

A

ota - face; trigeminal nerve 1 and 2 distribution

ito - shoulder, supraclavicular, neck, arm, scapula, deltoif

46
Q

xeroderma pigmentosa

A
  • AR
  • low endonuclease - decreased ability to repair DNA
  • risk BCC, SCC, melanoma
  • cutaneous and ocular photosensitivity
  • DX: fibroblasts stressed with UV = chromosomal breakage assessed
47
Q

mastocytosis

A

infiltration of mast cells
mastocytoma : MCC
urticaria pigementosa
diffuse cutaneous mastocytosis

48
Q

Familial lentiginosis syndromes:

A

LEOPARD
Peutz-Jeghers

49
Q

LEOPARD

A

Lentigines
EKG defects
Ocular hypertension
Pulmonary stenosis
Abnormal GU
Restricted growth
Deafness

50
Q

Peutz-Jeghers

A

AD
mucocutaneous pigmentation on lips and buccal mucosa
risk of polyps in GI tract

51
Q

hypertrichosis a/w

A

tri 18
cornelia de lange
turner
mucopolysaccharisosis

52
Q

hypotrichosis

A

incontinentia pigmentosia
ectodermal dysplasia

53
Q

fine light colored hair

A

tyrosinemia
homocystinuria
tri 21
pku

54
Q

nail dysplasia

A

tri 13 or 18
acrodermatitis enteropathica
EB
turner
carbamazepine, hydantoin, warfarin

55
Q

nail hypertrophy

A

rubinstein taybi

56
Q

aplasia cutis

A

tri 13 or 4p

57
Q

hamartomas

A

increased deposition of tissue components to the local organ

epidermal nevus
nevus sebaceous of Jadassohn

58
Q

epidermal nevus

A

overgrowth of keratinocytes in epidermis
linear wart like lesions
a/w:
skeletal
ocular
CNS

59
Q

nevus sebaceous of jadasohn

A

excessive sebaceous glands
solitary well circumscribed
yellow/orange/hairless cobblestone waxy plaque

60
Q

ichthyosis and types

A

abnormal keratinization
congenital AR
epidermolytic hyperkeratosis AD
vulgaris AD
x linked XLR
lamellar AR

61
Q

which ichthyosis associated with increased stratum corneum

A

all except epidermolytic

62
Q

which ichthyosis associated with increased granular layer

A

congenital
epidermolytic

63
Q

which ichthyosis associated with sulfatase deficiency

A

XL

64
Q

which ichthyosis associated with defect in profilaggrin?

A

vulgaris

65
Q

collodion

A

shiny tight scale –> thickended corneum
desquamate until 2-3 weeks
support with humid environment
risks: hypernatremia dehydration, infection

66
Q

harlequin ichthyosis

A
  • AR
  • oral retinoids may help
  • ectropion secondary to rigid skin around eyes
  • abnormal ears and nose
  • PT > FT
67
Q

ectodermal dysplasia

A
  • excessive desquamation
    MC = XL hypohidrotic ectodermal dysplasia
  • frontal bossing
  • depressed nasal bridge
  • periorbital wrinkling and hyperpigmentation
  • hypoplastic gum ridges and everted lips
  • decreased hair and sweat
  • increased asthma, allergies, eczema
    normal IQ
68
Q

cutis laxa

A

generalized elastolysis
decreased resiliency, droopy skin
AD - mild
AR- CDH and emphysema
XL - bladder/GI diverticulum, NDI, protuberance of occiput, hip dysplasia

69
Q

ehlers danlos

A

hyperextensible skin, joint hypermobile
intestinal and bladder diverticulum
umbilical/inguinal hernias
scoliosis
aortic aneurysm

70
Q

leiners syndrome aka nethertons

A
  • erythematous
  • desquamatic dermatitis
  • ftt
  • diarrhea
  • infections
  • functional complement 5 abnormality
  • abnormality of hair shaft circumflexa “bamboo hair”
71
Q

histology of subcutaneous fat necrosis

A

granulomatous reaction in fat with giant cells, fibroblasts, lymphocytes and histiocytes

72
Q

neonatal lupus rash

A

anti Ro , anti La, anti U1RNP
round or elliptical lesions with central clearing
worses with phototherapy
persists until 6-8 months when maternal Abs disappear

73
Q

causes of pustules

A

staph
listeria
gbs

74
Q

causes of vesicles

A

staph
listeria
gbs
pseudomonas
herpes
vzv

75
Q

causes of bullae

A

staph
syphillis

76
Q

causes of maculopapules

A

staph
strep
fungal
measles
enterovirus
rubella
syphillis

77
Q

causes of cellulitis

A

strep

78
Q

causes of impetigo

A

strep

79
Q

causes of abcesses

A

staph
strep
e coli
candida

80
Q

causes of pyoderma grangrenosum

A

pseudomonas

81
Q

causes of blueberry muffin rash

A

rubella
cmv
coxsackie
parvo
ttts
hemolytic disease
hereditary spherocytosis
neoplastic infiltrative disease
leukemia

82
Q

GPC on gram stain

A

bullous impetigo - staph

83
Q

psudeohyphae or yeast spore on KOH or gram stain

A

candida

84
Q

eos on wright stain, negative gram stain

A

erythema toxicum

85
Q

multinucleated giant cells on tzanck smear

A

herpes

86
Q

squamous cells or lymphocyes in wright stain
negative gram stain

A

miliaria

87
Q

keratinosis debris, pmns on wright stain
negative gram stain

A

neonatal pustular melanosis

88
Q

mites, ova, feces on mineral oil preparation

A

scabies

89
Q

bullae with no inflammatory cells/sterile

A

SSSS

90
Q

treponema dark field examination

A

syphillis

91
Q

biotin deficiency skin findings

A

alopecia
intertriginous and perioral dermatitis
scaling
seborrhea

92
Q

linoleic acid deficiency skin findings

A

alopecia
scaling
intertriginous dermatitis
decreased wound healing

93
Q

niacin deficiency skin findings

A

mucositis, hyperpigmented

94
Q

protein deficiency skin findings

A

scaling
hypopigmentation
peripheral edema

95
Q

pyridoxine deficiency skin findings

A

intertriginous and perioral dermatitis
mucositis

96
Q

riboflavin deficiency skin findings

A

intertriginous and perioral dermatitis
mucositis

97
Q

vit A deficiency skin findings

A

generalized scaling

98
Q

vit c deficiency skin findings

A

poor wound healing
bleeding gums

99
Q

zinc deficiency skin findings

A

acrodermatitis enteropathica AR

FTT
alopecia
diaper dermatitis
ocular
rash
risk candida and staph

100
Q

infiltration vs extravasation

A

infiltration = non vesicant
extravasation = vesicant

101
Q

pathophysiology of extravasation

A
  1. large fluid volume compressing tissue
  2. direct vesicant contact
  3. severe vasoconstriction
102
Q

which vesicant extravasation should you not try to treat with hyaluronidase

A

inotropes

103
Q

medications used for treatment of extravasations

A

hyaluronidase
phentolamine (decreases local vasoconstriction)

104
Q

Aquagenic wrinkling of the palms

A

CF

105
Q

why should you not give platelets in Kasabach Meritt?

A

trapped in lesion and further platelet activation

106
Q

PHACE most common CHD

A

coarctation

107
Q

MC site of neonatal psoriasis

A

scalp

108
Q

vernix components

A

stratum corneum (corneocytes) and sebaceous glands (sebum)

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