Derm Flashcards
Scale
Skin layer?
Epidermis
Change in brown, grey, black pigments
Skin layer?
Epidermis
Edema
Skin layer?
Dermis
Change in red, violacious, blue, yellow, green color
Skin layer?
Dermal
Telangectasia
Skin layer?
Dermis
Poorly demarcated borders
Skin layer?
Subcutaneous
Fixation to underlying tissue
Skin layer?
Subcutaneous
Target lesions are commonly seen in
SJS
Intetriginous
Seen in skin folds
Glaborous
Seen in non-hair-bearing skin
Excoriation
Scratch
Acral
Seen in head, neck, or extremities (vs truncal)
Difference between abscess and cyst?
Abscess has surrounding inflammation, cyst does not
Difference between erosion and ulcer?
Erosion is epidermis only, ulcer also includes dermis
Difference between erythema and purpura?
Erythema blanches, purpura does not
What are the 3 diseases that you see with arciform lesions?
- Granuloma annulare
- Leprosy
- Cutaneous T cell lymphoma
Which is the most common type of chronic cutaneous lupus?
Discoid
Cutaneous lupus with central scarring and possible alopecia
Discoid
What percent of patients with DLE develop SLE?
20%
Cutaneous lupus favoring trunk and extremities with little scarring
Subacute
Cutaneous lupus associated with Ro/SS-a Ab
Subacute
What percent of subacute cutaneous lupus develop SLE?
50%
Ro antibody in lupus correlates with what?
Photosensitivity
What are the two variants of subacute cutaneous lupus?
Psoriaform and annular
Cutaneous lupus associated with ANA antibodies
Acute
Cutaneous lupus associated with malar rash
Acute
Progressive, proximal muscle weakness with abnormal EMG and a rash
Dermatomyositis
What are Gottoron’s papules and in which disease are they seen?
Violaceous papules over hand knucles.
Dermatomyositis
Red and scaly disc-shaped plaques on head and neck which progress to plaques with hyperpigmented borders and pink, atrophic, scarred centers
DLE
What does generalized DLE mean and what are it’s implications?
Lesions that spread to trunk and arms. Increased risk for SLE.
Polycyclic leisons in sun-exposed areas with knuckle and malar sparing.
SCLE
What is Gottron’s sign and what disease is it pathognomonic for?
Violaceous macular erythema over any pony prominence.
Dermatomyositis
Heliotrope sign, shawl sign, ragged nail cuticles, periungual telangectasias, tnedon streaking in hands
Dermatomyositis
Mechanic’s hands, interstitial pneumonitis, increased CPK
Dermatomyositis
What implications does a diagnosis of dermatositis entail?
Internal malignancy
Esophageal dysfunction, arthritis, shawl sign, interstitial lung disease & mechanic’s hands
Dermatomyositis
Mechanic
s hands are a sign of what?
Which antibodies are involved?
Pulmonary dermatomyositis
Jo-1 & PC-1 antibodies (anti-synthetase)
Which cancer is common in patients with dermatomyositis in females? Asians?
F: ovarian
A: nasopharyngeal CA
What is morphea? What dot eh lesions look life?
skin-only scleroderma. Hard, bound-down indurated plaques. Active borders are red-violaceous.
Raynaud’s, Sclerodactyly, Esophageal dymotility, over face, cheast, extremities, anti-centromere
CREST (limited cutaneous systemic sclerosis)
Beak-like nose, digital pitted scars, salt & pepper changes, antitopoisomerase-1 (Scl-70)
Diffuse cutaneous systemic sclerosis
Hyperpigmented, slightly atrophic plaques mainly seen over shins
Diabetic dermopathy
Erythematous, indurated plaques that progress to form yellow atrophic plaques with telangectasias on anterolateral distal legs. May ulcerate
Necrobiosis lipodica diabeticorum
Ring-shapes papules/plaques in distal extremmities, associated with diabetes
Granuloma annulare
Superficial erythema with honey-colored crust
Impetigo
LArge, deep staph infection with pustules and crust
Pyoderma
Diffuse dermal infection with redness and swelling
Cellulitis
Pre-tibial myxemdema, pseudoclubbing, soft tissue swelling of hands & feet
Hyperthyroidism
Will correcting thyroid function improve skin disease?
Not necessarily
Thick lips, large tongue, loss of lateral 1/3 eyebrows
Hypothyroidism
Half of patients with vitiligo will develop which disease?
Hypothyroidism
What is the pathophysiology of vitiligo?
Autoimmine destrcution of melanocytes, favoring face, hands. Causes hypopigmented macules.
Tender, erythematous nodules over bilateral shin. May have fever, arthalgias
Erythema nodosum
Which conditions are associated with erythema nodosum?
UC, Chron’s, Sarcoidosis (Lofgren), Behcet’s, strep infections, drug allergies, pregnancy, malignancy
Ulcer with violacious, undertermined borner and purulent base. Usually lower extremities. Koebnerization.
Pyoderma gangrenosum
Pyoderma gangrenosum is associated with which conditions?
UC, Chron’s, RA, monoclonal IgA gammaopathy, hematologic malignancy
Arthitis, uveitis, erythema nodoum
Lofgren’s
Red-purple tender mamillated “mountain range” lesions pn arms, neck, face. May have fever, myalgias, leukocytosis. May be preceded by URI or flu.
Sweet’s syndrome
What conditions are associated with Sweet’s?
AML, solid tumors, strep, gCSF. IBD, pregnancy
Immune complex deposition around blood vessels causing PMN infiltration & palpable purpura.
Leukocytoclastic vasculitis
Leukocytoclastic vasculitis is associated with which conditions?
Beta lactams, NSAIDS, antibiotics, strep, TB, flu, malignancy
Which conditions are asspociated with cryoglobulinemic vasculitis?
Hep C (arthitis & glomerulonephritis), RA, malignancy
What are the classic symptoms of HSP?
IgA leukocytoclastic vasculitis, arthritis, abdominal pain, nephritis
What si the most common cause of HSP?
beta lactams