derm Flashcards

1
Q

layers of epidermis?

A
surface to base (Californians Like Girls in String Bikinis):
Corneum (keratin)
Lucidum 
Granulosum
Spinosum (desmosomes)
Basale (stem cells)
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2
Q

zonula occludens?

A

= tight junction
apical side of epithelial cell
claudins and occludins
prevents paracellular solute movement

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3
Q

zonula adherens?

A

= adherens junction
below zonula occludens
connects actin cytoskeletons of adjacent cells with cadherins (Ca dependent)

** loss of E-cadherin –> metastasis

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4
Q

macula adherens?

A

= desmosomes
below zonula adherens
keratin interactions –> structural support

** autoAbs –> pemphigus vulgaris

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5
Q

epithelial cell gap junctions?

A

made up of connexons

allow communication

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6
Q

epithelial cell integrins?

A

at basolateral surface

proteins that bind to collagen and laminin in basement membrane

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7
Q

hemidesmosomes?

A

at basolateral surface
connect keratin of basal cells to basement membrane

** autoAbs –> bullous pemphigoid

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8
Q

increased thickness of stratum corneum?

A

hyperkeratosis

seen in psoriasis, calluses

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9
Q

hyperkeratosis with retention of nuclei in stratum corneum?

A

parakeratosis

seen in psoriasis

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10
Q

epidermal accumulation of edematous fluid in intercellular spaces?

A

spongiosis

seen in eczematous dermatitis

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11
Q

separation of epidermal cells?

A

acantholysis

seen in pemphigus vulgaris

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12
Q

epidermal hyperplasia (increased stratum spinosum)?

A

acanthosis

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13
Q

decreased melanin production, normal melanocyte number?

A

albinism
defect in tyrosinase activity or tyrosine transport; or failure of neural crest cell migration in development

** increased risk of skin cancer

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14
Q

preggo with hyperpigmented areas on face?

A

melasma (chloasma)

assoc with preg or OCP use

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15
Q

autoimmune destruction of melanocytes?

A

vitiligo

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16
Q

melanocytic nevus?

A

common mole

** intradermal nevus: papular; junctional nevus: flat

17
Q

epidermal changes in psoriasis?

A

increased stratum spinosum and stratum corneum

decreased stratum granulosum

18
Q

rhinophyma?

A

bulbous deformation of nose

from chronic inflammatory changes of rosacea

19
Q

sudden appearance of multiple seborrheic keratoses?

A

Leser Trelat sign = sign of underlying malignancy

- GI, lymphoid

20
Q

honey colored crusting?

A

impetigo
S aureus or S pyogenes
(bullous usually S aureus)

21
Q

well-defined demarcation b/w infected and normal skin?

A

erysipelas
upper dermis and superficial lymphatic involvement
S pyogenes

22
Q

MC organism in skin abscess?

23
Q

bullae, purple skin, crepitus?

A

nec fasc

anaerobes or S pyogenes

24
Q

fever and generalized erythematous rash with sloughing?

A

staph scalded skin

** exotoxin destroys keratinocyte attachments in stratum granulosum ONLY

25
white painless NON-scrapeable tongue plaques?
hairy leukoplakia | EBV
26
flaccid intraepidermal bullae, oral involvement, Nikolsky +?
pemphigus vulgaris - potentially fatal IgG Abs to desmoglein (anti-desmosome) immunofluorescence: Abs in reticular pattern around epidermal cells ** bullae caused by acantholysis
27
tense blisters, no oral involvement, Nikolsky -?
bullous pemphigoid - not as bad as vulgaris IgG Abs to hemidesmosomes immunofluorescence: Abs in linear pattern at epidermal/dermal junction ** blisters contain eosinophils
28
pruritic papules, vesicles, bullae; often at elbows?
dermatitis herpetiformis IgA deposits at tips of dermal papillae assoc with celiac
29
multiple lesion types, including target lesions?
``` erythema multiforme infections: mycoplasma, HSV drugs: sulfa, beta lactams, phenytoin cancer autoimmune dz ```
30
SJS/SJS-TEN/TEN?
SJS < 10% BSA SJS-TEN: 10-30% TEN > 30%
31
small rough red/brown papules/plaques?
actinic keratosis premalignant --> squamous cell ca caused by sun exposure
32
painful lesions on anterior shins?
erythema nodosum subQ fat lesions ** assoc with sarcoid, coccidio, histo, TB, strep, leprosy, Crohn
33
pruritic, purple, polygonal, planar papules and plaques?
lichen planus mucosal involvement: Wickham striae (white lines) sawtooth lymphocytic infiltrate at dermal-epidermal junction ** assoc with HCV
34
UVA vs UVB?
UVA --> tanning, photoaging UVB --> sunburn UV radiation --> DNA mutation, keratinocyte apoptosis
35
pink pearly nodule, rolled borders, central crusting/ulceration?
basal cell carcinoma MC skin cancer locally invasive, rare mets ** palisading nuclei
36
ulcerative red lesions with frequent scale; sun-exposed areas?
squamous cell carcinoma 2nd MC skin cancer locally invasive, LN spread possible, rare mets * * keratin pearls on histo * * assoc with arsenic exposure
37
melanoma marker?
S-100
38
melanoma mutation?
BRAF kinase activating mutation ** BRAF V600E - can try vemurafenib (BRAF kinase inhibitor)