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Modules > Derm > Flashcards

Derm Flashcards

1
Q

Acanthosis nigrans

A

Thickened hyperpigmented zones of skin with a velvet like area usually involving the flexuaral areas( axilia, skin folds of neck, groin,etc)
Benign 80%- ad trait with variable penetrance, associated with obesity and endocrine issues, congenital syndrome; usually appear in childhood or during puberty
Malignant- older adults associated with gastrointestinal adenocarcinoma

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2
Q

Acanthosis

A

Hyperplasia of the stratum spinosum

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3
Q

Seborrheic keratosis

A

Middle aged older adults
Coin like plaques tan to dark brown (vary in size)
Horn like cysts on histo (whorls of keratin)
Leser-trelat sign- large numbers of plaques associated with paraneoolastic syndromes / GI carcinoid

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4
Q

Progression of dermatitis

A

acute (weeping erethymatous rash/spongiosis)–> subactute (crusting over of rash scaling and hyperkeratosis) –> chronic (lichenification from itching, scaling, hyperpigmentation)

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5
Q

Atopic dermatitis

A

Type 1 IgE mediated hypersentivity

Face in kids, flexor surface (antecubital and popliteal fossa) in adults

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6
Q

Contact dermatitis

A

Type IV T cell mediated

Metals (nickle), plants (poison ivy), and chemicals (household cleaners, meds)

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7
Q

MC type of contact dermatitis

A

irritant contact

non immunological rxn; toxic effect of chemical on local skin

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8
Q

Girl playing soccer develops rash on legs, face, and arms, what drug is she on and what is this?

A

contact photodermatitis

Tetracycline (sulfa, thiazides)

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9
Q

Ring shaped patches of allopecia on scalp with erythema and scaling

A

Tinea capitus MC in children

  1. ) Trichophyton tonsurans
  2. ) Micosporum canis (Woodlamp + )
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10
Q

MC cause of tinea

A

Trichophyton rubrum

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11
Q

MCC diaper rash and onccyomycosis

A

candida albicans

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12
Q

High fever, metal confusion, diarrhea, hypotension, erythematous rash associated with a drug rxn

A

TSS nafcillin

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13
Q

What does actinic keratosis progress to?

A

Squamous cell carcinoma

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14
Q

What is actinic keratosis associated with?

A

sun (UVB) damage, arsenic

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15
Q

Where is psorasis most commonly found?

A

Scalp and pressure areas like the elbow

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16
Q

Development of a rash at areas of trauma

A

Koebner phenomenon, psoriasis

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17
Q

Munro microabcesses

A

collection of neutrophils in the stratum corneum (associated with psoriasis)

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18
Q

Single oval shaped scaly pink patch on trunk that develps into papules on the back that follow line of cleavage

A

pityriasis rosea

herald patch followed by christmas tree distribution

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19
Q

When is psoriasis associated with a destructive arthritis ?

A

If patient is HLA B27

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20
Q

What population do you see scalded skin syndrome in?

A

neonates
granulosum layer
no scarring

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21
Q

Atopic triad

A

atopic dermatitis
allergic rhinitis
asthma

22
Q

What type of hypersensitivity rxn is pemphigus vulgaris ?

A

Type II, IgG to desmoglian

23
Q

What do the basal cells look like on histology in pemphigus vulgaris?

A

tombstones

24
Q

What does the dermal epidermal junction look like in lichen planus?

A

Sawtooth from lymphocytic infiltrate

25
Q

dermatitis hepatiformis is what type of hypersensitivity rxn?

A

Type III, IgA and gluten deposition at tips of dermal papilae

26
Q

What type of antibodies are present in dermatitis hepatiformis?

A

anti-reticulin antibodies

27
Q

What is erythema multiforme called when it involves 2 or more mucous membranes?

A

SJS

28
Q

How do you get erythema multiforme?

A
  1. Disease (mycoplasma, HSV)
  2. Drugs (sulfa, beta lactams, phenytoin)
  3. Autoimmune (lupus, preg)
  4. Cancer
29
Q

Pathogenesis of acne

A

Increased keratin of follicular epithelium–> increased sebum production–> propionobacterium acnes / bacterial lipase, cleaves FA and creates further inflammation
most common in adolescents

30
Q

acne roseacea

A

inflammatory disease of pilocebateous unit of middle aged people
Can be brought on be heat and alcohol
can evolve into rhinophyma

31
Q

How does cellulitis spread?

A

can cause lymphangiitis by elaboration of hylauronidases that let the s. pyogenes infection spread through the subcutaneous tissue

32
Q

What type of lesion does SLE produce?

A

skin lesions associated with epidermal atrophy

33
Q

Pathogenesis of SLE

A

antibodies to epidermal basement membrane or antiDNA antibody anitigen deposition in basement membrane –> degeneration of basal layer at dermal epidermal junction–>lymphoid infiltrate and atrophic epidermis

34
Q

Grenz zone

A

narrow zone beneath the epidermis in leprotamous leprosy that is free of bacteria , under the grenz zone are fomay macrophages with organisms

35
Q

MCC of inflammation in subcutaneous fat

A

erythema nodosum

36
Q

MC malignant tumor of the skin

A

basal cell carcinoma

37
Q

Do basal cell carcinomas metastisize?

A

No

38
Q

Pearl colored nodule with prominent vascular channels under the surface

A

basal cell carcinoma

39
Q

MC cancer associated with immumosuppresive therapy

A

squamous cell carcinoma

40
Q

ulcer at orifice of chronically draining sinus that does not improve with antibiotics

A

squamous cell carcinoma

41
Q

What is SCC associated with?

A

XP, immunosuppression, arsenic posioning, sun damage

42
Q

What is a phenotypic marker for underlying adenocarcinoma of the stomach

A

acanthosis nigrans

43
Q

are freckles pre-malignant?

A

no

44
Q

flat hyperpigemented lesion of forehead and cheeks in women

A 
pregnancy mask (or OCP use)
melasma/chloasma
45
Q

MC nevi in adults

A

intradermal nevus

raised papule , pigmented cells only in dermis

46
Q

nevi all over the body

A

dysplastic nevus syndrome

precursor to maligancy

47
Q

MC type of melanoma

A

Superficial spreading

mostly women over 50, lower extremities and back MC sites,

48
Q

Malignancy on sun exposed face of elderly people

A

lentigo maligna

49
Q

MC type of melanoma in blacks

A

acral lentigenous melanoma

palms, soles, and subungal (don’t confuse hematoma)

50
Q

Best system of staging for melanoma

A

Breslow system
Measured depth
less than 0.76 mm no metastatic potential
greater than 1.7 can metastisize to LNs

51
Q

Hyperpigmented spots on the skin that when scratched become intensely puritic and red

A

urticaria pigmentosa

pressure causes mast cells to release histamine which sets up a urticarial rxn

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