Derm Flashcards
Solar elastosis
1) etiology
2) presentation
1) accumulation of abnormal elastin in the dermis, which occurs as a result of the cumulative effects of prolonged and excessive sun exposure (photoaging)
2) extensive bruising + extensive wrinkling + scaly erythematous patches + irregularly shaped brown macules (hyper pigmentation or depigmentation)
Clark staging for melanoma
Level 1 : Melanoma confined to the epidermis (melanoma in situ)
Level 2 : Invasion into the papillary dermis
Level 3 : Invasion to the junction of the papillary and reticular dermis.
Level 4 : Invasion into the reticular dermis
Level 5 : Invasion into the subcutaneous fat.
*So SUBCUTANEOUS is worst prognosis.
Ocular albinism inheritance
x-linked recessive
albinism
o Code: Anna van Slyke: /absence of melanin production by skin melanocytes. Big tyro black dude in corner on a pile of rocks/most common form caused by deficiency of tyrosine hydroxylase or tirosinase (DOPA (tyrosinase) melanin) Tyrion standing on the counter/autosomal recessive. Tyro big black dude stuck in transporter in the desk + /other causes = defective tyrosine transporter + failed neural crest migration. /prone to developing sun-induced skin cancers, including squamous cell carcinomas, basal cell carcinoma, and melanomas. Locust on right of counter dressed as a hipster/example of locus heterogeneity.
o Location: Goeff’s hardware store across the street from UU church
organisms causing Athlete’s foot
o Code: tricyle on top of car + dandy lion on top of a microscope + ellie dressed as a gladiator in the front seat/3 fungi are responsible for the bulk of infections: trichophyton sp. + microsporum + epidermophyton.
o Location: Parked in YHS parking lot
Lentigo
Code: Lenny Pierce: his face looking like below/benign **melanocytic hyperplasia. /lowest risk of malignancy.
Location: Sitting on porch of Desiderio’s house
- scaly, irregular borders, grows bigger with time.
pathognomonic finding for molluscum
viral cytoplasmic inclusions in epidermal cells
Oral hairy leukoplakia T cell count
Hailing on Tim who’s doing lines off bones in road/associated with T cell count
Leukoplakia
o Code: Luke Pierce: mouthful of cigarettes and fishing/more common in smokers. white plaque on mouth/white plaque on oral mucosa for which a more specific diagnosis cannot be rendered (others like hairy are subtypes of leukoplakia). Big pile of carrots behind him/hyperkeratosis. Huge devil fishing next to him/high probability of progressing to oral cancer.
o Location: End of Cousin’s island bridge
Xeroderma pigmentosum
o Coded character: There’s a big spiral DNA in the room and Ivan is prying out playmobile castles with a huge crowbar/defect in nucleotide excision repair. Going endo on side wall into a nuclear bomb/UV-specific endonuclease deficiency. Everyone looks like zombies as below and sun is extremely intense in the room/this prevents repair of pyrimidine dimers because of ultraviolet light exposure. /patients experience recurrent lesions that rapidly progress to cancer. Tyrion is drilling too/autosomal recessive. /predisposes pts to squamous cell carcinoma + basal cell carcinoma + melanoma. His head is burnt red and peeling + looks like below/presentation = photosensitivity + poikiloderma + hyperpigmentation in sun-exposed areas.
o Location: DEMS lab room
endonuclease function
cleave phosphodiester bonds
Erythema multiforme
♣ Coded character: Erin Murray: Put it on Mike Outwin’s stomach + brother blacks + Bennett’s stomach + terry’s + on aloe cat/associated with mycoplasma pneumonia + HSV (most commonly) + drugs (sulfa drugs + penicillin + allopurinol + phenytoin) + cancer + autoimmune disease. Eryn on patio up against wall being attacked by T covered in ivy + T with long hair/autoimmune cell-mediated attack on epithelial cells by CD8+ and CD4+ lymphocytes. They all have targets on their stomachs/erythematous patches with pale + vesicular eroded centers known as “target lesions.” Below lesions all over erin murray’s palms and soles/can involve palms and soles. On her lips too/can be mucosal involvement in severe cases. Carrots attached to balloons all around her head/biopsy = apoptic keratinocytes + lymphocytic infiltrate.
♣ Location: Patio at uinta
drugs associated with Stevens-Johnson syndrome
associated with lamotrigine + phenytoin + ethosuximide + carbamazepine.
Rash associated with SJS
erythema multiforme
UVA and photo aging mechanism
Bunch of Al Qaeda storming room/UVA produces reactive oxygen species, which activate multiple inflammatory cell-surface receptors and nuclear transcription factors. Metal neo from matrix behind desk + miles is weaving bands of collagen fibrils/this leads to decreased collagen fibril production + upregulation of matrix metalloproteinases (including collagenases) that subsequently degrade type I and III collagen and elastin.
Photoaging histology
gradual thinning of the epidermis
photoaging sequela
Huge collagenous crosslinks all over wall/Increased cross linking of collagen
DLE presentation
thick, scaly, discoid plaques that erupt on unexposed skin and may result in scarring
Roseola
♣ Code: field covered in roses/roseola. Rosie Mcdonald holding an infant/usually under 2 yo. Infant is sweating profusely + having a seizure + macular rash like below/presentation = high fevers for a several days + seizures + diffuse macular rash. Brother black on a huge mound of hash + brother black with a hook arm/caused by HHV-6/HHV-7. Rosie Mcdonald is drooling tons of saliva onto the baby/transmitted by saliva. /also called exanthem subitum (exanthema = transient)
♣ Location: NYA lacross field
Other tumor marker for melanoma
HMB-45 (human melanoma black-45)
p16 gene product
cyclin-dependent kinase inhibitor 2A
Primary immunologic response to intracellular pathogens?
CD8+ + NK cells
c-JUN
Transcription factor.
24,25-dihydroxycholecalciferol
deactivated form of vitamin D. When you’re hypercalcemic, 24,25-dihydroxycholecalciferol will be increased.
D3 sources
sun + milk + animals.
UVA vs UVB and dna damage
Both cause DNA damage, but UVB does so directly through pyrimide dimers, and UVA indirectly through activation of inflammatory pathways and free radical production.
When is base excision repair important?
Repair of spontaneous/toxic deamination.
When is NER impt?
repairing bulky helix-distorting lesions (think of xeroderma pigmentosum which is an inability to repair pyrimidine dymers).
