Derm Flashcards
loss of ______ promotes metastasis
E-cadherin
adherens junction connects actin cytoskeletons of adjacnt cells with Cadherins
Californians Like Girls in String Bikinis
Corneum (KERATIN) Lucidum Granulosum, Spinosum (DESMOSOME) Basale (stem cell)
Hemidesmosome connects ______ in basal cells to underlying basement membranes. Auto-Ab =
Keratin Bullous Pemphigoid (antihemidesmosome)
Desmosome (macula adherens): Structural suppor via _______. Auto-Ab =
Kertain Pemphigus Vulgaris (Anti-desmoglein or desmosome)
Connexins vs Claudins/occludins
Connexin = Gap J(x) (increased in labor) Claudins = Tight j9X) = paracellular barrier
Normal _________ with decreased ______ = Albinism. Decrease tyrosinase/tyrosine transport. Failure of neural crest cell migration
Normal melanocyte #
Decreased melanin production
Autoimmune destruction of melanocytes = irregular areas of complete depigmentation like Sonali’s brother
Vitiligo
Papules/plaques with silvery scales (knee/elbow)
Auspitz sign: pinpoint bleeding when scales scraped off
Increased Spinosum
Decreased Granulosum
Parakeratotic scaling (nuclei in stratum corneum)
Psoriasis
- ->ass. with nail pitting and psoriatic arthritis (JOINT DISEASE BRUH BRUH)
- ->When you’re on your knees and elbows, you look More Sexual and Less Gr-anul-oss
Leser-Trelat sign: sudden apperance of multiple suborrheic keratoses, indicates _________
underlying malignancy (GI/lymphoid)
Suborrheic keratoses = looks stuck on; flat pigmented greasy epithelial prolif w/keratin
Sawtooth apperance of lymphocytes at dermal-epidermal j(x); associated with Hep C
Lichen Planus
Pruritis, Purple, Plygonal, Planar, Papules, Plaques
Lichen Planus
White painless plaques on tongue that can not be scraped off
Hairy Leukoplakia –> EBV
occurs in HIV+ or organ-transplant pt
Separation of epidermis upon manual stroking of skin
Nikolsky Sign
+ in Pemphigus vulgaris “Spread Nikoles Pussy Vagina”
(also seen In Staph Scalded Skin Syndrome: Staph got Scolded for Eating Nikoles Pussy at work)
- in Bullous Pemphigoid
Necrotizing fasciitis (flesh-eating bacteria). Causes bullae and purple color to the skin
Strep Pyogenes (or anaerobic bacteria)
causes of Steven Johnson
Anti-epileptics (LAMOTRIGINE, ethosuxamide, phenytoin, carbamazepine)
Allopurinol
Sulfa Drugs: Probenicid, Furosemide, Acetazolimide, Celecoxib, Sulfasalazine, Sulfonylurea, Sulfonamides
Penicillin
Prodrome of flu/fever followed by rapid onset of bullae/necrosis and sloughing of skin
Steven Johnson
more severe form = Toxic Epidermal Necrolysis
Epidermal hyperplasia –>symmetric hyperpigmented thickinenig of skin
Ass. with hyperinsulinemia (diabetes/Cushing) or visceral malignancy
Acanthosis Nigricans (especially in armpits)
Involves Oral Mucosa: PV or BP?
Pemphigus Vulgaris . Pour Vino into your mouth.
rough lesions (sandpaper) felt by patient
Actinic Keratosis (premalignant; SUN EXPOSURE)
Pretty much painful inflam on anterior shins (“subq fat)
Erythema nodosum. Associated with like any fucking infection esp the systemic fungi, crohns, and sarcoid
Most common Skin Cancer
Basal Cell Carcinoma>Squamous–>both associated with sun exposure; neither metastasize (unlike melanoma)
BCC: Pseudopalisading nuclei; commonly with telangiectasias and ulcerations
SCC: On face, low lip, ears. Keratin Pearls
(Actinic Keratosis = precursor)
Melanoma (
Significant metastasis risk; Sun exposure; fair skinned ppl at increased risk S-100 tumor marker Asymmetry Border irregularity Color variation Diameter >6mm Evolution over time
4 types of melanoma
Nodular
LENTIGO MALIGNA
ACRAL LENTIGINOUS
Superficial Spreading
Melanoma mutation and tx
BRAF Kinase activating mutation: Pts with the BRAF V600E mutation give VEMURAFENIB (Braf Kinase Inhibitor)
Main melanoma tx = excision with wide margins
Staph Aureus Scalded Skin Syndrome vs Toxic Epidermal Necrolysis
SSS: Sloughing of epidermims because exotoxin destroys keratinocyte attachments in STRATUM GRANULOSUM ONLY. More common in newborns and children, because they would say its So Gross.
TEN: Entire Epidermal-dermal junction destroyed (part of steven johnson)
