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MSK > Derm Final Concepts > Flashcards

Derm Final Concepts Flashcards

1
Q

Type of skin cancer; slow growing pink pearly papule/nodule with telangiectasis; fair skin and found on sun exposed areas (UV exposure is greatest risk); metastases RARE; Keratinocyte origin but no pre-cancer precursor like SCC; can be superficial or pigmented

A

Basal Cell Carcinoma

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2
Q

Pink macule or patch or thin papule (Superficial/Pigmented)

A

Superficial BCC

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3
Q

Seen in darker skin types (Superficial/Pigmented)

A

Pigmented BCC

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4
Q

Treatment for BCC

A

Surgical: Mohs surgery, curettage, excision

Non-surgical: Imiquimod

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5
Q

Pigmented skin cancer; Melanocyte origin; can arise de novo or from a pre-existing nevus; demonstrates any of the ABCDEs (asymmetry, borders, color, diameter and evolving); risk factors include lighter skin, hx of sunburns/tanning bed use, family hx, higher # of moles, red hair

A

Melanoma

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6
Q

melanoma in the epidermis or epidermal-dermal junction only with no invasion of dermis

A

Melanoma in situ

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7
Q

KEY prognostic factor for Melanomas; measurement from s. granulum to deepest point of melanoma invasion in dermis

A

Breslow depth

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8
Q

Type of biopsy needed for melanoma diagnosis

A

Excision biopsy (remove the entire lesion to accurately measure Breslow depth)

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9
Q

Tx for Breslow depth <0.8 mm

A

wide local excision or Mohs surgery

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10
Q

Tx for Breslow depth >0.8 mm

A

wide local excision and ALSO sentinel lymph node biopsy to assess for metastatic disease

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11
Q

If melanoma biopsy confirms metastatic disease, what needs to be confirmed for treatment?

A

genetic mutations to dictate the most effective immunotherapy

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12
Q

What genetic mutations are the most common in melanoma?

A

BRAF & CDKN2A

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13
Q

Pinpoint pink papules around nose, mouth, maybe eyes; can last up to months but not long-term like rosacea; can be triggered by aerosolized steroids and worsened by topical steroids

A

Perioral Dermatitis

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14
Q

Treatment for perioral dermatitis

A

topical metronidazole + oral antibiotics (doxy or minocycline)

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15
Q

a very common chronic skin disease due to inflammatory response to Malassezia (fungi); diffusely through areas of high sebum production (scalp, ears, central chest); erythema with overlying greasy yellow scale; infantile type is called “Cradle Cap”; hypopigmentation in darker skin

A

Seborrheic Dermatitis

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16
Q

Severe disease of _____ can be seen in untreated HIV or parkinson disease

A

Seborrheic Dermatitis

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17
Q

Treatment for Seborrheic Dermatitis

A

topical steroids (for flares) and ketoconazole (for Malassezia)

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18
Q

chronic disease that presents as largely symmetric erythematous well-defined plaques with overlying silvery scale; extensors (elbows, knees) and scalp, buttocks, sacrum, umbilicus are common locations; thought to be due to cytokines triggering a hyperproliferative state resulting in thick skin and excessive scale

A

Psoriasis

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19
Q

MOST COMMON type of psoriasis

A

Plaque Psoriasis (silvery scale)

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20
Q

type of psoriasis commonly seen in younger people; often seen after STREPTOCOCCAL pharyngitis

A

Guttate Psoriasis

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21
Q

type of psoriasis morphology; lesions located in SKIN FOLDS (axilla,groin, etc.); may lack scale due to moistness of area

A

Inverse/Flexural psoriasis

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22
Q

type of psoriasis; widespread, generalized erythema covering nearly ALL (>80%) of the body surface; hospitalization is sometimes needed

A

Erythrodermic psoriasis

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23
Q

type of psoriasis morphology; pustules; triggered by corticosteroid withdrawal; generalized; can be LIFE-THREATENING

A

Pustular psoriasis

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24
Q

indicates higher risk of psoriatic arthritis (90% have it); can involve pitting, onycholysis (separation of nail plate from nail bed) and hyperkeratosis

A

Nail Psoriasis

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25
Q

Psoriasis is complicated ____ driven disease involving cytokines (TNFa and IL-23)

A

T-cell

26
Q

What cytokine stimulates Th17 cells to release IL-17 and IL-22 leading to proliferation of keratinocytes and dermal inflammation?

A

IL-23

27
Q

High levels of ____ correlate with psoriasis severity

A

IL-22

28
Q

What gene accounts for up to 50% psoriasis?

A

PSORS1

29
Q

Histopathology of psoriasis

A
  1. Regular acanthosis with elongated rete ridges
  2. Vessels in dermal papillae
  3. Parakeratosis and lack of s. granulosum
  4. munro microabscesses (neutrophils on top of parakeratosis)
30
Q

Treatment for Psoriasis

A
  1. Topical steroids first for limited disease

2. Phototherapy, Biologic agents (TNF-a inhibitors) and Oral meds (Methotrexate) for systemic/widespread disease

31
Q

Acute red scaly rash that occurs in adolescents/young patients; starts as a HERALD patch (ring-shaped with clear center) and will progress to a CHRISTMAS TREE pattern along skin lines on trunk; unknown etiology but maybe associated with HHV6 infection; SELF-LIMITING in 6-8 weeks; no treatment needed

A

Pityriasis rosea

32
Q

Type I hypersensitivity reaction (Th2 cytokine predominance) that commonly impacts infants and young children; itchy (pruritus) rash; associated with other atopic diseases (seasonal allergy, asthma); commonly seen in flexural areas; increased serum IgE

A

Atopic Dermatitis

33
Q

Atopic dermatitis is caused by what mutation?

A

FLG (filaggrin) gene mutation –> epidermal barrier dysfunction –> transepidermal water loss

34
Q

Atopic dermatitis puts at risk for what secondary infections?

A

staph causing impetigo (crusting lesions)

35
Q

Treatment for atopic dermatitis

A

Repair epidermal barrier function (topical steroids first line tx & thick moisturizers to treat xerosis)

36
Q

What must be avoided as tx for Atopic Dermatitis?

A

systemic steroids (oral like prednisone) can cause rebound symptoms

37
Q

50-80% of children with Atopic Dermatitis will have another atopic disease, like Asthma or Allergic Rhinitis

A

Atopic Triad/March

38
Q

Eczema seen classically in lower legs in adults, very itchy and nummular (coin shaped)

A

Nummular Eczema

39
Q

Eczema described as “dry riverbed”, superficial fissuring from extreme dry skin leading to dermatitis; common in lower legs in winter months

A

Asteatotic Eczema

40
Q

Tx for Eczema (nummular and asteatotic)

A

moisturizer, topical steroids

41
Q

Skin disease seen in patients with lower extremity edema who then develop overlying dermatitis; DO NOT confuse with bilater lower extremity cellulitis; no fever, chills

A

Stasis dermatitis

42
Q

Tx for Stasis dermatitis

A

compression stockings, topical steroids

43
Q

Autoimmune blistering disease; generalized tense bullae; 20% involve mouth; intensely itchy (Pruritic)

A

Bullous Pemphigoid

44
Q

Elderly (Chronic); histology shows subepidermal bullae with eosinophils; DIF shows linear IgG and C3 at the basement membrane zone

A

Bullous Pemphigoid

45
Q

TX for Bullous Pemphigoid

A

potent topical steroids if localized; prednisone (Short term); steroid-sparing agents (Maintainance)

46
Q

Autoimmune blistering disease; generalized erosion with crusting; mouth always involved; erosion rather than blisters; Positive Nikolsky sign

A

Pemphigus Vulgaris

47
Q

Histology shows intraepidermal split (no eosinophils), DIF shows fishnet IgG and C3 in the epidermis

A

Pemphigus Vulgaris

48
Q

TX for Pemphigus Vulgaris

A

potent topical steroids if localized; prednisone (Short term); steroid-sparing agents (Maintainance)

49
Q

Very itchy, red-pink edematous papules and vesicles; linear (poison ivy) or geometric shapes to the rash; Delayed-type hypersensitivity (4)

A

Allergic contact dermatitis

50
Q

The most common cause of allergic contact dermatitis is

A

Nickel

  • then fragrances, neomycin, poison ivy
51
Q

TX for Acute allergic contact dermatitis

A

Topical steroid or prednisone depending on the severity

52
Q

Fungal skin infection often caused by microsporum canis; causes fragility and breakage of the hair leading to multiple patchy ALOPECIA and black dot patches on scalp; reversible; 2 types

A

Tinea Capitis

53
Q

type of tinea capitis in which spores coat the hair

A

ectothrix

54
Q

type of tinea capitis in which spores are in the hair

A

endothrix

55
Q

Treatment for Tinea Capitis

A

oral antifungals since TOPICAL INEFFECTIVE

56
Q

What tinea is more common in kids than adults?

A

Tinea Capitis

57
Q

presents within minutes to hours of ingestion; transient, pruritic erythematous edematous plaques anywhere on the body: wheals

A

Acute Urticaria

58
Q

skin disorder due to mast cell degranulation and release of histamine

A

Acute Urticaria

59
Q

tx for acute urticaria

A

Stop the offending medication, H1 antihistamines, +/- second-generation H1 antihistamines, +/- prednisone taper

60
Q

flesh-colored or brown verrucous papules and plaques occurring anywhere except mucus membranes/palms/soles; Very common in late middle age/elderly; Look “stuck on”; sun exposure is a risk factor;

A

Seborrheic keratosis

MSK (8 decks)

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