Derm path IV Flashcards
25 year old with alot of itching and rash that came on suddenly
mast cell dependent and IgE dependent
acute allergic reaction
what type of hives is mast cell dependent and IgE independent
drug or other substance that triggers mast cells directly
What type of hives is Mast Cell dependent IgE dependent
acute allergic reaction
what type of hives is mast cell independent and IgE independent
aspirin induced vasodilation
hereditary angioneurotic edema (C1 inhibitor deficiency)
Tx for acute urticaria
antihistamines, subcut epinephrine, IM injections corticosteroids
patient with known c1 inhibitor deficiency has acute urticaria, what do you Tx with
C1 inhibitor concentrates, kallikrein inhibitor or fresh frozen plasma
what does the rash look like in acute urticaria
wheals that are erythematous edematous circular plaques covered by intact normal epidermal surface
commonly on trunk and extremities
blanching means what
erythema fades to white with direct contact– good.. most likely just urticaria
how long does acute urticaria last
24 hours
sometimes days- months
what is spongiotic dermatitis
eczema
epidermal edema with prominent lymphocytes in dermis and epidermis
eczema
clinical sign eczema
acute onset red papulovesicular lesions which may ooze or crust
what type of HS is eczema
T cell mediated type IV
what is erythema multiforme
HS reaction to drugs, infections, malignancy, collagen vascular disorderts
what type of infections can cause erythema multiform
Herpes
deep fungal (histo)
salmonella typhii
leprosy
what drugs can cause erythema multiforme
antibiotics
salicylates
anti malerials
what is the multiforme pattern
red pale red
what is the severe systemic fibrile form of erythema multiforme with mucosal involvement
stevens johnson syndrome
what is toxic epidermal necrolysis
form of erythema multiforme with diffuse necrosis and sloughing of skin and mucosae
what is seborrheic dermatitis
chronic dermatitis
where is seborrheic dermatitis found
scalp forehead and glabella space (upper eybrow)
high density sebaceous glands
what infection can cause seborrheic dermatitis
malassezia furfur
what is psoriasis
chronic skin condition
affects skin of elbows, knees, scalp, lumbosacral area, intergluteal cleft and glans penis
psoriasis is assoc with
arthritis
HLA psoriasis
cW 0602
increased CD4 TH1 sensitized cells set off other T cells causing increased cytokines leading to epidermal proliferation
typical lesions in psoriasis
well demarcated pink-salmon plaque
koebner phenomenon
trauma can induce psoriatic lesions in predisposed people
what causes lichen simplex chornicus
chronic rubbing or scratchin
nodular lichen simplex chronicus
prurigo nodularis
lichen planus
self limiting chornic inflammatory condition of skin and mucous membranes
prognosis lichen planus
resolves spontaneously 1-2 years after onset
clincal presentation lichen planus
multiple plaques symmetrically distributed on extremities and glans penis
wickham striae appearance
sawtoothing and civatte bodies
lichen planus
what is discoid lupus erythematous
localized cutaneous manifestations of SLE with no assoc systemic manifestations
major cutaneous findings in discoid lupus erythematosus
malar erythema
discoid (coin like) scaling plaques
chronic plaques with thinned atrophic epidermis and areas of dilated tortuous dermal vessels
lupus erythematosus
central hypopigmentation surrounded by peripheral hyperpigmentation
lupus erythematosus
lymphopcytes in superficial and deep dermis
thinned epidermis with loss of rete ridges and hyperkeratosis
lupus errythematosus
granular deposits of IgG and C3 at dermoepidermal junction
+“band test”
lupus erythematosus
population commonly affected by rosacea
30-60 y.o F
stages of rosacea
- pre-rosacea (flushing)
- erythematotelengiectatic
- papulopustular
- phymatous
what skin condition has perifollicular inflammation changes similar to acne vulgaris
rosacea
what is a common friction lbister
intraepidermal blister usually just beneath stratum granulosum with scant or no inflammation in papillary dermis
what are the immune mediated bulla
pemphigus group of diseases
bullous pemphigoid
dermatitis herpetiformis
what are the genetic blistering diseases
epidermolysis bullosa- -inherited defects in collagen, laminin leading to several disorders with weak skin and blistering
-porphyrias
separation at the dermal epidermal junction is what type of blister
subepidermal
in general what are the pemphigus group of diseases
autoimmune skin diseases: IgG autoAb to desmosomes (spinous processes) of squamous epithelial cells
what are the 4 clinical and pathologic types of pemphigus diseases
pemphigus vulgaris pemphigus vegetans pemphigus foliaceus pemphibus erythematosis -paraneoplastic pemphigus
what is most common pemphigus disease
pemphigus vulgaris, invovles mucosa and scalp, face, axilla, groin and other pressure points
what is pemphigus foliaceus
benign course, involves face, scalp, chest and back, spares mucous membranes
epidemic in south america
when do you see paraneoplastic pemphigus
with malignancies (lymphoma)
