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Disease and Defense > Derm Review > Flashcards

Derm Review Flashcards

1
Q

Fitzpatrick skin types

A 
I- Never tans, always burns
II - Tans with difficulty, usually burns
III - average tanning sometimes burns
IV - easily tans, rarely burns
V - very easy to tan, rarely burns
VI - never burns
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2
Q

Skin pigmentation is due to…

A

Type of melanin produced

Distribution of melanosomes

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3
Q

Dark skin (2)

A

melanosomes larger and distributed individually throughout the cytoplasm of the keratinocyte

Eumelanin (black to brown pigment)

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4
Q

Light skin (2)

A

melanosomes smaller and distributed in clusters above the nucleus in the keratinocyte

-Pheomelanin (yellow to red-brown pigment)

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5
Q

Vitiligo (3)

A
  • Acquired depigmentation
  • complete absence of melanocytes
  • seen in periorifical and acral locations
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6
Q

Hemidesmosomes attach ______ to ______

A

epidermis to dermis (basal cells to basal lamina of dermal-epidermal junction)

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7
Q

Desmosomes attachments between _____ within _______

A

keratinocytes

within the stratum spinosum

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8
Q

Congenital disease of the hemidesmosomes

A

epidermolysis bullosa (EB)

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9
Q

Dystrophic epidermolysis bullosa (EB)

A
  • No collagen 7
  • problem with hemidesmosomes

-extensive dystrophic scarring causing deformity

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10
Q

Acquired problem of hemidesmosomes

A

Bullous Pemphigoid

-antibodies to hemidesmosomes

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11
Q

Epidermolysis bullosa simplex

A

defect in keratin 5 and 14

  • generalized blisters after birth
  • intraepidermal (not as severe scarring as recessive dystrophic variant)
  • Occurs less as patients age
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12
Q

Acquired disease of the desmosomes

A

Pemphigus Vulgaris

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13
Q

Pemphigus Vulgaris

A
  • skin lesions are flaccid bulla
  • abs to desmoglein
  • intraepidermal blisters
  • blisters on skin and oral mucosa
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14
Q

______ and ________ both are due to defects in filaggrin that cause a defect in the skin barrier function

A

Icthyosis Vulgaris and Atopic Dermatitis

skin is always dry

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15
Q

Ichthyosis Vulgaris appears as

A

plate like scales

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16
Q

Papillary dermis

A
  • upper layer
  • thin collagen bundles
  • interlocks with epidermal rete
  • increases strength and surface area
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17
Q

Reticular dermis

A
  • deeper layer
  • thick collagen bundles
  • visible elastic fibers
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18
Q

3 major constituents of the dermis and their functions

A

1) Collagen - forms the tensile strength
2) Elastic fibers - allow for resilience
3) Ground substance - facilitates diffusion

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19
Q

Acquired disorder of elastin

A

Solar elastosis

damaged elastic fibers from UV light

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20
Q

Congenital disorder of elastin

A

Pseudoxanthoma Elasticum

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21
Q

Acquired blistering disorder of DEJ

A

Bullous pemphigoid

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22
Q

Congenital blistering disorder of DEJ

A

Epidermolysis bullosa

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23
Q

What nail finding is associated with HIV and what is it caused by

A

proximal subungual white onychomycosis (basically white nail on the proximal half)

-caused by trichophyto rubrum

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24
Q

alopecia areata

A

autoimmune against hair follicles

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25
Q

Hair growth cycle

A

1) Anagen (growing hair)
2) Catagen (involuting hair)
3) Telogen (resting hair)

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26
Q

Anagen Effluvium

A

loss of growing hairs (e.g. chemo)

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27
Q

Telogen Effluvium

A

hairs go into resting cycle

28
Q

Dermatitis is the same thing as _________

A

Eczema

29
Q

Atopic dermatitis

located where?
Associated with what diseases?
defect where?

A

Due to defect in Filaggrin

Associated with asthma and allergic rhinitis

On flexor surfaces (skin folds)

30
Q

Seborrheic Dermatitis

caused by?
symptom?
location?

A

Malassezia furfur

Dandruff (psoriasis has a thicker more silver scale)

On scalp (aka cradle cap)

31
Q

Psoriasis

appearance/symptom
location
associated diseases

A

Silver scale, itchy

Extensor surfaces

Associated with increased risk of CV disease and arthritis

32
Q

Irritant Dermatitis (e.g. intertrigo) is caused by __________

A

common irritants (fragrance)

33
Q

Stasis Dermatitis

A

LE edema

On Lower legs

34
Q

Allergic contact dermatitis

caused by?
what kind of hypersensitivity reaction?

how do you diagnose it?

A

Common allergens

Delayed Type IV Hypersensitivity Reaction

Diagnosis confirmed with patch testing

35
Q

Type I hypersensitivity reactions

A
  • anaphylactic reactions
  • IgE ab to specific antigen → histamine release → vasodilation, smooth muscle contraction

EX) Urticaria and angioedema (peanut allergy, bee venom)

36
Q

Type IV hypersensitivity reaction

A

Langerhans cells (APCs) present antigen → make memory T cells that are sensitized to locally deposited antigens

Local reaction occurs - does NOT involve antibodies

EX) Morbilliform Drug Eruptions, Allergic contact dermatiti

37
Q

Impetigo is typically caused by ______ while erysipelas is usually caused by ______

A

staph

strep

38
Q

Impetigo appearance

A

honey colored crust, slightly bullous, localized spot

39
Q

Erysipelas appearance

A

spreading erythema across face, warm, tender, cliff-drop border

40
Q

Tinea Versicolor

A

Hyper or hypopigmented patches

Typically on chest

Warm, humid environment

Yeast (Malassezia furfur)

Short hyphae and spores (spaghetti and meatballs)

41
Q

Scabies

A

In between fingers

Infestation of the skin

42
Q

Seborrheic Keratosis

A

“Barnacles of life”
Benign skin tumor
Clonal proliferation of keratinocytes

43
Q

Intradermal Nevus

A

in dermis (skin colored), broad base

44
Q

Junctional Nevus

A

just in DEJ, flat, pigmented

45
Q

Compound nevus

A

melanocytes in dermis and DEJ

46
Q

Skin Defenses against UV radiation

A

DNA repair
Apoptosis of Cells with DNA damage
Defenses against ROS
Melanin

47
Q

Actinic Keratosis is a precursoe to _______ derived from a ________

A

SCC, keratinocyte

48
Q

UVA causes…

A

dark patches, wrinkles, loose skin, premature aging, DNA damage, melanoma, non-melanoma

49
Q

UVA penetrates ______ due to its ______ wavelength

A

Penetrates into dermis → damages collagen fibers

Longer wavelength

50
Q

UVB penetrates ______ due to its ______ wavelength

A

Only penetrates epidermis

Shorter wavelength

51
Q

UVB causes…

A

sunburn, eye problems, DNA damage, melanoma, non-melanoma

52
Q

UVR effects on the skin (6)

A

Damage to DNA, RNA, lipids and proteins

Pro-inflammatory effects

Immunosuppressive effects

Induction of innate defenses

Induction of apoptosis

Vitamin D synthesis

53
Q

Photodermatoses (3)

A

1) Lupus Erythematosus
2) Dermatomyositis
3) Mixed connective tissue disease (MCTD)

54
Q

Dermatomyositis appearance and presentation

A

Photodistributed

Scalp, periocular and extensor skin sites

Periorbital edema, eruption on upper eyelids (heliotrope)

55
Q

Samitz sign

A

ragged cuticles

associated with dermatomyositis

56
Q

Gottron’s papules

A

associated with dermatomyositis

on hands, knuckles, elbows, knees, diffuse red papules

57
Q

Gottron’s sign

A

poikiloderma over the knuckles, elbows, knees

associated with dermatomyositis

58
Q

Shawl sign

A

associated with dermatomyositis

poikiloderma across back and shoulders

59
Q

Adult onset of dermatomyositis can be associated with…

A

internal malignancy in patients with DM

60
Q

Neurofibromatosis signs include (5)

A

Cafe-au-lait
Axillary freckling
Optic Glioma and Lisch nodules (eyes)
Neurofibromas

61
Q

Tuberous Sclerosis

signs (3)

systemic associations?

A

genetic disorder

Adenoma sebaceum on the face (kinda looks like bad acne)

Hypomelanotic macules (on back)

Shagreen patch (big red bump)

Can involve heart, kidneys (renal cysts)

62
Q

Kaposi’s Sarcoma is associated with _____

A

HIV

63
Q

Pyoderma Gangrenosum

A

cut doesn’t heal, ulcerates

DO NOT debride, AVOID surgery - trauma induces it

Oral/topical anti-inflammatory agents preferred

64
Q

Pyoderma Gangrenosum Indicative of what underlying diseases?

A

IBD
Arthritis
Monoclonal gammopathy
Other hematologic disorders (myelogenous leukemia, myelofibrosis)

65
Q

Lichen Planus

appearance
associated disease

A

higher incidence of HepC

Purple, polygonal, pruritic papules

Wickham’s striae (overlying lace-like white line pattern on surface)

66
Q

Acanthosis Nigricans

A

Velvety hyperpigmentation of intertriginous surfaces

Common in obese patients

Stimulates epidermal keratinocytes and dermal fibroblasts to proliferate → skin thickening and looks darker

67
Q

Acanthosis Nigricans

associated with what diseases? (5)

A

Obesity, insulin insensitivity (DM)
Endocrinopathies
Drugs

Internal malignancy - IF they are losing weight
Adenocarcinoma of stomach

Disease and Defense (11 decks)

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