Derm Week Flashcards
What are the four layers of the epidermis?
stratum corneum, stratum granulosum, statum spinosum, stratum basale
How long does it take for a basal cell to reach the stratum corneum and how long does it stay there?
two weeks each (four weeks total)
What is the function of the stratum basale?
epidermal stem cells
What is the function of the stratum spinosum?
bulk of epidermis, contains desmosomes
What is the function of the stratum granulosum?
lipid granules for water-tight barrier
What is the function of the stratum corneum?
barrier of anucleated cells
What 2 important proteins are found in corneal cells?
keratin and filaggrin
What are the three types of epidermal cells and their function?
keratinocytes - main epidermal/barrier cells
melanocytes - secrete melanin to keratinocytes
Langerhans - APC
What is found in the dermis?
blood/lymphatic vessels hair follicles sebaceous & eccrine glands fibroblasts mast cells
What is a small, flat lesion?
macule
What is a large, flat lesion?
patch
What is a large, raised lesion?
plaque
What is a small, raised lesion without fluid?
papule
What is a small, raised lesion with fluid?
vesicle
What is a large, deep papule?
nodule
What is a vesicle filled with pus?
pustule
What is the highest potency topical steroid?
clobetasol
What is the high potency topical steroid?
fluicinonide
What is the medium potency topical steroid?
triamcinolone
What are the two low potency topical steroids?
desonide, hydrocortisone
What are the 6 side effects of topical steroids?
skin atrophy telangiectasias striae acne steroid rosacea hypopigmentation
What are the 6 types of psoriasis?
plaque inverse/flexural guttate erythodermic pustular
What is characteristic of guttate psoriasis?
raindrop-sized lesions after strep infection
What is characteristic of inverse psoriasis?
erythematous plaques in the flexural folds, without scaling
What is characteristic of pustular psoriasis?
clustered pustules, often after corticosteroid withdrawal
What is characteristic of psoriatic erythoderma?
erythematous skin, often the entire body
What are the extra-dermal manifestations of psoriasis?
nail pitting, arthritis
What should never be used to treat psoriasis?
oral steroids
What are the three systemic treatments for psoriasis?
phototherapy
methotrexate
biologics
What is the first step in management for red scaly rashes?
KOH exam
What are the hallmarks of pityriasis rosea?
herald patch, then Christmas tree rash, due to HHV6
What is the hallmark of secondary syphilis?
rash with palm and sole involvement
What are the hallmarks of nummular dermatitis?
multiple coin-shaped plaques, pruritic, weeping, crusting
What are the hallmarks of asteatotic dermatitis?
papular rash on arms, legs, or flank
looks like cellulitits
What are the hallmarks of pediculosis?
adult lice or nits attached to hair
visible to naked eye
treatment by removing nits or 1% permethrin lotion
What are the hallmarks of Sarcoptes (scabies)?
papules with burrows, often in the webs of fingers
treat with 5% permethrin cream or oral ivermectin
What are the hallmarks of seborrheic keratosis?
multiple pigmented, stuck-on growths, can’t be on palms/soles
What predisposes to acrochordons?
genetics, obesity, friction, marker for insulin resistance
What are small red moles?
cherry angiomas
What causes dermatofibroma formation?
minor trauma enduces spindle cell proliferation
What is important about solar lentigo?
sun exposure means higher risk for melanoma
What are the hallmarks of sebaceous hyperplasia?
multiple yellor or skin-colored papules
looks similar to basal cell carcinoma
What is a keloid?
overgrowth of scar tissue
What is treatment for a keloid?
steroid injection into the lesion
What is an epidermal inclusion cyst?
collections of debris (cells and oil) that smells bad
What are pilar cysts?
subcutaneous nodules, always on scalp
What are lipomas?
collections of fat under the skin, usually solitary, sometines tender
What is verruca vulgaris?
hyperkeratotic fungating papules and nodules, caused by HPV infecting basal cells
what is verrucae planae?
flat warts, often on dorsal hands, arms, or face
What are treatment options for warts?
cryotherapy, salicylic acid, waiting
What are the hallmarks of molluscum contagiosum?
dome-shaped, umbilicated papules, spread through direct contact
What is urticaria?
hives, caused by vascular reaction in the skin
What kind of hypersensitivity is urticaria?
Type 1
What is the most common cause of acute urticaria?
idiopathic
At what level of the skin does urticaria occur?
dermis
What is dermatographism?
urticaria from physical pressure
How does immunologic urticaria occur?
antigen binds IgE on mast cells
How does non-immunologic urticaria occur?
direct mast cell degranulation due to pressure or drugs
What is the treatment for urticaria?
high dose anti-histamines (4x dose on bottle of multiple drugs)
What is angioedema?
swelling in the subcutis, similar to urticaria but deeper
At what point should urticaria be biopsied?
6 weeks (can indicate systemic disease)
What is the most severe form of type 1 hypersensitivity?
anaphylaxis
What does atopic dermatitis affect?
usually cheeks, then extensor, then flexural, never nose
When does atopic dermatitis develop?
before age 5
How does atopic dermatitis start?
erythematous papules, can be weeping, crusting, or scaling
What is the atopic triad?
asthma, atopic dermatitis, allergic rhinitis
What is lichenification?
thickening of the skin that accentuates skin lines
What does eczema mean?
red and scaly
What causes atopic dermatitis?
multifactorial, including filaggrin mutation, impaired immune response, skin barrier dysfunction
What is the treatment for atopic dermatitis?
topical steroids and moisturization/skin care, especially vasoline
What is the second line therapy for atopic dermatitis?
topical calcineurin inhibitor
Is cream or ointment stronger?
ointment
How many kids with atopic dermatitis will develop allergic rhinitis or asthma?
more than half
What bacteria commonly infects atopic dermatitis?
staph aureus or GA strep
What is pityriasis alba?
patches with loss of pigment and scale, inflammatory cause
What fungi infect the skin?
Malassezia Candida Trichophyton Microsporum Epidermophyton
What is tinea pedis?
athlete’s foot
What causes tinea pedis?
Trichophyton rubrum growing in food/showers
Where does tinea pedis occur?
between the toes (interdigital) or along the heel/bottom of foot (mocassin)
How does moccasin-type tinea pedis present?
one hand, two feel
What causes vesiculobullous type tinea pedis?
type 4 immune response to fungal antigen
What are the three classes of topical antifungals?
imidazoles (static)
allylamines (cidal)
ciclopirox (both)
What is onychomycosis?
chronic fungal nail infection
How is onychomycosis treated?
oral antifungals for three months
How does tinea corpis present?
erythematous ring with scale and central clearing
How is tinea corpis treated?
topical antifungals (oral if hair follicles are involved)
How does T tonsurans grow?
inside hair follicle, causing hair to break off
What are the two main causes of tinea capitis?
Microsporum canis
Trichophyton tinsurans
What is a complication of tinea corpus treatment
kerion - inflammatory response that discharges pus, can become infected
How is tinea capitis treated?
oral griseofulvin or terbinafine
What are the hallmarks of diaper candidiasis?
erythematous plaques in skin creases with satellite papules, not responsive to rash cream
What predisposes to diaper candidiasis?
not changing diapers regularly (daycare)