Derma lectures Flashcards
Tuber=
Cellular infiltration in the reticular dermis and SC
Gumma is a type of
Tuber
Urticaria=
Edema of the dermis
Etiology of lower limb ulcers
Venous insuff. Arterial insuff.- PAD Neuropathy Microcirculation abnormalities Vasculopathy Vasculitis Pyoderma gangrenosun Tumor Injury Infection
Inflammation of the layer of fat under the skin=
Panniculitis
Leg looks like this- Livid brown color Atrophy Scarring Loss of hair
What is it called?
Lipodermatosclerosis
Venous ulcer location and properties
Mainly above inner/outer ankle
Moderate pain
Not deep
Irregular shape
Artrial ulcer location and properties
Sharply demarcated
Ring shape
Tose are not affected
Very painfull
Pyoderma gangrenosum- describe the ulcer
Painful Devrlops rapidly Purple Pustules Ulcers Mainlly on shins
Treatment for acne vulgaris
Benzoyl peroxide Retinoids Tretinoin gel Azelaic acid Erythromycin Oral isotretinoin Anti adronergic drugs- Spironolactone
Rosacea=
Chronic inflammatory skin disease in the central face with flushing erythema telangiectasia, papules and pustules
Rosacea treatment
Metronidazole
Low dose Doxyxycline
Azelaic acid
Isotretinoin
Lichen Planus etiology
Unknown
Possible autoimune (Ab against desmoglein 3/ collagen VII
Associated with Hep. C
Stress
Lichen Planus- how does it look like?
Pruritic Purple Papule Polygonal Wickham's striae Nail distrophy
NGU
לפרטנרים מלפני כמה זמן צריך לעדכן
2 months
Syphilis
לפרטנרים מלפני כמה זמן צריך לעדכן
Primary- 3 months
Secondary- 6 months
Early latent- 12 months
Vaginal pH
3.8-4.7
Syphilis most common non specific test
RPR
Syphilis most common specific test
TPPA
We give in case of Syphilis what I.M?
How much in primary?
Benzatene Penicillin
2.4 million I.U
Atypical course of Lymphogranuloma venarum
Intraanal entry -> Purulent proctitis (looks like IBD) -> Strictures and pistula
Lymphogranuloma venarum treatment
Doxycycline 2X100 mg for 21 days
HPV incubation period
6-12 months
Which virus doesnt have a specific therapy?
HPV
Lyme disease general treatment
Doxyxycline 100 mg X 2 per day for 10-21 days
Cefuroxime 500 mg X 2 per day for 10-21 days
Folliculitis Furuncle Carbucle treatment
Fuzidic acid
Penicillin
Cephalosporin
Impetigo local treatment
Mupirocin oinment
Fusidin acid oinment
Betadine
Erysiples treatment
Systemic aminopenicillin
Cephalosporines
Clindamycin
Ciprofloxacin
Herpes zoster treatment
Systemic acyclovir 5X800 mg
Painkillers
Scabies treatment
Benzoyl benzoat
Permethrin leave on for 12 h
Ivermectin
Classifications of Cutan lupus erythematus
Acute
Sub acute
Chronic
What is always present in case of Cutan lupus erythematus
Photosensitivity
Which Cutan lupus erythematus is always a part of SLE?
Acute CLE
Genetic factors affecting CLE
MHC complex and comlement cascade
Enviormental factors affecting CLE
UV Smoking Cold Female hormones Drugs Infections Stress
Which Ab are present in CLE?
ANA SSA SSB Anti-dsDNA C1q AB
Acute CLE symp.
Butterfly erythema
Photosensitivw lupus dermatitis
Subacute CLE symp.
Annular
Papulosquamous/psoriasiform
Annular form in SCLE describe it
Erythematous
Central atrophy
Scaly plaques
SCLE treatment
Avoid sun
Local cortico.
Chloroquine/Hydroxycloroquine
Systemic cortico.
Chronic CLE can be divided into
Localized discoid
Generalised discoid
Hypertrophic
Tumidos
What is the most fequent form of CCLE?
Discoid LE
Discoid LE skin symp.
Erythematous Telangiectasia Plaques covered with hyperkeratosis Scar formation Scarring alopecia
Sprcial feature of Discoid LE
Scarring alopecia
LE therapy
UV protection Vit. D Quit smoking Local cortico. Antimalarial drugs Azathioprin Methotrexate Biologic therapy
Biologic therapy for LE
Belimumab
What is the most frequent form of CLE?
Discoid
SCLE clinically can be two forms-
Annular
Psoriasiform
How does SCLE regress?
Vitiligo like hypopigmented mucules
Localized scleroderma=
Morphea
Two phases of localized scleroderma
Initial inflammatory
Late fibrotic
Localized scleroderma Limited types (3)
Plaque morphea
Guttate morphea
Suprficial morphea
Generalized morphea definition
4 or more plaques of more than 3 cm involving 2 ore more anatomical regions
Which scleroderma is common in kids?
Linear
Localized scleroderma treatment
Limited skin involvement
Topical cortico.
Topical calcineurin
PUVA
Localized scleroderma treatment
Severe skin involvement
MTX 12 months
Methylprednisone
Prednisolone
Localized scleroderma Limited types
Which is most common
Plaque type
Localized scleroderma Limited types
What is a sign of active inflammation?
Lilach ring
What can causes the mortality in case of Dermatomyositis?
Interstitial Lung Didease
Diagnostic criteria for Dermatomyositis
Proximal muscle weakness Positive muscle biopsy Increased skeletal muscle enzymes EMG Cutaneous symp.
Dermatomyositis Cutaneous symp.
Heliotrop rash Livid erythema Scalp involvement Gottorn papules (MCP) Gottorn sign (Elbows, knees) V sign Periungual sign Poikiloderma
Another type of Dermatomyositis
Amyopathic Dermatomyositis
Is psoriasis itchy?
Not that much
Primary and secondary lesions found in Psoriasis
Plaque Patch Papules Scaling Fissures Rhages
Psoriatic skin lesions induced by traume to the skin is also called
Koebner phenomenon
Psoriasis prelevance
1-2% of adults
Genetics assoiciated with Psoriasis
HLA-B27
Medications that can evoke Psoriasis?
B Blockers
Lithium
INF-a
Psoriasis- where is it usually found on the body?
Elbows Knees Scalp Back Nails Folds
Nails symp. in Psoriasis
Beau pitting Oildrop sign Onycholysis Keratosis Dystrophy
Histology findings in Psoriasis
Papillomatosis
Acanthosis
Parakeratosis
What is Guttate Psoriasis
Many smll scaly papules
Guttate Psoriasis is often triggered by
Strep.
Special forms of Psoriasis
Erythrodermic
Pustulosa
Inverse
Palmoplantar
Scoring systems for Psoriasis
PASI (Psoriasis Area Severity Index)
BSA (Body Surface Area)
For patient with 90% PASI (Psoriasis Area Severity Index) how will you treat?
Methotrexate= Folic acid antagonist Adalimumab= Anti TNF-a
Treatment for Buulous Pemphigoid
Methotrexate
Azathioprin
Dapson
Doxyxycline
Define Dermatitis herpatiformis
Autoimmune bullous disease
Auto-Ag in Dermatitis herpatiformis
Tranglutaminase 3
Describe classic case of BCC
Sun exposed skin Old age Shiny Pearly border Telangiectasia Ulceration
Types of BCC
Nodular
Superficial
Pigmented
Low risk BCC treatment
Surgical excision with 3-5 mm borders
High risk BCC treatment
MOHS surgery (Microscopically Oriented Histologic Surgery)
Non surgery BCC treatment
Radiation
Cryotherapy
Laser therapy
Sonidegib
How do we classify SCC
By differentiation
Well, moderate, poorly
In which case will we use radiation in SCC?
In situ form, does not invase the BM
SCC therapy most likely will be
MOHS
Which skin cancer do not form on mucos mmb.?
BCC
Which cancer is in connection with chronic sun exposure?
SCC
Melanoma classification
Superficial spreading
Nodular
Lentigo maligna
Acral lentigoid
Therapy for primary melanoma
Surgical removal with 5-20 mm border according to Breslow scale
Breslow I means
Intraepidermal
Breslow V means
Enters fat
Melanoma immunotherapy
Nivolumab
Pemprolizumab
New therapy for Melanoma?
Ipilimumab (Target cytotoxic T cells)
Vemurafenib
Psoriasiform hyperplasia=
Elongation of rete ridges and elongation of dermal papillae
Which WBC are found in Billous pemphigoid and where can we find them?
Eosinophils
In the papillary dermis and the blister fluid
Dermatitis herpatiformis
What will we see on histology and on IF?
Fibrin and neutrophils at the tip of dermal papillae
Small microabscess
IgA type Ab at the tips of dermal papillae
Special histological feature of BCC
Palisade
SCC may arrise from (2 lesions)
Keratoacanthoma
Actinic keratosis
Common mole is also called
Melanocytic nevi
Where can we find junctional nevus?
Epidermis
Where can we find compound nevus?
Epidermis and dermis
Nevus that is only present in the dermis?
Intradermal
Dermis can be divided into
Papillary dermis
Papillary reticular
Reticular dermis
Kaposi sarcoma
Purple Singular/wide spread Flat/raised HHV8 Immunosuppression AIDS Skin Mucosal Internal organs
Kaposi sarcoma histology
Plump spindled shape stromal cells
