Dermatolgy Flashcards
epidermal layers
Californians Like Girls in String Bikinis stratum Corneum stratum Lucindum stratum Granulosum Stratum Spinosum Stratum Basalis
tight jnxs
zonula occludens
composed of claudins and occludins
adherens jnx
zonula adherens below tight jnx connects actin cytoskeltons of adjacent cells with CADherins Ca dependent, ADhesion proteins loss of E-cad -> mets
desmosomes
macula adherens
structural support via keratin interactions
autoAb -> phemphigus vulgaris
hemidesmosomes
connects keratin in basal cells to BM
autoAb -> bullous pemphigoid
hemidesmosomes are down bullow
macule
flat lesion
patch
macule >1cm
birthmark/congenital nevus
papule
elevated solid lesion > 1cm
mole/nevus, acne
plaque
papule >1 cm
psoriasis
vesicle
small fluid containing blister
bulla
large fluid containing blister >1cm
bullous pemphigoid
pustule
vesicle w/pus
pustual psorisis
scale
flaking off of stratum corneum
eczema
psoriasis
SCC
crust
dry exudate
impetigo
hyperkeratosis
increased thickening of stratum corneum
psoriasis
calluses
parakeratosis
hyperkeratosis w/retention of nuclei in stratum corneum
psoriasis
spongiosis
epidermal accumulation of edematous fluid in intercellular spaces
eczematous dermatitis
acanthrolysis
seperation of epidermal cells
pemphigus vulgaris
acanthosis
epidermal hyperplasia (increased spinosum) acanthrosis nigricans
albinism
normal melanocyte number w/decreased melanin production
d/t decreased tyrosinase activity or defective transport
can also be d/t failure of neural crest cell migration
increased risk for skin CA
partial albinism seen in chediak higashi syndrome
melasma
hyperpigmentation associated w/prego (mask of prego)
or OCP use
vitiligo
irregular areas of complete depigmentation d/t autoimmune destruction of melanocytes
acne
obstructive and inflammatory disease of pilosebaceous unit
atopic dermatitis
aka eczema pruitic eruption commonly on skin flexures associated w/other ectopic diseases (asthma, allergic rhinitis) starts on face in infancy antecubital fossa in adullts
melanocytic nevus
common mole benign
melanoma can arise
intradermal nevi are papular
jnx nevi are flat
psoriasis
papules and plaques w/silvery scaling
knees, elbows
acanthosis w/parakeratotic scaling
increased stratum spinosum
decreased stratum granulosum
Auspitz sign- pinpoint bleeding spts (exposed dermal papillae)
associated w/nail pitting and psoriatic arthritis
rosacea
inflammatory facial skin disorder characterized by erythematous papules and pustules, no comedones
facial flushing
chronic inflammatory changes -> rhinophyma
seborrheic keratosis
flat greasy pigmented squamous epi proliferation w/keratin filled cysts (horn cyst)
common in elderly
benign
leser-trelat sign
sudden appearance of multiple seborrheic keratoses indicates underlying malignancy (GI, lymphoid)
verrucae
warts caused by HPV
soft, tan colored, cauliflower like papules
epidermal hyperplasia, hyperkeratosis, koilocytosis
condyloma acumminatum on genitals
urticaria
hives
pruitic wheals that form after mast cell degraulation
impetigo
S. aureus or S. pyogens
bullous impetigo
usually S. aureus
cellulitis
acute, painful spreading infection of deeper dermis and subq
S. pyogens or S. aureus
erysipelas
upper dermis and superficial lymp
S. pyogens
well demarcated
abscess
S. aureus
necrotizing fasciitis
anerobes
S. pyogens
crepitus
bullae and purple color
staphylococcal scalded skin syndrome
exotoxin destroys keratinocyte attachements to stratum granulosum destryoing epidermal-dermal jnx
fever and generalized erythematous rash w/sloughing of upper layers of epi that heals completely
molluscum contagiosum
poxvirus
hairy leukoplakia
irregular white painless plaques on tongue that cannot be scraped off
EBV mediated
HIV and organ transplant recipients
pemphigus vulgaris
potentially fatal autoimmune disorder
IgG against desmoglein
flaccid intraepidermal bullae d/t acantholysis
oral mucosa involved
immunofluroescenes -> reticular(net-like) pattern
nikolsky sign +
bullous pephigoid
less severe then pemphigus vulgaris
IgG against hemidesmosomes (abs are bullow)
tense blisters containing eos affect skin, but spare oral mucosa
linear pattern at epi-dermal jnx
nikolsky sign -
dermatitis herpetiformis
pruitic papules, vesicles, and bullae
elbows
IgA at dips of dermal papillae
celiacs
erythema multiforme associaions
M. pneumoniae HSV sulfa drugs beta lactams phenytoin CA autoimmune
erythema multiforme
multiple types of lesions
macules, papules, vesicles, target lesions
SJS
> 30% of skin involved called toxic epidermal necrolysis
SJS-TEN
acanthosis nigricans
hyperinsulinemia (DM, obesity, cushings) visceral malignancy (gastric adenocarcinoma)
actinic keratosis
premalignant lesions d/t sun
small, round, erythematous or brownish papules or plaques
SCC risk
erythema nodosum
painful inflammatory lesion of subq fat ant shin sarcoidosis coccidiomycosis histo TB strep leprosy chrons
6 P’s of lichen Planus
Pruitic Purple Polygonal Plnar Papules Plaques
lichen planus
wickham striae
sawtooth infiltrate of lymphocytes at dermal-epi jxn
associated w/hepC
pityriasis rosea
Herald patch followed by scaly erthematous plawues often in ‘x-mas tree’
resolves in 6-8wks
BCC
MC skin CA sun-exposed areas locally invasive rarely mets pink pearly nodules telangiectasias rolled borders central crusting/ulceration basal cells have pallisading nuclei
SCC
2nd MC skin CA excessive sun exposure immnosupressed arsenic face, lower lip, ears, hands, locally invasive may spread to lymph nodes r w/scale keratin perals arely mets ulcerative red lesions
keratoacanthoma
variant that grows rapidly (4-6wks)
may regress spontaneously
melanoma
significant risk of mets S-100 HMB-45 activating BRAF kinase mutation Tx w/vemurafenib (BRAF kinase inhibitor)
types of melanoma
superficial spreading
nodular
lentigo maligna
acral lentiginous
