Dermatologic disorders Flashcards
The most common form of cutaneous T-cell lymphoma. It generally affects the skin, but may progress internally over time. Symptoms include rash, tumors, skin lesions, and itchy skin.
Mycosis fungoides
Involves the skin in about 25% of patients. The most common lesions are erythema nodosum, plaques, maculopapular eruptions, subcutaneous nodules, and lupus pernio. Treatment is not required, since the lesions usually resolve spontaneously in two to four weeks.
Sarcoidosis
A chronic mucocutaneous disease that affects the skin, tongue, and oral mucosa. The disease presents itself in the form of papules, lesions, or rashes. It is sometimes associated with oxidative stress, certain medications and diseases (HCV), however the underlying pathology is currently unknown.
Lichen planus
A chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis.
Leprosy
It is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign. Left untreated, it can be progressive, causing permanent damage to the skin, nerves, limbs and eyes.
Leprosy
Onset within the 1st year of life in 60% of cases. 25% will develop it between 1-5 yrs old. Childhood illness clears up in up to 40% of patients. Pruritic, erythematous, oozing rash with vesicles and edema that often involves the face and flexor surfaces.
Atopic dermatitis. If it does not clear up it is called chronic atopic dermatitis
It is a type I hypersensitivity reaction (Th2 cells) associated with asthma and allergic rhinitis
(Chronic) atopic dermatitis
Three types of fungus that commonly causes skin disease (Dermatophyte infection) in animals and humans
Microsporum (skin and hair), Epidermophyton (skin and nails) and Trichophyton (skin, hair, and nails)
Caused by Trichophyton (most common cause in U.S.) and Microsporum dermatophytes. Seen in children 3-14 yrs/old. 3 clinical patterns: ectothrix, endothrix (more likely to cause hair to break), and favus
Tinea Capitis
Causes tinea versicolor. It’s a lipophilic fungus that can cause disseminated infection in patients receiving IV lipid preparations. “Spaghetti and meatball” appearance on skin scraping.
malassezia furfur
Caused by a group of soil-inhabiting fungi and produce warty, nodular, cauliflower-like lesions. The lesions are painless and usually occur on the feet but hands can be involved. No bone or muscle invasion and no fistula formation. It occurs in the tropics and is characterized by sclerotic bodies in biopsy.
Chromoblastomycosis
Localized, indolent, deforming lesions of the foot and hand. Lesions are characterized by abscesses and draining sinuses; triad: abscesses, welling, grains (granule) exudation; bone and muscle involvement is common; grow slowly and usually painless. Lesions can be caused by bacteria or fungi (worse).
Mycetoma
Bacterial Mycetoma is caused by
Actinomyces israelli, and Nocardia species
Fungal (Eumycotic) mycetoma is caused by
pseudallescheria boydii
Caused by Sporothrix schenckii a saprophyte in soil and vegetation.
Sporotrichosis
Infection associated with traumatic implantation from rose thorns, sphagnum moss, and straw.
Sporothrix schenckii causing Sporotrichosis
It is dimorphic: “cigar-shaped” yeast at 37 degrees c, and mycelia with “rosettes” conidia at 23 degrees c. It is easily cultured. It causes a disease that can be lymphocutaneous: ulceration at the site of inoculation, spread along lymphatic tract, with draining sinuses, or Disseminated (only in immunocompromised host): CNS, lungs, etc).
Sporothrix schenckii
lymphocutaneous Sporotrichosis is treated with
Potassium iodide
An adverse drug reaction of the skin
Drug eruption
Benign neoplasm of melanocytes
Epidermal nevus
Most common mole in children
Junctional nevus
Most common mole in adults
Intradermal nevus
Characterized by a flat macule or raised papule with symmetry, sharp borders, evenly distributed color, and a small diameter (
Nevus
An inflammatory skin disease with erythema and scaling that affects nearly the entire cutaneous surface
Exfoliative dermatitis (Erythroderma)
The most common cause of erythroderma is
Exacerbation of an underlying skin disease (psoriasis, contact dermatitis, seborrheic dermatitis, lichen planus, pityriasis rubra pilaris or a drug reaction)
The conjunctivae and oral mucosa, along with the epidermis (skin) become erythematous (red and inflamed). Edema is often seen in the hands and feet.
Kawasaki’s disease
Pruritic, planar, polygonal, purple papules often with reticular white lines on the surface (Wickham striae) that commonly involve the wrists, elbows, and oral mucosa. Characterized histologically by a saw-tooth appearance at the dermal epidermal junction. The etiology is unknown but it is associated with hepatitis C infection
Lichen planus
A skin disorder characterized by chronic itching and scratching (self-perpetuating scratch-itch cycle). The constant scratching causes thick, leathery, brownish skin.
Lichen simplex chronicus
Characterized by a bilateral malar erythema (also known as the “butterfly rash”) and lesions that tend to be transient, follow sun exposure
Acute cutaneous lupus erythematosus
A clinically distinct subset of cases of lupus erythematosus that is most often present in white women aged 15 to 40, consisting of skin lesions that are scaly and evolve as polycyclic annular lesions or psoriasiform plaques.
Subacute cutaneous lupus erythematosus (SCLE)
Chronic skin condition of sores with inflammation and scarring favoring the face, ears, and scalp and at times on other body areas. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. The center areas may appear lighter in color with a rim darker than the normal skin.
Chronic (Discoid) lupus erythematosus (DLE)
Characterized by large and irregular (malignant) cells forming in the skin of the nipple, indicating underlying breast cancer.
Paget’s disease
A benign skin rash that may inflict substantial discomfort in certain cases. Classically, it begins with a single “herald patch” lesion, followed in 1 or 2 weeks by a generalized body rash lasting about 6 weeks
Pityriasis rosea
Self limited disease lasting approximately 6 weeks. Age group: 10-43 yrs. More common in the spring and autumn. Rarely recurs suggesting an infectious cause
Pityriasis rosea
A group of chronic disorders characterized by reddish orange, scaling plaques and keratotic follicular papules.
Pityriasis rubra pilaris (PRP)
Symptoms may include reddish-orange patches on the skin, severe flaking (pityriasis), uncomfortable itching, thickening of the skin on the feet and hands, and thickened bumps around hair follicles. For some, early symptoms may also include generalized swelling of the legs, feet and other parts of the body.
Pityriasis rubra pilaris (PRP)
Well-circumscribed, salmon-colored plaques with silvery scale that usually occurs on extensor surfaces and scalp. Pitting of the nails may also be present.
Psoriasis
Due to excessive keratinocyte proliferation possibly with an autoimmune ( Th1 T-cell) etiology associated with HLA-C.
Psoriasis
Characterized histologically by parakeratosis (retention of nuclei by the stratum corneum), elongation of the dermal papillae which can cause pinpoint bleeds beneath the silvery scale.
Psoriasis
Psoriasis is treated with
Corticosteroids and immune-modulating therapy (to combat autoimmune reaction), as well as with UV-A light plus psoralen to damage keratinocytes
An inflammatory skin disorder affecting the scalp, face, and torso. Typically presents with scaly, flaky, itchy, and red skin. It particularly affects the sebaceous-gland-rich areas of skin. In adolescents and adults, it usually presents as scalp scaling similar to dandruff or as mild to marked erythema of the nasolabial fold.
Seborrheic dermatitis
A benign squamous proliferation that commonly occurs in the elderly and presents as raised, discolored plaques on the extremities or face and often has a coin-like, waxy, ‘stuck-on’ appearance.
Seborrheic keratosis
It is characterized by keratin pseudocysts on histology. If many suddenly arise (Leser-Trelat sign), it suggests underlying carcinoma of the GI tract.
Seborrheic keratosis
A rash of oval or irregularly-shaped spots often merging to form a larger patch, occasional fine scaling, mildly itchy, with a sharp border that occurs on the trunk and proximal extremities.
Tinea versicolor
It is usually caused by the Malassezia globosa fungus (Malassezia furfur is responsible for a small number of cases). These yeasts are normally found on the human skin and only become troublesome under certain circumstances, such as a warm and humid environments.
Tinea versicolor
Flesh-colored papules with a rough surface that is due to HPV infection of keratinocytes characterized by koilocytic change commonly on the hands and feet.
Verruca (Wart)
A form of eczema that is characterized by changes that occur when skin becomes abnormally dry, itchy, and cracked. Lower legs tend to be especially affected, although it can appear in the underarm area as well.
Asteotic Eczema
The most common form of ichthyosis, affecting around 1 in 250 people. A skin disorder causing dry, scaly skin.
Ichthyosis Vulgaris
It is usually an autosomal dominant inherited disease (often associated with filaggrin), although a rare non-heritable version exists. The symptoms of the inherited form are not usually present at birth but generally develop between 3 months and 5 years of age. The symptoms will often improve with age, although they may grow more severe again in old age
Ichthyosis Vulgaris
Present with a variety of infectious disorders, often occurring in response to an inflammatory tinea of the feet, resulting in an eczematous dermatitis. The inflammation is in the absence of a locally visible cause.
Id Reaction
Characterized by round or oval-shaped itchy lesions. It is recurrent and chronic, and may appear at any age, although it is most common in people in their 60’s. Does not appear to be a genetic condition, is not related to food allergies, and is not contagious.
Nummular Eczema
Characterized by itchy, coin-shaped patches that can affect any part of the body, but the legs and buttocks are the most common areas. Flare-ups are associated with dry skin, so the winter season is a particularly bad time for those with this condition.
Nummular Eczema
A rare, severe infection associated with an immense number of mites, with marked scales and crusts, usually accompanied by lymphadenopathy and eosinophilia. Infection that can be confused for psoriasis
Norwegian Scabies
A severe, autosomal recessive form of ichthyosis associated with mutations in the SPINK5 gene.
Netherton’s Syndrome
Characterized by chronic skin inflammation, universal pruritus (itch), severe dehydration and stunted growth. Patients with this disorder tend to have a hair shaft defect (trichorrhexis invaginata), also known as “bamboo hair”.
Netherton’s Syndrome
An autoimmune blistering disease of the skin and mucous membranes with characteristic lesions that are scaly, crusted erosions, often on an erythematous base. No clinically apparent mucosal involvement is present even with widespread disease.
Pemphigus Foliaceus
Presents as a pruritic, erythematous, oozing rash with vesicles and edema that arises upon exposure to allergens or irritants. It is a type IV hypersensitivity reaction
Contact Dermatitis
Autoimmune destruction of desmosomes between keratinocytes due to IgG antibody (type II hypersensitivity) against desmoglein (a component of desmosomes).
Pemphigus Vulgaris
It presents as blisters of the skin but the oral mucosa is spared. Tense bullae do not rupture easily. Immunofluorescence highlights IgG along the basement membrane in a linear pattern
Bullous Pemphigoid
Autoimmune deposition of IgA at the tips of dermal papillae. It presents as pruritic vesicles and bullae that are grouped. It has a strong association with celiac disease; resolves with a gluten-free diet.
Dermatitis Herpetiformis
Common acute, self-limited disorder. Hypersensitivity reaction with targetoid rash (central epidermal necrosis surrounded by erythema) and bullae that is most commonly associated with HSV infection (also could be mycoplasma infection, drugs such as penicillin or sulfonamides, autoimmune diseases, and malignancy).
Erythema Multiforme
When Erythema Multiforme is accompanied by oral mucosa/lip involvement and fever it is termed
Stevens-Johnson syndrome (SJS)
Epidermal hyperplasia with darkening of the skin (‘Velvet-like’ skin) that often involves the axilla or groin. It is associated with insulin resistance or malignancy (especially gastric carcinoma). There is a benign familial type, and an autosomal dominant type.
Acanthosis Nigricans
Presents as an elevated nodule with a central, ulcerated, crater surrounded by dilated vessels (‘pink, pearl-like papule’) that is classically located on the upper lip.
Basal Cell Carcinoma
It presents as an ulcerated, nodular mass, usually on the face (classically involving the lower lip).
Squamous Cell Carcinoma
A precursor lesion of squamous cell carcinoma and presents as a hyperkeratotic, scaly plaque, often on the face, back, or neck.
Actinic keratosis
Localized loss of skin pigmentation due to autoimmune destruction of melanocytes.
Vitiligo
A Mask-like hyperpigmentation (tan or dark skin discoloration) of the cheeks. Although it can affect anyone, it is particularly common in women, especially pregnant women and those who are taking oral or patch contraceptives or hormone replacement therapy (HRT) medications.
Melasma
Autosomal dominant disorder characterized by formation of dysplastic nevi that may progress to melanoma
Dysplastic nevus syndrome
Presents as a mole-like growth with “ABCD” - Asymmetry, Borders are irregular, Color is not uniform, Diameter > 6mm.
Melanoma
Melanoma subtype characterized by lentiginous proliferation (radial growth) with a good prognosis
Lentigo maligna melanoma
Most common subtype of melanoma, characterized by dominant early radial growth with a good prognosis. Usually has a redish hue
Superficial spreading melanoma
Melanoma subtype characterized by early vertical growth with a poor prognosis
Nodular melanoma
Melanoma subtype arising on the palms or soles, often in dark-skinned individuals and not related to UV light exposure
Acral lentiginous melanoma
Superficial bacterial skin infection, most often due to Staph aureus or Strep pyogenes. It most commonly affects children and presents as erythematous macules that progress to pustules, usually on the face (rupture of pustules results in erosions and dry, crusted, honey-colored sreum)
Impetigo
Deeper (dermal and subcutaneous) infection, usually due to S aureus or Strep pyogenes that presents as a red, tender, swollen rash with fever.
Cellulitis
Sloughing of skin with erythematous rash and fever (leading to significant skin loss) due to Staph aureus infection (exfoliative A and B toxins result in epidermolysis of the stratum granulosum).
Staphylococcal Scalded Skin Syndrome
Firm, pink, umbilicated papules due to poxvirus. Affected keratinocytes show cytoplasmic inclusions
Molluscum Contagiousum (cytoplasmic inclusions are called molluscum bodies)
Characterized by gottron lesions, scaly erythematous eruptions or red patches overlying the knuckles, elbows, and knees. Other skin manifestations involve periungual telangiectasias, a heliotropic (purple) rash over the upper eyelids (racoon eyes), and shawl sign.
Dermatomyositis
A well-differentiated squamous cell carcinoma that develops rapidly and regresses spontaneously and presents as a cup-shaped tumor filled with keratin debris.
Keratoacanthoma
Circumscribed or diffuse hard smooth ivory colored areas of immobile skin. Localized (morphea) and linear. Progressively systemic, causes CREST syndrome, sclerotic plaques, mat telengectasias.
Scleroderma
The disease is characterized by onycholysis (detachment of the nail from the nail bed), blistering of the skin in areas that receive higher levels of exposure to sunlight, hyperpigmented skin and hypertrichosis of the cheeks and temples, Scarring, milia (a keratin-filled cyst that can appear just under the epidermis or on the roof of the mouth), and dyspigmentation. No erythema.
Porphyria Cutanea Tarda
An inflammation of the fat cells under the skin (panniculitis) characterized by tender, red nodules or lumps that are usually seen on both shins.
Erythema Nodosum
A premalignant condition of thick, scaly, or crusty patches of skin. It is more common in fair-skinned people and it is associated with those who are frequently exposed to the sun, as it is usually accompanied by solar damage.
Actinic Keratoses
Painless, persistent, thickening and whitish discoloration of the lip at the border of the lip and skin
Actinic cheilitis
The defining characteristic is that it is dome-shaped, symmetrical, surrounded by a smooth wall of inflamed skin, and capped with keratin scales and debris. It always grows rapidly, reaching a large size within days or weeks, and if untreated will starve itself of nourishment, necrose (die), slough, and heal with scarring.
Keratoacanthoma
A kind of skin rash notable for pale red, raised, itchy bumps. It might also cause a burning or stinging sensation. The majority of cases have an unknown (idiopathic) cause, but it is frequently caused by allergic reactions (there are many nonallergic causes)
Urticaria (Hives)
a medical condition in which hair is lost from some or all areas of the body, usually from the scalp
Alopecia Areata
Alopecia Areata limited only to the beard
Alopecia areata barbae
