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DIT topics > dermatology > Flashcards

dermatology Flashcards

1
Q

four primary causes of acne

A

hyperkeratosis
sebum overproduction
propionibacterium acnes proliferation
inflammation

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2
Q

epithelial cell junction that connects epithelial cells to the BM

A

hemidesmosomes

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3
Q

what is this skin disorder?

pruritus associated with asthma or allergic rhinitis

A

atopic dermatitis (eczema)

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4
Q

what is this skin disorder?

allergy to nickel

A

allergic dermatitis

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5
Q

what is this skin disorder?

parakerototic scaling

A

psoriasis

parakerototic scaling: nuclei still in stratum corneum + thickening of stratum corneum

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6
Q

caused by HPV type 2 and 4

A

common warts (verrucae)

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7
Q

layers of the epidermis

A

Come’on Lets Get Sun Burnt
C - stratum Corneum (keratinocytes)
L - stratum Lucidum
G - stratum Granulosum
S - stratum Spinosum (keratinocytes in SS connected by spines = desmosomes)
B - stratum Basale (stem cells + melanocytes here)

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8
Q 
skin cell that:
produces melanin
responsible for skin/eye/hair color
originate from neural crest cells 
located in stratum basale
A

melanocytes

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9
Q

what is located in the dermis?

A

blood vessels

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10
Q

pinpoint bleeding spots from exposure of dermal papillae (vessels here) when scales scraped off is a clinical feature of

A

psoriasis (called Auspitz sign)

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11
Q

cell that has the following roles:
makes collagen (part of ECM), glycosaminoglycans, reticular + elastic fibers, glycoproteins
provides STRUCTURAL integrity
important role in wound healing: secretes backbone of CT
stimulated by tissue damage

A

fibroblasts

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12
Q

protein found in hemidesmosomes

A

integrins

bind to collagen + laminin in BM to maintain INTEGRITY of the basolateral membrane

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13
Q

autoantibodies to integrin in hemidesmosomes results in

A

bullous pemphigoid

BULLOous = BELOW

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14
Q

protein found in desmosomes

A

desmoglein

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15
Q

autoantibodies to desmoglein in desmosomes results in

A

pehmphigus vulgaris

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16
Q

epithelial cell junction that joins adjacent cell membranes and prevents diffusion of fluid (impermeable) across the paracellular space

A

tight junctions

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17
Q

protein found in tight junctions

A

claudins + occludins

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18
Q

epithelial cell junction that connects the actin cytoskeleton’s of adjacent cells using cadherins
located below tight junctions

A

adherens junctions

CADherins = Calcium dependent ADhesion proteins

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19
Q

epithelial cell junction that resists shearing using keratin

found in simple + stratified squamous + muscle tissue

A

desmosome

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20
Q

epithelial cell junction which makes a connexon: a channel protein that allows electrical + chemical communication between adjacent cells
found in cardiac cells: myocytes communicate electrical signal from SA node → AVnode →bundle of His →purkinje system

A

gap junction

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21
Q

soft, tan-colored cauliflower like papules
hyperkeratosis: ↑ thickness of stratum corneum
epidermal hyperplasia
koilocytosis

A 
verrucae = common warts
hands = vulgaris (HPV 2 and 4)
genitals = condyloma acuminatum (HPV 6 and 11)
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22
Q

benign
arises from nevocytes (type of melanocyte)
↑ risk melanoma if congenital or atypical

A

melanocytic nevus

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23
Q

↑ melanin pigment with normal number of melanocytes

A

ephelis (freckles)

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24
Q

pruitic rash on skin flexures
rash worsens with scratching, in dry mo (winter), washing every day (Infant)
starts on face in infants → behind knees, antecubital fossa in adults
associated with atopic diseases: asthma + allergic rhinitis

A

atopic dermatitis (eczema)

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25
Q

type IV hypersensitivity reaction following exposure to allergen
pruritic, linear rash at site of contact

A

allergic contact dermatitis

nickel, poision ivy, neomycin

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26
Q

papules and plaques with SILVERY scaling on knees + elbows
parakaratosis (nuclei still in stratum corneum)
↓stratum granulosum
↑stratum spinosum
+ Auspitz sign
possible nail pitting, arthritis (1/3 patients)

A

psoriasis: overproduction of new skin cells

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27
Q

treatment for verrucae

A

salicylic acid - OTC
imiquimod: ↑IFN to fight virus
liquid N2 in office

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28
Q

treatment of psoriasis

A 
moisturizers - emollient (oil based)
topical: normalize skin cell production →↓ inflammation
steroids
tar cream
vitamin D analogs
retinoids
phototherapy
oral: MTX, cyclosporine (rebound flaure after finish - not given often), retinoids
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29
Q

treatment for atopic dermatitis (eczema)

A

mild: moisturizing soap + emollient (oily)
mild-mod: calcineurin inhibitors (tracolimus or pimecrolimus)
flares: topical steroids
open lesion: antibiotics (cover s. aureus + strep)
prevent itch: antihistamines
if also have asthma/allergic rhinitis: LK inhibitor
UV light therapy
severe case/major flare: systemic steroids (short term)
very severe case (drugs of last resort): MTX, cyclosporine, azathioprine

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30
Q

treatment for acne due to hyperkaratosis

A

vitamin A analogs, such as:

topical: retinoic acid, tretinoin
oral: isotretinoin

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31
Q

treatment for acne due to sebum overproduction

A

isotretinoin
spironolactone (aldosterone antagonist: antiandrogen →↓cortisol, testosterone)
OCPs

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32
Q

treatment for acne due to propionibacterium acnes proliferation

A 
oral antibiotics: 
erythromycin
tetracycline
doxycycline
minocycline
topical: clindamycin
benzoyl peroxide (DOC of acne): ↓ bacterial growth
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33
Q

treatment for acne due to inflammation

A

steroids

34
Q

flat, greasy, pigmented lesion with “stuck on” or “tortoise shell” appearance

A

seborrheic keratosis

35
Q

benign flat, greasy, pigmented with squamous epithelial proliferation with KERATIN-FILLED CYSTS (horn cysts) in elderly

A

seborrheic keratosis

36
Q

sudden appearance of multiple seborrheic keratoses

A

Leser-Trelat sign

underlying malignancy: GI, lymphoid

37
Q

normal melanocyte number

↓ melanin production

A

albinism

38
Q

↓ melancoyte number

A

vitiligo

39
Q

↓tyrosine activity or defective tyrosine transport → ↓ melanin production

A

albinism

40
Q

autoimmune destruction of melanocytes → complete depigmentation

A

vitiligo

41
Q

stimulation of melanocyte → hyperpigmentation
well-demarcated macules
associated with pregnancy “mask of pregnancy”, OCP, HRT
resolves in mos.

A

melasma

42
Q

honey-colored crusting near lips/nose of kid
S. aureus or S. pyogenes
very contangious

A

impetigo

43
Q

treatment of impetigo

A

mild: topical mupirocin
severe: oral dicloxacillin or cephalexin (1st gen cephalosporin)

44
Q

painful, rapidly spreading infection of dermis and suq tissue
S. aureus or S. pyogenes
usually due to break in skin or another infection

A

cellulitis

45
Q

treatment of cellulitis

A

non-MRSA (non-purulent): oral dicloxacillin or cephalexin

MRSA (purulent): TMP-SMX or clindamycin

46
Q

tender beyond visible area of infection
rapidly spreading celluitis along fascia plane
subq crepitus due to methane + CO2 from aneorbic bacteria
aneorobic bacteria or S. pyogenes (group A strep)

A

necrotizing fasciitis

“flesh eating bacteria”

47
Q

treatment of necrotizing fasciitis

A

immediate surgical debridement to open pressure

IV carbapenem + clindamycin

48
Q

exotoxin A + B destroy keratinocyte attachments in stratum granulosum

A

staphylococcal scalded skin syndrome

caused by S. aureus

49
Q

fever + generalized erythematous rash
SLOUGHING of upper layers of epidermis
heals completeley
newborns + children

A

staphylococcal scalded skin syndrome

50
Q

white plaques on tongue

CAN’T be scraped off

A

hairy leukoplakia

51
Q

white plaques on tongue
EBV mediated infection in immunocompromised (HIV +)
5-25% are precancerous lesions

A

hairy leukoplakia

52
Q

destruction of epidermal-dermal junction

A

toxic epidermal necrolysis

53
Q

treatment of SSSS

A

cover s. aureus:
nafcillin
oxacillin
vancomycin

54
Q

separation of epidermis upon manual stroking of skin

A

+ Nikolsky sign (pemphigus vulgaris)

55
Q

very severe chronic autoimmune skin disorder
painful, flaccid (wrinkly) bullae caused by acantholysis (separation of epidermal cells) due to autoantibodies against desmosomes
ORAL MUCOSA involved
+ Nikolsky sign

A

pemphigus vulgaris

56
Q

IF: reticular pattern of antibodies around epidermal cells

A

pemphigus vulgaris

57
Q

tense blisters containing EOSINOPHILS
NO oral mucosa
- Nikolsky sign

A

bullous pemphigoid

58
Q

IF: linear pattern at epidermal-dermal junction

A

bullous pemphigoid

59
Q

pruritic vesicles associated with celiac disease

A

dermatitis herpetiformis

60
Q

skin disorder associated with HIV

A

hairy leukoplakia

61
Q

skin disorder associated with hepatitis C

A

lichen planus

62
Q

pruritic papules due to deposits of IgA at tips of dermal papillae
worse with gluten intake

A

dermatitis herpetiformis (not due to HSV infection)

63
Q

blistering skin disorder following an infection or drug reaction
pruritic
multiple lesions present: macules, papules, vesicles, target lesions

A

erythema multiforme

64
Q

severe form of stevens-johnson syndrome with >30% of body SLOUGHING off

A

toxic epidermal necrolysis

65
Q

fever + bulla + necrosis + SLOUGHING (separate epidermis from dermis)+ high mortality rate
hypersensitivity reaction to a drug
affecting skin + MUCOUS membranes

A

stevens-johnson syndrome

66
Q

skin disorder with an ↑ risk of squamous cell carcinoma

A

actinic keratosis

67
Q

thick scaly, crusty, sandpaper-like skin
premalignant lesions ( ↑ risk of squamous cell carcinoma)
cause by sun exposure (esp fair skinned)

A

actinic keratosis

68
Q

treatment of actinic keratosis

A

5-FU

liquid N2

69
Q

hyperpigmented, VELVETY thickening of skin (hyperplasia of stratum spinosum)
neck + axilla
hyperinsulinemia: diabetes, obesity, cushing syndrome
>40 yo: visceral malignancy (gastric adenocarcinoma)

A

acanthosis nigricans

70
Q

> 40 yo with velvety rash on neck or axilla

A

acanthosis nigricans (with a visceral malignancy)

71
Q

12-20 yo
painful, red, inflammatory lesion of subq (both shins)
associated with: sarcoidosis, coccidiodomycosis, histoplasmosis, TB, group A strep, leprosy
resolves in 3-6 wks

A

erythema nodosum

72
Q 
autoimmune skin disorder
Pruritic
Purple
Polygonal
Papules
Plaques
MUCOSA involved
A

5’Ps of lichen Planus

73
Q

sawtooth infiltrate of lymphocytes at dermal-epidermal junction

A

lichen planus

74
Q

“herald” patch on trunk or back → days later: multiple small patches along ribs (“christmas tree”) distribution
resolves in 6-8 wks

A

pityriasis rosea

75
Q

thickened scar around face/chest

A

keloid

76
Q

skin rash + proximal muscle weakness

A

dermatomyositis (associated with increase risk of malignancy)

77
Q

rash on palms + soles

A

2° syphilis
rocky mountain spotted fever
coxsackie A virus
kawasaki disease (desquamation)

78
Q

dermatologic findings in 1-3° syphilis

A

1°: painless chancre
2°: macuolopapular rash on palms + soles, condylomata lata
3°: gummas

79
Q

acrodynia: peeling of finger tips

A

kowasaki disease

mercury poisioning

80
Q

skin lesion due to bacillus anthracis

A

black eschar with necrosis surrounded by edematous ring caused by lethal factor and edema factor

DIT topics (115 decks)

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