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MSK/Derm > Dermatology > Flashcards

Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

Epidermal layers

A

Californians Like Girls in String Bikinis - Corneum (keratin), Lucidum, Granulosum, Spinosum (desmosomes), Basale (stem cells)

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2
Q

Epithelial cell junctions

A

From top to bottom: Tight junction (claudins and occludins), Adherens junction (CADherins - Ca dependent adhesions), Desmosome (keratin interactions), Gap junction (connexon channels), Hemidesmosomes (connects to basement membrane), Integrins (maintain INTEGRity of basolateral membrane)

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3
Q

Albinism

A

NORMAL MELANOCYTE NUMBER - decreased melanin production due to decreased tyrosinase activity - FAILURE OF NEURAL CREST CELL MIGRATION

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4
Q

Melasma

A

Hyperpigmentation during pregnancy

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5
Q

Vitiligo

A

Complete depigmentation - autoimmune destruction of melanocytes

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6
Q

Acne

A

Obstruction of pilosebaceous unit (can be caused by steroid use - androgen stimulation) - Tx: Isotretinoin

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7
Q

Atopic dermatitis

A

TYPE I HYPERSENSITIVITY - common on skin flexures (antecubital fossa), starts on face in infancy (can be associated with asthma or allergic rhinitis)

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8
Q

Allergic contact dermatitis

A

TYPE IV HYPERSENSITIVITY - linear/geometric shapes – Langerhans cells, CD4 T cells, SPONGIOTIC dermatitis

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9
Q

Melanocytic nevus

A

Benign – intradermal (papular), junctional (flat macules)

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10
Q

Psoriasis

A

Silvery scaling (knees and elbows), acanthosis with parakeratotis (nuclei still in stratum corneum), increased stratum spinosum and decreased granulosum, Auspitz sign (pinpoint bleeding when scales are scraped off) — Treatment can be topical (vitamin D analogs inhibit keratinocyte proliferation) or systemic (methotrexate)

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11
Q

Rosacea

A

Face - erythematous papules and pustules - flushing in response to stimuli (alcohol, heat) - OLDER MEN - Tx: sunscreen, avoid triggers, metronidazole

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12
Q

Seborrheic keratosis

A

FLAT, GREASY, STUCK ON - Kerain filled cysts (horn cysts) - Leser Trelat sign (sudden appearance of a bunch can mean GI or lymphoid malignancy)

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13
Q

Verrucae

A

Warts - HPV 6/11 - epidermal hyperplasia, hyperkeratosis, koilocytosis

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14
Q

Urticaria

A

Hives - pruritic wheals with mast cell degranulation - superficial dermal edema with lymphatic channel blockage - no epidermal changes

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15
Q

Impetigo

A

S. aureus or S. pyogenes - honey colored crusts - Tx: mupirocin

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16
Q

Cellulitis

A

PAINFUL, SPREADING - deeper dermis and subq infection - S. pyogenes or S. aureus

17
Q

Erysipelas

A

Upper dermis and superficial lymphatics - S. pyogenes - well defined demarcation - Tx: Penicillin

18
Q

Abscess

A

Almost always S. aureus - OFTEN MRSA!!

19
Q

Necrotizing fasciitis

A

Anaerobic bacteria or S. pyogenes - CREPITUS (methane/CO2 production) - causes bullae and purple skin

20
Q

Staph scalded skin syndrome

A

EXOTOXIN destroys keratinocyte attachment in strratum granulosum (SLOUGHING of skin, fever)

21
Q

Herpes

A

HSV1 (mouth) and 2 (genitals) - Tx: thymidine kinase inhibitor

22
Q

Molluscum contagiosum

A

Umbilicated papules (POXVIRUS) - children or sexually transmitted in adults (HIV patients)

23
Q

Varicella zoster virus

A

Chickenpox (varicella - dew drop on rose petal) and shingles (zoster - dermatomal distribution) - Tx: thymidine kinase inhibitor

24
Q

Hairy leukoplakia

A

White, painless plaques on tongue that can’t be scraped off - EBV - found in HIV patients

25
Q

Pemphigus vulgaris

A

IgG aginst desmoglient (desmosomes) - flaccid intrapidermal bullae (acantholysis) — oral mucosa also — reticular (net like) immuno stain – Nikolsky sign +

26
Q

Bullous pemphigoid

A

IgG against hemidesmosomes (“down BULLO”) – tense blisters with eosinophils – NO ORAL! – linear pattern on immuno – Nikolsky sign -

27
Q

Dermatitis herpetiformis

A

Pruritic papules, vesicles, and bullae - IgA at dermal papillae - CELIAC!!!

28
Q

Erythema Multiforme

A

Infections, drugs, cancers, autoimmune - TARGET LESIONS

29
Q

Stevens-Johnson syndrome

A

Sulfas, cillins, seizure drugs, allopurinol — fever, bullae, necrosis, sloughing of skin (2 mucous membranes involved) - TARGET LESIONS — toxic epidermal necrolyisis is more severe (> 30% body area)

30
Q

Acanthosis nigricans

A

Epidermal hyperplasia - hyperpigmented skin (axilla or neck) - velvety texture on skin, also commonly have skin tags – hyperinsulinemia and visceral malignancy

31
Q

Actinic keratosis

A

PREMALIGNANT d/t sun exposure — rough, erythematous brownish papules – risk of SCC - Tx: shave biopsy

32
Q

Erythema nodosum

A

PAINFUL - subq fat on anterior shins - sarcoidosis, cocci, histo, TB, strep, leprosy, Crohns

33
Q

Lichen Planus

A

6 Ps - Pruritic, Purple, Polygonal Planar Papules and Plaques — Wickham striae on mucosa, sawtooth infiltrate of lymphocytes at dermal-epidermal junction — HEPATITIS C

34
Q

Pityriasis rosea

A

Herald patch — CHRISTMAS TREE - self resolving in 6-8 weeks – HHV 6 and 7 — Tx: antihistamines and topical steroids

35
Q

Sunburn

A

UVA (tanning and photoaging), UVB (sunburn)

36
Q

Basal cell carcinoma

A

Pinky, pearly papule with telangiectasia, rolled borders, and central crust/ulcer — MC skin cancer - sun exposed areas (UPPER LIP) – nonhealing ulcers w/ infiltrating growth — palisading nuclei

37
Q

Squamous cell carcinoma

A

Second MC type - excessive exposure to sunlight, immunosuppression, arsenic exposure – LOWER LIP/ear/hands – can spread to lymph nodes – ulcerative red lesions with scales (keratin pearls!)

38
Q

Melanoma

A

S-100 tumor marker (neuroendocrine) – Breslow depth is prognostic marker — ABCDE – superficial spreading, nodular, letigo, and sacral – activating mutation in BRAF kinase (BRAF V600E - tx: vemurafenib)

MSK/Derm (4 decks)

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