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Skin_MS > Dermatology - Acute Inflammatory > Flashcards

Dermatology - Acute Inflammatory Flashcards

1
Q

What is defined by a pruritic rash consisting of transient raised erythmetous wheals that persists for less than 24 hours? It involves edema of the dermis.

A

Urticaria

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2
Q

What is Urticaria mediated by after exposure to allergen?

A

Immune response - IgE and histamine Eosinophils and lymph

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3
Q

What is defined by painful (less pruritic) intense edema of the dermis and epidermis, especially the eyes, lips, palms, groin? If it is laryngeal it can become emergent.

A

Angiodedema

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4
Q

Name some the type 1 IgE mediated allergens for Urticaria.

Food: 
Latex:
Stinging insects: 
Medications: 
Aeroallergens:
A

Shellfish, fish, peanuts, tree nuts, eggs, milk, soy, wheat

Latex

Bees, wasps, hornets, fire ants, bedbugs, fleas, mites

Medications: sulfa, penicillins, cephalosporins

Aeroallergens: dust mites, pollen, molds, animal dander

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5
Q

Explain the immediate hypersensitivity reaction

A

First Exposure: Production of IgE by B cell in response to T cell cytokine release. IgE binds to FcE receptor on mast cells or basophils.

Next Exposure: Antigen exposure and crossing linking of bound IgE, Mast cell activation and release of mediators (histamine, leukotrienes, cytokines, chemotatci functions, enzymes)

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6
Q

Name the autoimmune causes of immune Urticaria

A

Autoimmune diseases - Hashimotos immune thyroiditis (antithyroid antibodies), SLE, vasculitis

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7
Q

What are the infections causes of immune Urticaria?

A

Viral - Cytomegalo virus, Epstein-Barr, HIV, Hep A, B, C

Parastitic, Fungal, or bacterial

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8
Q

What are some physical Urticaria stimulations?

A 
Solar
Cholinergic (Sweating vs Heat)
Cold
Dermographism (friction, can write on skin)
Water
Vibratory
Pressure (burning hands, feet, or butt)
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9
Q

Smal papules on red skin that occur on the back of the neck within 30 minutes of exercise…

A

Cholinergic Urticaria

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10
Q

Erythmetous area of skin that persists due to a cold object being held on it…

A

Cold Urticaria

Positive Ice Cube Test

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11
Q

Erythmetous lines that persists after ‘drawing’ on ones arm with blunt object

A

Dermophraphic Urticaria

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12
Q

What are causes of direct mast cell degranulation in non-immune urticaria?

A 
Narcotics - Codein and Morphine Sulfate
Aspirin
NSAIDs
Radiocontrast Media
Dextran
Ace inhibitors angioderma
Vancomycin - Red Man Syndrome
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13
Q

What are histamine containing foods that cause a non-immune Urticaria?

A 
Strawberries
Tomatoes
Shrimp
Lobster
Cheese
Spinach
Eggplant
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14
Q

What is defined by erythematous iris-shaped papular and veisculobullous lesions that involves the extremities (palms and soles) and mucous membranes? Half of cases are in pts under 20 years old and more common in males.

A

Erthema Multiforme

Can differentiate from hives because it does not itch and it is fixed!

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15
Q

What are the causes of Erthema Multiforme?

A

Sulfonamides (bactrim), phenytoin, barbiturates, phenylbutazone, penicillin, allopurinol

Infection of Herpes Simplex Virus, Mycoplasma

More than 50% of cases are idiopathic

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16
Q

Erthema Multiforme Minor VS Major

A

Minor involves less than 1 mucosal site, usually caused by a post herpes simplex infection with onset of EM rash at day 10

Major EM is usually caused by a drug reaction, Severe with extensive mucous membrane involvement - Steven Johnson Syndrome. Or occurs after a mycoplasma pneumonia reaction

17
Q

What is the key feature of Steven Johnson Syndrome?

A

Toxic Epidermal Necrolysis

Extensive mucosal and epidermal necrosis and sloughing

It occurs 1-3 weeks post initial drug exposure

Life threatening - pts treated in burn unit - Total body 2nd degree burn

18
Q

What are risk factors for SJS?

A

Systemic Lupus Erythematosis
HLA-B12
HIV

19
Q

What is defined by a fixed hyper pigmented or erythmetous macule/patch that can itch, burn, or be asymptomatic? Usually is predisposed to face and genitals.

A

Fixed Drug Eruption

Usually reoccurs in same area if exposed to drug again. Mechanism is unknown. Hyperpigmentation may be permanent.

20
Q

What is defined by erythmetous tender nudules that typically occur on the anterior aspect of shins and in young women?

A

Panniculitis Erythema Nodosom

21
Q

What are the causes of Panniculitis Erythema Nodosom?

A

Strep, TB, Fungal Infection

Meds - Oral Contraceptives, Sulfa, NSAIDs

Autoimmune - IBD, Sarcoid

22
Q

What is defined by tender erythmetous nodules occurring in middle aged females on the posterior legs? They may turn into plaques with ulceration.

A

Panniculitis Erythema Induratum

23
Q

What is Panniculitis?

A

A focus of inflammation in subcutaneous tissue. Usually an erythmatous nodule in SQ fat, either septal or lobular depending on where the disease process begins. Can be diagnosed with skin biopsy

Skin_MS (13 decks)

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