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Disease and Defense Unit III Derm & Virology > Dermatology Facts > Flashcards

Dermatology Facts Flashcards

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Dermatology Board Prep flashcards
1
Q

What Type of Epithelia is the Epidermis?

A

stratified squamous

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2
Q

2 Parts of Dermis

A

Papillary layer, Reticular layer

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3
Q

2 types of melanin

A

Eumelanin: Dark and Brown
Pheomelanin: yellow and red

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4
Q

What causes Fitzpatrick skin types?

A

Type of Melanin produced and distribution (above nucleus or throughout cytoplasm)

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5
Q

Layers of the Epidermis (5)

A

Stratum Basalis: columnar or cuboidal keratinocytes, contains melanocytes and langerhans cells
Stratum Spinosum: tonofilaments link cells, involucrin synthesis
Stratum Granulosum: profilaggrin granules
Stratum Lucidum: thick skin only, no nuclei or organelles
Stratum Corneum: anucleated, filled w/ keratin

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6
Q

Hemidesmosomes

A

Attach keratinocytes to basement membrane, affected by collagen VII or Laminin 5 deficiencies

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7
Q

Desmosomes

A

Link keratinocytes together, tonofilaments link desmosomes intracellularly

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8
Q

Albinism

A

Tyrosinase Deficiency

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9
Q

Vitiligo

A

Autoimmune against melanocytes

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10
Q

Epidermolysis Bullosa

A

Congenital hemidesmosome protein disorders, comes in 3 types (simplex, junctional, dystrophic) based on where blisters occur

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11
Q

Bullous Pemphigoid

A

acquired EB, type II hypersensitivity to hemidesmosomes

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12
Q

Pemphigus Vulgaris

A

acquired EB, type II hypersensitivity to desomsomes

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13
Q

Icthyosis Vulgaris

A

filaggrin mutation, loss of barrier function and results in severely dry skin

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14
Q

Irritant Contact Dermatitis

A

Inflammatory condition caused by strong or weak irritants. Includes friction of skin in body folds
Burns more than itches

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15
Q

Allergic Contact Dermatitis

A

Type IV delayed hypersensitivity reactions

Allergen contact produces T cells which causes reaction later in exposure or with second exposure

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16
Q

Causes of Irritant Contact Dermatitis

A

acids/ bases

soap, skin products, perfumes, wool, raw food, body secretions, friction

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17
Q

Causes of Allergic Contact Dermatitis

A

Nickel, Balsam of Peru, Neomycin, Fragrance Mix 1, Quaterium-15, Cobalt, Bacitracin, Formaldehyde

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18
Q

Atopic Dermatitis

A

Usually occurs at young age, associated w/ dry skin or history of atopy
Itchy skin w/ skin crease involvement, asthma/allergy history, xerosis, flexural eczema, onset under 2 years

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19
Q

Causes of atopic dermatitis

A

skin disruption, filaggrin mutation, elevated IgE, Eosinophilia, TH2 immune response

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20
Q

Psoriasis

A

Subtypes of chronic plaque disease, Guttate, Erythroderma, Pustular Psoriasis, Psoriatic Arthritis
Associated w/: Arthritis, Crohns, insulin resistance, CVD

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21
Q

Atopic Dermatitis vs. Psoriasis

A

Atopic is common in children, usually occurs on knees, elbow, or face and is usually immune mediated.
Psoriasis has more locations, greater presentation variety, and is not associated w/ xerosis or asthma

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22
Q

Seborrheic Dermatitis

A

Thin plaques w/ pink or yellow erythema and flaky/greasy scales.
Post-Puberty onset, Commonly on scalp, Sign of PD
Caused by M Furfur

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23
Q

Stasis Dermatitis

A

Chronic venous insufficiency in lower extremity, bilateral erythema and scaling

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24
Q

Cellulitis vs. Dermatitis

A

Cellulitis produces warm erythematous patches in dermis and subcutaneous tissue, usually unilateral
Dermatitis erythematous papules and scaly plaques in epidermis and dermis, more likely to be bilateral

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25
Q

Drug Eruptions and Viral Exanthems

A

Type IV hypersensitivity reactions, start 7-14 days after starting medication, diffuse and bilateral on trunk.
Viruses can have similar eruptions or predispose individuals to eruptions (EBV and ampicilin)

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26
Q

Immediate vs Delayed hypersensitivity

A

Urticaria (hives and wheals) start

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27
Q

Types of Collagen in Dermis

A

Type I: 85%
Type III: fetal dermis, less scarring
Type IV: basement membrane and around vessels
Type VII: anchoring fibrils attaching dermis to epidermis

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28
Q

2 Main Components of Ground Substance

A

Hyaluronic Acid and Dermatan Sulfate (glycosaminoglycans)

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29
Q

Collagen Deficiencies

A

Scurvy: acquired from Vit C Deficiency

Ehlers-Danlos: congenital, hyperflexibility

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30
Q

Elastin Deficiencies

A

Solar Elastosis: acquired, basophilic histology

PXE: genetic mutation in efflux channels, tangled and calcified elastin, “plucked chicken”, HTN from vessel damage

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31
Q

Leukocytoclastic Vasculitis

A

Immune complex deposition in vasculature walls causes hemorrhage and palpable purpura.

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32
Q

Nerve Fibers in Dermis

A

Unmyelinated nerve endings at junction for pain and itch.
Pancinian Corpuscles: Vibration and pressure sensation
Meissner’s Corpuscles: fine touch and tactile sensation

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33
Q

Two types of hair

A

thick pigmented and vellus

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34
Q

Sebaceous Gland

A

Holocrine secretion, acne

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35
Q

Eccrine gland

A

Merocrine secretion, acetylcholine mediated

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36
Q

Apocrine Gland

A

axilla and genitals, sialomucin, decapitation

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37
Q

Apoeccrine Gland

A

Hybrid, hyperhidrosis, cholinergic control, treated w/ Botox

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38
Q

Skin findings in diabetes

A

Acanthosis nigricans, yellow skin, brown patches on legs, foot ulcers

39
Q

Skin findings in hyperthyroidism

A

smooth, warm, and moist skin. Pretibial myxedema

40
Q

Skin findings in hypothyroidism

A

Dry skin, brittle nails, sparse hair, delayed wound healing, puffy madarosis

41
Q

Skin findings in Addison’s Disease

A

increased pigmentation

42
Q

Skin findings in Cushing’s Disease

A

Round face, buffalo hump, fat in extremities

43
Q

Endocarditis skin findings

A

splinter hemorrhages, janeway lesions, osler nodes, roth spots,

44
Q

Sarcoidosis skin findings

A

hyperpigmented plaques, erosive plaques, granulomatous tattoos

45
Q

Scleroderma skin findings

A

thick skin of fingers and hands, skin tight around mouth, Reynauds

46
Q

Viral Hep B/C findings

A

Lichen planus, vasculitis, cryoglobulinemia

47
Q

Pyoderma Gangrenosum

A

punched out ulcers, don’t debride

48
Q

Endothelial Benign Neoplasms of Skin (3)

A

Cherry Angioma
Hemangioma
Port Wine Stain

49
Q

Sebacceous Gland Benign Neoplasms

A

sebacceous hyperplasia and nevus sebaceous

50
Q

Fibroblast Benign Neoplasms (1)

A

Dermatofibroma

51
Q

Keratinocyte Benign Neoplasms (2)

A

seborrheic keratosis, actinic keratosis

52
Q

Cherry Angioma

A

middle age onset, bright red smooth topped papules w/ truncal distribution

53
Q

Hemangioma

A

Grow rapidly in infants and then disappear at 10%/year. Stains w/ Glut-1

54
Q

Port Wine Stain

A

Seen in infants, Does not resolve, changes from pink to purple plaque, capillaries lined w/ flat endothelia

55
Q

Sebaceous Nevus

A

yellow-orange plaque on face or scalp, increases at puberty, alopecia associated, Hamartoma

56
Q

Sebaceous Hyperplasia

A

oil gland, yellow-white papule w/ central dell, most common on face from sunlight

57
Q

Acrochordons

A

skin tags in areas of rubbing

58
Q

Dermatofibroma

A

firm brown papules, most common legs.

elongated rete ridges in epidermis w/ basal layer melanin

59
Q

Seborrheic Keratosis

A

light brown, slightly raised, papules or plaques, not on soles or palms, onset in 40s-50s

60
Q

Neurofibroma

A

soft, flesh-colored papules in dermis

61
Q

Causes of Non-Bullous Impetigo

A

Strep Pyogenes or Staph Aureus

Gram stain

62
Q

Non-Bullous Impetigo Clinical

A

single erythematous macule w/ overlying blister, yellow crust, usually on face. Adjacent lesions develop. Glomerulonephritis and LA possible.

63
Q

Causes of Bullous Impetigo

A

staph aureus

64
Q

Bullous Impetigo Clinical

A

all body areas, single flaccid blister that collapses, adjacent lesions form

65
Q

Erysipelas

A

Strep Pyogenes, on face, 2-5 day incubation, area of painful erythema and edema, regional LA

66
Q

Cellulitis Causes

A

Staph Aureus, Strep Pyogenes, Hameophilius influenza

67
Q

Cellulitis Clinical

A

painful erythema, warm, lymphatic streaking

Gram stain rarely effective

68
Q

Bacterial Skin Infections (4)

A

Non-Bullous Impetigo
Bullous Impetigo
Cellulitis
Erysipelas

69
Q

Fungal Skin Infections (3)

A

Candidiasis
Dermatophyte
Tinea Versicolor

70
Q

Dermatophytes

A

Keratin-eating, might see tinea capitis/facei/corporis/cruris/manuum/pedis/uniquum
KOH examination of hyphae or arthrospores

71
Q

Candidiasis

A

glucose/serum eating, common on mucous membranes, oral/angular/cutaneous. Caused by corticosteroids, ABX, diabetes
KOH examination of pseudohyphae or yeast

72
Q

Tinea Versicolor

A

Lipid-eating, post puberty, Malassezia Furfur, truncal scaly macules that are hyper or hypopigmented
KOH spaghetti and meatball

73
Q

Skin Infestations (2)

A

Scabies

Lice

74
Q

Scabies

A

Spread person to person, in web spaces, flexures, axilla, wrist, genitals, buttocks. Wavy erythematous papules
Mineral oil observation of eggs

75
Q

Lice

A

3 types, pruritis w/ erythema and scale, nits on hair

76
Q

Ointments

A

high potency, hydrating, low sensitization and irritation risks, best on non-intertrigenous site, greasy, avoid face, hands and groin

77
Q

Creams

A

moderate potency, some hydration, high sensitization risk, low irritation risk, used on all body sites, well accepted

78
Q

Gels

A

high potency, drying, high sensitization and irritation, good for oral mucosa and scalp

79
Q

Lotions

A

low potency, some drying, some sensitization and irritation, best for scalp and intertrigenous areas

80
Q

Foams

A

high potency, stain free, quick drying, best on hairy areas,

81
Q

1 FTU =?

A

0.5 grams

82
Q

FTUs to cover areas

A 
Face and Neck - 2.5
Trunk front and back - 7
One arm - 3
One hand both sides - 1
One leg - 6
One foot -2
83
Q

Classes of corticosteroids

A

7 classes based on vasoconstriction assays

84
Q

3 common corticosteroid topicals

A
  1. 5% hydrocortisone cream/ointment: class 7
  2. 1% triamcinolone cream/ointment: class 4
  3. 05% clobetasol propionate cream/ointment: class 1

Long term effects of thin skin, adrenal suppression, Cushing syndrome

85
Q

Vitamin D Metabolism

A

UVR causes non-enzymatic formation of cholecalciferol and ergocalciferol. These are activated to Di-hydroxy vitamin D3 in liver and kidneys. Can also be obtained in diet.

86
Q

Basal Cell Carcinoma Appearance

A

flat, firm, pale/pink, shiny, bleed after injury

87
Q

Squamous Cell Carcinoma Appearance

A

growing lumps w/ rough surfaces or red patches

88
Q

Skin Cancer Epidemiology

A

3.5 million prevalence, 2 million incidence

89
Q

Skin Cancer Risk Factors

A

UVR, fair skin, gender, chemicals, radiation, previous skin cancer, phototherapy, genetics, immunosuppression, HPV, smoking

90
Q

Actinic Keratoses

A

Precursors to SCC

91
Q

BCC molecular pathology

A

Patched 1 mutation common, in hedgehog pathway.

Vismodegib is inhibitor of smoothened in same pathway.

92
Q

Melanoma molecular pathology

A

BRAF mutation treated w/ Vemurafinib. MEK inhibitors also used since it is in same pathway (Trametinib, Cobemetinib)

93
Q

Breslow Depth

A

The distance melanoma has invaded from top of granular layer, great prognostic indicator

94
Q

Clarke Level

A

how far melanoma penetrates into skin (I to V), I is only epidermis, V reaches subcutis

Disease and Defense Unit III Derm & Virology (2 decks)

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