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

Dermatology Facts 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
Drug Eruptions and Viral Exanthems
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)
26
Immediate vs Delayed hypersensitivity
Urticaria (hives and wheals) start
27
Types of Collagen in Dermis
Type I: 85% Type III: fetal dermis, less scarring Type IV: basement membrane and around vessels Type VII: anchoring fibrils attaching dermis to epidermis
28
2 Main Components of Ground Substance
Hyaluronic Acid and Dermatan Sulfate (glycosaminoglycans)
29
Collagen Deficiencies
Scurvy: acquired from Vit C Deficiency | Ehlers-Danlos: congenital, hyperflexibility
30
Elastin Deficiencies
Solar Elastosis: acquired, basophilic histology | PXE: genetic mutation in efflux channels, tangled and calcified elastin, "plucked chicken", HTN from vessel damage
31
Leukocytoclastic Vasculitis
Immune complex deposition in vasculature walls causes hemorrhage and palpable purpura.
32
Nerve Fibers in Dermis
Unmyelinated nerve endings at junction for pain and itch. Pancinian Corpuscles: Vibration and pressure sensation Meissner's Corpuscles: fine touch and tactile sensation
33
Two types of hair
thick pigmented and vellus
34
Sebaceous Gland
Holocrine secretion, acne
35
Eccrine gland
Merocrine secretion, acetylcholine mediated
36
Apocrine Gland
axilla and genitals, sialomucin, decapitation
37
Apoeccrine Gland
Hybrid, hyperhidrosis, cholinergic control, treated w/ Botox
38
Skin findings in diabetes
Acanthosis nigricans, yellow skin, brown patches on legs, foot ulcers
39
Skin findings in hyperthyroidism
smooth, warm, and moist skin. Pretibial myxedema
40
Skin findings in hypothyroidism
Dry skin, brittle nails, sparse hair, delayed wound healing, puffy madarosis
41
Skin findings in Addison's Disease
increased pigmentation
42
Skin findings in Cushing's Disease
Round face, buffalo hump, fat in extremities
43
Endocarditis skin findings
splinter hemorrhages, janeway lesions, osler nodes, roth spots,
44
Sarcoidosis skin findings
hyperpigmented plaques, erosive plaques, granulomatous tattoos
45
Scleroderma skin findings
thick skin of fingers and hands, skin tight around mouth, Reynauds
46
Viral Hep B/C findings
Lichen planus, vasculitis, cryoglobulinemia
47
Pyoderma Gangrenosum
punched out ulcers, don't debride
48
Endothelial Benign Neoplasms of Skin (3)
Cherry Angioma Hemangioma Port Wine Stain
49
Sebacceous Gland Benign Neoplasms
sebacceous hyperplasia and nevus sebaceous
50
Fibroblast Benign Neoplasms (1)
Dermatofibroma
51
Keratinocyte Benign Neoplasms (2)
seborrheic keratosis, actinic keratosis
52
Cherry Angioma
middle age onset, bright red smooth topped papules w/ truncal distribution
53
Hemangioma
Grow rapidly in infants and then disappear at 10%/year. Stains w/ Glut-1
54
Port Wine Stain
Seen in infants, Does not resolve, changes from pink to purple plaque, capillaries lined w/ flat endothelia
55
Sebaceous Nevus
yellow-orange plaque on face or scalp, increases at puberty, alopecia associated, Hamartoma
56
Sebaceous Hyperplasia
oil gland, yellow-white papule w/ central dell, most common on face from sunlight
57
Acrochordons
skin tags in areas of rubbing
58
Dermatofibroma
firm brown papules, most common legs. | elongated rete ridges in epidermis w/ basal layer melanin
59
Seborrheic Keratosis
light brown, slightly raised, papules or plaques, not on soles or palms, onset in 40s-50s
60
Neurofibroma
soft, flesh-colored papules in dermis
61
Causes of Non-Bullous Impetigo
Strep Pyogenes or Staph Aureus | Gram stain
62
Non-Bullous Impetigo Clinical
single erythematous macule w/ overlying blister, yellow crust, usually on face. Adjacent lesions develop. Glomerulonephritis and LA possible.
63
Causes of Bullous Impetigo
staph aureus
64
Bullous Impetigo Clinical
all body areas, single flaccid blister that collapses, adjacent lesions form
65
Erysipelas
Strep Pyogenes, on face, 2-5 day incubation, area of painful erythema and edema, regional LA
66
Cellulitis Causes
Staph Aureus, Strep Pyogenes, Hameophilius influenza
67
Cellulitis Clinical
painful erythema, warm, lymphatic streaking | Gram stain rarely effective
68
Bacterial Skin Infections (4)
Non-Bullous Impetigo Bullous Impetigo Cellulitis Erysipelas
69
Fungal Skin Infections (3)
Candidiasis Dermatophyte Tinea Versicolor
70
Dermatophytes
Keratin-eating, might see tinea capitis/facei/corporis/cruris/manuum/pedis/uniquum KOH examination of hyphae or arthrospores
71
Candidiasis
glucose/serum eating, common on mucous membranes, oral/angular/cutaneous. Caused by corticosteroids, ABX, diabetes KOH examination of pseudohyphae or yeast
72
Tinea Versicolor
Lipid-eating, post puberty, Malassezia Furfur, truncal scaly macules that are hyper or hypopigmented KOH spaghetti and meatball
73
Skin Infestations (2)
Scabies | Lice
74
Scabies
Spread person to person, in web spaces, flexures, axilla, wrist, genitals, buttocks. Wavy erythematous papules Mineral oil observation of eggs
75
Lice
3 types, pruritis w/ erythema and scale, nits on hair
76
Ointments
high potency, hydrating, low sensitization and irritation risks, best on non-intertrigenous site, greasy, avoid face, hands and groin
77
Creams
moderate potency, some hydration, high sensitization risk, low irritation risk, used on all body sites, well accepted
78
Gels
high potency, drying, high sensitization and irritation, good for oral mucosa and scalp
79
Lotions
low potency, some drying, some sensitization and irritation, best for scalp and intertrigenous areas
80
Foams
high potency, stain free, quick drying, best on hairy areas,
81
1 FTU =?
0.5 grams
82
FTUs to cover areas
``` 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
Classes of corticosteroids
7 classes based on vasoconstriction assays
84
3 common corticosteroid topicals
2. 5% hydrocortisone cream/ointment: class 7 0. 1% triamcinolone cream/ointment: class 4 0. 05% clobetasol propionate cream/ointment: class 1 Long term effects of thin skin, adrenal suppression, Cushing syndrome
85
Vitamin D Metabolism
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
Basal Cell Carcinoma Appearance
flat, firm, pale/pink, shiny, bleed after injury
87
Squamous Cell Carcinoma Appearance
growing lumps w/ rough surfaces or red patches
88
Skin Cancer Epidemiology
3.5 million prevalence, 2 million incidence
89
Skin Cancer Risk Factors
UVR, fair skin, gender, chemicals, radiation, previous skin cancer, phototherapy, genetics, immunosuppression, HPV, smoking
90
Actinic Keratoses
Precursors to SCC
91
BCC molecular pathology
Patched 1 mutation common, in hedgehog pathway. | Vismodegib is inhibitor of smoothened in same pathway.
92
Melanoma molecular pathology
BRAF mutation treated w/ Vemurafinib. MEK inhibitors also used since it is in same pathway (Trametinib, Cobemetinib)
93
Breslow Depth
The distance melanoma has invaded from top of granular layer, great prognostic indicator
94
Clarke Level
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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