Dermatopathology

Question 1

Hydrocortisone

Answer 1

Class: Steroid
Therapeutics: Dermatitis, psoriasis
Side Effects: Atrophy/thinning of skin (collagen), stretch marks, talangiectasias, acne, cataract or glaucoma if applied near eye
Misc.: Seven classes, w/class I being the strongest and class VII being the weakest; side effects may be permanent

Question 2

Cyclosporine

Answer 2

Class: Immunosuppressant
Therapeutics: Inflammatory conditions (psoriasis)
Side Effects: Raise blood pressure, damage kidneys if used long-term

Question 3

Methotrexate

Answer 3

Class: Folate analog
Mechanism: Inhibits DHFR
Therapeutics: Inflammatory conditions (psoriasis), conditions needing immunosuppression
Side Effects: Hepatotoxicity (develops slowly, can give up to 4.5 g over life); pulmonary toxicity (develops quickly); leukopenia; rarely, renal toxicity

Question 4

Biologics

Answer 4

Mechanism: Block TNF-a
Therapeutics: Inflammatory conditions, arthritis
Side Effects: Few (may unmask neurologic disease, latent infections (must do PPDs), malignancies)

Question 5

UV light therapy

Answer 5

Class: UVA, UVB, UVC
Mechanism: Immunosuppression of T-cells via type I or type II reactions –> mono- or bifunctional adducts in DNA
Therapeutics: Inflammatory conditions: atopic dermatitis, CTCL, lichen planus, psoriasis (not useful for non-inflammatory conditions)
Side Effects: Skin cancer, thinning/leathering of skin

Question 6

Isotretinoin (Accutane)

Answer 6

Class: Retinoid
Mechanism: Stimulate epithelial cell turnover; also anti-inflammatory
Therapeutics: Acne
Side Effects: Teratogenic effects (washes out in three weeks)

Question 7

Acitretin (Soriatane)

Answer 7

Class: Retinoid
Mechanism: Stimulate epithelial cell turnover; also anti-inflammatory
Therapeutics: Psoriasis
Side Effects: Teratogenic effects (stays in fat stores for three years)