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Dermatopathology: Inflammatory Disorders Flashcards

1
Q

Syndrome of dermal edema due to mast cell degranulation

A

Uritcaria

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2
Q

Urticaria involves edema in this skin layer

A

Dermis

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3
Q

What causes urticaria?

A

Mast cell degranulation (which causes dermal edema)

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4
Q

What is the typical age of a patient with Urticaria?

A

Any age, peak age 20-40 years old

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5
Q

Who is more likely to have Urticaria, male or female?

A

Female > male (2:1 ratio)

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6
Q

Urticaria types involving the immune system exhibit this type of hypersensitivity

A

Type 1
Are IgE dependent

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7
Q

Type of Urticaria that is commonly acute

A

IgE dependent types

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8
Q

What triggers the IgE dependent types of Urticaria?

A

Allergic triggers (e.g. food, insect bites, parasites, drugs)

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9
Q

What type of Urticaria involves mast cell degranulation?

A

Both IgE dependent and independent types

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10
Q

Type of Urticaria that is typically acute but may become chronic

A

IgE independent types
Hives –> eventual epidermal hyperplasia, fibrosis, lichenification

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11
Q

Where on the body does Urticaria occur?

A

In areas of pressure, vibration, or exposure to agent

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12
Q

Dermographism (stroking causes wheal reaction) occurs in these 2 conditions

A

Urticaria and Cutaneous mastocytosis

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13
Q

What is dermographism?

A

Stroking causing wheal reaction
As seen in urticaria

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14
Q

When does Urticaria resolve?

A

Within 30 minutes

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15
Q

Transient rapidly edematous papules/plaques
Superficial dermal edema
Well-defined

A

Wheals (aka hives)

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16
Q

Edematous papules/plaques in deeper dermis and subcutaneous
Less well defined and lack erythema

A

Angioedema

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17
Q

Does this describe Wheals or Angioedema:
Superficial dermal edema

A

Wheals

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18
Q

Does this describe Wheals or Angioedema:
Deeper dermis and subcutaneous

A

Angioedema

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19
Q

Does this describe Wheals or Angioedema:
Raised erythematous

A

Wheals

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20
Q

Does this describe Wheals or Angioedema:
Lack erythema

A

Angioedema

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21
Q

Does this describe Wheals or Angioedema:
Well-defined

A

Wheals

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22
Q

Does this describe Wheals or Angioedema:
Less well defined

A

Angioedema

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23
Q

Angioedema without wheals may be caused by this

A

Hereditary C1 esterase inhibitor deficiency

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24
Q

Hereditary C1 esterase inhibitor deficiency may cause this

A

Angioedema without wheals

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25
Q

Reaction pattern of epidermal spongiosis
Has many causes

A

Eczema

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26
Q

Does this describe the acute or chronic phase of eczema:
Pruritic erythematous rash with oozing, edema, vesicles

A

Acute

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27
Q

Does this describe the acute or chronic phase of eczema:
Acanthosis, hyperkeratosis, lichenification

A

Chronic

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28
Q

Eczematous rash caused by type I hypersensitivity

A

Atopic dermatitis

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29
Q

Type of eczema associated with allergic phenotype

A

Atopic dermatitis

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30
Q

Type of eczema where pathogenesis is uncertain but involves defective water barrier

A

Atopic dermatitis

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31
Q

What is the typical onset of Atopic dermatitis?

A

Most begin by age 6 weeks
Most resolve by late childhood, but may persist in adults

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32
Q

Type of eczema often involving face and flexor surfaces

A

Atopic dermatitis

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33
Q

Type of eczema that is T cell mediated (type IV) hypersensitivity reaction to direct exposure to external antigens

A

Allergic contact dermatitis

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34
Q

Type of eczema due to chemical or physical exposure to chemicals, often occupations
Not immunologically mediated and much more common

A

Irritant contact dermatitis

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35
Q

Chronic exposure to irritant or antigen in eczema leads to this

A

Lichenification

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36
Q

Does this describe the histology of acute or chronic contact dermatitis:
Spongiosis and vesicles
Dermal edema, inflammation with eosinophils

A

Acute

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37
Q

Does this describe the histology of acute or chronic contact dermatitis:
Epidermal hyperplasia with hyperkeratosis
Mild spongiosis

A

Chronic

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38
Q

Mild chronic eczema in areas of high sebum production

A

Seborrheic dermatitis

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39
Q

What is the age peak of Seborrheic dermatitis?

A

30-50 years

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40
Q

Seborrheic dermatitis is associated with this commensal organism

A

Malassezia furfur

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41
Q

Malassezia furfur is a commensal organism associated with this condition

A

Seborrheic dermatitis

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42
Q

High or altered sebum production is associated with Seborrheic dermatitis and occurs during these 2 points in life

A

Neonatal period
Androgens and puberty

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43
Q

Infantile form of Seborrheic dermatitis is most common in this location on the body

A

Scalp

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44
Q

Seborrheic dermatitis in infants typically resolves by this age

A

3 months with decreased sebaceous activity

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45
Q

Acute self-limited CD8+ T cell mediated hypersensitivity reaction to systemic antigen

A

Erythema Multiforme

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46
Q

What age is the typical patient with Erythema Multiforme?

A

Any age, most in young adults

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47
Q

Erythema Multiforme is often preceded by systemic infection, especially one of these two

A

Herpes virus, Mycoplasma

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48
Q

Condition with this morphology:
Interface vacuolar change
Individual keratinocyte apoptosis
Mild spongiosis
Dermal edema and perivascular lymphocytes

A

Erythema Multiforme

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49
Q

Condition where the classic lesion is a Target lesion

A

Erythema Multiforme

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50
Q

In Erythema Multiforme, lesions appear within this timeframe

A

Within 24 hours
Heals in 2 weeks

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51
Q

Acute self-limited CD8 T cell mediated hypersensitivity reaction to systemic antigen that may exhibit Koebner phenomenon (skin lesions that appear in lines of trauma)

A

Erythema Multiforme

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52
Q

What is the Koebner phenomenon?

A

When skin lesions appear in lines of trauma (e.g. scratch lines)

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53
Q

Erythema Multiforme with mucosal involvement and fever

A

Erythema Multiforme Major
Also Stevens-Johnson Syndrome

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54
Q

How is Erythema Multiforme Major different from general Erythema Multiforme?

A

Erythema Multiforme Major has mucosal involvement and fever

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55
Q

Stevens-Johnson Syndrome is a more severe form of this condition but has mucosal involvement and high fever
<10% of skin surface

A

Erythema Multiforme

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56
Q

More severe form of Erythema Multiforme with mucosal involvement and high fever, <10% of skin surface

A

Stevens-Johnson syndrome

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57
Q

More severe form of Erythema Multiforme with diffuse, widespread skin sloughing, full-thickness necrosis (split at DEJ), >30% skin surface

A

Toxic epidermal necrolysis

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58
Q

More severe forms of Erythema Multiforme (Stevens-Johnson Syndrome and Toxic epidermal necrolysis) are most often due to this

A

Drug reactions

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59
Q

Prognosis of severe forms of Erythema Multiforme (Stevens-Johnson Syndrome and Toxic epidermal necrolysis) are related to this

A

Extent of skin loss

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60
Q

Chronic immune mediated disorder of keratinocyte proliferation with environmental triggers

A

Psoriasis

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61
Q

Psoriasis is associated with these two genotypes

A

HLA-Cw6 and HLA-B27

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62
Q

HLA-Cw6 and HLA-B27 genotypes are associated with this condition

A

Psoriasis

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63
Q

What is the typical age of a patient with psoriasis?

A

All ages, teen and up most common

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64
Q

In psoriasis, T cells release cytokines which cause proliferation of this cell type

A

Keratinocytes

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65
Q

Infection that will aggravate psoriasis

A

HIV

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66
Q

Phenomenon seen in Psoriasis when skin lesions appear in lines of trauma

A

Koebner phenomenon

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67
Q

“Test tubes in a rack” morphology is seen in this condition

A

Psoriasis (psoriasiform acanthosis)

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68
Q

Auspitz sign (bleeding points when the scales of skin are scraped off) is seen in this condition

A

Psoriasis

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69
Q

What is the Auspitz sign?

A

Small bleeding points when the scales of skin are scraped off
Seen in psoriasis

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70
Q

Munro microabscesses (neutrophils in the stratum corneum) are seen in this condition

A

Psoriasis

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71
Q

In psoriasis, thinned papillary dermal tips lead to this

A

Auspitz sign (small bleeding points when the scales of skin are scraped off)

72
Q

In psoriasis, this leads to the Auspitz sign (small bleeding points when the scales of skin are scraped off)

A

Thinned papillary dermal tips

73
Q

Thinned papillary dermal tips are seen in this condition

74
Q

Where on the body does psoriasis occur?

A

Sites of trauma: Koebner phenomenon, extensor surfaces (forearm, elbows, low back)

75
Q

Erythematous plaques with silvery scale are seen in this condition

76
Q

Involvement of nails with pitting and ridges may occur in this condition characterized by demarcated scaly, erythematous plaques

77
Q

Genotype associated with psoriatic arthritis

78
Q

20% of patients with psoriasis also have this, which is associated with the HLA-B27 genotype

A

Psoriatic arthritis

79
Q

Plaque forming lichenoid dermatosis

A

Lichen Planus

80
Q

What is the peak age of Lichen Planus?

A

40-50 years

81
Q

Lesions caused by CD8 T cell mediated reaction against basal keratinocytes with altered self antigen
Associated with environmental exposure

A

Lichen Planus

82
Q

What type of T cells are involved in Lichen Planus?

83
Q

Dense band of lymphocytes under acanthotic epidermis and “sawtooth” configuration of basal layer are seen in this condition

A

Lichen Planus

84
Q

Basal keratinocyte apoptosis seen as “dead reds” is apparent in this condition

A

Lichen Planus

85
Q

What are the 5 P’s of Lichen Planus?

A

Pruritic
Purple
Polygonal
Planar
Papules

86
Q

Lesions that are pruritic, purple, polygonal, planar, and papules are characteristic of this condition

A

Lichen Planus

87
Q

When does Lichen Planus resolve?

A

Self-resolving, may take 2-3 years
Lesions heal with hyperpigmentation

88
Q

Fine white lines due to areas of hyperkeratosis that are characteristic of Lichen Planus

A

Wickham’s striae

89
Q

Wickham’s striae (fine white lines due to areas of hyperkeratosis) are characteristic of this condition

A

Lichen Planus

90
Q

In Lichen Planus, Wickham’s striae is seen as fine white lines due to this

A

areas of hyperkeratosis

91
Q

Condition where oral lesions often have lace-like network

A

Lichen Planus

92
Q

Androgen dependent plugging of pilosebaceous unit

A

Acne vulgaris

93
Q

What is the peak age of Acne vulgaris?

A

Adolescence
Arises in androgenic stages (Puberty, Cushing Syndrome, PCOS)

94
Q

Pathogenesis of Acne vulgaris is caused by increased proliferation and cohesion of this type of cell at neck of hair follicle

A

Keratinocytes

95
Q

In Acne vulgaris, comedones are formed by the accumulation of these 2 things

A

Corneocytes and sebum

96
Q

In Acne vulgaris, corneocytes and sebum accumulate to form this

97
Q

Bacteria that causes Acne vulgaris

A

Cutibacterium acnes (Propionibacterium)

98
Q

Persistent facial erythema and inflammatory papulopustules

99
Q

What is the typical age of a patient with Rosacea?

A

Middle age

100
Q

Who is more likely to have Rosacea, male or female?

101
Q

Centrofacial erythema, telangiectasias and flushing are seen in this condition

102
Q

The proposed pathogenesis of Rosacea involves these 2 things

A

Aberrant immune response and neurovascular dysregulation

103
Q

In Rosacea, sebaceous hyperplasia may distort tissue architecture, causing this

104
Q

In Rosacea, this may distort tissue architecture and cause Phyma

A

Sebaceous hyperplasia

105
Q

Rhinophyma is a common feature of this condition

106
Q

Prototypical septal panniculitis

A

Erythema Nodosum

107
Q

Inflammation of subcutaneous fibroadipose tissue

A

Panniculitis

108
Q

Condition that is probably a delayed type hypersensitivity to antigens deposited in subcutaneous tissues

A

Erythema Nodosum

109
Q

Condition characterized by sudden onset of red, warm, tender nodules
Mostly on anterior legs

A

Erythema Nodosum

110
Q

Where on the body is Erythema Nodosum typically seen?

A

Mostly anterior legs

111
Q

When do Erythema Nodosum lesions resolve?

A

Over the course of a few weeks

112
Q

Condition involving septa with edema and neutrophils, later with lymphocytes and granulomas with fibrosis

A

Erythema Nodosum

113
Q

Epidermal infection with HPV

114
Q

Warts are an epidermal infection with this

115
Q

Warts are an HPV infection of this skin layer

116
Q

Common wart, usually of hands

A

Verruca vulgaris

117
Q

Common wart located on sole of foot or palm of hand

A

Verruca plantaris/palmaris

118
Q

Flat wart, usually of face or back of hand

A

Verruca plana

119
Q

Genital wart

A

Conyloma accuminatum

120
Q

What is Conyloma accuminatum?

A

Genital wart

121
Q

Condition with this histology:
Epidermal hyperplasia
Papillomatosis and parakeratosis
Koilocytes
Prominent keratohyalin granules

122
Q

Endophytic growth is painful and seen especially in this type of wart

A

Verruca plantaris/palmaris

123
Q

Term for when warts occur as cauliflower like projection above skin surface

A

Exophytic growth

124
Q

Common self-limited infection by Pox virus

A

Molluscum contagiosum

125
Q

Molluscum contagiosum is a common self-limited infection by this

126
Q

Condition that forms umbilicated pearly domed papules

A

Molluscum contagiosum

127
Q

Invaginated squamous epithelium and keratinocytes that have molluscum bodies are seen in this condition

A

Molluscum contagiosum

128
Q

In Molluscum contagiosum, this type of cell has molluscum bodies

A

Keratinocytes

129
Q

Fungal infections of keratinized skin

A

Dermatophytoses

130
Q

Dermatophytoses of the trunk and extremities

A

Tinea corporis

131
Q

Describe the typical patient with Tinea corporis

A

All ages, especially in hot/humid environments

132
Q

Dermatophytoses of the scalp

A

Tinea capitis

133
Q

Typical age of a patient with Tinea capitis

A

Usually children

134
Q

Dermatophytoses that is associated with hair loss (alopecia)

A

Tinea capitis

135
Q

Dermatophytoses that is usually seen in children

A

Tinea capitis

136
Q

Dermatophytoses that affects all ages, especially in hot/humid environments

A

Tinea corporis

137
Q

Dermatophytoses of the beard

A

Tinea barbae

138
Q

Dermatophytoses of the feet and hands
Aka athletes foot

A

Tinea pedis/manus

139
Q

Dermatophytoses of the genital folds, especially with obesity

A

Tinea cruris

140
Q

Tinea cruris is associated with this condition

141
Q

Dermatophytoses that is an infection associated with color changes

A

Tinea versicolor

142
Q

Tinea versicolor is caused by infections with this

A

Malassezia furfur

143
Q

In Tinea versicolor, Malassezia furfur finfections show “spaghetti and meatballs” in this stain

A

PAS/GMS stain

144
Q

Tinea versicolor is most commonly seen on this part of the body

145
Q

Condition with this histology:
Normal appearing skin
May have spongiosis, parakeratosis
PAS stain for fungus in stratum corneum

A

Dermatophytoses

146
Q

Superficial epidermal infection

147
Q

Impetigo is most often caused by either of these two bacteria

A

Strep pyogenes
Staph aureus

148
Q

Impetigo is most common in this age group

149
Q

Impetigo most often affects these parts of the body

A

Face and hands

150
Q

Condition that forms pustules that ruptures to form lesions covered by honey colored crust

151
Q

Toxin mediated production of subcorneal blisters

A

Staph scalded skin syndrome

152
Q

What age group is most often affected by Staph scalded skin syndrome?

A

Infants and children

153
Q

In Staph scalded skin syndrome, localized Staph infection leads to production of these

A

Epidermolytic Toxins A and B

154
Q

In Staph scalded skin syndrome, Epidermolytic toxins A and B binds this

A

Desmoglein 1

155
Q

Type of split in Staph scalded skin syndrome

A

Subcorneal

156
Q

Staph scalded skin syndrome may remain localized to form this

A

Bullous impetigo

157
Q

What is the difference between Staph scalded skin syndrome and Bullous impetigo?

A

Bullous impetigo is localized while SSSS is the hematogenous dissemination of toxin

158
Q

Nikolsky sign is positive in these two conditions

A

Pemphigus Vulgaris and Staph scalded skin syndrome

159
Q

What is the Nikolsky sign that is seen in Pemphigus vulgaris and Staph scalded skin syndrome?

A

Blister expands when pressure is applied

160
Q

Type of split in Toxic epidermal necrolysis

A

Dermal-epidermal junction

161
Q

Infection of the superficial dermis with lymphatic involement

A

Erysipelas

162
Q

What layer of skin does Erysipelas affect?

A

Superficial dermis

163
Q

Erysipelas is most often caused by this

A

Streptococcus pyogenes

164
Q

Describe the typical patient with Erysipelas

A

Affects very young or aged/debilitated

165
Q

Condition that results in sharply demarcated erythematous plaques and may be associated with fevers

A

Erysipelas

166
Q

Erysipelas is an infection of the superficial dermis with this involvement

167
Q

Infection of the deeper dermis

A

Cellulitis

168
Q

Cellulitis affects this skin layer

A

Deeper dermis

169
Q

Cellulitis is most often caused by either of these 2 bacteria

A

Strep pyogenes and Staph aureus

170
Q

Condition with localized areas of erythema, deep infection leads to ill-defined borders

A

Cellulitis

171
Q

What is the difference between Cellulitis and Erysipelas?

A

Cellulitis is an infection of the deeper dermis, Erysipelas infects the superficial dermis

172
Q

Polymicrobial infection of subcutaneous fat/fascia

A

Necrotizing fasciitis

173
Q

Necrotizing fasciitis is often initiated by this bacteria

A

Group A Streptococcus

174
Q

While Necrotizing fasciitis is often initiated by Group A Streptococcus, this bacteria is also frequently involved

A

Staphylococcus aureus

175
Q

Elderly, diabetes, alcoholism, and vascular disease are risk factors for this polymicrobial infection

A

Necrotizing fasciitis

176
Q

Condition that may begin as cellulitis but has pain out of proportion to clinical appearance

A

Necrotizing fasciitis

177
Q

Necrotizing fasciitis may begin as this, but has pain out of proportion to clinical appearance

A

Cellulitis

Skin & MSK (20 decks)

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