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Derm > Disorders > Flashcards

Disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

Urticaria

A

Hives. Pruritic wheals formed after mast cell degranulation. Characterized by superficial edema and lymphatic channel dilation.; if pt presents with urticaria and angioedema, evaluate for sepsis!

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2
Q

Verrucae

A

Warts, caused by HPV. Soft, tan-colored, cauiliflower like papules. Epidermal hyperplasia, hyperkeratosis, koilocytosis. Condyloma acuminatum on genitals.

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3
Q

Atopic dermatitis

A

Pruritic eruptions, commonly on skin flexures. Often associated with other atopic diseases (asthma, allergic rhinitis). Usually starts on face in infancy and often appears in the antecubital fossae thereafter.

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4
Q

Psoriasis

A

salmon colored papules and plaques with silvery scaling, especially on knees and elbows. Can be associated with nail pitting and psoriatic arthritis.
Due to excessive keratinocyte proliferation, possible autoimmune etiology
Histo: acanthoses (epidermal hyperplasia), parakeratotic scaling (nuclei still in stratum corneum).
Tx: NO ORAL STEROIDS + corticosteroids, UVA + psoralen + immune-modulating therapy

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5
Q

Auspitz sign

A

In psoriasis. Pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off.

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6
Q

Allergic contact dermatitis

A

Type 4 hypersensitivity that follows allergen exposure. Lesions at site of contact.

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7
Q

Seborrheic keratosis

A

Flat, greasy pigmented squamous epithelial proliferations with keratin-filled cysts. Looks like mud on the wall.

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8
Q

Leser-Trelat sign

A

Sudden appearance of multiple seborrheic keratoses, indicating an underlying malignancy.

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9
Q

Impetigo

A

Very superficial skin infection that is highly contagious and has honey colored crusts. Caused by S. aureus or S. pyogenes.

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10
Q

Cellulitis

A

Acute, spreading infection of dermis and subcutaneous tissues.
Usually from S. pyogenes or S. aureus.
Often starts with a break in the skin from trauma or another infection.
Can progress to nec fac

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11
Q

Necrotizing faciitis

A

Deeper tissue injury, usually from anaerobic bacteria or S. pyogenes. Results in crepitus from methane and CO2 production. “Flesh-eating bacteria”. Causes bullae and a purple color to the skin.

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12
Q

Staph scalded skin syndrome

A

Exotoxin destroys keratinocyte junctions in stratum granulosum. Fever and generalized erythematous rash that heals completely. Seen in newborns and kids usually.
In TEN, skin separation is at E-D junction (much worse)

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13
Q

Hairy leukoplakia

A

White, painless plaques on the tongue that cannot be scraped off. EBV mediated. Occurs in HIV pts.

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14
Q

Eczema

A

= Dermatitis; a broad term encompassing both acute and chronic phases of superficial inflammatory conditions with pruritus or burning

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15
Q

DRESS/DIHS

A
  • often caused by anticonvulsants (phenytoin)/antibiotics/NSAIDS
  • pt will have facial edema/LAD/fever/other organ involvement
  • if edema/rash get CBCs and LFTs
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16
Q

FDE

A
  • often b/c of laxatives/tetracycles/NSAIDS
  • round solitary patch that is in the same site each time pt takes the drug
  • heals with hyper pigmentation
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17
Q

SJS/TEN

A

life-threatening

  • SJS <30% BSA
  • often involves buccal/ocular/genital mucosa
  • dusky macules which coalesce to form flaccid blisters
  • put pt in burn unit + IVIg + withdraw causative drug + multidisciplinary
  • +Nikolsky sign (touch and it flakes off)
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18
Q

Acne vulgaris

A

comedones, pustules, nodules; due to keratin plugging and inflammation of hair follicles and excess androgens; Propionobacterium produce lipase to digest sebum that releases pro inflammatory fatty acids

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19
Q

Lichen Planus

A

Purple, pruritic, polygonal papules
Wickham striae: reticular white lines (esp oral)
histo: inflammation at E-D Junction and sawtooth appearance
Assoc with chronic HEP C

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20
Q

Molluscum Contagiosum

A

Firm, pink, umbilicated papules due to poxvirus. Most often kids or immunocompromised.
Histo: Affected keratinocytes show cytoplasmic inclusions (molluscum bodies)

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21
Q

Nevus

A

Benign neoplasm of melanocytes.

Congenital at birth and acquired later in life (junctional –> intradermal)

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22
Q

Pityriasis rosea

A

“Herald patch” followed days later by Xmas tree distribution of multiple plaques with collarette scale. Self-resolving in 6-8 weeks.

23
Q

Scabies

A

Burrowing
“Itching all night”
do mineral oil prep
initial infestation to sx –> 3-4 wks

24
Q

Bedbugs

A

Cimex Lectularius
3 bites in a row
bites usually resolve in a week
vector for HepB, Chagas Dz

25
Q

Brown recluse spider

A

have violin-shaped, dark brown cephalothorax
red, white, blue bites
often confused with MRSA
complications: hemolysis, tissue necrosis

26
Q

Dermacantor Tick

A

RMSF, Tick Paralysis

27
Q

Ambyloma/LoneStar Tick

A

Erlichiosis, STARI

28
Q

Ioxides Tick

A

Lyme Dz, Babesiosis, Human Anaplasmosis

29
Q

Milia

A

Small epidermoid cysts
flesh colored
appear at any age
spontaneously resolve

30
Q

Dermatofibroma

A

firm, hyper pigmented dome shaped papules

if you pinch them, they dimple

31
Q

Cherry Angiomas

A

benign, vascular proliferation
common on ppl >40
usually on trunk

32
Q

Angiokeratomas

A

Vascular lesions often with overlying scale

Assoc with Fabry’s Disease

33
Q

Epidermal Inclusion Cysts

A

benign, mobile
filled with rancid, cheesy smelling keratinaceous debris (ew)
if ruptured, the inside is sterile so no antibiotics needed (unless a bacterial abcess)

34
Q

Skin tag (acrochordons)

A

can be a marker for insulin resistance!

35
Q

Gorlin Syndrome

A

Basal Cell Nevus Syndrome
mutation in PTCH1
BCCs early - 23yo
MSK defects and jaw cysts

36
Q

Henoch Schonlein Purpura

A
  • most common systemic vasculitis in kids
  • follows seasonal pattern with peak incidence in winter probably because of more infx then
    Ig a
37
Q

Leukocytic Vasculitis

A

Due to antibiotic use

Palpable hemorrhagic papules coalescing into plaques bilaterally on lower extremities

38
Q

Polyarteritis Nodosa

A

medium sized vasculitis
necrotizing
hematuria, anemia, casts in urine, high ESR
subcutaneous nodules
CUTANEOUS AND SYSTEMIC (just steroids) have diff tx

39
Q

Fixed drug eruption

A
  • Round patch with possible bulla formation
  • heals with hyper pigmentation
  • same place each time
  • due to phenolphthalein (laxatives), tetracyclines, NSAIDs, food coloring
40
Q

Guttate psoriasis

A

assoc. with recent episode of strep throat,

drop lesions

41
Q

Varicella Zoster Virus

A
  • chicken pox in kids
  • incubates 10-21 days
  • contagious (via respiratory) 4 days before and 5 days after rash
  • can lead to pneumonia, ataxia, encephalitis, myocarditis
  • Reye’s syndrome if treated with aspirin in kids
42
Q

Herpes Zoster Virus

A
  • caused by reactivation of VZV, which was latent in DRG

- acyclovir, valacyclovir

43
Q

Bullous pemphigoid

A
  • elderly
  • disruption of basal layer
  • DEEP, tense bullae
  • linear IgG and C3 at E-D junction
  • antibodies to BP230 and BP180
  • antibodies to hemidesmosomes
44
Q

Pemphigus vulgaris

A
  • genetic predisposition
  • usually 40’s, 50’s
  • chronic dz
  • antibodies to Demoglein 1 and Desmoglien 3
  • flaccid, SUPERFICIAL bullae
  • +Nikolsky sign
  • azathioprene, rituximab, mycophenolate moteil, oral steroids
  • CHICKEN WIRE on immunofluorescence
45
Q

Pemphigus foliaceus

A
  • scale crusts that look like corn flakes
  • no systemic involvement, rare mucosal involvement
  • antibodies to Desmoglein 1
  • Tx: steroids, mycophenolate moteil, dapsone, antimalarials
46
Q

Linear IgA Bullous Dermatosis

A
  • tense bullae in a string of pearls pattern
  • may be drug induced (vanc)
  • neutrophils
  • linear IgA at E-D junction
47
Q

Dermatitis Herpetiformis

A
  • Autoimmune
  • associated with gluten sensitive enteropathy
  • pruritic vesicles on extensor surfaces
  • subepidermal vesicles with neutrophils
  • granular IgA at dermal papillae
48
Q

Herpex Simplex Virus

A 
painful, grouped vesicles on an erythematous base
HSV 1 is above the belt
HSV 2 is below the belt
- goes latent in VRG
- Tzank prep doesn't differentiate type
- viral culture
- DIRECT FLUORESCENT ANTIBODY
49
Q

Dyshydrotic eczema

A
  • very pruiritc vesiclopapules

- palms, soles, sides of fingers

50
Q

Bullous Impetigo

A

diagnosed with bacterial culture

51
Q

Tinea Versicolor

A

spots on the back usually in the summer months,
due to malathesia which is not a dermatophyte,
you’ll see spaghetti and meatball on KOH (short hyphae + small round spores)

52
Q

Intertrigo

A

inflammation of large skin folds, can be complicated by candida

53
Q

Kerion

A

painful, boggy mass of broken hair follicles

- inflamed tinea capitis

Derm (5 decks)

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