final exam Flashcards

Question

What are the typical signs of papules with lichen planus: 1. polygonal outline 2. waxy sheen 3. umbilical depression in the center 4. all of the above are true

Answer 1

polygonal outline Pruritic – The lesions are very itchy. Purple – They have a violaceous (purplish) hue. Polygonal – The papules have an angular, multi-sided (polygonal) shape. Planar – The lesions are flat-topped. Papules – They appear as small, raised bumps. Wickham's Striae – Fine, white, lacy lines on the surface of the papules.

Answer 2

mucous membranes The correct answer is: **2. mucous membranes** Lichen planus is not just limited to the skin. It can also affect the mucous membranes, which include: * Oral cavity (mouth): The inside of the cheeks, tongue, lips, and gums can be affected. * Genital area: The inside of the vagina, penis, or scrotum can be involved. * Esophagus: In rare cases, lichen planus can cause inflammation and scarring in the esophagus, leading to difficulty swallowing. * Eyes: Lichen planus can affect the eyes, causing inflammation, and in rare cases, damage to the cornea. The other options are incorrect: * **1. Joints:** While some patients with lichen planus may experience joint pain or arthralgias (joint stiffness), it is not a direct manifestation of the disease. * **3. Hair:** While there are conditions where hair loss can occur in combination with lichen planus, such as lichen planopilaris (inflammatory hair loss), hair loss is more of a separate phenomenon. * **4. Nails:** Nail involvement in lichen planus is extremely rare.

Answer 3

vacuole degeneration In lichen planus, a hallmark histopathological feature is the degeneration of the basal cell layer, often described as vacuolar (or hydropic) degeneration. This process results in the formation of small vacuoles at the basal layer, leading to the characteristic “lichenoid” infiltrate of lymphocytes immediately beneath the epidermis. Additionally, the damaged basal cells may form colloid (Civatte) bodies. papillomatosis -not the defining feature of lichen planus granulosis -not the primary histological process characteristic acantholysis -seen in conditions like pemphigus vulgaris, not in lichen planus.

Answer 4

erosive ulcerative

Answer 5

lichenification. Explanation: Lichenification refers to the thickening and roughening of the skin due to chronic scratching or rubbing. In atopic dermatitis (eczema), chronic inflammation and persistent itching lead patients to scratch repeatedly, which results in lichenification over time. Why the Other Options Are Incorrect: Node: A node is a larger, deeper lesion (often seen in conditions like rheumatoid arthritis) and is not characteristic of atopic dermatitis. Sclerosis: Sclerosis involves hardening of tissues and is not a typical feature of atopic dermatitis; it is more commonly associated with conditions like morphea or systemic sclerosis. Atrophy: Atrophy refers to thinning of the skin, which can be seen with prolonged corticosteroid use but is not a primary manifestation of atopic dermatitis. Key Points for Atopic Dermatitis: Itching: Persistent and intense pruritus is a hallmark. Erythema: Red, inflamed skin is common during flare-ups. Lichenification: Resulting from chronic scratching and rubbing. Distribution: Commonly affects flexural areas (inside of elbows, behind knees) in adults, while infants often have facial involvement.

Answer 6

flexion surface of the limbs

Answer 7

based on common occurrence in children

Answer 8

in folds Localization Classifications: Restricted-Localized: This form involves a limited area of the body, such as a single limb or a specific region. It is less common and may present as isolated patches. Palar-Plantar: This type affects the palms of the hands and soles of the feet. While less common, it can present with thickened skin and fissures. In Folds: Also known as flexural or flexure areas, this form affects the skin folds, such as the inside of the elbows (antecubital fossae) and behind the knees (popliteal fossae). It is one of the most common presentations, especially in children. JACIONLINE.ORG Nail: Nail involvement in AD is less common but can include changes like pitting, ridging, and onycholysis (separation of the nail from the nail bed).

Answer 9

erythematous squamous. This is the classic presentation of atopic dermatitis. It is characterized by: Erythema (redness). Scaling (dry, flaky skin). Pruritus (intense itching).

Answer 10

before 1 year of age. This condition often begins in infancy or early childhood, with many cases presenting within the first six months of life

Answer 11

Key Clinical Signs of Atopic Dermatitis: Denier-Morgan's Symptom: Infraorbital folds. Lichenification: Thickened skin with exaggerated skin lines due to chronic scratching. Pruritus: Intense itching, often worse at night. Xerosis: Dry, scaly skin. Flexural Involvement: Red, scaly patches in the folds of the elbows, knees, and neck.

Answer 12

Parental Allergic Dermatoses: Children with parents who have allergic conditions, such as atopic dermatitis, asthma, or hay fever, are at a higher risk of developing AD. The risk increases when both parents are affected. Atopic dermatitis is part of the atopic triad, which includes eczema, asthma, and allergic rhinitis

Answer 13

enzymopathies and intestinal dysbiosis if a kid has eczema, there is an association with gut imbalance and improper function of enzymes, there's a good chance the gut microbiome might be off-balance and enzymes are not functioning optimally.

Answer 14

Presence of lichenization at the elbow and knee bends: Lichenization refers to thickened, leathery skin resulting from chronic scratching or rubbing. Its presence in the flexural areas (elbows and knees) is characteristic of AD and supports the diagnosis.

Answer 15

correction of xerosis key treatment Moisturization: Regular application of emollients is essential to restore the skin barrier and prevent dryness (xerosis). Ointments are generally more effective than creams or lotions due to their higher oil content. HERALDSUN.COM.AU Topical Corticosteroids: These are used to reduce inflammation during flare-ups. It's important to use them as directed to avoid potential side effects. Topical Calcineurin Inhibitors: Medications like tacrolimus and pimecrolimus can be used as steroid-sparing agents to manage inflammation. Antihistamines: These may help alleviate itching, especially if there's a significant allergic component. Phototherapy: Ultraviolet light therapy can be beneficial for moderate to severe cases. Systemic Therapies: For severe or refractory cases, systemic treatments such as oral corticosteroids, immunosuppressants, or biologic agents may be considered.

Answer 16

The correct pairings of disease signs are: Grouped vesicles – D. Herpes simplex Vesicles, erosion, a feeling of pain along the nerve trunks – C. Herpes zoster Erosion with dense infiltration in base, painless – B. Primary syphilis Bubbles, erosion, positive Nikolsky's symptom – A. Pemphigus

Answer 17

. vulgar. Explanation: Warts are benign skin growths caused by the human papillomavirus (HPV). They vary in appearance and location, and are classified into several types: Common Warts (Verruca Vulgaris): Typically found on the hands, these warts are rough, raised, and flesh-colored. MY.CLEVELANDCLINIC.ORG Plantar Warts: Occur on the soles of the feet, often causing discomfort due to pressure. MY.CLEVELANDCLINIC.ORG Flat Warts: Smaller and smoother, these warts can appear anywhere on the body and often occur in clusters. MY.CLEVELANDCLINIC.ORG Filiform Warts: Thread-like warts that typically appear around the eyes, nose, or mouth. MY.CLEVELANDCLINIC.ORG Genital Warts: Occur in the genital and anal areas, caused by specific strains of HPV.

Answer 18

valacyclovir.فايلا سايكو فير Explanation: Valacyclovir is an antiviral medication effective in treating and preventing recurrent herpes simplex virus (HSV) infections, including both oral and genital herpes. It works by inhibiting viral DNA replication, thereby reducing the severity and duration of outbreaks. DRUGS.COM Analysis of Options: Azithromycin: This is an antibiotic used to treat bacterial infections, not viral infections like herpes. Valacyclovir: An antiviral agent specifically indicated for the treatment of HSV infections. Oratadine: This appears to be a misspelling of "loratadine," which is an antihistamine used for allergy symptoms, not for treating herpes. Terbinafine: An antifungal medication used to treat fungal infections, not viral infections like herpes.

Answer 19

papules, on a narrow base, uneven surface, blood in case of injury no crusts

Answer 20

cockscomb Itching: While warts can cause itching, it is not a specific or defining feature. Wide: This is not a characteristic description of ano-genital warts. Hard on palpation: Warts are typically soft, not hard. Hard lesions may suggest syphilitic condylomata or malignancy.

Answer 21

syphilitic condillomas Ano-genital warts must be differentiated from syphilitic condylomata lata, which are: Broad-based, flat, and moist lesions. Associated with secondary syphilis. Highly infectious and require different treatment (penicillin). Why Other Options Are Incorrect: Bartholinitis: Inflammation of the Bartholin gland, presenting as a painful lump near the vaginal opening. Pyoderma: Bacterial skin infection with pustules and crusts. Genital herpes: Presents with painful vesicles, ulcers, and crusts, not papules.

Answer 22

Cryotherapy (freezing with liquid nitrogen) is a first-line treatment for ano-genital warts. It destroys the wart tissue by freezing it. UV irradiation: Not used for genital warts; UV therapy is used for conditions like psoriasis. Antibiotics: Warts are caused by a virus (HPV), not bacteria. Antifungal: Warts are not fungal infections.

Answer 23

Grouped vesicles on an edematous-hyperemic background Explanation: Correct Answer (4): Herpes zoster is characterized by a rash consisting of grouped vesicles (small blisters) on an edematous (swollen) and hyperemic (red) background. This presentation is typical of the condition. Incorrect Answers: 1. No subjective feelings: This is incorrect. Patients often experience pain, itching, or tingling in the area where the rash will develop. 2. Itching: While itching can occur, it is not the most characteristic symptom. Pain and tingling are more commonly reported. 3. Nodes: The term "nodes" refers to lumps or swellings, which are not typical in herpes zoster presentations.

Answer 24

Hemorrhagic. Explanation: Herpes zoster can present in several clinical variants, including: Hemorrhagic: Vesicles filled with blood (hemorrhagic blisters). Bullous: Large blisters. Ophthalmic: Involvement of the ophthalmic branch of the trigeminal nerve. Disseminated: Widespread rash, often in immunocompromised patients.

Answer 25

famacyclovir Correct Answer (3): Famciclovir is an antiviral medication used to treat herpes zoster. It helps reduce the severity and duration of the infection. Incorrect Answers: 1. Tetracycline: This is an antibiotic used for bacterial infections, not viral infections like herpes zoster. 2. Amoxicillin: Another antibiotic, amoxicillin is ineffective against viral infections such as herpes zoster. 4. Hydroxychloroquine: Primarily used for autoimmune conditions like lupus and rheumatoid arthritis, hydroxychloroquine is not indicated for treating herpes zoster.

Answer 26

Smear Examination for Acantholytic Cells: Correct Answer: This test involves examining a sample from the base of a blister or an oral erosion under a microscope to identify acantholytic cells, which are detached epidermal cells characteristic of pemphigus vulgaris.

Answer 27

polymorphism of the rash Dermatitis herpetiformis, also known as Duhring's disease, is a chronic autoimmune skin condition characterized by intensely itchy, blistering eruptions. The rash typically appears on the elbows, knees, buttocks, back, and scalp. YALEMEDICINE.ORG Characteristics of Dermatitis Herpetiformis: Primary Element - Pustule: Incorrect. The primary lesions in dermatitis herpetiformis are intensely itchy, erythematous papules and vesicles, not pustules. Polymorphism of the Rash: Correct. The rash exhibits polymorphism, meaning it presents in various forms, including papules, vesicles, and urticarial plaques. No Objective Feeling: Incorrect. The condition is characterized by intense pruritus (itching), which is a significant symptom. Positive Nikolsky's Sign: Incorrect. Nikolsky's sign, which involves the skin separating from the underlying tissue when slight pressure is applied, is typically negative in dermatitis herpetiformis.

Answer 28

Asbo-Hanzen's syndrome. Explanation: Asbo-Hansen's sign (often spelled Asbo-Hansen or Nikolsky variant) is a key diagnostic indicator for pemphigus. It involves applying pressure to an intact blister, causing it to spread laterally into adjacent normal skin. This occurs due to acantholysis (loss of cell adhesion) in pemphigus. Why Other Options Are Incorrect: Köbner's Phenomenon: Seen in psoriasis or lichen planus, where new lesions form at sites of skin trauma. Not related to pemphigus. Balzer Test: Used to diagnose tinea versicolor (fungal infection). Scales are scraped and examined under a microscope after applying iodine. Symptom of Pincus: Not a recognized clinical sign in dermatology. Likely a distractor. Key Diagnostic Signs in Pemphigus: Nikolsky Sign: Skin sloughs off with lateral pressure. Asbo-Hansen Sign: Blister spreads with direct pressure. Biopsy with Immunofluorescence: Confirms intraepidermal acantholysis and IgG autoantibodies.

Answer 29

dapsone 2% salicylic paste is typically used for other skin conditions, such as psoriasis or acne. Penicillin is an antibiotic used for bacterial infections and is not effective for this dermatosis. Hydroxychloroquine is used for autoimmune conditions like lupus and rheumatoid arthritis, but it is not a primary treatment for Duhring's dermatosis. Additional Management: Gluten-Free Diet: and topical corticosteroids