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Clinical Dermatology > Gen Derm 1 > Flashcards

Gen Derm 1 Flashcards

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Dermatology Board Prep flashcards
1
Q

What HLA is associated with early onset psoriasis and guttate psoriasis?

A

HLA CW6

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2
Q

What HLA is associated with saroiliitis- associated psoriasis?

A

HLA B27

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3
Q

What HLA is associated with guttate and erythrodermic psorasis?

A

HLA B13, B17

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4
Q

Psoriasis has an increase in what cytokines?

A

TH1 cytokines, IL1, IL2, IL6, TNFa

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5
Q

Psoriasis has an decrease in what cytokines?

A

IL10

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6
Q

What stimulates the Th17 cells to secrete what?

A

IL23 stimulates Th17 to secrete IL17, IL22

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7
Q

What cytokine causes neutrophil chemotaxis that form the pustules of Kogoj and Munro?

A

CXCL8

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8
Q

Keratinocytes secrete what antimicrobial proteins?

A

Keratinocytes secrete antimicrobial proteins (hBD 1-2, cathelicidin LL37, and SLP1)

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9
Q

Systemic drug triggers for psoriasis?

A

(HB LITT) Hypocalcemia B-blockers Lithium, IFNs, TNFalpha, Terbinafine

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10
Q

What systemic drug triggers have a long latency?

A

Lithium, B blockers

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11
Q

What is impetigo herpetiformis? How/when does it present? What do you treat with?

A

Pregnancy associated generalized pustular psoriasis which begins in the flexures then generalizes. 3rd trimester. Treat with 1mg/kg of prednisone. Cyclosporine in refractory cases.

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12
Q

What is von Zumbusch pustular psoriasis associated with?

A

Fever, leukocytosis, hypoalbuminemia, hypocalcemia

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13
Q

Is there a fetal risk for impetigo herpetiformis?

A

Yes, Increased risk of stillbirth and perinatal mortality remains high, due to placental insufficiency, premature rupture of membranes, preterm labor and intrauterine growth restriction.

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14
Q

What syndrome can palmopustular pustulosis be associated with?

A

SAPHO. Synovitis, Acne, Pustulosis, Hyperostosis. Osteitis + IBD.

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15
Q

Psoriasis nail pits is d/t problems in what area of the nail?

A

Proximal matrix

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16
Q

Psoriasis nail leukonychia is d/t problems in what area of the nail?

A

distal matrix

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17
Q

Psoriasis nail subungal hyperkeratosis is d/t problems in what area of the nail?

A

nail bed> distal matrix

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18
Q

Psoriasis nail oil spots, splinter hemorrhages, onycholysis, subungal hyperkeratosis are d/t problems in what area of the nail?

A

Nail bed (oil spots d/t exocytosis of lymphocytes) (splinter hemorrhages d /t fragility of capillaries), subungal hyperkeratosis and distal onycholysis are d/t parakeratosis of the nail bed

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19
Q

What retinoid is effective for psoriasis? what type of psoriasis?

A

Acitretin. Erythrodermic and pustular psoriasis

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20
Q

What does ustekinumab inhibit?

A

IL12, IL23

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21
Q

Treatment for pustular von Zumbusch?

A

acitretin> cyclosporine> MTX> biologics

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22
Q

whats the woronoff ring?

A

plae blanching rink around psoriatic lesions

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23
Q

What are the scalp, skin, hand and nail clinical features of PRP?

A

Scalp erythema, folliculocentric keraototic papules on erythematous base, orange waxy keratoderma of palms and soles, thick yellow-brown nails

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24
Q

What the classic PRP types in adults and kids?

A

Type 1 adult, type 3 kids

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25
Q

What is the localized form of PRP?

A

Type 4 in children.

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26
Q

Treatment for PRP? name 4. whats 1st line?

A

Firt line is acitretin or isotretinoin 2mg/kg/day. Also vitamin A, MTX, TNF alpha inhibitors.

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27
Q

Histopath for PRP?

A

checkerboard (alternating vertical and horizontal parakeratosis and orthohyperkeratosis)

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28
Q

What drugs induce Pityriasis Rosea?

A

To get good PR, ACE stole GOLD from the BARbituates, but was b-BLOCKED by ICEsotretinoin. Ace inhibitors, gold, barbiturates, beta-blockers, isotretitoin.

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29
Q

What is inverse PR?

A

involvement of intertriginous sites, or more prominent involvement oft he limbs

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30
Q

What treatments for PR will hasten clearance?

A

erythromycin for 14 days, acyclovir 800 mg five times daily for 1 week

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31
Q

Pregnant women with PR will have what?

A

Increased likelihood of spontaneous abortion if they get PR during the first 15 weeks of gestation

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32
Q

Location of intertriginous/axillary granular parakeratosis?

A

axilla, inguinal, inframammary

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33
Q

Whats the #1 systemic finding in erythroderma?

A

peripheral ymphadenopathy

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34
Q

Whats the #1 cause of erythroderma in healthy patients? in HIV patients?

A

in healthy patients it’s psoriasis, in HIV patients it’s drugs

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35
Q

What are some causes of drug induced erythroderma?

A

Allopurinol, sulfa, antiepileptics, Isoniazid, HAART, minocycline. Picture tristan thompson eating at RED.

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36
Q

What is the diagnostic criteria for sezary syndrome?

A
  1. T cell clone in the blood (preferably same as skin)
  2. > 1000 cells/mcL or
  3. CD4:CD8 ratio of >10:1
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37
Q

Treatment for CARP?

A

Minocycline 100mg BID for 6 wks

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38
Q

Genes encoding what epidermal proteins are associated with AD development?

A

Filaggrin mutation and SPINK

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39
Q

What cytokines are upregulated in eczema?

A

IL4,IL5, IL12, IL13,

40
Q

What is hertoghe sign?

A

diminished lateral eyebrows in eczema

41
Q

Children with eczema can often have what 4 associated derm things?

A

pityriasis alba, lichen spinulosis, dyshidrotic eczema, juvenile plantar dermatosis

42
Q

what are some ocular complications of eczema. In adults? in kids?

A

In adults, atopic keratoconjunctivitis. In kids, vernal keratoconjunctivitis. Posterior subcapsular cataracts. Keratoconus (elongation of the cornea). Retinal detachment.

43
Q

In high risk AD patients, what is the best prevention?

A

Breastfeeding in the first 4-6 months of life

44
Q

When during the menstrual cycle does progesterone dermatitis start?

A

Luteal phase (1 week before menses)

45
Q

What is the diagnostic test for progesterone dermatitis?

A

intradermal injection of progesterone

46
Q

MOA of irritant dermatitis? Need sensitization? most common site?

A

Via direct damage of keratinocytes by irritant, not immune mediated. Does not need sensitization. Hands most common site

47
Q

Cross-reaction definition?

A

compounds with similar chemical structures ie poison ivy and mango peel

48
Q

Co-reaction definition?

A

compounds that are commonly used together ie neomycin and bacitracin

49
Q

Phytophotodermatitis is due to a reaction between what and what?

A

fucocoumarins and UVA, which causes blistering and then hyperpigmentation afterwards

50
Q

Bergamot oil causes phytophotodermatitis via what?

A

5-methoxypsoralen, a furocoumarin

51
Q

Fingertip ACD?

A

Florist, tulip

52
Q

Eyelid ACD?

A

tosylamide> acrylates from nail products

53
Q

Disperse Dye ACD types? Found where?

A

Blue dyes 106, 124. Found in 100% acetate (derived from cellulose) and 100% polyester liners of women’s clothing.

54
Q

Cosmetic ACD?

A

fragrance

55
Q

Perianal ACD? Name 2

A

Lidocaine and preservatives

56
Q

Shoe dermatitis? Name 3

A

Mercaptobenzzothiazole (rubber accelerator) Chromates (leather), and Colophony (adhesives)

57
Q

Airborne ACD?

A

compositae

58
Q

Ulcer ACD?

A

bacitracin, neomycin, lanolin

59
Q

What can have delayed positive patch test? name 6

A

Gold, neomycin, PPD, corticosteroids, dodecyl gallate (preservative in foods), palladium

60
Q

How do you treat hydrofluoric acid Irritant Contact dermatitis ?

A

Neutralize with calcium gluconate.

61
Q

How do you neutralize phenol?

A

65% ethyl or isopropyl alcohol.

62
Q

What is a cause of non-immunologic contact urticaria?

A

nettle/urticaceae family which has sharp hairs on plants that contain histamine, serotonin, and acetylcholine. Everyone which contacts it gets urticaria.

63
Q

What is the cause of mechanical Irritant contact dermatitis?

A

Prickly pear (opuntia spp.) which causes glochid dermatitis causing penetrating injuries. Inoculates clostridium tetani, s aureus, s shenckii and atypical mycobacteria

64
Q

Chemical ICD: Bromelin?

A

Pineapple

65
Q

Chemical ICD: calcium oxalate? name 3 flowers, 1 plant, 1 fruit

A

daffodil (narcissus spp), hyacinth, tulip, dumbcane, pineapple

66
Q

Chemical ICD: capsacin?

A

Solanaceae family with hot peppers

67
Q

Chemical ICD: phorbol esters + diterpenes (latex)? name 3

A

Euphorbiacea family in croton plant, spurges, and poinsettas

68
Q

Chemical ICD: ranunculin/protoanemonin? how do you differentiate between this and phytophoto?

A

Buttercups and marigolds. No post-vesticular hyperpigmentation like in phytophoto

69
Q

Chemical ICD: Thiocyanates? name 2

A

alliacea family with garlic AND brassicaceae family with blackmustard/radish

70
Q

Phytophotodermatitis plant families (4) Floating on the MAR

A

Fabaceae, Moracea, Apiaceae/umbelliferae, Rutaceae

71
Q

Apiaceae/umbelliferae contains what plants and vegetables?

A

Hogweed, parsley, chervil, parsley, parsnips, celery, carrots

72
Q

Rutaceae contains what plants ? 2

A

Cirtus (lemon, lime, grapefruit), hawaiian leis

73
Q

Moraceae contains what plants? 2

A

figs, mulberry

74
Q

Fabaceae contains what plants? 2

A

Scurf Pea, Balsam of Peru

75
Q

Rhus dermatitis is what family? What is the allergen?

A

Anacardiaceae. Allergen is urushiol’s derivative called pentadecylcatechol

76
Q

Exotic hardwoods can cause what type of ACD?

A

Erythema multiforme like reaction

77
Q

Test for nickel?

A

DMG test

78
Q

Chromates found in?

A

Green Dyes, Cement, leather

79
Q

Cobalt found in?

A

Blue-green dyes, glass/pottery, cement, Vitamin B12 injections (hand dermatitis), metal products

80
Q

Poral reaction in what allergen?

A

Cobalt

81
Q

Most common cause of oral lichenoid reaction?

A

Amalgams

82
Q

Risk factors for latex allergy?

A

Spina bifida, healthcare profession

83
Q

Latex will cross react with what?

A

Bananas, Avocado, chestnut, kiwi, passion fruit

84
Q

Most common glove allergy?

A

Thiuram

85
Q

What allergen is released from bleached elastic?

A

Carbamates

86
Q

What is the #1 cause of shoe dermatitis?

A

MBT (mercaptobenzothiazole)

87
Q

What do thiurams cross react with?

A

disulfiram (treatment for alcohol abuse)

88
Q

Wet suit dermatitis?

A

neoprene (dialkyl thioureas)

89
Q

PPD found in?

A

Hair dye, printer ink, black rubber

90
Q

What are the 4 types of rubber accelerators?

A

Thiuram, Carbamates, Diphenylguanidine, benzothiozoles, Hexamethylenetetramine

91
Q

Allergy to glue that holds leather products together?

A

p-tert-butylphenol formaldehyde (PTBP)

92
Q

Allergy to PVC and plastic materials?

A

Epoxy resin

93
Q

Allergy to Krazyglue for artificial nails?

A

Cyanoacrylates (ethyl)

94
Q

Dermabond allergy ingredient?

A

Octyl cyanoacrylate

95
Q

Artificial joint and dental prostheses allergy?

A

methacrylate

96
Q

What textile has the least formaldehyde?

A

polyester

Clinical Dermatology (11 decks)

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