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Clinical Dermatology > Gen Derm 2 > Flashcards

Gen Derm 2 Flashcards

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Dermatology Board Prep flashcards
1
Q

Name all formaldehyde releasing perservatives. 5

A

quaternium 15 (dowicil 200), imidazolidinyl urea, diazolidinyl urea, DMDM hydantoin, bronopol,

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2
Q

Common allergen in wet wipes?

A

methylchloroisothiazolinone/ methylisothiazolinone (MCI/MI) aka Kathon CG

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3
Q

What do parabens cross react with?

A

PPPASTA family (para-aminosalicylic acid, PABA, PPD, AZO dyes, Sulfonamides, thiazides, ester anesthetics)

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4
Q

Thimerosal cross-reacts with what? Thimerosal found in what?

A

Vaccines, eye-drop solutions. Mercury and piroxicam

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5
Q

What is propylene glycol found in?

A

ECG and lubricant jelly, antifreeze, brake fluid, crisabrole

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6
Q

Cocoamidopropyl betaine derived from that 2 ingredients?

A

DMAPA, amidoamine (amidopropyl dimethylamine [amidoamine])

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7
Q

What ACD allergen is found in mycolog (nystatin/triamcinolone)? What should they not be given in case it develops into a systemic ACD?

A

ethylenediamine. Cannot be given aminophylline (bronchodilator)

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8
Q

Does natural Henna cause PPD allergy?

A

No, natural henna contains lawsonia inermis

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9
Q

Hair bleach ACD? What kind of ACD does it cause?

A

ammonium persulfate which causes contact urticaria

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10
Q

Home perm ICD?

A

ammonium thioglycolate. ICD> ACD

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11
Q

Salon perm ACD?

A

glyceryl monothioglycolate, which can remain on the hair shaft for > 3months

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12
Q

Chloroxylenol ACD found in?

A

Disinfectant solution for household and surgical as well as makeup

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13
Q

What’s the #1 ester anesthetic ACD?

A

Benzocaine (used for hemorrhoids), other esters include procaine, tetracaine

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14
Q

What does neomycin cross react with?

A

aminoglycosides (gentamicin and tobramycin)

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15
Q

Steroid ACD: group A screening agent? what does the class include?

A

Tixocortol pivalate: hydrocortisone, prednisone, prednisolone, and metylprednisolone

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16
Q

Steroid ACD: group B screening agent? what does the class include?

A

Budesonide: triamcinolone, desonide, fluocinolone, fluocinonide, halocinonide, hydrocortisone butyrate

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17
Q

Steroid ACD: group C screening agent? what does the class include?

A

Betamethasone: betamethasone, desoximetasone, dexamethasone, flucortisone

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18
Q

Steroid ACD: group D screening agent? what does the class include?

A

Hydrocortisone 17-butyrate: mometasone, aclomethasone, betamethasone valerate, clobetasol

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19
Q

Which steroid classes cross react with each other?

A

Class B and D

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20
Q

What percentage of users develop ACD to nitrogen mustard?

A

65% w/ aqueous solution, 5% with ointment

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21
Q

Leather sofa allergy?

A

Dimethylfumarate

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22
Q

What does pentadecylcatechol in urushiol cross react with?

A

Japanese lacquer tree, cashew nutshell, mango rind, ginkgo pulp

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23
Q

What does colophony cross react with? What family does colophony come from?

A

Pinaceae family. Cross reacts with balsam of peru, turpentine, benzoin, wood tars, spices

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24
Q

What is the sensitizer for compositae/asteraceae ?

A

sesquiterpene lactone

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25
Q

What does sesquiterpene lactone cross-react with?

A

Cross reacts with permethrin

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26
Q

ID reaction usually develops in people with what types of rashes? (3)

A

contact dermatitis, stasis dermatitis, tinea pedis

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27
Q

Most common immunologic contact urticaria from?

A

potatoes #1, celery, raw meat, fish and shellfish

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28
Q

Other causes of immunologic contact urticaria from? 3

A

Latex, ammonium persulfate (hair bleach), bacitracin

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29
Q

Other causes of non-immunologic contact urticaria ? 3

A

caterpillars, jelly fish, DMSO (intersitital cystitis)

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30
Q

Birch pollen allergy associated with contact urticaria to what?

A

apples, pears, cherries

31
Q

what type of patch testing do you do for contact urticaria?

A

open patch testing because a prick, scratch/intradermal testing can cause anaphylaxis

32
Q

What are the #1 and other causes of EM?

A

HSV1, Mycoplasma pneumoniae, histoplasma capsulatum

33
Q

For Erythema nodosum + Erythema multiforme think of what cause?

A

Histoplasma capsulatum

34
Q

What is the antiviral prophylaxis to prevent EM?

A

Valtrex 1gm/day or Famvir 250mg/day

35
Q

SJS HLA subtype for Asians exposed to carbamazepine?

A

HLA B 1502

36
Q

SJS HLA subtype for Europeans exposed to carbamazepine?

A

HLA B 3101

37
Q

SJS HLA subtype for Chinese exposed to allopurinol?

A

HLA B 5801

38
Q

What is the major mediator of apoptosis in SJS? What are the other ones?

A 
#1 Granulysin (directly causes apoptosis).
Other ones: Granzyme B, perforin, FasL (CD 95L)
39
Q

How does FasL work to cause apoptosis?

A

Binds to Fas death receptor (CD95/ APO1), activate caspases, causes apoptosis

40
Q

Most common HIV drugs to cause SJS?

A

NNRTs: nevirapine, abacavir

41
Q

Describe the SCORETEN system for SJS. When do you have to tally it for maximum predictive value?

A

Must be tallied within 1-3 days of hospitalization. TAMEBUG. Tachy >120, Age >40, Malignancy, Epidermal loss >10%, Bicarb >20, Urea>27, Glucose >250

42
Q

What antiseizure medication in the bezodiazepine class can cause SJS?

A

Clobazam

43
Q

Do sulfaonamide antibiotics cross react with non-antibiotic sulfonamides (HCTZ, hypoglycemic agents)?

A

No

44
Q

what blood tests can you do to differentiate SJS from other morbiliform drug eruptions?

A

Granulysin, high mobility group protein B1

45
Q

What is Mucha Haberman disease?

A

Febrile ulceronecrotic PLEVA variant that presents with high fever, lymphadenopahty, arthritis, mucosal, pulmonary and GI involvement. Associated with increased TNF alpha levels.

46
Q

What type of PLEVA is the fastest to resolve? which is the slowest?

A

Diffuse distribution is fastest to resolve. Peripheral distribution is the slowest to resolve.

47
Q

1 cause of Fixed Drug? Other causes?

A

Sulfonamides is #1. naproxen, tetracyclines, psudoephedrine for non-pigmented FDE.

48
Q

Most common sites for FDE?

A

Oral and genital mucosa

49
Q

Does FDE occur every time you’re exposed to the drug?

A

No, there is a refractory period.

50
Q

What is the single most important predictor of GVHD?

A

HLA compatibility

51
Q

What stem cell source increases your risk of GVHD?

A

peripheral blood ? bone marrow ? cord blood

52
Q

Clues to early acute GVHD? name 3

A

acral erythema, violaceous hue on ear, follicular peri-eccrine erythema

53
Q

How do you stage the severity of GVHD on skin, Gi and liver?

A

Skin by BSA, GI by volume of diarrhea, liver by bilirubin

54
Q

Most common non-sclerotic GVHD?

A

lichenoid eruption on arms and hands, then atopic dermatitis like

55
Q

What 3 histopath findings do you look for in GVHD?

A

basal vaculolar, apoptotic cells in adnexae, epidermal dysmaturation

56
Q

what lab test do you do for chronic GVHD?

A

MRI to detect fasciitis

57
Q

What do you give for acute GVHD? what is the mortality rate ?

A

Steroids first line. 70% mortality for steroid-refractory cases

58
Q

What drug can decrease incidence of visceral GVHD?

A

CCR5 (maraviroc) by blocking CCR5 mediated CD8+ T cell recruitment to liver and gut

59
Q

What is the correlation between LP and hep b?

A

Hep B vaccine associated with oral LP and bullous LP in children

60
Q

What are drugs that cause lichen planus?

A

HANGing House Plant. HCTZ, ACE inhibitor, NSAIDs, Gold Hydroquinone, Penicillamine

61
Q

What % of patients who have oral LP subsequently develop cutaneous LP?

A

10%

62
Q

What LP can have eosinophils?

A

drug- induced LP and hypertrophic LP

63
Q

What can hypertrophic LP lead to?

A

multiple KAs or follicular based SCCs

64
Q

What is graham little piccardi lasseur syndrome

A

variant of LPP with classic triad: (1) non-scarring pubic and axillary hair loss w/ (2) disseminated spiny keratosis pilaris like papules (3) scarring alopecia on scalp

65
Q

What do you see on DIF for lichen planus?

A

shaggy fibrinogen along BMZ

66
Q

Treatment for EDP? Erythema Dyschromicum perstans

A

clofazamine, dapsone, LP

67
Q

What cells do lichen nitidus have on histology?

A

lymphocytes, histiocytes, and giant cells

68
Q

What is the DDX of lichen nitidus?

A

lichen spinulosis and disseminate and recurrent infundibulofolliculitis

69
Q

Disseminate and recurrent infundibulofolliculitis clinical presentation?

A

Presents as ITCHY follicular-based eruption on the trunk and proximal extremities that affects young black adults. Looks like goosebumps lined up in the row

70
Q

Treatment for disseminate and recurrent infundibulofolliculitis? Name 4

A

Vitamin A 50K BID and isotretinoin (0.5 mg/kg/day for 16 weeks or PUVA or Urea 40%

71
Q

80% of people with LSA have what antibodies

A

IgG autoantibodies against ECM1

72
Q

HLA associated with LSA

A

HLA DQ7

73
Q

What is the accessory tragus derived from?

A

1st brachial arch

74
Q

Granular layer keratin

A

K2e and K10

Clinical Dermatology (11 decks)

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