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Clinical Dermatology > Gen Derm 2 > Flashcards

Gen Derm 2 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
What does sesquiterpene lactone cross-react with?
Cross reacts with permethrin
26
ID reaction usually develops in people with what types of rashes? (3)
contact dermatitis, stasis dermatitis, tinea pedis
27
Most common immunologic contact urticaria from?
potatoes #1, celery, raw meat, fish and shellfish
28
Other causes of immunologic contact urticaria from? 3
Latex, ammonium persulfate (hair bleach), bacitracin
29
Other causes of non-immunologic contact urticaria ? 3
caterpillars, jelly fish, DMSO (intersitital cystitis)
30
Birch pollen allergy associated with contact urticaria to what?
apples, pears, cherries
31
what type of patch testing do you do for contact urticaria?
open patch testing because a prick, scratch/intradermal testing can cause anaphylaxis
32
What are the #1 and other causes of EM?
HSV1, Mycoplasma pneumoniae, histoplasma capsulatum
33
For Erythema nodosum + Erythema multiforme think of what cause?
Histoplasma capsulatum
34
What is the antiviral prophylaxis to prevent EM?
Valtrex 1gm/day or Famvir 250mg/day
35
SJS HLA subtype for Asians exposed to carbamazepine?
HLA B 1502
36
SJS HLA subtype for Europeans exposed to carbamazepine?
HLA B 3101
37
SJS HLA subtype for Chinese exposed to allopurinol?
HLA B 5801
38
What is the major mediator of apoptosis in SJS? What are the other ones?
``` #1 Granulysin (directly causes apoptosis). Other ones: Granzyme B, perforin, FasL (CD 95L) ```
39
How does FasL work to cause apoptosis?
Binds to Fas death receptor (CD95/ APO1), activate caspases, causes apoptosis
40
Most common HIV drugs to cause SJS?
NNRTs: nevirapine, abacavir
41
Describe the SCORETEN system for SJS. When do you have to tally it for maximum predictive value?
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
What antiseizure medication in the bezodiazepine class can cause SJS?
Clobazam
43
Do sulfaonamide antibiotics cross react with non-antibiotic sulfonamides (HCTZ, hypoglycemic agents)?
No
44
what blood tests can you do to differentiate SJS from other morbiliform drug eruptions?
Granulysin, high mobility group protein B1
45
What is Mucha Haberman disease?
Febrile ulceronecrotic PLEVA variant that presents with high fever, lymphadenopahty, arthritis, mucosal, pulmonary and GI involvement. Associated with increased TNF alpha levels.
46
What type of PLEVA is the fastest to resolve? which is the slowest?
Diffuse distribution is fastest to resolve. Peripheral distribution is the slowest to resolve.
47
1 cause of Fixed Drug? Other causes?
Sulfonamides is #1. naproxen, tetracyclines, psudoephedrine for non-pigmented FDE.
48
Most common sites for FDE?
Oral and genital mucosa
49
Does FDE occur every time you're exposed to the drug?
No, there is a refractory period.
50
What is the single most important predictor of GVHD?
HLA compatibility
51
What stem cell source increases your risk of GVHD?
peripheral blood ? bone marrow ? cord blood
52
Clues to early acute GVHD? name 3
acral erythema, violaceous hue on ear, follicular peri-eccrine erythema
53
How do you stage the severity of GVHD on skin, Gi and liver?
Skin by BSA, GI by volume of diarrhea, liver by bilirubin
54
Most common non-sclerotic GVHD?
lichenoid eruption on arms and hands, then atopic dermatitis like
55
What 3 histopath findings do you look for in GVHD?
basal vaculolar, apoptotic cells in adnexae, epidermal dysmaturation
56
what lab test do you do for chronic GVHD?
MRI to detect fasciitis
57
What do you give for acute GVHD? what is the mortality rate ?
Steroids first line. 70% mortality for steroid-refractory cases
58
What drug can decrease incidence of visceral GVHD?
CCR5 (maraviroc) by blocking CCR5 mediated CD8+ T cell recruitment to liver and gut
59
What is the correlation between LP and hep b?
Hep B vaccine associated with oral LP and bullous LP in children
60
What are drugs that cause lichen planus?
HANGing House Plant. HCTZ, ACE inhibitor, NSAIDs, Gold Hydroquinone, Penicillamine
61
What % of patients who have oral LP subsequently develop cutaneous LP?
10%
62
What LP can have eosinophils?
drug- induced LP and hypertrophic LP
63
What can hypertrophic LP lead to?
multiple KAs or follicular based SCCs
64
What is graham little piccardi lasseur syndrome
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
What do you see on DIF for lichen planus?
shaggy fibrinogen along BMZ
66
Treatment for EDP? Erythema Dyschromicum perstans
clofazamine, dapsone, LP
67
What cells do lichen nitidus have on histology?
lymphocytes, histiocytes, and giant cells
68
What is the DDX of lichen nitidus?
lichen spinulosis and disseminate and recurrent infundibulofolliculitis
69
Disseminate and recurrent infundibulofolliculitis clinical presentation?
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
Treatment for disseminate and recurrent infundibulofolliculitis? Name 4
Vitamin A 50K BID and isotretinoin (0.5 mg/kg/day for 16 weeks or PUVA or Urea 40%
71
80% of people with LSA have what antibodies
IgG autoantibodies against ECM1
72
HLA associated with LSA
HLA DQ7
73
What is the accessory tragus derived from?
1st brachial arch
74
Granular layer keratin
K2e and K10

Clinical Dermatology (11 decks)

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