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Gen Derm/Med Derm Flashcards

1
Q

Madarosis

A

can be associated with hypothyroidism

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2
Q

Follicular thyroid carcinoma

A

Cowdens

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3
Q

Most common thyroid carcinoma

A

papillary thyroid carcinoma

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4
Q

Cutaneous PAN

A

Hepatitis C > B

Classic PAN is B>C

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5
Q

IBD associations

A

PG

EBA

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6
Q

Antibody in primary biliary cirrhosis

A

Anti-mitochondrial antibody

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7
Q

Mechanism in Scleroderma

A

TGF-B, endothelin-1, PDGF, IL-4

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8
Q

Wilson’s disease mutation

A

ATP7B

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9
Q

Chromophode renal carcinoma

A

Birt-Hogg-Dube

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10
Q

Lindsay’s nails

A

half and half

renal disease

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11
Q

Acquired angioedema

A

Decreased C1-INH activity
Decreased C1q and C2/C4
AAE type 1: lymphoproliferative disorder
AAE type 2: autoimmune disease

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12
Q

Bazex tumor

A

upper aerodigestive

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13
Q

Antiepiligrin cicatricial pemphigoid; cancer

A

adenocarcinoma (GI and lung> other)

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14
Q

Carcinoid tumor details

A

must have met to liver for carcinoid syndrome (for mid-gut)
bronchial and gastric do not need mets
Increased 5-HIAA in urine

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15
Q

Dermatomyositis and malignancy

A

most common: ovarian cancer

Other: lung, colorectal, pancreatic, non-Hodgkin lymphoma

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16
Q

Erythema Gyratum repens: cancer type

A

lung cancer > esophageal or breast

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17
Q

EMPD

A

CK7+, GCFDP-15+, CK20-

perianal has 5x risk of internal malignancy

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18
Q

Familial Atypical mole and multiple melanoma syndrome

A

CDKN2A, AD
p16, p14
ultimately inhibit p53 (tumor suppressor)

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19
Q

hypertrichosis lanuginosa acquisita: cancer

A

lung, colorectal, and breast cancer

F>M

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20
Q

Leser-Trelat: cancer

A 
gastric adenocarcinoma (most common)
colon, breast, others
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21
Q

malignant acanthosis nigricans: cancer

A

GI cancer

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22
Q

Multicentric Reticulohistiocytosis

A

malignancy (no specific)

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23
Q

Necrolytic Migratory Erythema

A

glucagonoma (pancreatic islet cell carcinoma, a2-glucagon)

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24
Q

NXG

A

IgG-k gammopathy

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25
Pagets disease of the breast
ductal breast CA
26
Paraneoplastic Pemphigus: cancer
non-hodgkin lymphoma or CLL Castleman (children-most common), thymoma, sarcoma They can die of bronchiolitis obliterans
27
Pityriasis Rotunda Association
HCC | Other: TB, leprosy, liver, lung disease, gastic and esophageal carcinoma
28
plane xanthoma
paraproteinemia, myeloma, lymphoproliferative
29
Most common skin with POEMS
hyperpigmentation, hypertrichosis, sclerodermoid
30
Schnitzler
urticaria+ IgM-k
31
Scleromyxedema
IgG lambda
32
Sweets
IBD | Malignancy (AML most common)
33
Tripe Palms
lung cancer | If associated with acanthosis nigricans (gastric cancer)
34
HLA-B13, HLA-B17
guttate and erythrodermic psoriasis
35
Drugs associated with psoriasis
Lithium, B-blocker, TNF-a,
36
Impetigo Herpetiformis
pregnancy associated pustular psoriasis | early delivery recommended
37
pityriasis amiantacea
psoriasis is # 1 cause
38
Most Common PSA
Oligoarthritis, DIP and PIP involvement ``` Other types Asymmetric DIP RA like Anklylosing spondy Arthritis mutilans: telescoping ```
39
PRP vs Psoriasis
No nail pits in PRP
40
Nail changes in psoriasis
pits: proximal matrix leukonychia: distal matrix oil spots, salmon patches, onycholysis: nail bed
41
PRP Types
1: generalized adult 2: atypical adult, chronic course 3: juvenile, generalized (1st 2 years and adolescence) 4: juvenile, localized 5: atypical juvenile: sclerodermoid changes, early onset
42
Drug induced PR
ACE, B-blockers, gold older population no herald resolved in 2 weeks after stopping drug
43
Definition of erythroderma
> 90% BSA M>F age=50
44
Most common cause of erythroderma
psoriasis
45
Most common drugs implicated in erythroderma
allopurinol, sulfa, antiepileptics, HAART
46
Pseudoatrophoderma coli
variant of CARP on neck, responds to mino
47
Atopic derm resolution
60% resolve by age 12
48
Atopic Dermatitis Inflammatory Profile
TH2 (acute) IL4, 5, 12, 13 TH1 (chronic) IFN-y
49
Atopic Dermatitis, Ocular Involvement
atopic keratoconjunctivitis posterior subcapsular cataracts keratoconus
50
Progesterone dermatitis
occurs during luteal phase 1 week before menses RX: OCP Estrogen dermatitis: also a thing, but chronic and worse with menses
51
Allergic Contact Dermatitis
Type IV hypersensitivity
52
Phytophotodermatitis, type of dermatitis
irritant (fucocoumarins+ UVA)
53
Nail products implicated with eyelid dermatitis
tosylamide> acrylates
54
Delayed patch test positives
metals (gold, palladium), corticosteroids
55
Which causes a worse burn/irritation: alkali or acid
alkali
56
Non-immunologic urticaria
Urtica dioica (nettle)
57
Chemical ICD causes
Calcium oxalate: daffodil (amaryll/Lilacea); dumb cane (Dieffenbachia); pineapple Bromelin: pineapple (Anana cosmosus) Capsaicin: peppers (Solanaceae) Phorbol Esters: Croton (Euphorbia), buttercups (ranunculin) Thiocyanates: Alliacea (garlic), Brassicaceae (black mustard, radish)
58
Phytophoto causes
Apiaceae, Umbelliferae: hogweed, cow parsley, parsnips, carrots Rutaceae: citrus, bergamot Moraceae: fig, mulberry Fabaeae: Balsam of peru
59
Photoallergic contact dermatitis
Allergen+ light (UVA)
60
Rhus dermatitis
Anacardiaceae, Toxicodendron | poison ivy, poison oak, poison sumac
61
Asteraceae
Same as Compositae
62
Autosensitization
= id reaction (secondary sites, distant to primary exposure)
63
Contact urticaria
raw vegetables or meats birch pollen allergy (apples, pears, cherries) potato is #1 Latex (health care workers, most common) 50% cross reactivity with (Bananas, avocados, chestnuts, kiwi, passion fruit) Other: hair bleach, ammonium persulfate, bacitracin
64
Non-immunologic contact urticaria
lower risk of anaphylaxis Urticaceae (nettles, #1) DMSO
65
EM with Erythema nodosum
classic for histoplasma
66
SJS
Granulysin felt to mediate apoptosis FasL (CD95L) also associated with apoptosis 1-2 weeks after med Ocular sequelae most common (80%) Mortality SJS < 5% TEN 30%
67
HLA B1502
SJS associated with carbamazepine in asians and E. Indians
68
HLA B3101
Carbamazepine in europeans
69
HLA B5701
abacavir
70
HLA B5801
allopurinol Han chinese
71
SCORTEN
TAMEBUG (tachycardia > 120, age >40, malignancy, epidermal loss >10%, bicarbonate >20, BUN > 27, glucose > 250 ``` SCORTEN mortality 0-1: 3.2% 2: 12.1 3: 35.3 4: 58.3 5+: > 90 ```
72
Cross-reactive SJS: Carbamazepine
Phenytoin, Phenobarbital +/- Lamotrigine Valproic acid does not cross-react Levetiracetam does not cross react
73
Mucha-Haberman
PLEVA+ fever+ LAD | associated with increased TNF-a
74
PLEVA/PLC Path
No eosinophils!! | CD8+ T-cells predominate
75
Drugs associated with fixed drug eruption
1-2 weeks after initial exposure patch test within a prior site of involvement sulfonamides (#1 cause of genital) NSAIDs Phenolphthalein Non-pigmented Pseudoephedrine NSAIDs tetrahydrozoline
76
Frictional Lichenoid eruption
1-2mm lichenoid papules on the extensor surfaces in spring and summer; young boys
77
Most common US ACD
Rhus
78
Most common world wide ACD
Nickel
79
Contact Dermatitis
80% ICD | 20% ACD
80
Clothing Dermatitis allergens
Formaldehyde and Releasers | Dispersion Blue dye
81
Shoe Dermatitis
Adhesives (colophony, p-tert-butyl) Rubber accel (Mercaptobenzothiazole) Leather (chromates) Dyes
82
Adhesive dermatitis
ICD> ACD | rubber, resin, acrylate
83
Alkali Dermatitis Causes
Ca/Na/K hydroxides, ammonia, lye, soap, detergent, bleaches?, depilatories Rx: weak acid, lemon juice or vinegar
84
Acid Dermatitis Causes
Sulfuric Acid: brown discoloration Nitric Acid: yellow Hydrofluoric Acid (used for etching glass): neutralize with calcium gluconate
85
Phenol
glomerulonephritis and arrhythmias | neutralized with 65% ethyl alcohol or isopropyl alcohol
86
Green Felt/Tattoo
Chromate Also Leather and Cement, chromic gut cross react with nickel and cobalt
87
Blue Green Pottery/Tattoo
Cobalt Also: cement, leather?, cosmetics Cross-Reacts with Chromate and Nickel
88
Most frequent persistent positive patch test
Gold
89
Most common glove allergy
Thiuram | Co-Reacts with Disulfuram
90
Bleached Elastic Allergen
Carbamate | Must do use test, may not have positive patch
91
Wet Suit Dermatitis
Dialkyl thioureas (Neoprene)
92
Hair Dye, Black Henna
P-phenalenediamine (PPD) | Also in black rubber and photo developing solution
93
adhesive, Hair wax, chewing gum, violin
Rosin (colophony and abietic acid)
94
Glue for Leather
p-tert-butylphenol formaldehyde resin (PTBP)
95
PVC, plastic, paint, and sculpture
epoxy (Bisphenol A) | only a problem when wet
96
Cyanoacrylates
Ethyl-> Krzy glue Butyl -> Glu Stitch Octyl -> Dermabond
97
Methylacrylates
``` Rigid Plastic (Ortho/Dental) Bone Cement ``` ***Diffuses through rubber and polyvinyl gloves***
98
GVHD in solid organ transplant
small intestine>liver> kidney> heart
99
Risk factors for GVHD
Occurs in 50% of HSCT MOST IMPORTANT IS HLA COMPATIBILITY HLA matched 40% HLA unmatched 60-70% matched unrelated donor female donor> male donor older age Stem cell source: peripheral blood> bone marrow>cord blood Myeloablative Pre-Treatment increases risk (more damage to host tissues)
100
Most commonly affected organ in GVHD
skin
101
GVHD pathophys
donor lymph recognize HOST protein-APC
102
Time of acute GVHD
< 100 days usually 2-6 weeks (peak at day 30) Acral erythema, perifollicular erythema + GI (severity based on diarrhea) + Liver (severity based on bilirubin)
103
Timing chronic GVHD
> 100 days 80% lichenoid
104
Novel treatment for visceral GVHD
miraviroc (CCR5 antagonist): decreases CD8 recruitment to liver and gut
105
Lichen Planus: Frequency of Forms
4% adults affected by oral LP | 1% cutaneous
106
HCV association with LP
oral, erosive LP
107
Allergens associated with LP
mercury, copper, gold, cinnamates
108
Drug Induced LP: Drugs
HCTZ, ACE, B-Blockers; anti-malarials, quinine; penicilliamine, gold; TNF-1; NSAIDs
109
Graham-Little-Piccardi-Lasseur
LPP + non-scarring alopecia
110
Drug-Induced LP
often spares mucosa sun exposed areas more eczematous or psoriasiform LATENCY PERIOD: 12 months
111
LP DIF
shaggy fibrinogen along BMZ, + IgM (> IgA, IgG, C3)
112
Lichen Sclerosus Disease Association
Auto-Immune thyroid disease Also 80% have circulating antibodies to ECM-1
113
Balanitis Xerotica Obliterans
male penile LSA
114
HLA associated with LS
HLA-DQ7
115
Risk of SCC in LS
5% risk in anogenital LS
116
Fogo Selvagem
PF in Brazil, associated with Simulium (black fly)
117
BP HLA
HLA DBQ 0301
118
PNP antibodies
desmoplakin, BPAG-1, pelctin, periplakin, envoplakin, DSG &3
119
Drug Induced BP
Furosemide, ACE, Ceph, B-lactam, penicillamine
120
Mucous Membrane Pemphigoid, Treatment of Choice
Dapsone
121
Anti-p200
Form of BP | target laminin y1, associated with psoriasis; dermal side on SSS
122
Anti-p105
Form of BP | looks like SJS/TEN, Dermal side on SSS
123
Drug Induced Linear IgA
Vancomycin> PCN/CSN, captopril, LITHIUM, Nsaids> phenytoin
124
EBA target
NC1 domain of col VII (anchoring fibril)
125
IgA pemphigus target
desmocollin1
126
Pemphigus Vulgaris, Other Disease Associations
Autoimmune: myasthenia, thymoma, autoimmune thyroid
127
TTG2, TTG3
TTG-2 is target for gut involvement with DH | TTG-3 is target in skin
128
Darier's mutation and location
ATP2A2 (SERCA2- Ca), AD | Endoplasmic reticulum
129
Hailey-Hailey mutation and location
ATP2C1 (hSPCA1), Golgi NO MUCOSAL INVOLVEMENT spares hair on histology
130
ANA: homogenous
dsDNA, histone
131
ANA: peripheral
dsDNA
132
ANA: speckled
Ro/La, U1RNP, Sm, RNAPoly, Scl-70
133
ANA: nucleolar
U3RNP, ant-PM/Scl
134
ANA: discrete speckled
Centromere | anti-centromere antibodies
135
False positive DIF
rosacea, telangiectasias, PMLE
136
Type of light associated with worsening of chronic cutaneous lupus
UVR (UVB> UVA)
137
HLA associated with SCLE
B8, DR3
138
Drugs Associated with SCLE
HCTZ (most common), terbinafine, griseofulvin, NSAIDs, CCB, anti-histamines, PPI, docetaxel, ACE, and TNF (etanercept)
139
Neonatal Lupus Systemic Involvement
Cardiac: 30-40% with heart block Hepatobiliary Hematologic
140
Most common hereditary complement disorder
C2 only 10-20% risk of SLE with homozygous Still most common cause of complement deficiency associated SLE
141
Other complement deficiencies associated with SLE risk
C1q (90%)> C1 r/s > C4 | C1, 2, 4 associated with SLE and infection risk
142
Acquired anti-C1q antibodies
30-50% of patients with SLE, associated with severe renal disease
143
Target in Bullous Lupus
NC1, NC2 of Col VII More common in AA Must have SLE
144
SLE Inflammatory signature
IL-6, IL-17, TNFa | Type 1 IFN (IL-18-> IFN-y)
145
Number of items for SLE criteria
4 (including one immunologic)
146
Minocycline DILE
+ ANCA | - histone antibodies
147
TNF-a DILE
anti-dsDNA | prominent skin involvement
148
Drugs associated with DILE
hydralazine, procainamide> methyldopa, isoniazid, penicillamine, PTU
149
Jessners
CD8+ cells
150
REM, DIF
negative
151
Most common malignancy associated with DM
Ovarian GI Detected within 1-2 years
152
Brunsting variant of DM
Classic Juvenile DM 90% gradual onset, calcinosis cutis
153
Banker variant of DM
``` Vasculopathic/Ulcerative JDM 10% rapid onset with severe muscle disease vasculitis cutaneous ulcerations ```
154
Wong Type DM
clinical features of PRP with DM
155
anti-Fodrin antibodies
Sjogren syndrome | 70%, most sensitive and specific
156
Antibody agains Type II collagen
Relapsing polychondritis
157
MAGIC syndrome
Behcets + relapsing polychondritis MTX most effective Rx
158
Felty syndrome
seropositive RA neutropenia, splenomegaly refractory leg ulcers a/w risk of lymphoma/leukemia
159
Morphea | antibodies
anti ss-DNA antibodies Anti-topoisomerase II None have scl-70 or anti-centromere
160
Parry Romberg Syndrome
progressive hemifacial atrophy
161
Melorheostosis
roughening long bone surface under area of linear morphea
162
Atrophoderma of Pasini and Pierini
brown-gray hyperpigmented plaques with cliff-drop edge Type of morphea decreased thickness of skin compared to normal
163
Antibodies in Scleroderm
Anti-Scl Anti-RNA Pol III Anti-centromere (LCSS)
164
Scleroderma most common cause of mortality | most common site of visceral involvement
mortality: pulmonary common: GI-> GERD
165
CXCL4
marker of skin and lung fibrosis, as well as PAH
166
Eosinophilic Fasciitis
Excellent response to steroids | Metalloproteinase inhibitor 1 = serologic marker of disease
167
Paraneoplastic syndrome with skin sclerosing
POEMS | Carcinoid (legs)
168
Ingestions associated with scleroderma like presentation
Toxic Oil Syndrome (Rapeseed oil, flu-like symptoms) L-tryptophan infegestion (fever, eosinophilia, myalgia, fasciitis) Polyvinyl chloride Meds: Taxanes, Bleomycin Vitamin K
169
Isomorphic response
new lesions in areas of trauma
170
Isotropic response
new dermatosis that favors a prior site of trauma/disease
171
linear red to skin colored cords
Interstitial Granulomatous Dermatitis and Arthritis Most commonly associated with GA
172
umbilicated skin-colored to violaceous papules digits and elbows
PNGD LCV + basophilic collagen degeneration, palisaded granulomas SLE ANCA+ Vasculitis RA
173
Perforating calcific elastosis
multiparous black women, periumbilical
174
MAD PORES
EPS ``` Marfans Acrogeria Downs Penicillamine, PXE Osteogenesis Imperfecta Rothmund-Thompson Ehlers Danlos Scleroderma ```
175
Interstitial Granulomatous Drug Eruption
CCB ACE TNFa Photodistributed Histo: may also have interface
176
EBA
IBD is most common cause
177
Drug Induced Sarcoid
IFN-a, ribavirin (Hep C) HAART TNF
178
Darier-Roussey
subcutaneous sarcoid
179
Lupus Pernio
beaded nasal rim and lung sarcoid
180
Lofgren
EN, LAD, white men; good prognosis
181
Heerfordt
parotid, uveitis, cranial nerve palsy
182
Blau
early onset < 5 yo sarcoid like, associated with NOD2 mutation
183
Red Necrobiosis Causes
Rheumatoid Nodule | Necrobiosis Lipoidica
184
P Acnes and Acne Pathophys
lipases TAG -> FFA TLR2 activation -> IL-1, 8, 12, TNF-a Coproporphyrin III
185
Neonatal Acne
weeks-months | malassezia or stimulation by maternal androgen
186
Increased total testosterone
ovarian source
187
Increased DHEAS or 17-hydroxyprogesterone
Adrenal source | 21- hydroxylase or 11-hydroxylase defect

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