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Derm 2020 > Granulomatous Disorders > Flashcards

Granulomatous Disorders Flashcards

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Dermatology Board Prep flashcards
1
Q

Sarcoidosis can be induced by IFN-a

A

True

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2
Q

Sarcoidosis peaks at 20-40 years and again at 60y

A

True

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3
Q

Sarcoidosis can relate to Hodgkin lymphoma

A

True

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4
Q

Mycobacterial DNA/RNA is not usually found in sarcoidosis lesions

A

False 80%

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5
Q

Pathology of sarcoidosis

A

Aggregates of epithelioid cells with sparse lymphocytic component “naked”
- in some cases, tuberculoid granuloma are observed
—> these are NON CASEATING granuloma with lymphoid cuff >25% granulomas diameter
—> caseous necrosis is typically absent
—> epidermis usually normal

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6
Q

List types of sarcoidosis

A
  1. Maculopapular
  2. Plaque or nodules
  3. Scar sarcoidosis
  4. Lupus pernio
  5. Subcutaneous sarcoidosis
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7
Q

Maculopapular sarcoidosis has a poorer prognosis compared to other forms

A

False - more favourable

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8
Q

Polarisable foreign bodies are often found in biopsies

A

True

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9
Q

Nodular and plaque sarcoidosis is much rarer than maculopapular sarcoidosis

A

False - almost as common as maculopapular

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10
Q

Nodular and plaque scarring do not scar

A

False - permanent scarring can occur when they resolve

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11
Q

Nodular and plaque sarcoidosis activity persists for <18 months

A

False >2years

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12
Q

Sarcoidosis Nodular and plaque type can be associated with sarcoidosis of the upper resp tract and bony cysts

A

False not associated unlike lupus pernio

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13
Q

Lupus pernio is very painful and tends to ulcerate

A

False - not painful and does not ulcerate

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14
Q

Lupus pernio is more mutilating than lupus vulgaris

A

False - less mutilating

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15
Q

In a minority of cases, lupus pernio is associated with sarcoidosis of the upper resp tract, especially with involvement of nasal rims

A

False - majority >1/2 have involvement eg. Paratracheal granulomas and infiltration of vocal cords
- also associatd with pulmonary fibrosis and chronic uveitis

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16
Q

Lupus pernio is associated with bony cysts affecting terminal phalanges —-> when this occurs, nails are usually dystrophic

A

True

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17
Q

Scar sarcoidosis — tattoo sarcoidosis is considered a variant

A

True

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18
Q

Scar sarcoidosis can occur decades after tattoo

A

True

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19
Q

Scar sarcoidosis is often located on the knees

A

True

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20
Q

Most cases of subcutaneous sarcoidosis are in males

A

False - white women in 5th to 6th decades

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21
Q

Subcutaneous sarcoidosis may form indurated linear bands from elbow to hand

A

True

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22
Q

Sarcoid dactylitis occurs with SC sarcoidosis

A

True

23
Q

Scarring alopecia secondary to sarcoidosis is often in Caucasian women

A

False - African women

24
Q

Nail changes in sarcoidosis

A

Splinter haemorrhages, thinning, pitting, thickening, longitudinal ridging, onycholysis, paronychia, pterygium, subungal HK, TRACHYONYCHIA, red /brown nail bed discolouration all reported in sarcoidosis

25
Q

What are ocular findings in sarcoidosis

A

Anterior/posterior uveitis, chorioretinitis, periblepharitis, papilloedema, retinal haemorrhage

26
Q

What are chest radiograph stages of sarcoidosis

A

Stage 0 - normal CXR
Stage 1 - bilateral hilar LN without pulmonary involvement
Stage 2 - bilateral hilar LN with pulmonary involvement
Stage 3 - pulmonary involvement without bilateral hilar involvement

27
Q

Haemoptysis is a common feature of sarcoidosis

A

False - rare

28
Q

Extracutaneous features of sarcoidosis

A

PERL <3 MPN
Pulmonary
Eye
Reticuloendothelial system (lymphadenopathy, spleen 5-10% , BM inv rare)’
Liver (hepatomegaly, periportal areas affected, severe chronic cholesterol syndrome, portal hypertension and Budd-Chirac rare)

Heart (arrhythmias, heart block , sudden death, cor pulmonale)

MSK (transient or chronic poly arthralgias common, myalgias rare)
Parotid (enlargement and xerostomia)
Neurological

29
Q

What is Heerfordt syndrome

A

Parotid gland enlargement, with cranial nerve palsy, uveitis and fever

30
Q

What are nonspecific lesions of sarcoidosis

A 
Erythema nodosum
Sweet syndrome
Cutaneous calcinosis
Prurigo
Digital clubbing (poor prognostic sign)
PG associated
31
Q

Sarcoidosis pulmonary function test results

A

Abnormal RFTs in 20% in patients with mild disease,
Obstructive and restrictive abnormalities
- reduced DLCO and VC
- as functional impairment occurs with decreased FVC and diffusing capacity

32
Q

Granuloma annulare subcutaneous form is usually in middle aged women

A

False , in children

33
Q

List CLINICAL subtypes of GA

A

Localised
Generalised
Perforating
Subcutaneous

34
Q

List histological subtypes of GA

A

Necrobiotic palisading granulomas
Interstitial
Sarcoidal
Subcutaneous

35
Q

What infections can trigger GA?

A 
Scabies
Hep B/C
TB
HPV
VZV
EBV
Parvovirus B19
HIV
Borrelia burgdorferi
36
Q

Traumatic triggers of GA

A

Vaccination,
Tuberculin testing
Arthropod bites
Isomorphic response - saphenectomy, waxing, PUVA

37
Q

75% cases of GA are localised

A

True

38
Q

subcutaneous GA occurs on scalp and legs, particularly pretibial

A

True

39
Q

Subcutaneous GA involves the mucous membranes commonly

A

False - uncommon except in HIV patients

40
Q

GA most common locations?

A 
60% isolated to hands and arms
20% on legs and feet
7% upper and lower extremity
5% on trunk and other
RARE facial lesions
41
Q

Actinic granuloma more common in males

A

False - females

42
Q

Actinic granuloma has more telangiectasia, alopecia and yellow discolouration than GA

A

False - absent

43
Q

Necrobiosis lipoidica more common in males

A

False - females

44
Q

Annular erythematous rim enhancing lesions with central atrophy and telangiectases accurately describes NL

A

True

45
Q

Comedo like lesions can be seen at periphery of NL

A

True

46
Q

IBD is not associated with NL

A

False , it is

47
Q

Palisaded neutrophilic and granulomatous dermatitis (PNGD), where annular plaques or linear cords favour trunk, axillae and medial thighs in patients with RA or seronegative arthritis

A

False, this is interstitial granulomatous dermatitis

48
Q

Palisaded neutrophilic and granulomatous dermatitis —> asymmetrical umbilicated papules over elbow and extensor surfaces

A

False symmetrical

49
Q

PNGD occurs in pt with RA, systemic LE, Wegener’s

A

True

50
Q

Cutaneous crohn’s - erythematous plaques, lymphoedema and knife-like ulcerations most commonly in the anogenital region

A

True

51
Q

There is consistent correlation between mucutaneous disease and degree of GI involvement

A

False

52
Q

Cutaneous involvement of crohn’s can be indicative of colonic rather than ileal involvement

A

True

53
Q

Treatment of cutaneous crohn’s includes metronidazole 250mg tds for 3 mo , pred, sulfasalazine, AZA, 6-MP

A

True

Derm 2020 (59 decks)

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