HIGH YIELD II

Question 1

what is this?

cutaneous orthokeratotic reaction

pressure induced hyperkeratotic plaque

chronic form has nucleus

associated pain

differential diagnosis:

• plantar verrucous carcinoma
• epidermal inclusion cyst

Answer 1

intractable plantar keratosis (IPK)

Question 2

what is this?

40 y/o mentally delayed

skin clear of other keratoses

dermoscopy required

20% develop SCC within base of the horn

Rx urea 40 cream qd for 3 months

orthotic with Mortons extension, silicone shield

Answer 2

cutaneous horn

Question 3

what is this?

small focal hyperkeratotic
1-3 mm diameter plantar keratosis
adjacent to MTPJs

dermatoglyphics widened and obliterated with central compact keratin

stein berg originally describe as plugged eccrine duct but evidence later refuted

Answer 3

porokeratosis planters discreta

Question 4

what is this?

focal loss of stratum granulosum centrally is histologic evidence of pressure induced lesions

previously thought to be hyper keratinization of terminal portion of eccrine ducts

dilated eccrine ducts

Answer 4

coronoid lamella

Question 5

what is this?

chronic limb edema, velvety papillomatous

becomes irregular warty projections

acquired not inherited disorder

chronic lip edema

emollients

Answer 5

lymphedema keratoderma

Question 6

what is this?

Aka Haxthausen’s disease

Circumscribed hyperkeratoses primarily of palms and soles

Acanthosis and dilated capillaries are seen in the upper dermis
-topical comb of 40% urea cream

*oral retinoids

Answer 6

keratoderma climactericum

Question 7

what is this?

multiple horny growths

Caused by excess arsenic ingestion

Test toenails for traces of arsenic in diet

Treatments
▪ Extracorporeal membrane oxygenation
▪ Chelation with dimercaprol

Answer 7

Arsenical Keratosis

Question 8

Overproduction of normal or abnormal keratin
-autosomal dominant inheritance

Hereditary disorders of keratinization
-diffuse, disseminated and focal thickening hyperkeratosis of palms and or soles

Answer 8

Palmar Plantar Keratodermas

Question 9

what is this?

keratins are intermediate filament proteins

• form cytoskeleton in all epithelial cells
• keratinization process as in maturation of basal epidermal cells, aka the march of death

over 50 genes encode keratins

Answer 9

keratinization disorders

Question 10

most common keratoderma

non epidermolytic
-miscodes type II keratin

presents with dozens of superficial plantar keratoses
-inspect palmar skin fold lines for horny plugs

what is this?

Answer 10

palmoplantar punctate keratoses

Question 11

what is this?

deep blistering with hyperkeratosis

• limited to palms and soles
• autosomal dominant, mutations in keratin 9 on chromosome 17

ballooning degeneraton of supra basal cells

Answer 11

epidermolytic palmoplantar keratodermas

Question 12

what is this?

rare, autosomal dominant diffuse form

• onset between 5-15 yrs of age
• esophageal cancer

Answer 12

hotel evans syndrome

Question 13

what is this?

mutilating keratderma, honeycomb like calluses

begins in infancy or early childhood

pseudoainhum

hearing loss

Answer 13

vohwinkel syndrome