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DERM > Inflammatory Derm > Flashcards

Inflammatory Derm Flashcards

1
Q

Extensor surfaces

A

elbows, knees, forearm, neck

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2
Q

Thickening of the stratum corneum (Hyperkeratosis)

Retained nuclei in stratum corneum epidermis (parakeratosis) &

Epidermal thickening/hyperplasia (acanthosis) with

elongated clubbed interdigitations (rete ridges) corresponding to the typical erythematous plaques

A

Psoriasis

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3
Q

characterized by hyperkeratosis and squamous dysplasia and is considered a premalignant lesion to squamous cell carcinoma. It is typically related to chronic ultraviolet exposure and is most common on sun-exposed areas of the scalp, ears, face, and dorsum of the hands.

A

Actinic keratosis

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4
Q

Thinning of the epidermis is a common feature of

A

scleroderma

or topical glucocorticoid use

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5
Q

Allergic contact dermatitis is a delayed-type hypersensitivity reaction.

Initially (sensitization), ______ cells mirgrate to regional lymph nodes and present haptens to naive T cells, leading to clonal expansion.

On re-exposure to the hapten, sensitized CD8+ T cells cause tissue destruction that manifests as pruritic erythema, vesicles, and/or bullae ___ days after exposure.

A

Langerhans
2-3

*Hapten: (antigen like Urushiol poison ivy)

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6
Q

Bullous pemphigoid is caused by autoantibodies against ____ on keratinocytes.

A

hemidesmosomes

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7
Q

Pemphigus vulgaris is caused by autoantibodies against ____ on keratinocytes

A

desmosomes

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8
Q

Immune complex deposition in small cutaneous vessels causes

A

cutaneous small vessel vasculitis (CSVV)

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9
Q

Medications that function as haptens (phenytoin, sulfonamides) can cause this condition.
Presents with nonblanchable purpura and petechiae

A

cutaneous small vessel vasculitis (CSVV)

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10
Q

multiple target-shaped skin lesions on the trunk and/or extremities likely indicate

A

erythema multiforme (EM)

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11
Q

Erythema multiforme is a target-shaped, inflammatory skin lesion that typically arises in the setting of infection, particularly with herpes simplex virus or Mycoplasma pneumoniae. It is caused by the deposition of infectious antigens in keratinocytes, leading to a strong ____ mediated immune response.

A

cell-mediated (cytotoxic T-cell)

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12
Q

Dermatitis herpetiformis, a manifestation of _____ sensitivity, is caused by the subepidermal deposition of IgA. It is associated with pruritic papules and vesicles on the forearms, knees, and/or scalp

A

gluten

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13
Q

a delayed-type hypersensitivity reaction that causes inflammatory nodules in the subcutaneous fat. Presents with tender, erythematous nodules on the bilateral shins.

A

Erythema nodosum

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14
Q

Removal of the scale results in small bleeding points

due to dilated capillaries in dermal papillae

A

Psoriasis

Auspitz sign

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15
Q

a common skin disorder characterized by activation of T helper cells and proliferation of keratinocytes

A

Psoriasis

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16
Q

First-line treatment options for localized psoriasis include high-potency topical corticosteroids and vitamin D analogs. Vitamin D analogs inhibit T-cell and _____ and stimulate keratinocyte differentiation.

A

keratinocyte proliferation

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17
Q

Spongiosis is intercellular epidermal edema that histologically appears as an increase in the width of spaces between cells. Spongiosis is often associated with ____

A

eczematous dermatitis
contact dermatitis
and others

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18
Q

Common conditions displaying ____ include psoriasis, seborrheic dermatitis, and acanthosis nigricans.

A

acanthosis

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19
Q

Acantholysis is the loss of cohesion between keratinocytes in the epidermis. It is a characteristic finding in the ____ family of disorders.

A

pemphigus

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20
Q

Urticaria (hives) is due to increased permeability of the microvasculature, leading to ____ of the superficial dermis.

A

edema

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21
Q

Presents with pruritic, purple/pink, polygonal papules and/or plaques on flexural surfaces
Hyperkeratosis (thickening of stratum corneum),
band-like lymphocytic infiltrates at dermoepidermal jxn,
Hypergranulosis (prominent granular layer),
sawtooth rete ridges,
scattered eosinophilic colloid bodies

A

Lichen planus

Flexural surfaces: wrists and ankles
*also: nails, oral mucous membranes, and genitalia

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22
Q

A pruritic rash affecting the extensor surfaces, face, and/or extremities.
Presents in childhood usually with a history of other atopic disorders (allergic rhinitis, asthma).

A

Atopic dermatitis

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23
Q

Chronic lesions often show white, lacy markings known as Wickham striae over the plague

A

Lichen planus

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24
Q

Severe cases of Erythema Multiforme can affect oral mucous membranes and the tongue.

Typically develops as erythematous, round papules that evolve into target lesions with a dusky central area, a dark red inflammatory zone surrounded by a pale ring, and an erythematous halo in the lesion’s periphery.

EM is most frequently associated with infections like (2)

A

Herpes simplex virus
Mycoplasma

*Sulfonamides, cancers, collagen diseases, fungal infections

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25
Q

Characterized by rapid onset of erythematous macules with necrosis and skin sloughing especially of mucosal surfaces like the mouth. Systemic signs (fever, hypotension) are common.

A

Stevens-Johnson syndrome

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26
Q

Dermatitis herpetiformis (DH) is characterized by erythematous pruritic papules, vesicles, and bullae that appear symmetrically on the extensor surfaces (elbows, knees), upper back, and buttocks due to deposition of IgA at the _____ junction.

A

dermoepidermal

*Celiac’s disease

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27
Q

The immune response against gliadin in Celiac’s also targets tissue transglutaminase, leading to the production of IgA and IgG tissue transglutaminase autoantibodies. In the skin, these antibodies ____ with epidermal transglutaminase,

A

cross-react

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28
Q

Small-bowel histologic findings:

Small bowel intraepithelial lymphocytosis
Crypt hyperplasia (elongation)
Progressive villous atrophy (height shrinkage)
A

Celiac’s disease

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29
Q

This condition is characterized by skin fragility and blistering lesions in sun-exposed areas.

Labs: Elevated urinary porphyrin levels
(uroporphyrin, heptacarboxyl porphyrin)

A

Porphyria cutanea tarda

30
Q

a group of conditions characterized by pruritic, erythematous, papulovesicular rash, with blisters and ulcers and weeping drainage.
Histo: Spongiosis & edema

A

Eczematous dermatitis (eczema)

31
Q

New topical cream then a few days later an erythematous, papulovesicular, weeping lesion. This is likely _____, a form of eczema caused by a type IV (delayed) hypersensitivity reaction to an antigen on the skin surface.

A

acute allergic contact dermatitis (ACD)

32
Q

Dyskeratosis is abnormal, premature keratinization of individual keratinocytes below the stratum granulosum. May be found in diseases such as

A

squamous cell carcinoma

33
Q

In a susceptible child, a febrile maculopapular rash that begins on the face and spreads to the trunk and extremities is suggestive of ____ or _____

The additional finding of postauricular (behind the ears) lymphadenopathy is most suggestive of _____.

A

measles (Rubeola)
rubella (German measles)

rubella (Togavirus)

34
Q

characterized by a transient maculopapular rash that appears for a few days on the chest and trunk once the patient’s fever subsides.

A

Roseola (HHV-6)

aka exanthem subitum (roseola infantum)

35
Q

This illness is first characterized by redness of the cheeks (“slapped-cheek” appearance), followed by a maculopapular rash on the extremities and trunk.

A

Parvovirus is responsible for fifth disease (erythema infectiosum)

36
Q

a group of inherited disorders characterized by epithelial fragility (bullae, blisters, erosions, ulcers) triggered by minor trauma (usually on hands, soles of feet, mouth)

A

Epidermolysis bullosa

37
Q

It is caused by mutations impairing keratin filament assembly in the intraepidermal and dermoepidermal adhesion complexes

A

Epidermolysis bullosa

38
Q

Intraepidermal cleavage plane are visible on histology

A

Epidermolysis bullosa

39
Q

Atopic dermatitis is a multifactorial disorder but is commonly seen in association with loss of function mutations in ____ and other epidermxal barrier proteins.

A

filaggrin

40
Q

Intense pruritus

Infants: red, crusted lesions involving extensor surfaces & face

Children & adults: flexural eczema & lichenification

A

Atopic dermatitis

41
Q

Disrupted skin barrier increases antigen exposure and hypersensitivity

Associated with asthma & allergic rhinitis

A

Atopic dermatitis

42
Q

Initially, Langerhans cells present haptens to naive T cells, leading to clonal expansion. On reexposure, sensitized CD8+ T cells are recruited to skin and destroy tissue. Release of ____ by T cells further amplifies the immune response.

A

interferon gamma

43
Q

blistering rash began as tender papules that quickly progressed to form vesicles and flaccid bullae that rupture easily and crusted over

A

Bullous Impetigo

44
Q

The blistering in Bullous Impetigo is caused by production of exfoliative toxin A, a serine protease that targets _____ in the superficial epidermis, by some strains of S aureus.

A

Desmoglein 1

45
Q

The blistering in Bullous Impetigo is caused by production of _____, a SERINE protease that targets desmoglein 1 in the superficial epidermis, by some strains of S aureus.

A

Exfoliative toxin A

46
Q

Desmoglein is a ___ component of desmosomes in epidermal cellular junctions;

A

cadherin

47
Q

Patients with psoriasis frequently develop additional complications, including (3)

A

Psoriatic arthritis (HLA-B27)

Yellow pitting, thickened nails

Uveitis

48
Q

a common extradermal manifestation of systemic sclerosis (scleroderma).

A

Pulmonary fibrosis

49
Q

Formation of lesions at sites of trauma (Köbner phenomenon)

A

Lichen Planus

50
Q

scattered, scaly, pink plaques

A

Lichen Planus

51
Q

BP is caused by antibodies against hemidesmosomes along the basement membrane of the

A

dermal-epidermal junction

52
Q

causes the entire epidermis to separate from the dermis, forming subepidermal, nonacantholytic TENSE blisters.

A

Bullous Pemphigoid

53
Q

Immunofluorescence shows IgG and/or C3 deposits in a linear pattern along the basement membrane.

A

Bullous Pemphigoid

54
Q

Intraepidermal cleavage
Acantholysis (detached keratinocytes)
“Tombstone cells” along basal layer

A

Pemphigus Vulgaris

55
Q

Immunofluorescence shows Net-like intercellular IgG

A

Pemphigus Vulgaris

56
Q

Predominantly elderly
Tense bullae
Rare oral/mucosal involvement

A

Bullous Pemphigoid

57
Q

Middle-aged or elderly
Flaccid bullae
Oral/mucosal involvement
Positive Nikolsky sign

A

Pemphigus Vulgaris

58
Q

It presents with painful flaccid bullae and erosions affecting the skin and mucosal membranes. The bullae spread laterally with pressure and new blisters may form with gentle rubbing.

A

Pemphigus Vulgaris

59
Q

Physical examination is notable for multiple skin patches with necrotic centers and occasional ulcerations
+ NEUTROPENIA

A 
Ecthyma gangrenosum 
(Pseudomonas aeruginosa)
60
Q

The most common cause of nonpurulent cellulitis is

A

Group A streptococcus

Streptococcus Pyogenes

61
Q

The most common cause of purulent cellulitis is

A

Staphylococcus aureuS

62
Q

a highly contagious disease that presents with an intensely pruritic rash (usually worse at night) involving the flexor surfaces of the wrist, lateral surfaces and webs of the fingers, elbow extensor surfaces, and axillary folds. Patients usually have excoriations with small, crusted, red papules scattered around the affected areas.

A

Scabies

63
Q

The lepromin skin test will be POSITIVE in patients with ______ as they exhibit a strong CD4+ TH1 cell-mediated immune response to Mycobacterium leprae.

Patients with ______ will test NEGATIVE due to their weak TH1 cell-mediated immune response

A

tuberculoid leprosy

lepromatous leprosy

64
Q

Affected tissues show extensive accumulation of acid-fast bacilli within macrophages and often a TH2 cytokines.

Patients develop more numerous, poorly demarcated plaques that are widespread across the body.
Leonine facies.
Degeneration/loss of the nose and digits.

A

lepromatous leprosy

65
Q

localized inflammation damages the skin and cutaneous nerves, leading to the development of a small number of hypopigmented, well-demarcated plaques with decreased/absent sensation

A

tuberculoid leprosy

TH1 cytokines

66
Q

Vesicle base reveals intranuclear inclusions in keratinocytes and multinucleated giant cells (positive Tzanck smear).

A

VZV

67
Q

Tinea corporis presents with round or ovoid lesions with a raised, scaly border and central clearing.

Trichophyton r is the most common cause and infects ____ matter in the stratum corneum of the superficial EPIDERMIS but does NOT invade the dermis.

A

keratinized

68
Q

Cutaneous wart (verruca vulgaris).caused by

A

human papillomavirus

69
Q

typically present as rough, skin-colored papules.

Biopsy shows epidermal hyperplasia, thickened stratum corneum (hyperkeratosis), disrupted papilloma formation, and cytoplasmic vacuolization (koilocytosis)

A

Cutaneous wart (verruca vulgaris)

70
Q

Herpangina (oral blisters or ulcerations)

Extremity blisters, vesicles, ulcerations

Aseptic meningitis

Myocarditis

SUMMER SUMMER SUMMER

A

Enterovirus

DERM (3 decks)

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