Inflammatory Dermatoses

Question 1

A pruritic, erythematous, oozing rash with vesicles and edema that commonly involves the face and flexor surfaces…

Answer 1

Atopic Dermatitis

Question 2

What type of reaction causes atopic dermatitis?

Answer 2

Type I hypersensitivity reaction

Question 3

What 2 disorders are associated with atopic dermatitis?

Answer 3

Asthma

Allergic rhinitis

Question 4

A pruritic, erythematous, oozing rash with vesicles and edema that occurs upon exposure to an allergen…

Answer 4

Contact dermatitis

Question 5

What are 3 broad categories of allergens that can cause contact dermatitis?

Answer 5

Poison ivy and nickel jewelry—type IV hypersensitivity
Irritant chemicals—detergents
Drugs—penicillin

Question 6

What is the treatment for contact dermatitis?

Answer 6

Removal of offending agent and topical glucocorticoids

Question 7

What are the three skin abnormalities found with acne vulgaris?

Answer 7

Comedones (whiteheads and blackheads)
Pustules (pimples)
Nodules

Question 8

What is the cause of acne vulgaris?

Answer 8

Chronic inflammation of hair follicles and the associated sebaceous glands

Question 9

What is the mechanism for the formation of comedones seen with acne vulgaris?

Answer 9

Hormone-associated increase in sebum production and excess keratin production causing blocking of the follicles and cause the formation of comedones

Question 10

What is the mechanism for the formation of pustule and nodule formation seen with acne vulgaris?

Answer 10

Propionibacterium acnes infection→ produces lipases causing breakdown of sebum→ release of proinflammatory fatty acids causing pustule and nodule formation

Question 11

What are the treatment options for acne vulgaris?

Answer 11

Benzoyl peroxide—antimicrobial

Vitamin A derivatives—reduction of keratin production

Question 12

A patient presents with well-circumscribed lesions on the extensor surfaces of his arms and legs and on his scalp. Ther is an association with HLA-C and the patient reports that the lesions become worse with localized trauma. The lesions are salmon-colored plaques with a silvery scale. What is the most likely diagnosis?

Answer 12

Psoriasis

Question 13

Psoriasis is caused by excess proliferation of _______.

Answer 13

Keratinocytes

Question 14

What are the 4 major aspects of psoriasis seen on histology?

Answer 14

Acanthosis
Parakeratosis
Collections of neutrophils in the stratum corneum
Thinning of the epidermis above elongated dermal papillae

Question 15

What is acanthosis seen with psoriasis?

Answer 15

Epidermal hyperplasia

Question 16

What is parakeratosis seen with psoriasis?

Answer 16

Hyperkeratosis with retention of keratinocyte nuclei in the stratum corneum

Question 17

With respect to psoriasis, where do neutrophils collect within the epidermis?

Answer 17

Stratum corneum

Question 18

What is Auspitz sign seen with psoriasis?

Answer 18

Thinning of the epidermis above elongated dermal papillae→bleeding when scale is picked off

Question 19

What are the treatment options for psoriasis?

Answer 19

Corticosteroids
UV light with psoralen
Immune-modulating therapy

Question 20

A patient presents with pruritic, planar, polygonal, purple papule lesions on her wrists, elbows, and oral mucosa. The lesions are characterized by reticular white lines on the surface (Wickham striae). Upon microscopy inflammation of the dermal-epidermal junction is visualized with a saw-tooth appearance. What is the most likely diagnosis in this patient?

Answer 20

Lichen Planus

Question 21

What infection is associated with Lichen Planus?

Answer 21

Chronic hepatitis C virus infection