Inflammatory Lesions Flashcards by mirko niro

Scabies

A. Etiologic agent
B. Incubation period
C. Treatment

A. Sarcoptes scabiei

B. 4-6 weeks

C. Permethrin 5% lotion

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Molluscum contagiosum

A. Incubation period
B. Etiologic agent

A. 2-7 weeks

B. Pox virus
MCV1 - most common
MCV2 - adults and immunocompromised

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Verruca vulgaris

A. Incubation period
B. Etiologic agent

A. 2-9 months

B. Human papillomavirus
HPV 1: palmar/plantar
HPV 2, 4: common warts
HPV 3, 10: flat warts
HPV 7: butcher’s
HPV 5, 8: EV
HPV 6, 11, 16, 18: anogenital

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Chromomycosis

A. Etiologic agent
B. Stain
C. Characteristic histologic finding

A. Fonsecaea, Cladosporium, Phialophora

B. Periodic Acid Schiff (PAS), Grocott’s Methenamine Silve (GMS)

C. Copper pennies

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Mycetoma

A. Etiologic agent
B. What do you call the eosinophilic rim surrounding the granule

A. Eumycetoma: Madurella mycetomatis (fungal)
Actinomycetoma: Nocardia braziliensis (bacteria)

B. Splendore Hoeppli phenomenon

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Pityriasis versicolor

A. Etiologic agent
B. Stain

A. Malassezia globosa or furfur

B. PAS, GMS

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Dermatophytosis

A. Common etiologic agent/s
B. Stain

A. Trichophyton and Microsporum

B. GMS

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Tuberculosis verrucosa cutis

A. Pathogenesis
B. Level of immunity

A. Reinfection of immune patients

B. High cell mediated immunity

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Lupus vulgaris

A. Mechanism of spread
B. Level of immunity

A. Hematogenous or lymphatic

B. Moderate to high immunity

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Lepromatous leprosy

A. Level of immunity
B. Etiologic agent
C. Stain
D. Types of reversal reactions
E. Treatment

A. Poor cell mediated immunity

B. Mycobacterium leprae

C. Fite-faraco, Auramine Rhodamine (gold)

D. Type 1: BT/BB/BL
Type 2 (ENL): LL

E. Rifampicin 600mg/month x 12 months
Dapsone 100mg/day x 12 months
Clofazimine 300mg/month and 50mg/day x 12 months

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Tuberculoid leprosy

A. Level of immunity
B. Stain
C. Treatment

A. High cell mediated immunity

B. (-) Fite-faraco, absent M. leprae

C. Rifampicin 600mg/month x 6 months
Dapsone 100mg/day x 6 months

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Subcutaneous Fat Necrosis of the Newborn

A. Pathogenesis
B. Complication

A. Hypoxic injury to fat

B. Hypercalcemia - screen for the first 6 months

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Erythema Induratum

A. Disease association
B. Site of predilection
C. Tests

A. Tuberculosis

B. Calves

C. PPD, Quantiferon gold

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Erythema nodosum

A. Disease association
B. Predilection site

A. Streptococcal, OCP, Sarcoidosis

B. Pretibial area

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Polyarteritis nodosa

A. Size of involved vessel
B. Clinical manifestations

A. Medium vessel vasculitis

B. Livedo reticularis, Subcutaneous nodules, Ulceration

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Rosacea

A. Etiologic agent
B. Triggers

A. Demodex mite

B. Sunlight, heat/cold, stress, strong emotions, alcohol, hot beverages, spicy food, chemical irritation

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Mastocytosis

A. Mutation
B. Stain

A. C-Kit

B. Leder, Giemsa, Toluidine blue, Tryptase, CD117/cKit

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Lichen amyloidosis

A. Deposit
B. Stain

A. Altered keratin

B. Congo red (apple-green polarization), Thioflavin (yellow/fluorescent), Crystal violet

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Causes of ochronosis

Exogenous: Hydroquinone, Phenolic acid

Endogenous: Alkaptonuria (Homogentisic acid accumulation)

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Stain for hypertrophic scars and keloid

Verhoeff-Van Gieson (loss of elastic fibers)

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Stain for morphea

Reduced number of CD34+ cells in the dermis

Verhoeff-Van Gieson (preservation of elastic fibers)

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Cutaneous lymphoma

A. Most common subgroup
B. Age of predilection
C. Stain

A. Mycosis fungoides/CTCL

B. 75% diagnosed after 50yo

C. CD4 > CD8 T cell
CD3 T cell
CD30 (large atypical T cells) - also in LyP
CD20 B cells
Bcl-6 germinal B cells

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Lichen sclerosus et atrophicus

A. Autoantigen
B. Associated malignancy
C. Stain
D. Treatment

A. Autoantibody against ECM1 (same with lipoid proteinosis)

B. 5% risk for SCC

C. Masson Trichrome

D. Ultrapotent topical steroid

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Characteristic clinical finding of erythema annulare centrifigum

Trailing scale - inner desquamation

Langerhans cell histiocytosis A. Most common extracutaneous involvement B. Stain

A. Bone B. S100+, CD1a+, CD207/Langerin+

Stain for Xanthogranuloma

CD68+, CD207/Langerin-

True of False: Lipid profile is normal in half of the patients with Xanthelasma

True

Treatment of choice for Granuloma faciale

Glucocorticoids

Treatment of choice for EED

Dapsone

Sweet Syndrome A. Associated malignancy B. Treatment

A. Acute myelogenous leukemia (esp ulcerative/bullous type) B. Systemic steroids

Treatment of choice for Well’s disease

Systemic steroids

Leukocytoclastic vasculitis A. Clinical characteristic B. Size of involved vessel

A. Palpable purpura B. Small vessel vasculitis

Identify the deposition in the following diseases: A. Rheumatoid nodule B. Gout C. Granuloma annulare D. Necrobiosis lipoidica

A. Fibrin B. Monosodium urate crystals C. Mucin D. Dead collagen

Bullous Lupus Erythematosus A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal (sublamina densa) B. Neutrophil C. Continuous homogenous granular IgG > IgA, IgM, C3 along the DEJ D. Floor/dermal side E. Collagen 7 (290 kD) F. Associated with systemic lupus erythematosus G. See LE treatment algorithm

Linear IgA Bullous Dermatosis / Chronic Bullous Disease of the Childhood A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal B. Neutrophil C. Linear IgA along DEJ D. Roof or Floor or Both E. BPAG2 specifically LAD1 (120 kD) and 97 kD cleaved portion F. Drug (Vancomycin), PCN, CPN G. Dapsone

Dermatitis Herpetiformis A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal (papillary dermis) B. Neutrophil C. Granular or Fibrillar IgA along DEJ D. - E. Epidermal transglutaminase 3 F. Gliadin (antigenic component of Gluten) G. Gluten-free diet (wheat, rye, barley), Dapsone

Bullous Pemphigoid A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal (lamina lucida) B. Eosinophil C. Linear C3 > IgG along DEJ D. Roof of the split/epidermal side E. BPAG2 (180 kD) NC16A domain / COL17 > BPAG1 (230 kD) F. G.

Porphyria Cutanea Tarda A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal B. Non-inflammatory C. Thick, waxy, homogenous deposits of anti-type IV collagen antibody of IgG and C3 at the DEJ and blood vessel walls D. - E. F. G.

Epidermolysis Bullosa Acquisita A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal (sublamina densa) B. Cell poor C. Linear IgG > C3, IgA along DEJ D. Floor of the split/dermal side E. Collagen VII (290 kD) F.

Cicatricial pemphigoid A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal B. Neutrophil C. Linear C3 and IgG along DEJ D. Floor of the split/dermal side E. BP180, Laminin 332 (Epiligrin or Laminin 5), and Beta-4-integrin F. G.

Bullous Erythema Multiforme A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subepidermal B. Neutrophil C. Granular C3 and IgM along DEJ D. Floor of the split/dermal side E. - F. G.

Darier Disease A. Mutation B. Mode of inheritance C. Histologic finding D. DIF

A. ATP2A2 B. Autosomal dominant C. Suprabasal split, more dyskeratosis, corp ronds (spinous layer) and grains (granular layer) D. Negative

Hailey-Hailey Disease A. Mutation B. Mode of inheritance C. Histologic finding D. DIF

A. ATP2C1 B. Autosomal dominant C. Intraepidermal split with acantholysis at all level of the epidermis (“dilapidated brick wall”), less dyskeratosis D. Negative

Pemphigus vulgaris A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment H. Substrate varianr

A. Suprabasal B. - C. Intercellular IgG, C3 on the epidermal keratinocytes D. E. Desmoglein 3 > Desmoglein 1 (160 kD) F. Associated with myasthenia gravis, thymoma, autoimmune thyroiditis G. H. Monkey esophagus

Acute Generalized Exanthematous Pustulosis A. DIF B. Most common offending drugs

A. Negative B. Beta blockers, Cephalosporins, Calcium channel blockers, Macrolides

DIF of Sneddon-Wilkinson Disease

Negative

Pemphigus Foliaceus A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Subcorneal B. C. Intercellular IgG, C3 D. E. Desmoglein 1 (160 kD) F. G.

Etiologic agent of bullous impetigo

Staphylococcal exfoliatin A

Stevens-Johnson Syndrome A. Site of split B. Predominant cell C. DIF D. IIF/Salt-Split Skin E. Antigen F. Etiology/Trigger G. Treatment

A. Full thickness epidermal necrosis B. - C. Negative D. - E. - F. Sulfonamides, Carbamazepine (HLAB1502), Allopurinol (HLAB5801) G. Supportive

Stain for Stasis Dermatitis and Pigmented Purpuric Dermatosis

Perl Stain (Blue)

First line treatment of PRP

Acitretin

Psoriasis vulgaris A. Strongest association B. Earliest histopath change C. Offending drugs

A. HLAcw6 B. Dilated blood vessels C. Lithium, Beta blockers

Most common etiology of erythema multiforme

Recurrent HSV infection

Common offending drugs that cause fixed drug eruption

NSAIDs - lips Sulfonamides - genitalia

Syphilis A. Etiologic agent B. Stain C. Treatment D. Tests

A. Treponema pallidum B. Warthin Starry C. Benzathine penicillin G 2.4 million units IM D. Non-Treponemal: VDRL & RPR Treponemal: FTA-ABS & MHA-TP

Stain for mycosis fungoides

CD3+, CD20- Others: CD4, CD5, CD7, CD8

Subtype of porokeratosis that is highly associated with malignant degeneration

Linear

Stain for discoid lupus erythematosus

Basement membrane: PAS Mucin: Alcian blue, Colloidal iron, Toluidine blue, Mucicarmine

Patterns of Grover Disease

Darier Disease (most common) Hailey-Hailey Disease Pemphigus (vulgaris and foliaceus) Sudoriferous acrosyringeal acantholytic disease Spongiotic