Intro

Question 1

guttate

Answer 1

drop like

Question 2

gyrate

Answer 2

twisted spiral

Question 3

nail matrix

Answer 3

produces major part of nail plate

Question 4

nail bed

Answer 4

contains blood vessels, lymphatics

consists of epidermis and dermis

Question 5

Anagen Phase growth factors, hormones, stress,

immunologic and physical injury

Answer 5

(growth) – hairs with pigmented malleable proximal ends

* extremely sensitive to drugs,

Question 6

Catagen Phase

Answer 6

(transition) – duration is usually a few weeks

Question 7

Telogen Phase

Answer 7

(reset) hair falling out; club hairs with depigmented rounded proximal ends

Question 8

Macule

Answer 8

A circumscribed area of change in normal skin color without elevation or depression. Generally considered less than 0.5-1.0 cm, which may be brown, blue, red, or hypopigmented
Ex: vitiligo, tinea versicolor, Lentigo, freckles, mongolian spot

Question 9

Patch

Answer 9

large macule equal to or greater than 0.5 -1.0cm across. Patches may have some subtle surface change, such as a fine scale or wrinkling, but although the consistency of the surface is changed, the lesion itself is not palpable.
Ex: sunburn, melasma, port wine stain

Question 10

Papule

Answer 10

An elevated solid lesion, generally considered less than 0.5cm in diameter, is palpable, color varies
Ex: warts, lichen planus, acne, molluscum contagiosum

Question 11

Plaque

Answer 11

A circumscribed, elevated, superficial, solid lesion more than 0.5cm in diameter (often formed by the confluence of papules)
Ex: psoriasis, pityriasis rosea, tinea corporis, secondary syphilis

Question 12

acuminate

Answer 12

pointed

Question 13

fili-form

Answer 13

threadlike

Question 14

bulla

Answer 14

A circumscribed collection of free fluid greater than 0.5cm in diameter
Ex: drug eruption, contact dermatitis

Question 15

nodule

Answer 15

A circumscribed, elevated, solid lesion more than 0.5cm in diameter; a large nodule is referred to as a tumor
Ex: warts, erythema nodosom, lypoma, lymphoma, BCC, SCC

Question 16

scales

Answer 16

excess dead skin, flakes of stratum corneum

Question 17

crust

Answer 17

dried serum, blood o purulent exudate dries on the skin surface

Question 18

erosion vs

ulcer

Answer 18

epidermis, no scarring

involves dermis, will scar

Question 19

Desquamation

Answer 19

skin coming off in scales

Question 20

Pityriasiform

Answer 20

branny powdery scale

Question 21

Sensitization Phase

Answer 21

– a hapten (low molecular weight substance) penetrates into dermis and combines with epidermal protein; a message is sent to T Cell precursors, and sensitized T Cells are formed.

Question 22

Elicitation Phase

Answer 22

– on reexposure to the antigen-protein complex, sensitized T Cells release lymphokines which recruit inflammatory cells causing inflammation

Question 23

type I hypersensitivity

Answer 23

IgE

urticaria, angioedema

Question 24

type II

Answer 24

Drug + Cytotoxic Ab cause lysis of cells such as platelets or leukocytes
Petechiae due to thrombocytopenic purpura, drug-induced pemphigus

Question 25

type III

Answer 25

IgG or IgM antibodies formed to drug

, serum sickness

Question 26

type IV

Answer 26

Mediated by T Cells, monocytes and macrophages rather than antibodies
Clinical Pattern: Morbilliform exanthematous reactions, Contact/allergic Dermatitis, fixed drug eruption, lichenoid eruptions, Stevens-Johnson syndrome, toxic epidermal necrolysis

Question 27

Best way to diagnose allergic contact dermatitis

Answer 27

patch testing, readings taken at 48 and 72 hours

Question 28

allergen specific IgE antibody test

Answer 28

RAST

Question 29

fastest allergy test

Answer 29

scratch test, 15 minutes

Question 30

main treatments for immune responses/allegies?

Answer 30

steroids
Control inflammation, Stronger potency for thicker more dense plaques.
– Can compromise barrier function so short contact recommended
– Ointments penetrate skin better, creams have more chemicals

Question 31

Tacrolimus (Protopic) and Pimecrolimus (Elidel):

Answer 31

Non‐steroidals, decrease risk of steroid side effects, risk of malignancy including skin/lymphoma,
-good for face or skin folded areas

Question 32

most commonly scaling pink papules/or plaques on flexural surfaces, neck, eyelids, dorsum of hands; dermatographism

Answer 32

atopic dermatitis, type I

Question 33

Drugs with High Probability of adverse cutaneous rxn:

Answer 33

PCN and related abx, carbamzepine, allopurinol, gold salts

Question 34

blanch, pink papules/plaques, commonly oval or linear, may coalesce, usually last <24hrs

Answer 34

urticaria, tx w/antihistamines

Question 35

Deeper (dermis and SQ) form of urticaria with larger ill defined areas of edematous involvement

exam: eyelids, lips, tongue, hands, feet, genitalia most commonly involved

Answer 35

angioedema

Question 36

lesions may develop over 10 days or more. Iris or targetlike lesions are typical.
- 70% cases have lesions on lips and buccal mucosa
- Distal extremities and face are common sites
- Individual lesions heal in 1-2 weeks without scaring, new lesions appear in crops and entire episode can last for up to 1 month
may follow HSV or mycoplasma

Answer 36

erythema multiforme

Question 37

• Nodular (3-20cm), erythematous eruption, tender, not sharply marginated
  
  • Mostly on the anterior lower legs, bilateral but not symmetrical (may occur on knees and arms
    but only rarely on the face and neck)
  • nodules are bright to deep red, are located on the subcutaneous fat
    may occur from sarcoid

Answer 37

erythema nodosum

Question 38

what typically causes SJS and TEN

Answer 38

drug rxn