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Dermatology - Clinical Medicine IV > Lichenifcation & Acantholysis > Flashcards

Lichenifcation & Acantholysis Flashcards

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Dermatology Board Prep flashcards
1
Q

What is tiny perifollicular papules around hair follicles?

A

keratosis pilaris

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2
Q

What causes keratosis pilaris?

A

keratization causing plugging hair follicular

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3
Q

Where do you get keratosis pilaris?

A

upper thighs, lateral upper arms and cheeks

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4
Q

What is the treatment of keratosis pilaris?

A

moisturizers with ingredients like lactic acid, urea, salicyclic acid (Cerave SA, amlactin)

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5
Q

What type of condiation is ichthyosis vulgaris?

A

Autosomal dominant

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6
Q

Fine, adherent scale on extremities and trunk with sparing of flexures, larger scale on lower legs, hyperlinear palms and soles

A

Ichthyosis Vulgaris

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7
Q

What is the pathology of ichthyosis vulgaris?

A

absent stratum granulosum in some people, decreased or absent profilaggrin, also possible increased adherence of stratum corneum

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8
Q

What do pt have ichthyosis vulgaris with (secondary)?

A

malnutrition, infectious disease, sarcoidosis and other paraneoplastic disorders

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9
Q

How do you treat ichthyosis vulgaris?

A

reduction of scales as in KP

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10
Q

the patient has an itch in a particular location and begins to itch – the itching causes a cascade of itching/ scratching in a cycle which leads to thickening of the skin

A

Lichen Simplex Chronicus

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11
Q

When do lichen simplex chronicus pts complain of symptoms?

A

at rest, not when busy

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12
Q

What are the histologic findings for LSC?

A

epidermal thickening, hyperkeratosis, acanthosis, spongiosis. Papillary dermal fibrosis with vertical streaking of collagen bundles

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13
Q

What is the treatment for LSC?

A

topical steroid, itch prevention, oral snti-puritics including doxepin, phototherapy, psych referral

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14
Q

Darkening and thickening of the skin – marker of underlying disease

A

ACANTHOSIS NIGRICANS

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15
Q

Where does acanthosis nigricans present?

A

skin folds - axillae, groin, back of neck

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16
Q

What are the 7 types of acanthosis nigricans?

A

obesity related, syndromic (Cushings, PCOS), benign(over dorsal hands and feet in AA), drug induced (nicotinic acid, insulin, systemic steroids, hormonal tx), hereditary (autosomal dominant), malignant (stomach CA in 90%), mixed

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17
Q

When is acanthosis nigricans itchy?

A

malignancy

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18
Q

What is threatment for acanthosis nigricans?

A

topical retinoids for cosmetic apperance, creams with exfoliating properties

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19
Q

Chronic inflammatory skin condition that is a T cell mediated auto immune disease

A

lichen planus/ lichen planopilaris

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20
Q

Where does lichen planus occur?

A

nails, hair follicles, skin, oral mucosa, vaginal mucosa, penis

21
Q

What can cause lichen planus/lichen planopilaris?

A

stress, genetic predisposition, skin trauma (koebnerization), herpes zoster, hepatitis (self antigen modification on surface of basal keratinocytes), meds such as quinidine, hydrxychloroquine, captopril

22
Q

What is the skin findings for lichen planus?

A

usually symmetrical, scaly papules and plaques, purplish to pink, flat topped, mildly pruritic , may be linea

23
Q

What do you see orally in lichen planus?

A

Wickham Striae

24
Q

What do you see on the scalp with lichen planus?

A

telangectasia, erythemia, scarring

25
Q

What is the dx for lichen planus?

A

get hepatitis hx

biopsy = positive DIF (IG at base of epidermis)

26
Q

What is the treatment for lichen planus?

A

spontaneous resolution, topical steroids, calcineurin inhibitors

27
Q

Transient acantholytic dermatosis

A

Grover’s disease

28
Q

Who gets grover’s disease?

A

men over 50

29
Q

What can grover’s disease be related to?

A

sweat or heat

30
Q

Where do you get grover’s disease?

A

back and chest

31
Q

What does grover’s disease look like?

A

Multiple tiny uniform perifollicular papules that are itchy

32
Q

What is the treatment for grover’s disease?

A

topical steroids, topical aloe/anti-itch meds (AlcortinA gel, Novacort Gel)

33
Q

Rare heriditary blistering disease caused by defective mortar between cells - Chronic acantholytic dermtosis

A

Hailey-Hailey

34
Q

Where do you get hailey-hailey?

A

skin folds, axilla/groin, under breast and butt

35
Q

What do skin lesions look like in hailey hailey?

A

ring-like then clear, sometimes secondarily infected, with malodor and weeping- no scars

36
Q

What makes hailey hailey worse?

A

heat and sweating

37
Q

What is the treatment for hailey hailey?

A

staying dry, avoid overheating, topical steroids, oral TCN
afamelanotide
Can go into remission after years and disease improves over time

38
Q

What is things to know about hailey hailey?

A

gross smell and rare, no good treatment

39
Q

Hereditary and chronic acantholytic dermatosis – autosomal dominant (50% inheritance rate)

A

Darier disease

40
Q

When does darier disease start?

A

adolescence

41
Q

What does skin like in darier disease?

A

Greasy scaly papules over hair bearing areas, flexural folds – malodor is common
Bumpy sebborheic dermatitis

42
Q

What are some clinical presenations of darier diseas

A

small pits on the palms and soles and longitudinal pink nail stripes and V shaped nick at the free edge of the nail is very common

43
Q

What are symptoms exaccerbated by darier disease?

A

sun, heat, bacterial infections

44
Q

What is the treatment for darier disease?

A

Ranges from sun protection, moisturizers for mild disease to topical/oral retinoids for severe disease or even cyclosporine

45
Q

What is the most common type of acanthosis and what is it related to?

A

obesity, insulin resistantce

46
Q

What are the two disease states related to acanthosis nigricans?

A

PCOS and cushings

47
Q

What malignancy is related to acanthosis nigricans?

A

GI tumors (stomach 90%)

48
Q

Who gets a benign variant that doesnt indicate underlying disease in acanthosis nigricans?

A

AA, in hands and feet

49
Q

What is the main clinical manifestation in grover disease?

A

pruritis

Dermatology - Clinical Medicine IV (31 decks)

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