Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology > Lupus/Pemphigus > Flashcards

Lupus/Pemphigus Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

What do you see with generic lupus

A

1) Lymphocyte-rich interface dermatitis
2) Basal keratinocyte apoptosis
3) Typically associated with planum disease but not always

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With generic lupus, what would you see on biopsy

A

lymphocyte rich interface dermatitis that makes it hard to tell the epidermis from dermis

basal keratinoctyte apoptosis

dead reds with satellitosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do you see with Discoid Lupus Erythematosis (DLE)

A

depigmentation (pigmentary incontinence)
crusting
erosion ulceration
tissue loss/fibrosis
UV-sensitive
Secondary infection common (cytology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes Discoid Lupus Erythematosis (DLE)

A

immune mediated (idiopathic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What exacerbates Discoid Lupus Erythematosis (DLE)

A

UV-light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common site for Discoid Lupus Erythematosis (DLE) to occur

A

the nasal planum

can also see it on the perioral and periocular skin
(mostly sticks to the face- but can become generalized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Discoid Lupus Erythematosis (DLE) that is generalized

A

GDLE - generalized discoid lupus erythematosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

lupus variant where erosion to ulceration lesion occur at the mucocutaneous junctions

A

Mucocutaneous Lupus Erythematosus (MCLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should you always do before biopsying

A

cytology treat any infections prior to biopsying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are different differentials for lupus erythematosus

A

1) Mucocutaneous pyoderma (lichenoid band-reaction pattern)
2) Epitheliotropic lymphoma
3) VKH-like syndrome (uveodermatologic)
4) Vitiligo
5) Squamous Cell Carcinoma
6) Nasal philtrum arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If you biopsy a mucocutaneous pyoderma it is indistinguishable from

A

DLE - use antimicrobial first before treating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What breeds commonly get vitiligo

A

rottweilers and schnauzers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Animals with uveodermatologic disease present with eye or skin issues first

A

eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What breeds are overrepresented for nasal philtrum arteritis

A

St Bernards
Giant Schnauzers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

With nasal philtrum arteritis, where do you typically see the lesions

A

ulceration/erosions on the dorsal alar ridge of the nose

dont biopsy these

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the breed-specific lupus disease

A

1) Vesicular Cutaneous Lupus Erythematosus (VCLE)
-Collies/Shetlands
2) Exfoliative Cutaneous Lupus Erythematosus (ECLE)
-German Short-Haired Pointers/ Viszlas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the different Lupoid Diseases

A

1) Discoid Lupus Erythematosus (DLE)
2) Generalized Discoid Lupus Erythematosus (GDLE)
3) Mucocutaneous Lupus Erythematosus (MCLE)
4) Vesicular Cutaneous Lupus Erythematosus (VCLE)
5) Exfoliative Cutaneous Lupus Erythematosus (ECLE)
6) Systemic Lupus Erythematosus (SLE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vesicular Cutaneous Lupus Erythematosus (VCLE) occurs in what breeds

A

Collies/Shetland sheepdogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is seen with Vesicular Cutaneous Lupus Erythematosus (VCLE)

A

Vesicular Disease- primarily ventrum
+/- mucocutaneous junctions
can resemble pyoderma

no age/gender predisposition but occurs in collies/shetland sheepdogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What breeds is Exfoliative Cutaneous Lupus Erythematosus (ECLE) seen in

A

German Short-haired pointers/ Viszlas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why do German short-haired pointers and viszlas get Exfoliative Cutaneous Lupus Erythematosus (ECLE)

A

Autosomal recessive genetic
young (median: 8months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is seen with Exfoliative Cutaneous Lupus Erythematosus (ECLE)

A

scaling/alopecia (exfoliative dermatitis) that is generalized
systemic: arthralgia, dyscrasias
occurs in young german short-haired pointers and viszlas

can resemble sebaceous adenitis

22
Q

Is VCLE or ECLE better prognosis

A

VCLE

ECLE affects other body systems

23
Q

T/F: DLE can become SLE

A

False - it is its own distinct clinical issue

SLE is very rare

24
Q

What are the symptom criteria of SLE diagnosis

A

Fever
IMPA/polymyositis
Discoid rash
Proteinuria
Dyscrasias (thrombocytopenia most common)
Photosensitivity
Ulcerative stomatitis
Body cavity effusions
Neurologic disorders
ANA?

25
Q

What might be a helpful test for SLE diagnosis

A

ANA (anti-nuclear antibody) titers

Positive if > 1:160

Can be positive in normal dogs or any with immune mediated disease or infectious disease (Bartonella, Ehrlichia)

Can be negative in SLE cases

only want to run in suspicious patients with lots of the criteria

26
Q

How do you treat Lupus *

A

Tacrolimus (topically) - massaged in and distract them from licking

Systemically: Steroids, Cyclosporine, Azathioprine, Apoquel, Hydroxychloroquine, or subtherapeutic doses of Doxycycline

Sunscreen for DLE

27
Q

What immunosupressive drug might be used for ECLE

A

Mycophenolate

28
Q

Symmetric Lupoid Onychodystrophy (SLO)

A

idiopathic immune mediated disease where multiple nails are affected, also the dewclaws*
secondary infection possible
painful

29
Q

Biopsy diagnosis of Symmetric Lupoid Onychodystrophy (SLO) requires

A

Amputation of P3

30
Q

How do you treat Symmetric Lupoid Onychodystrophy (SLO)

A

Pentoxifylline - 30mg/kg BID
Same treatment for vasculitis

Omega-3 fatty acids

Severe: Cyclosprine, Steroids

Treatment is slow and the claws may never be normal

31
Q

Is prognosis of pemphigus foliaceus or vulgaris better

A

foliaceus

32
Q

What is the pathogenesis of pemphigus foliaceus

A

auto-antibodies to desmosomes- connections of superficial cells in the epidermis leading to acantholytic keratinocytes

33
Q

What is the pathogenesis of pemphigus vulgaris

A

aut-antibodies to hemidesmosomes which lifts the superficial epidermis and only have basal keratinocytes (tombstone effect)

34
Q

Pemphigus foliaceus is _______ while vulgaris is

A

foliaceus: superficial
vulgaris: deep

35
Q

Why is the prognosis of Pemphigus vulgaris much worse than with pemphigus foliaceus

A

Vulgaris - significant risk for sepsis with widespread ulceration

36
Q

What is seen on cytology of pemphigus foliaceus

A

Lots of neutrophilic infiltration
acantholytic keratinocytes
+/- secondary bacterial infection

37
Q

What are reasons you might see acantholytic keratinocytes on cytology

A

1) pemphigus foliaceus
2) bacterial pyoderma
3) dermatophytosis

38
Q

What are the 3-Ps of pemphigus foliaceus in sites

A

Pawpads
Pinna
Planum

cats have crusting at claw folds and nipples

39
Q

What is the most common dermatologic immune disease of dogs and cats

A

pemphigus foliaceus

40
Q

What do you see with pemphigus foliaceus

A

Pustules (fragile)
Crusting/erosions
Acantholytic keratinocytes* on cytology
secondary infections, pruritus vairable

Dogs: hyperkeratosis of the face and paws
Cats: face, nail beds, perinipular

41
Q

Where do cats typically get pemphigus foliaceus lesions

A

Face
nail beds
Perinipular

42
Q

What are differentials for pemphigus foliaceus

A

Pyoderma
Demodicosis
Dermatophytosis (Trichophyton)
DLE (if only on face)
Cutaneous drug eruption
Acantholysis- Staph, Dermatophyotisis

43
Q

although pemphigus foliaceus can be diagnosed with clinical suspicion and cytology, what is needed for the definitive diagnosis

A

biopsy

44
Q

pemphigus foliaceus is typically idopathic but could occur secondary to

A

drug reaction
paraneoplastic syndrome

45
Q

What is seen with pemphigus vulgaris

A

Rare, severe, life-threatening
-Ulcers on Oral, mucocutaneous junctions, paws
-No acantholytic keratinocytes

Idiopathic (drug reaction)

46
Q

T/F: you will see acantholytic keratinocytes with pemphigus vulgaris

A

False- only foliaceous

47
Q

What are you differentials for pemphigus vulgaris

A

subepidermal blistering diseases

48
Q

T/F: pemphigus vulgaris is rare in cats

A

True

49
Q

What are the pemphigus variants

A

Pemphigus erythematousus (PF/DLE hybrid)

Pemphigus vegetans (papillomatous PV)

Paraneoplastic pemphigus

50
Q

What is the goal of pemphigus treatment

A

Immunosuppression for goal of epithelialization
-Steroids (immunosuppressive)
-Cyclosporine
-Azathiorpine
-Mycophenolate
-Apoquel (PF)
-Adequan (PF)

51
Q

How do you diagnose all variants of pemphigus

A

Biopsy

52
Q

How do you treat pemphigus

A

Immunosuppression for goal of epithelialization
-Steroids (immunosuppressive)
-Cyclosporine
-Azathiorpine
-Mycophenolate
-Apoquel (PF)
-Adequan (PF)

Dermatology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions