MOST COMMON QUESTIONS Flashcards
What are the 3 zones in target lesions of Erythema multiforme?
- central dusky purpura
- Elevated edematous pale ring
- surrounding macular erythema
compare AD ans seborrheic dermatitis based on their site involvement
AD involves the cheeks in infants (spares the central face), spares the diaper area
Seborrheic dermatitis can involve the diaper area, central face and scalp
first line treatment of vitiligo for pediatric and facial involvement
topical corticosteroids
most common clinical pattern of psoriatic arthritis
oligoarthritis with swelling and tenosynovitis of 1 or a few hand joints (70%)
nail groove can be seen in what condition
Myxoid cyst AKA synovial and digital mucous cyst
infants with seborrheic dermatitis with cradle cap were found to have impaired function of this enzyme which is required for the metabolism of essential fatty acids
delta - 6 - desaturase
Cellulitis etiology
S. Aureus/ Strep pyogenes
When is varicella most infectious
1 - 2 days before eruption of lesions
in cutaneous porphyrias, the photosensitivity is caused by absorption of UV radiation in what band of the UV spectrum by the porphyrins?
Soret Band (400 - 410 nm)
6th disease
Roseola infantum / Exantum subitum
common cause of sudden, unexplained high fever in young children between 6 and 36 months of age. Prodromal fever is usually high and may be accompanied by convulsions and lymphadenopathy. Suddenly, on about the fourth day, the fever drops. Coincident with the decrease in temperature, a morbilliform erythema of discrete, rose-colored macules appears on the neck, trunk, and buttocks and sometimes on the face and extremities. Often, there is a blanched halo around the lesions. The eruption may also be papular or rarely even vesicular. The mucous membranes are spared. Complete resolution of the eruption occurs in 1β2 days
deep folliculitis due to a cutaneous dermatophyte infection
Majocchi Granuloma
Majocchi granuloma is due to disruption of infected hair follicles so that hair shafts and fungi penetrate into the dermis and subcutaneous tissue. It presents with an irregular red, scaly plaque in which there are follicular papules, pustules and nodules. It is usually found on one lower leg.
Varnish-like crust
bullous impetigo
DOC for dermatophyte onychomycosis
Terbinafine
exaggerated skin injury occurring after minor trauma such as bump, bruise, needle stick injury. A more severe injury, such as a surgical procedure, can result in persistent ulceration in a patient with pathergy. It typically occurs in patients with Behcet disease.
Pathergy
n-serrated pattern of immunofluorescence in DIF means?
the split is above the basal lamina
n-serrated pattern is typically found in the most common sAIBD (Subepidermal Autoimmune Bullous Disease) bullous pemphigoid.
etiologic agent for non-inflammatory tinea capitis
All microsporum and trichophyton except T. concentricum
The underlying cause of TTP is a congenital or acquired deficiency of the vWF-cleaving protease, _________
ADAMTS13
vWF is secreted by the endothelial cell in long multimers, which should be cleaved into monomers by ADAMTS13 and released into the circulation. Instead, multimers circulate and extend from the surface of the endothelial cells in the microvasculature. Platelets adhere to these multimers and the surface of the endothelial cell, leading to microvascular thrombosis.
Herald / Mother patch
salmon-colored
Pityriasis rosea
golden period in detecting early signs of nerve function impairment
12 months or less
horizontal indentations, or ridges, that develop across the nails
Beauβs Lines
can be seen in psoriasis
give some differentials of leprosy
- tinea corporis
- psoriasis
- pityriasis rosea
- DLE
- granuloma annulare
- lupus vulgaris
- tuberculosis verruca cutis
- neurofibromatosis
- leukemia cutis
- xanthomas
- pityriasis versicolor
- pityriasis alba
- post-inflammatory hypopigmentation
- birthmarks
- vitiligo
- scleroderma
Subepidermal Immunobullous Diseases
- bullous pemphigoid (BP),
- epidermolysis bullosa acquisita (EBA),
- cicatricial pemphigoid (CP),
- pemphigoid gestationis (PG),
- linear IgA dermatosis (LAD),
- dermatitis herpetiformis (DH), and
- bullous systemic lupus erythematosus (BLSE)
azoles are active against what organisms
Yeasts > dermatophytes
hallmark of ACD
Itch
relative contraindications to prednisolone therapy in leprosy
- HTN
- DM
- Pregnancy
- mature cataracts
- glaucoma
- less than 15 y/o
- more than 60 y/o
- lack of cooperation
etiologic agent of total dystrophic pnychomycosis
Candida sp.
causative agent for black dot tinea
T. tonsurans and T. violaceum
Treatment for Impetigo contagiosa
- oral or topical antibiotics for 7 - 10 days
- Cloxacillin
- Children: 25 - 50 mkday in 4 divided doses
- Adults: 500 mg QID
- 1st generation cephalosporins like cephalexin
- Children: 25 - 50 mkday in 4 divided doses
- Adults: 500 mg QID
- Mupirocin ointment BID
- Cloxacillin
characterized by adherence of the distal portion of the nail bed to the ventral surface of the nail plate
Pterygium Inversum Unguis
It results from the extension of the zone of the nail bed that normally contributes to the formation of the nail plate. This eventually leads to a more ventral and distal extension of the hyponychium.
general management of AD
- skin hydration with moisturizers
- avoid overbathing
- avoid irritating or aggravating factors
- may give oral sedating antihistamines particularly at night
- short courses of topical steroids
- saline compresses or oral antibiotics for acute weeping eczematous dermatitis
Neutrophils exit from the tips of a subset of dermal capillaries (the βsquirting papillaeβ), leading to their accumulation in the overlying parakeratotic stratum corneum
Munroβs microabscess
Present in psoriasis
Chronic Cutaneous LE
common histologic denominator in all forms of pemphigus
acantholysis, lysis of the intercellular adhesive junctions between neighboring squamous epithelial cells that results in the rounding up of detached cells
inflammatory manifestations of tinea capitis
Kerion
Favus
Telogen shed may be estimated by what test?
Pull Test
grasping 40 hairs firmly between thumb and forefinger, followed by a slow pull that causes minimal discomfort to the patient A count of more than 4β6 club hairs is abnormal
Classification of cutaneous Manifestations of lupus erythematosus
trench fever
B. quintana
give a differential diagnosis for guttate psoriasis
pityriasis rosea
acquired, depigmented dermatosis caused by repeated exposure to chemicals
Leukoderma
Pemphigus vulgaris has autoantibodies directed to what?
Desmoglein 1 and 3
* presents with generalized flaccid blisters with ulcers in the oral mucosa; many erosions because the flaccid bullae easily ruptures
Treatment of moderate acne
causative agent of tinea versicolor
Malassezia globosa
difference of verruca from calluses?
verruca has no dermatoglyphics (fingerprints)
SCC in situ of the glans penis or prepuce
ERYTHROPLASIA OF QUEYRAT
* caused by high-risk HPV types (16, 18, 31, 35)
* single or multiple, fixed, well-circumscribed, erythematous, moist, velvety or smooth, red-surfaced plaques on the glans penis (Fig. 29.26).
what do you check when there is cellulitis of the lower extremity
Look at the foot for tenia pedis infection
Differentiate BCC from SCC
BCC - face especially the NOSE is the more common site of predilection (dorsum of the hands in SCC); rodent ulcer; (+) telangiectasia; (+) friability
SCC is more associated with chronic long term sun exposure; metastasis is more common; may have necrotic border
doubling time og M. leprae
12 days
5th Disease
Erythema Infectiosum
What is the lovibond angle in nail clubbing?
180o or more
characterized by an acute eczematous eruption triggered by purulent discharge from a primary infected site
Infectious eczematoid dermatitis (IED)
dermatitis that develops on the area macerated from the discharge from an infected ulcer or sinus
locations frequently involved in adult AD
Hands and wrists
class 2 potent steroids
Fluocinonide 0.05% cream/gel/ointment
mometasone furoate 0.1% ointment
Hutchinson Triad of Congenital Syphilis
- changes in the incisor teeth (hutchinson teeth - malformation of the central upper incisors that appear in the secondary or permanent teeth
- opacities of the cornea
- eighth cranial nerve deafness
this indicates the involvement of the nasociliary nerve presenting as herpes zoster vesicle present on the tip or side of the nose.
hutchinsonβs sign
Porphyria cutanea tarda is deficient in what enzyme?
uroporphyrinogen decarboxylase (UROD)
give some Differentials for exfoliative dermatitis
- psoriasis
- atopic dermatitis
- eczema
- allergic contact dermatitis
- irritant contact dermatitis
Chancroid
Haemophilus ducreyi
Chancroid (soft chancre) is an infectious, ulcerative STD caused by the gram-negative bacillus Haemophilus ducreyi (the Ducrey bacillus) One or more tender ulcers on the genitalia and painful inguinal adenitis that may suppurate, are characteristic of the disease.
Bullous impetigo etiology
Staphylococcus aureus
The angle formed by the dorsal surface of the distal phalanx and the nail plate
Lovibond angle
Black or brown pigmentation of the normal nail plate
Melanonychia
bacillary angiomatosis
bartonella hensellae
bartonella quintana
Individual melanocytes in the βbuckshotβ scatter throughout the epidermis are typical of?
Superficial Spreading melanoma
general mechanism for Type 1 reactions in leprosy
Enhanced cell-mediated immune response
*generally ocuur in borderline leprosy (BT, BB, BL)
*occur at existing skin lesions
etiology of EM
Adult: HSV 1 > 2
Children: Mycoplasma pneumoniae
Maculae cerulae is seen in whart disorder
Pediculosis Pubis
Maculae cerulae are blue-gray macules, which are actually a discoloration of the skin due to the insectβs bite. They are due to altered blood pigments of the infested humans or the excretion products of the louseβs salivary glands
Casal Necklace
Pellagra (Vitamin B3 Deficiency)
*photosensitive eruption
* occurs symmetrically on the face, neck and upper chest (casal necklace), extensor hands and backs of the hands
Possible side effect of dapsone
hemolytic anemia
Holster sign
dermatomyositis
KOH finding of dermatophytes
Long Septated hyphae
most common type of xamthomas
Xanthelasma/ Xamthelasma palpebrarum
incubation period of measles
8 - 12 days
Gottron Papules
Dermatomyositis
Gottron papules refer to a violaceous hue located at the dorsal-lateral interphalangeal (IP) and/or metacarpophalangeal (MCP) joints.
βsplit endsβ
Trichoptilosis
most serious complication of varicella
Varicella Pneumonia
causative agent of granuloma inguinale
Klebsiella granulomatis
give differentials for tinea pedis
Atopic dermatitis - never on the plantar arch (can involve plantar arch in tinea)
Allergic contact dermatitis - usually symmetrical (in tinea, may involve one hand and both feet)
Treatment for herpes zoster
Acyclovir 800 mg 1 tab q4 5x/day for 7 days
San joaquin valley fever
Coccidioidomycosis
onychomycosis that is HIV related
proximal subungal onychomycosis
joints affected in psoriasis
DIP, PIP joints
spares the MCP and MTP joints
exaggerated skin markings; criss-cross pattern
Lichen Simplex Chronicus
Wickham striae
Lichen Planus
The usual presentation of the disease is classical lichen planus. Symptoms can range from none (uncommon) to intense itch.
Papules and polygonal plaques are shiny, flat-topped and firm on palpation.
The plaques are crossed by fine white lines called Wickham striae.
Hypertrophic lichen planus can be scaly.
Atrophic lichen planus is a rare annular variant with an atrophic centre.
Bullous lichen planus is rare.
Size ranges from pinpoint to larger than a centimetre.
Distribution may be scattered, clustered, linear, annular or actinic (sun-exposed sites such as face, neck and backs of the hands).
Location can be anywhere, but most often front of the wrists, lower back, and ankles.
Colour depends on the patientβs skin type. New papules and plaques often have a purple or violet hue, except on palms and soles where they are yellowish-brown.
Plaques resolve after some months to leave greyish-brown post-inflammatory macules that can take a year or longer to fade.
Chicken wire pattern of intercellular IgG in DIF
Pemphigus vulgaris
Give evidence of recent Strep infection for Scarlet fever
Increased Antistreptolysin O or DNAse B titer
HPV type of external genital warts
HPV 6 and 11
KOH finding of tinea versicolor
short hyphae with spores
(spaghetti and meatballs)
color of pityriasis versicolor in woodβs lamp
yellowish to yellowish-green fluorescence
aspirin is contraindicated in varicella because?
may produce Reyeβs syndrome (encephalopathy with liver damage)
what is the normal lovibond angle?
160o
differentials for molluscum contagiosum
- verruca
- syringoma - benign sweat gland tumor usually on the face around the eyes
- sebaceous hyperplasia - sebaceous gland hypertrophy usually on seborrheic areas of the face
- basal cell carcinoma
- condyloma acuminata
- epithelial inclusion cyst
Multiple facial mollusca - disseminated invasive fungal infection like cryptococcosis, histoplasmosis, coccidioidomycosis and penicillosis
(Tinea Corporis) βdue to corticosteroid therapy
Tinea Incognito
fungal skin infection when the clinical appearance has been altered by inappropriate treatment, usually a topical steroid cream. The result is that the original infection slowly extends.
Darier Sign
Urticaria Pigmentosa, Mastocytoma, Mastocytosis
refers to the urtication and erythematous halo that are produced in response to the rubbing or scratching of these lesions. This is due to mast cell degranulation induced by physical stimulation
number of hair normally shed daily
100 - 150 strands daily
concentric blanching of erythematous skin near periphery of healing psoriatic plaque
Woronoff ring
- it is often the first sign that the patientβs psoriasis is responding to phototherapy.
- ring-like hypopigmentation zone around regressing psoriasis lesions.
what increases and decreases absorpption of itraconazole
food INCREASES absorption
antacids and gastric acid suppressors DECREASES absorption
areas of hair loss with absence of follicular ostia
Citcatricial / Scarring alopecia
common disorder of the hair follicles that clinically gives the impression of blackheads (Fig. 33.30), but the follicles are filled with funnel-shaped, horny plugs within which are bundles of vellus hairs. The hairs are round at their proximal ends and shredded distally.
Trichostasis spinulosa results from retention of telogen hairs, which are derived from a single hair matrix. It is primarily caused by a hyperkeratosis of the follicular infundibulum, which leads to a partial obstruction of the follicular orifice and thus does not permit shedding of small telogen hairs.
Extension of discolouration into the skin surrounding the nail
Hutchinson sign
- clinical clue to subungal melanoma
- involvement of the nail plate + periungual skin
how can you differentiate anagen and telogen hair?
- Anagen hair has a pigmented bulb and is surrounded by a gelatinous root sheath (left);
- Telogen hair has a nonpigmented bulb and lacks a root sheath. (right)
Squamous cell carcinoma in situ
Bowen Disease
BD may be found on any part of the body as an erythematous, slightly scaly and crusted, noninfiltrated patch from a few millimeters to many centimeters in diameter (Fig. 29.24). The lesion is sharply defined. The scale may be pronounced enough for the lesion to be mistaken for psoriasis, or the plaque may have a stuck-on appearance and be mistaken for a broad, sessile seborrheic keratosis
Ugly duckling sign
Melanoma
- one mole among may that sticks out and looks different
how do you differentiate pediculosis corporis from scabies?
pediculosis corporis spares the hands and feet
Bullae are often arranged in rosettes or an annular array, the so-called string of pearls configuration
Childhood Linear IgA Disease (Chronic Bullous Disease of Childhood)
etiology of Erysipelas
Group A strep
how can you view burrows of scabies
via india ink or gentian violet
Buttonhole sign
With application of gentle pressure, a neurofibroma will easily invaginate into the subcutis
Neurofibromas can be invaginated with the tip of index finger back into the subcutis and again reappear after release of pressure. [14] Other condition where one can find positive buttonhole sign are anetoderma (macular atrophy - localized loss of elastoc tissue resulting in herniation of subcutaneous tissue) and dermatofibroma.
produces non-inflammatory type of Tinea pedis
T. rubrum - produces dry erythema with scaling
most common type of melanoma
Superficial Spreading melanoma
most common internal cause of pruritus
CKD
Hepatitis associated with polyarteritis nodosa (PAN)
Hepatitis B
most common causes of mortality in SJS
- sepsis
- electrolyte imbalance
secondary lesions of syphilis
Condyloma lata
- also check lesions on the palms and soles
most common type of melanoma in asians/ darker population
Acral lentiginous melanoma - specific type of melanoma that appears on the palms of the hands, the soles of the feet, or under the nails. The word βacralβ means βextremityβ in Greek and refers to the occurrence of this type of melanoma on the extremities (hands and feet).
Differentiate Hypertrichosis form hirsutism
Hypertrichosis is an overgrowth of hair not localized to the androgen-dependent areas of the skin.
Hirsutism is an excess of terminal hair growth in women in a pattern more typical of men.
drug of choice for bullous systemic LE
Dapsone
areas spared in scabies in adults
face, scalp, mucosa
most common complication of herpes zoster
post-herpetic neuralgia
delicate scaling in pityriasis versicolor can be elicited by what maneuver
Grattinage maneuver
https://www.youtube.com/watch?v=0cAJpDJT95g
scaling is dust-like/furfuraceous, and in some macules, may only become apparent after a combination of light scaping and scratching
average incubation period of leprosy
2 - 5 years
It usually begins in adolescence, appearing first as minute, round, skin-colored or hyperpigmented macules or papules that develop singly or in sparse numbers on the malar regions or on the cheeks below the eyes.
DERMATOSIS PAPULOSA NIGRA
causative agent of lyme disease
Borrelia burgdorferi - transmitted via bit of an ixodes tick
Forchheimer sign
German measles (Rubella)
*exanthem of pinhead-sized red macules or petechiae on the soft palate and uvula
3 major triggers of dyshidrotic eczema
stresss, atopy, contactants
presents as SUBCORNEAL blister formation
Pemphigus foliaceus
% BSA of SJS
<10% BSA
u-serrated pattern of immunofluorescence in DIF means?
The split is in the sub-lamina densa
Presence of the u-serrated pattern indicates the sAIBD subtype epidermolysis bullosa acquisita (EBA)
give some differentials for psoriasis
- fungal infections
- seborrheic dermatitis
- pityriasis rosea
- lichen planus - chiefly affects flexor surfaces of the forearms, wrists, shins and ankles; may have very fine scales; scalp less frequently involved; nails may have pterygium
- psoriasiform subset of subacute cutaneous LE - located usually on the upper trunk, arms as well as signs of photsensitivity
- chronic contact dermatitis and dyshidrotic eczema
usually results from hair shaft fracture
Anagen Effluvium
It is frequently seen following the administration of cancer chemotherapeutic agents, such as the antimetabolites, alkylating agents, and mitotic inhibitors. These agents result in temporary shutdown of the hair matrix with resultant tapering of the shaft (Pohl-Pinkus constrictions).
percent of KOH used for dermatophyte infection
10% KOH
junction between palmoplantar and glabrous skin
Wallace line
causative agent of pediculosis capitis
Pediculus humanus var. capitis
describe childhood AD
- less exudative, drier and more PAPULAR lesions
- classic locations are the antecubital and the popliteal fossa, flexor wrists, eyelids, face and around the neck
- lesions are 2-4 mm excoriated papules and lichenified plaques, slightly scaly
adverse effect of cyclosporine
HTN and nephrotoxicity
differentials for tinea corporis
- contact dermatitis - history of exposure to contactant; absence of central clearing and advancing border
- atopic dermatitis - absence of advancing borders and central clearing plaques; found on flexural areas in adults and extensors in infants
- psoriasis - erythematous plaques with silvery white scales; (+) koebner phenomenon and auspitz sign
- pityriasis rosea
- pityriasis alba
- tinea versicolor
- erythema migrans
- subacute LE
- cutaneous T cell lymphoma
differentials for tinea pedis
- pitted keratolysis - bacterial infection producinf pits on the stratum corneun; positive foot odor; negative KOH
- P. aeruginosa webspace infection - presence of gram negative bacteria on gram stain and culture; negative KOH
- Erythrasma - coral red fluorescence on woodβs light; negative KOH
- Contact dermatitis - exposure to contactants; negative KOH
- Dyshidrotic eczema - minute tapioca-like vesicles on the lateral sides of the toes and soles; negative KOH
- Psoriasis
Nail pitting
*caused by parakeratosis from the proximal matrix
psoriasis
cause of black dot tinea
*this occurs due to the fungi invading the follicle (endothrix)
T. tonsurans
neonatal varicella may occur if the mother develops infection when?
5 days before and 2 days after delivery
etiology of pityriasis rosea
HHV 6 & 7
%BSA of TEN
>30% BSA
HPV types of plantar warts (Verruca plantaris)
HPV 1, 2, 27, 57
Thrombotic thrombocytopenic Pentad
- Microangiopathic Hemolytic anemia - coombβs negative
- Thrombocytopenic purpura - (+) platelet aggregation in the microvasculature
- Neurologic abnormalities
- Fever
- Renal Disease
incubation period of rubella
14 - 17 days
most common cause of inflammatory type of tinea pedis
T. mentagrophytes
primary lesion of syphilis
chancre
cardinal signs of Leprosy
- hypopigmented or reddish skin lesion with definite loss of sensation
- skin smear positive for AFB
- enlargement plus tenderness of the peripheral nerves
exclamation point hairs
Alopecia Areata
Cat scratch disease
Bartonella henselae
SAUCER RIGHT SIDE UP APPEARANCE in leprosy
Tuberculoid leprosy
Saucer right side up: sharpy defined and elevated border that slopes down to a flattened atrophic center
nephritogenic strains of Streptococcus
Type 49, 55, 57, 60 and strain M - Type 2
Treatment for Paucibacillary Leprosy
Dapsone, Rifampicin
clues to correct diagnosis of alopecia areata
- history of periodic regrowth,
- nail pitting (Fig. 33.2), and the
- presence of tapered fractures or βexclamation pointβ hairs.
what causes hypopigmentation in pityriasis versicolor
due to the metabolites PITYRIACITRIN which absorbs UV light ans AZELAIC ACID which inhibits tyrosinase enzyme
site of injury in the epidermis of miliaria rubra
prickle cell layer (stratum spinosum)
ash-leaf macules
tuberous sclerosis
(+) anti-Jo-1 antibody
Dermatomyositis
unilateral eye swelling after nighttime encounter with typanosoma cruzi
Romanaβs sign (Reduviid bites)
type of miliaria that is ALWAYS preceded by some other dematitis (contact derm, lichen simplex xhronicus, intertrigo)
Miliaria pustulosa
Osler Nodes
Infective endocarditis
*PAINFUL, erythematous nodule with pale center on the fingertips
*from septic emboli leading to clogging of distal vessles
Impetigo contagiosa etiology
S. aureus, Group A strep;
Group B strep in newborns
give a differential for dermatitis herpetiformis
Scabies
* DH can be seen on the nape, scapula, extensors, buttocks
severity-of-illness score that estimates the risk of death in TEN
SCORTEN
HSV 2 reactivates most commonly in what ganglia
Sacral ganglia (S2 - S4)
spares the folds of the inguinal area
diaper dermatitis
conditions that are (+) for pathergy test
- Behçet disease,
- pyoderma gangrenosum,
- Sweet syndrome, and
- bowel-associated dermatosisβarthritis syndrome.
HPV type of pigmented warts
HPV 4, 60, 65
Give conditions that presents with Koebner phenomenon (Isomorphic Response)
Psoriasis
Vitiligo
Verruca plana
Lichen planus
Molluscum contagiosum
Granuloma inguinale
The disease begins as single or multiple subcutaneous nodules, which erode through the skin to produce clean, sharply defined lesions, which are usually painless (Fig. 14.36A).
More than 80% of cases demonstrate hypertrophic, vegetative granulation tissue, which is soft, has a beefy-red appearance, and bleeds readily. Approximately 10% of cases have ulcerative lesions with overhanging edges and a dry or moist floor (Fig. 14.36B).
Treatment for scabies
5% Permethrin lotion - apply from the neck down. leave on overnight for 8-10 hours and rinse off in the morning. Use once a week for 2 weeks
*we repeat after 1 week because we wait for the eggs to hatch again
Most common type of BCC
Nodular/Classic Basal Cell Carcinoma
Nodular BCC is composed of one or a few small, waxy, semitranslucent nodules forming around a central depression that may or may not be ulcerated, crusted, and bleeding. The edge of larger lesions has a characteristic rolled border. Telangiectases course through the lesion. Bleeding on slight injury is a common sign. As growth progresses, crusting appears over a central erosion or ulcer, and when the crust is knocked or picked off, bleeding occurs, and the ulcer becomes apparent. This ulcer is characterized by chronicity and gradual enlargement over time The lesions are asymptomatic, and bleeding is the only difficulty encountered. The lesions are most frequently found on the face
etiologic agent of tinea pedis
T. rubrum, T. interdigitale and E. flocossum
Differential diagnosis for intertrigo
- tinea cruris
- candidal intertrigo
- inverse psoriasis
- erythrasma
6 Types of Vitiligo
- Localized/Focal
- Segmental
- Generalized - most common
- Universal
- Acrofacial - distal fingers and facial orifices
- Mucosal
Bullous Pemphigoid has IgG Ab against what?
Bullous Pemphigoid Antigen 1(BPAG 1 or BP 230)
and
Bullous Pemphigoid Antigen 2 (BPAG 2 or BP 180 or Type XVII collageβn)
*presents as TENSE blisters and it is VERY PRURITIC
MOA of acitretin in psoriasis
antiproliferative and enhances keratinocyte differentiation
usually cause the non-inflammatory type of tinea pedis
T. rubrum
periodic idiopathic shedding of the nail beginning at its proximal end
The temporary arrest of the function of the nail matrix may cause onychomadesis.
what is targeted by the antibodies in Epidermolysis Bullosa Acquisita?
Type VII Collagen, which is a major component of the anchoring fibrils
KOH finding of Pityriasis versicolor
short, thich hyphae with numerous round yeast cells (spaghetti and meatballs)
3 day measles
german measles
Calabar swelling
Loa loa infection
The first sign is often painful, localized, subcutaneous, nonpitting edema called Calabar or fugitive swelling
This is a sign to be elicited in case of secondary syphilis and cutaneous vasculitis, where there is deep dermal tenderness on pressing the lesion (e.g., papular lesions of syphilis) with a pinhead.
Buschke-Ollendorff Sign
Groove sign or Dry riverbed sign
*follows the course of the underlying vessels
Eosinophilic fasciitis
differentials for total dystrophic onychomycosis
- alopecia areata - twenty nail dystrophy; no hyphae on KOH
- lichen planus - may also present as 20 nail dystrophy or dorsal pterygium (scarring process leads to fusion of the proximal nail fold to the nail bed)
- Nail psoriasis - may present as onychodystrophy but with associated psoriatic lesions in the body
Staphylococcal Scalded skin syndrome is caused by what toxins?
Exfoliative toxins Type A and B
Pastia Lines are accentuated in what disease
This is accentuated in SCARLET FEVER
*In body folds, especially the armpits and elbows, fragile blood vessels (capillaries) can rupture and cause classic red streaks called Pastia lines.
*accebtuation of the skin folds & linear petechial eruption
*usually on the antecubital and axillary folds
βbloodhound-likeβ facies
Cutis Laxa (Generalized elastolysis)
treatment of psoriasis that is safe in children, pregnant and lactating women
Broad band and narrowband UVB (311nm)
satellite pustules; intertriginous area
Candida
most common type of psoriasis
plaque type/ psoriasis vulgaris
pruritus may persist for several weeks after treatment after treatment due to the bodyβs response to dead mites
post-scabetic pruritus
lesions of bullous pemphigoid appear as tense bullae, filled with clear fluid, on normal or erythematous skin (Fig. 23β12, B). Bullous pemphigoid is characterized by _____________. Early lesions show a perivascular infiltrate of lymphocytes and variable numbers of eosinophils, occasional neutrophils, superficial dermal edema, and associated basal cell layer vacuolization. The vacuolated basal cell layer eventually gives rise to a fluid-filled blister (Fig. 23β12, C). The blister roof consists of fullthickness epidermis with intact intercellular junctions, a key distinction from the blisters seen in pemphigus.
subepidermal nonacantholytic blisters
Differential diagnosis for vitiligo
- morphea
- lichen sclerosus
- Pityriasis alba - fine scale, s slightly papular, and is poorly defined.
- Tinea versicolor favors the center back and chest and has a fine scale; yeast and hyphal forms are demonstrable with potassium hydroxide (KOH) examination
- severe chronic actinic dermatitis - may develop vitiligo-like depigmentation.
- Chemical leukoderma may closely resemble vitiligo
Oil spot
Psoriasis
*yellow areas of subungal parakeratosis from the distal matrix
most common type of porphyria
Porphyria Cutanea Tarda
most common benign tumor of the skin
seborrheic keratosis
- stuck on greasy appearance
incubation period of varicella
10 - 23 days
heliotrope rash
dermatomyositis
indications for systemic corticosteroid use in leprosy
- Severe Type I and Type II reaction
- Silent neuritis
- inflamed skin patch over a major nerve trunk like cheeks, elboows and knee
melanoma with the highest risk of metastasis
Nodular melanoma
class 3 potent, upper midstrength steroids
betamethasone valerate 0.1% ointment
fluticasone propionate 0.005% ointment
general pathology of vitiligo
autoimmune destruction of melanoctyes
surface has the peau dβ orange appearance
erysipelas
most common epithelial precancerous lesion
Actinic / Solar Keratosis
represent in situ dysplasias resulting from sun exposure They are found chiefly on the chronically sun-exposed surfaces of the face (Fig. 29.11), ears, balding scalp, dorsal hands, and forearms. They are usually multiple, discrete, flat or elevated, verrucous or keratotic, red, pigmented, or skin colored. Usually, the surface is covered by an adherent scale, but sometimes it is smooth and shiny. On palpation, the surface is rough, like sandpaper, and at times lesions are more easily felt than seen. T
characterized by episodic, recurrent vasospasm of the fingers and toes resulting in white, blue, and red discoloration provoked by cold or stress
Raynaud phenomenon
* Pallor (white) - Cyanosis (blue) - Rubor (red) (PCR)
most effective scabicide but NEUROTOXIC for infants
Lindane
unable to close eyes due to paralysis of the zygomatic branch of the facial nerve; seen in leprosy
Lagophthalmos
Ectothrix dermatophytes that are positive for woodβs lamp
- Microsporum canis
- Microsporum audouinii
- Microsporum distortum
- Microsporum ferrugineum
incubation period of molluscum contagiosum
2 - 7 weeks
tender boggy plaques exuding pus; cause scarring and permanent alopecia in Tinea capitis
Kerion Celsii