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Skin > Norton Part 9 > Flashcards

Norton Part 9 Flashcards

1
Q

what is the pathogenesis of acne vulgaris

A

obstruction of sebaceous follicles by sebum promotes proliferation of Propionibacterium acnes (anaerobe)

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2
Q

where is acne vulgaris distributed

A

face, chest, and upper back

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3
Q

what type of lesions are commonly seen in acne vulgaris patients

A

both obstructive and inflammatory lesions

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4
Q

what obstructive lesions are seen in acne vulgaris

A 
closed comedones ("whiteheads")- flesh colored dome shaped papule
open comedones ("blackheads")- dilated pore filled with keratinous material (not dirt)
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5
Q

what is the progression of the lesion in acne vulgaris

A

papules/pustules to nodules to cysts

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6
Q

what are the risk factors for acne vulgaris

A 
male
puberty
cushings
oily complextion
androgen excess
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7
Q

what are the 4 components of acne vulgaris

A

keratinization of lower portion of the follicular infundibulum with development of a keratin plug blocking outflow of sebum to skin surface
hypertrophy of sebaceous glands with puberty
lipase-synthesizing bacteria (p. acnes) colonizing upper and midportion of hair follicle
inflammation of the follicle associated with release of cytotoxic and chemotactic factors

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8
Q

acne rosacea is what type of disorder

A

a chronic inflammatory disorder that affects blood vessels and pilosebacous units

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9
Q

when does acne rosacea usually occur

A

b/w 30-50

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10
Q

what are some triggers of acne rosacea

A 
sun exposure
alcohol
spicy foods
exercise
stress
temperature extremes
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11
Q

what are the four stages of acne rosacea

A
  1. flushing episodes (pre-rosacea)
  2. persistent erythema and telangiectasis
  3. pustules and papules
  4. rhinophyma
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12
Q

what is rhinopehyma and where is it seen

A

skin on nose becomes thick and greasy, hyperplasia of sebaceous glands, connective tissue and vasculature
seen in acne rosacea

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13
Q

what sites is acne rosacea normally found

A

nose and cheeks including nasolabial folds

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14
Q

what is seen histologically in acne rosacea

A

perifollicular infiltrate of lymphocytes surrounded by dermal edema and telangiectasia
in rhinophyma- hypertrophy of sebaceous glands and follicular plugging by keratotic debris

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15
Q

what is panniculitis

A

inflammation of fat lobules or the connective tissue septa separating fat lobules

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16
Q

what is erythema nodosum

A

inflammatory reaction of the connective tissue septa separating fat lobules
not a disease but a fraction to various etiologies

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17
Q

erythema nodosum is most common in what patients and located where

A

females 20-30

usually on anterior aspect of tibia

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18
Q

what is seen in erythema nodosum

A

fever, malaise, and joint pain may precede the rash
painful, red, subcutaneous, elevated nodules
nodules are indurated and poorly circumscribed
bilateral but not symmetrical

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19
Q

what are some causes of erythema nodosum

A 
idiopathic
strep
sarcoidosis
inflammatory bowel disease
fungal infection 
pregnancy
meds- OCPs, sulfa, amiodarone, antibiotics
syphilis
TB
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20
Q

what is the workup for erythema nodosum

A

chest X-ray to r/o TB and sarcoidosis
VDRL test to r/o syphilis
CBC, ESR, CRP and cultures as appropriate

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21
Q

what is seen histologically in erythema nodosum

A

septal panniculitis (little to no necrosis of lobule)

early: widening of septa from fibrin, edema and neutrophilic infiltrate
chronic: mononuclear cells and granulomatous inflammation of septum with fibrosis

22
Q

what is a verrucae (wart)

A

benign growths caused by infection of epidermal cells with human papilloma virus (HPV)

23
Q

verrucae (warts) generally occur in what population

A

children and young adults

24
Q

how are warts transmitted

A

skin to skin contact

25
Q

intralesional brown-black dots are pathognomonic of what and represent what

A

verrucae (warts)

represent thrombosed vessels

26
Q

the common wart (verruca vulgaris) is most common where

A

elbows
knees
fingers
palms

27
Q

what does the common wart (verruca vulgaris) present as

A

flesh-colored papule with hyperkeratotic surface

28
Q

the flat wart (verruca plana) presents how

A

flesh colored, slightly raised papule and flat surface

29
Q

where are flat warts (verruca plana) usually found

A

chin
dorm of hands
leg

30
Q

plantar wart (verruca plantaris) presents as what

A

flesh-colored papule with hyperkeratotic surface

31
Q

what wart is found on the underside of the foot and may cause pain if on pressure areas

A

plantar wart (verruca plantaris)

32
Q

what cases plantar warts (verruca plantaris)

A

HPV 1

33
Q

what is the most common STD

A

anogential wart (condyloma acuminatum)

34
Q

what causes anogenital warts (condyloma acuminatum)

A

HPV 6 and 11 (STDs)

35
Q

soft, fleshy pink papillomas on the genitalia, perineum, and anus are seen in what

A

anogential warts (condyloma acuminatum)

36
Q

what is seen histologically in verrucous

A

exophytic
“church spike” of “veracious” acanthosis
koilocytes (cells with vacuolated cytoplasm)
infected ells may show prominent keratohyline granules

37
Q

moluscum contagiosum is caused by what

A

poxvirus

38
Q

how is moluscum contagiosum spread

A

skin to skin contact and is highly contagious

39
Q

what does moluscum contagiosum present as

A

asymptomatic smooth, dome-shaped papule with central umbilication
flesh colored and translucent

40
Q

papules with a cheezy core that can be expressed are seen in what

A

moluscum contagiosum

41
Q

what is seen histologically in moluscum contagiosum

A 
cup-shaped lesion with scalloped border
verrucous acanthosis (epidermal hyperplasia)
molluscum bodies in cells of stratum corner and stratum granulosum (ovoid, homogeneous, cytoplasmic inclusion bodies)
42
Q

impetigo is distinguished from contact dermatitis how

A

painful leasions in impetigo

43
Q

what is the most common form of impetigo

A

nonbullous

44
Q

what sites is nonbullous impetigo found

A

face and extremities

45
Q

honey colored crust when vesicles rupture is seen in what

A

nonbullous impetigo

46
Q

what does nonbullous impetigo present as

A

papules that progress to vesicles on erythematous base

47
Q

bullous impetigo is seen in what patients and where

A

young children

trunk is more frequently affected

48
Q

bullous impetigo presents as what

A

vesicles tha tenlarge to form flaccid bullae w/ clear yellow fluid contents
later becomes darker and more turbid
ruptured bull leave thin brown vrust

49
Q

what is the most common cause of impetigo (both kinds)

A

staph aureus

50
Q

what is seen histologically in impetigo

A

accumulation of neutrophils under stratum corneum

Skin (12 decks)

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