OLD PATTON LIM Flashcards
What immunobullous disease is treated with dapsone?
Linear IgA disease that is NOT associated with drugs, if it is then the Tx is to remove the drug; dermatitis herpetiformis
This is a dilated superficial blood vessel
telangiectasia
What is an erosion that is specifically caused by scratching?
Excoriation
What are the two biochromes of the epidermis?
melanin = brown and Carotenoids = yellow
What is a good way to Tx a keloid?
inject with steroids, re-excising would be dumb because they are known to be prone to keloid formation
What is the key feature in the allergic contact dermatitis from plants?
Linear nature of the rash
How is DRESS different from morbilliform drug reactions?
it involves organs not just skin, most commonly the liver
How is the oral disease of paraneoplastic pemphius different from pemphigus vulgaris and foliaceous?
It is the most severe and pemphigus foliaceous doesn?t have oral involvement anyway
This disease involves autoantibodies against type VII collagen
Epidermolysis bullosa acquisita NOT the hereditary epidermolysis bullosa
What is a macule?
a circumscribed FLAT discoloration
What is a circumscribed collection of blood greater than 0.5 cm
purpura
What is the most common cause of the morbilliform drug eruption?
When someone is mistreated with ampicillin when they have mononucleosis (doc thought they had strep throat)
MOA of ipilimumab
binds CTLA4 to disinhibit T cells for Tx of melanoma
How is the Tx of mucous membrane pemphigoid different from that of bullous pemphigoid and pemphigus vulgaris?
Mucous membrane pemphigoid involves more rigorous tx not only with corticosteroids but also cyclophosphamide because of the serious sequela that can occur
Hallmark of MCV infections
umbilicated lesions ZOMG
What is a linear loss of epidermis with sharply defined, nearly vertical walls?
fissure
This is a tumor of scar tissue that grows beyond the bounds of the initial cut
keloid
Telangiectasias are very characteristic of what CA?
Basal cell carcinoma
If you see lichenification, was the initial lesion most likely painful, itchy, or not noticed by the patient?
itchy, lichenification results from repeated scratching of the skin
What is the most common cause of allergic contact dermatitis?
reaction to toxicodendron plants (i.e. poison ivy, poison sumac)
What must you work up a patient for if they have porphyria cutanea tarda?
liver disease
Why do UV and radiated skin often have telangiectasias?
UV and other forms of radiation cause cutaneous atrophy and expose the dilated blood vessels
What does DRESS stand for?
Drug Rash Eosinophilia and Systemic Symptoms
What is the most common subtype of melanoma?
superficial spreading
When Txing melanoma, what drug inhibits MEK?
Trametinib
This is a circumscribed and flat bump in the skin that may be brown, blue, red (yellow, cerulean, indigo, sea green, red-orange, orange-red)
MACULE
What is the most common cause of erythema multiforme?
HSV-1 also Mycoplasma pneumoniae
Enzyme deficient in porphyria cutanea tarda
uroporphyrinogen decarboxylase; note, in case of distractor that acute intermittent porphyria is urobilinogen deaminase
If one felt inclined to differentiate between a depigmented macule and a hypopigmented macule, how would one embark on this endeavor?
One could use a Wood’s lamp. By doing so, one would note that a depigmented macule would have a “brilliant” purple color change. Conversely, with a hypopigmented macule, one would note a less “brilliant” color change
When you see vesicles or bullae in a linear pattern what should you be thinking?
contact dermatitis
What drug binds CTLA-4
Ipilimumab
What are vemurafinib and dabrafenib?
BRAF inhibitors for Tx of melanoma
What are the 3 diseases under the pemphigus grouping?
Pemphigus vulgaris, Pemphigus foliaceous, and Paraneoplastic pemphigus
T/F: one can make the diagnosis of dysplastic nevus clinically
nope, dysplastic nevus is a histological Dx
Why don?t erosions heal with scarring? Where else in the body does this occur?
Because the basal layer of epidermis remains intact. This also occurs in the GI tract? Think about Crohn’s Dz, you get stricture formation and creeping of the mesenteric fat because you have lost more than the basal layer of cells of the mucosa. Therefore, there will be scar formation. Same deal in skin.
What are the two biochromes of the dermis?
Oxyhemoglobin (bright red), Reduced hemoglobin (bluish red)
How can you get a definitive diagnosis of allergic contact dermatitis to everyday materials?
patch testing
Which drugs are the most common cause of DRESS, Stevens-Johnson syndrome, and Toxic Epidermal Necrolysis?
Aromatic anti-convulsants, sulfonamide antibiotics, and allopurinol
This is a circumscribed deposit of blood less than 0.5 cm in diameter
petechiae
What is a very common cause of cutaneous atrophy?
overuse of topical steroids or injection of SubQ steroid when it was supposed to be IM
What color are Spitz nevi?
pink to red
Autoantibodies to what kind of structures are present in the pemphigus group of immunobullous diseases?
desmosomes
These well circumscribed lesions contain a wall and a lumen and may contain solid or fluid matter?
Cyst
Compare and contrast the Tx of bullous pemphigoid and pemphigus vulgaris
They are actually the same? First use corticosteroids and follow up with steroid sparing drugs (mycophenolate moxetil and azathioprine) once under control. BUT rituximab seems to be reserved only for pemphigus vulgaris
What is the Tx of Linear IgA disease when not caused by an underlying drug problem?
Dapsone
How do you differentiate Stevens-Johnson syndrome from Toxic Epidermal Necrolysis?
less than 10% of body SA is involved in SJS and greater than 30 is involved in TEN? The inbetweeners are a mixed SJS-TEN Dx
T/F: there is no need to give systemic corticosteroids in allergic contact dermatitis
false, they are usually given d/t the severe nature of the rash
What are petechiae?
circumscribed deposit of blood less than 0.5 cm
What is the most common cause of erythema multiforme?
HSV
What is a lesion that involves a focal loss of epidermis ONLY? What is the next stage?
erosion, ulcer
What is the most common malignancy associated with paraneoplastic pemphigus?
Non-Hodgkin’s lymphoma
What is a patch?
A patch is a macule more than 3-4 cm in diameter
What is an excoriation?
An erosion caused specifically d/t scratching
What is the most common cause of Linear IgA disease?
Vancomycin and other drugs
What is the most common immunobullous disease?
bullous pemphigoid
What are excess dead epidermal cells produced by abnormal keratinization and shedding?
Scales
What is an area of thickening of the epidermis induced by scratching?
lichenification
What is a nevus that is present at birth?
Congenital nevus. OMG science
What eponym describes the ability to easily dissect through a bulla?
Nikolsky sign
Type of hypersensitivity in allergic contact dermatitis
Type IV
What is a cyst?
A circumscribed lesion with a wall and a lumen that may contain fluid or solid matter