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DCNP Review > Pigmentary/Vascular Disorders > Flashcards

Pigmentary/Vascular Disorders Flashcards

1
Q

What is caused by hyperpigmentation due to excessive deposition of melanin into the epidermis or dermis

A

Melasma

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2
Q

Risk factors for melasma include

A

Middle-eastern, Spanish/Hispanic, Asian, skin types IV and V, hormone replacement therapy, pregnancy, oral contraceptives, UV exposure, photosensitizing medications

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3
Q

Melasma involving the epidermis presents:

A

Symmetrical tan/brown macules and patches

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4
Q

Melasma involving the dermis presents:

A

Symmetrical Grey-brown patches and macules

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5
Q

Regimen for use of hydroquinone 4% to treat melasma

A

BiD for 3 to 6 months. Maximum effect is 2 months so if no improvement by 2-3 months, discontinue.

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6
Q

What medication can be used off-label to treat melasma?

A

Azelaic acid 15 or 20% BID

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7
Q

What combination therapy can be used to treat melasma?

A

Fluocinolone 0.01%, tretinoin 0.05% and hydroquinone 4% at bedtime daily for 8-24 months

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8
Q

Ocular manifestations with Sturge Weber syndrome include

A

Glaucoma

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9
Q

Early neurological manifestations with Sturge Weber syndrome include

A

Seizures

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10
Q

A pink colored patch located at the nape of an infant’s neck is

A

Port wine stain

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11
Q

The fluency of the pulse dye laser settings to treat port wine stain should be

A

11-12 joules

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12
Q

A port wine stain located on the axillary area is labeled as

A

V2 area

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13
Q

The term buphthalmos refers to

A

One eye being larger than the other

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14
Q

A port wine stain has a higher risk of neurological involvement when located where?

A

Bilateral forehead and eye areas

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15
Q

Squamous atypua may be associated with

A

Erythema ab igne

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16
Q

The presence of a white forelock is often noted in

A

Piebaldism

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17
Q

A common dermatologic medication that is linked to ochronosis

A

Minocycline

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18
Q

50% of all cases of oculocutaneous albinism is due to a mutation in which gene?

A

P

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19
Q

Melanin synthesis in temperature sensitive oculocutaneous albinism is most likely to occur in what location?

A

Lower legs

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20
Q

The correct twrm to describe hypopigmentayion is

A

Leukoderma

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21
Q

The number of melanocytes in oculocutaneous albinism is

A

Normal

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22
Q

Dyskeratosis congenital is often linked with leukoplakia in the genital and/or oral mucosa. This leukoplakia is linked to possible development of?

A

SqCC

23
Q

Pegged teeth are often associated with what condition?

A

Incontinetia pigmenti

24
Q

The medication of choice to treat prurigo pigmentosa is

A

Dapsone

25
Q

Diffuse bluish gray discoloration on the palms is termed

A

Argyria

26
Q

The first stage of incontinentia pigmenti is characterized by which type of lesions?

A

Vesicles

27
Q

A patient diagnosed with post inflammatory hyperpigmentation has lesions that appear grayish blue. The color of lesion is associated with hyperpigmentation of the

A

Dermis

28
Q

An autoimmune type of disorder that often accompanies vitiligo is

A

Thyroid

29
Q

The most common classification type of vitiligo that occurs in children is

A

Segmental

30
Q

Piliosis describes vitiligo in which area

A

Scalp hair

31
Q

Vitiligo is estimated to affect what percentage of the general population?

A

2%

32
Q

Where does repigmentation of vitiligo occur?

A

Often appears in the perifollicular areas

33
Q

A preferred treatment option for pregnany woman with vitiligo is

A

Narrow Band UVB

34
Q

50% of patients with CARPreapond favorably to which antibiotic?

A

Minocycline

35
Q

Minocycline in the treatment of CARP does what?

A

Inhibits neutrophils migration, inhibits protein kinase C and downregulates cytokines

36
Q

The most common pattern of melasma is

A

Centrofacial

37
Q

Which pigment depth of melasma is most responsive to treatment?

A

Epidermal

38
Q

Velvety hyperpigmented plaques favoring intertriginous areas describes what condition?

A

Acanthosis Nigricans

39
Q

What patients are predominantly affected by acanthosis nigricans?

A

African Americans, native Americans and hispanics

40
Q

Acanthosis nigricans is associated with what conditions

A

Diabetes, insulin resistance, obesity, PCOS, genetic syndromes

41
Q

What type of malignancy is acanthosis nigricans associated with?

A

Gastric Adenocarcinoma

42
Q

Acanthosis nigricans associated with malignancies is described as

A

Middle-age or older adult onset and unusual locations

43
Q

What labs should be checked in a patient with acanthosis nigricans?

A

HgB A1C, serum insulin and TSH

44
Q

Treatment of acanthosis nigricans includes

A

Topical retinoids, topical vitamin D analogs, urea, salicylic acid, systemic retinoids, chemical peels and weight loss

45
Q

Hyperpigmented hyperkeratouc macules/papules often coalesce into reticulated patches/plaques that favor the neck, chest, upper back and axilla.

A

Confluence and Reticulated Papillomatosis

46
Q

What type of vitiligo spreads rapidly over 6-24 months with partial or compete distribution with dermatomal ot blaschko’s lines distribution. Usually affects face (50%), followed by trunk, extremities and neck

A

Segmental

47
Q

Treatment of segmental vitiligo includes

A

Topical corticosteroids, calcineurin inhibitors (off label), targeted phototherapy and surgical grafting

48
Q

Non-segmental vitiligo treatment includes

A

Topical corticosteroids, calcineurin inhibitors (off-label), ruxolitinib BID

49
Q

Active vitiligo treatment includes

A

First line therapy is systemic glucocorticoids. NbUVB, systemic immunosuppression (Methotrexate, cellcept, cyclosporin)

50
Q

Progressive macular hypomelanosis wood’s lamp findings include:

A

Orange to red follicular fluorescence

51
Q

Treatment of progressive macular hypomelanosis includes

A

Combination of phototherapy and topical ABX, BPO is combo with clindamycin 1%, PUVA, NBUVB and oral isotretinoin

52
Q

What medication causes bluish-gray discoloration of nails, face, sclerae, hard palate and/or pretibial areas?

A

Hydroxychloroquine

53
Q

Topical tacrolimus can cause what shade of discoloration

A

Brown

DCNP Review (12 decks)

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