Random Dermatology Questions Flashcards
What parasite causes American trypanosomiasis? What is it’s vector?
- Trypanosoma cruzi
- Reduviid insects (kissing bugs)
The image below represents keratin debris located superficially in the conjunctiva. What is this called? What condition is it associated with?
- Bitot’s spots
- Vitamin A deficiency
The image below depicts retinal phakomas (astrocytic retinal hamartomas) which are present in the minority of patients with this condition:
Tuberous sclerosis
*These usually don’t require treatment because they don’t affect vision
**There are three types of retinal phakomas; one type is referred to as the “mulberry lesion”
List the four disorders that fall under the spectrum of keratosis pilaris atrophicans.
- Keratosis pilaris atrophicans faciei (ulerythema ophryogenes)
- Atrophoderma vermiculatum
- Keratosis follicularis spinulosa decalvans
- Folliculitis spinulosa decalvans
*Image: cheek of a boy with atrophoderma vermiculatum (“wormlike atrophy of the skin”)
What is the eponymous syndrome that refers to the chronic granulomatous conjunctivitis and pre-auricular adenopathy that occurs with cat scratch disease of the eye?
Oculoglandular syndrome of Parinaud
What is the name of the skin test for cat scratch disease?
Hanger and Rose test
*Note this is rarely used because the diagnosis of cat scratch disease is usually made clinically.
Glomeruloid hemangioma can be seen in healthy patients, but is also known to be associated with several conditions. List four disease associations.
*Image: dilated capillaries within a lumen, simulating the appearance of a renal glomerulus.
- POEMS syndrome
- Castleman disease
- ITP
- Sjogren’s syndrome
What type of gammopathy is erythema elevatum diutinum associated with?
IgA gammopathy
*Note: recurrent strep infections can also flare the disease
List seven diseases that erythema elevatum diutinum has been associated with.
- HIV infection
- SLE
- Sjogren’s
- Lymphoma
- Breast cancer
- Dermatitis herpetiformis
- Celiac disease
What is the name for an acquired unilateral nevus of Ota?
Sun’s nevus
What organism causes tinea nigra?
Hortaea werneckii
This disease is characterized by small white to pinkish papules that occur diffusely in the oral cavity. It occurs most commonly in Native Americans, in Greenland, and in Turkey and HPV-13, 24, and 32 have been associated.
Heck’s disease
*Note: the lesions may spontaneously resolve.
**Note: treatment options include cryosurgery, CO2 laser, electrosurgery, and topical (β), intralesional, and systemic IFN.
Erythema palmare is usually most marked on the hypothenar areas, and is associated with elevated levels of estrogen. What are the three most common causes of elevated estrogen in this condition?
- Hepatic cirrhosis
- Hepatic metastases
- Pregnancy
How often does erythema multiforme minor involve the mucosa?
About 25% of the time, and generally only the oral mucosa
How long do the episodes of erythema multiforme minor typically last?
1-4 weeks
Other than HSV, what infection is commonly associated with erythema multiforme minor and SJS?
Mycoplasma infections
What percentage of cases of erythema gyratum repens is associated with internal malignancy? What is the most commonly implicated malignancy?
- 80%
- Lung cancer
By what time period dose erythema gyratum repens usually preceed the associated malignancy (if there is one)?
By about 9 months! All patients with erythema gyratum repense should be extensively investigated for malignancy
What HPV type is associated with giant condylomas of Buschke and Lowenstein?
HPV6
*Giant condylomas of Buschke and Lowenstein are virally induced verrucous carcinomas. Not all verrucous carcinomas are virally induced.
What is the name of the sign where a pilomatricoma is stretched, revealing many facets and angles?
Tent sign
List four diseases that are associated with mulitple pilomatricomas.
- Myotonic dystrophy
- Rubinstein–Taybi syndrome
- Trisomy 9
- Turner syndrome
*Note: rarely multiple pilomatricomas will be inherited in an autosomal dominant fashion with no disease associations.
What disease is associated with epidermoid cysts that show pilomatrical differentiation?
Gardner syndrome
What word describes “split ends” (i.e. splitting of hairs at the ends)?
Trichoptilosis
What type of monoclonal gammopathy has been associated with pyoderma gangrenosum?
IgA gammopathy (10% of patients)
What is the eponymn associated with hereditary angioedema?
Quincke edema
What type of gammopathy is associated with Schnitzler syndrome?
IgM gammoptahy
*Note: the associated urticaria tends to be non-pruritic. There is also fever and disabling bone pain.
Can antihistamines suppress dermatographism?
Yes; the addition of an H2 blocker, such as ranitidine, can also be helpful
True or false: in patients with cholinergic urticaria, there’s typically a 24 hour refractory period after an episode of urticaria.
True
Tay syndrome is also known as:
Congenital ichthyosis with trichothiodystrophy
Which antibiotic in the tetracycline family is the most photosensitizing?
Demeclocycline
Buschke-Ollendorf syndrome is also known as:
Dermatofibrosis lenticularis
What antibody has been associated with mechanic’s hands seen in dermatomyositis?
Antisynthetase antibody; 70% of patients with this antibody have mechanic’s hands
What is the target for anti-Jo-1 antibodies?
Histadyl tRNA synthetase
Which drug can cause a rash that closely mimics the rash associated with dermatomyositis?
Hydroxyurea
Interstitial lung disease is often the cause of death in dermatomyositis. What antibody is associated with pulmonary findings?
Anti-Jo-1 and other anti-synthetase antibodies such as anti-PL7 and anti-PL12
What are the two eponymously named childhood forms of dermatomyositis?
Brunsting (steroid responsive, more common type) and Banker (steroid unresponsive, high death rate)
Which antibody is associated with a favorable prognosis in dermatomyositis?
Anti-Mi-2 antibody
What are the two types of systemic scleroderma?
Progressive systemic sclerosis and Thibierge-Weissenbach syndrome (CREST syndrome)
This lesion tends to occur on the upper legs of young women. It’s considered a small-cell variant of Spitz nevi.
Pigmented spindle cell nevus
True or false: clefts are present in pigmented spindle cell nevi, just like in Spitz nevi.
True
What type of special-location nevus can show poorly cohesive nests?
Genital skin nevi
True or false: buckshot scatter is common in acral nevi, and does not represent a malignant feature.
True
Name this nevus that can mimic malignant melanoma (note: there is cytologic atypia, no mitoses, and no expansile growth pattern).
Ancient nevus
*Note: it’s named for its resemblance to ancient schwanommas
**Note: it’s usually comprised of two populations of cells: large pleomorphic melanocytes and small melanocytes
Name this nevus (note: there are lymphocytes intermingled among the nevus cells, like people would intermingle at a cocktail party).
Halo nevus
Name this pigmented lesion (note the wedge shape and sclerotic stroma).
Blue nevus
Name this lesion (note: there’s a lymphoid band at the periphery of a melanocytic lesion, “like riot police trying to hold back a crowd of people”; there is no intermingling of lymphocytes within the melanocytes).
Melanoma
What type of blue nevus is this (note the dendritic melanocytes and sclerotic stroma).
Common blue nevus
What type of blue nevus will have epitheliod melanocytes?
A cellular blue nevus
This type of blue nevus is a variant of cellular blue nevus, but lacks the sclerotic stroma. This type of blue nevus is seen in the CARNEY complex.
Epithelioid blue nevus
This type of blue nevus often has fingerlike projections deep in the dermis and small, smudged, hyperchromatic nuclei.
Deep penetrating nevus
Where are collagen I, II, and III found?
- Collagen I: mature skin, bone, and tendons
- Collagen II: cartilage
- Collagen III: fetal skin, blood vessels
Where is collagen IV and VII found?
- Collagen IV: basement membrane
- Collagen VII: anchoring fibrils of the basement membrane
Borrelia burgdorferi is the most common cause of lyme disease in American. What is the most common cause in Europe? What is the cutaneous manifestation of this berreliosis that occurs in 10% of European patients with lyme disease (hint: it affects acral skin)?
- Borrelia afzelii
- Acrodermatitis chronica atrophicans
Acrodermatitis chronica atrophicans is also eponymously known as:
Herxheimer disease
If an autoimmune blistering disorder targets desmoglein 1, where will the split occur histologically?
In the granular layer
List the four types of localized lichen myxedematosus.
- Discrete papular lichen myxedematosus
- Acral persistent papular mucinosis
- Self-healing papular mucinosis
- Papular mucinosis of infancy
Keloidal blastomycosis is also known as:
Lobomycosis
What is the eponymous name for angiosarcoma in the setting of an lymphedematous limb?
Stewart-Treves syndrome
In which condition is the “hanging curtain” sign seen?
Pityriasis rosea; it occurs when the scaly plaque is stretched, and the scale folds across the line of stretch
What oral drug has been show (in one small study) to improve the itch and duration of rash in pityriasis rosea?
Oral erythromycin
*UVB can also be used to speed the disappearance of lesions, after the inflammatory phase has passed
What demographic is particularly susceptible to papular pityriasis rosea?
Children, especially black children
True or false: pityriasis rosea can be very dangerous for pregnant women.
True; it can lead to premature delivery and fetal loss, especially in the first trimester
What three features define Naxos syndrome?
Palmoplantar keratoderma, wooly hair, and cardiomyopathy
Name the condition characterized by white spots that appear on the palms and then gradually extend peripherally to involve the whole hand. The condition is asymptomatic and often occurs in patients with a history of atopic dermatitis.
Keratolysis exfoliativa
Name the condition characterized by multiple depressions in the palmar creases filled with comedo-like keratinous plugs. This condition occurs most commonly in black patients.
Keratosis punctata of the palmar creases
Name this condition.
“Music box” spine keratoderma, a variant of punctate keratoses of the palms and soles
List three tuberculid reactions (i.e. Id reactions) seen in TB.
- Erythema induratum
- Lichen scrufulosorum
- Papulonecrotic tuberculid
In angiokeratoma corporis diffusum (Fabry’s disease), what is the enzyme that’s deficient? What accumulates as a result?
- Alpha-galactosidase A
- Neutral glycosphingolipid ceramide trihexose
*Note: this disorder is X-linked recessive
Use the mneumonic “PEPSI LiTe” to come up with a differential for angiod streaks (breaks in Bruch’s membrane).
“PEPSI LiTe”
- Pseudoxanthoma elasticum
- Ehlers-Danlos syndrome
- Penicillamine/Padget’s disease of the bone
- Sickle-cell anemia
- Increased Phosphate
- Lead poisoning
- Thalassemia
What’s the diagnosis? Hint: this rare autosomal recessive condition presents in infancy with a hoarse cry. It’s due to a mutation in extracellular matrix protein 1.
Lipoid proteinosis
What’s the condition called where follicular vesiculopustules form on the scalp, which rupture easilty and dry up after a few days? What’s it called if large scars are left behind?
- Acne miliaris necrotica
- Acne varioliformis
*Note: in some patients, especially those that manipulate their lesions, S. aureus may be cultured.
What’s the eponymously named condition in which a patient with rosacea develops prominent woody edema of the skin?
Morbihan’s disease
What’s the eponymously named sign for fraying of the cuticles seen in dermatomyositis?
Samitz sign
What gene is mutated in Naxos syndrome?
Plakoglobin
True or false: quinidine, sulfonlyureas, and griseofulvin are all known to cause photosensitivity.
True
What two types of HPV are known to cause “Butcher nodules”?
HPV 2 and 7
