Skin

Question 1

Pemphigus vulgaris

Answer 1

Autoimmune blistering
Mainly elderly
Autoantibodies to desmoglein 1 and 3
Epidermal issue

Cutaneous or mucosal

Treat with immunosuppressives or rituximab

Question 2

Ichthyosis Vulgaris

Answer 2

Autosomal dominant
Profilaggrin gene defect
Defect in cornification
Scales on body
Dry skin and hyperlinear palms

Predisposed to other hypersensitivities (atopic dermatitis, allergic rhinitis, food allergies, asthma)

Question 3

UVC

Answer 3

200-280 nm

Mostly eaten up by the ozone layer

Question 4

UVB

Answer 4

280-320 nm

Penetrates epidermis and superficial dermis

Erythema and sunburn

Question 5

UVA

Answer 5

320-400 nm

Deep dermis

Tanning, photoaging

Question 6

Sun Protection FActor (SPF)

Answer 6

Measures UVB exposure

SPF = Minimal erythema dose protected / Minimal erythema dose unprotected

Question 7

What is the layer that the papillary dermis interdigitates with?

Answer 7

Rete Ridges of the epidermis

Question 8

Marfan syndrome

Answer 8

Mutation in fibrillin

Tall, flexible joints
Myopia
Aortic dilation or anuerysm
Mitral valve prolapse
Long limbs and fingers
Striae/Stretch marks

Question 9

Morphea

Answer 9

Sclerosis (thickening of collagen)
Autoimmune
More common in females

No serious internal organ involvement
Erthematous or indurated plaques that expand slowly
Fibrotic or atrophic scars
Joint and neurologic complications

Question 10

Limited systemic sclerosis

Answer 10

CREST syndrome
More common in young and middle aged women

Calcinosis cutis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangeietctsia over the face

Question 11

Diffuse Systemic Sclerosis

Answer 11

Widespread sclerosis of the skin
Pulmonary fibrosis
Renal failure
GI disease
Cardiac disease

Question 12

Erythema nodosum

Answer 12

Common in young women

Usually idiopathic, but can be caused by infection of upper respiratory tract via streptococcus

Tender, red nodules that arise in the shin

Inflammation of subcutaneous fat (panniculitis)

Question 13

Bullous Pemphigoid

Answer 13

Autoimmune bullous dermatosis
Elderly
Contains entire epidermis in blister roof (very stable)
DIF shows deposits of IgG and C3 along BMZ
IIF shows linear staining of on the epidermal side
Antibodies to BP230 and BP180

Treat with immunosuppressants

Question 14

Mucous Membrane Pemphigoid

Answer 14

Recurrent bliser of mucous membranes, but also skin
Can cause blindness, scars, strictures
Antibody to BP 180
Sometimes anti-laminin332, which may be linked to malignancy risk

DIF shows linear deposits of IgG and C3 along the BMZ
IIF shows linear staining of epidermal, dermal and epidermal side… if anti-laminin 332, then only on dermal side

Question 15

Epidermolysis Bullosa Acquisita

Answer 15

Rare autoimmune bullous dermatosis
Slight trauma causes blistering and erosion
Mechanically stressed areas like hands, feet
Atrophy, scars, pigmentation disorders
Antigen Type VII collagen
DIF shows IgG and C3 deposit
IIF shows dermal side

Question 16

Epidermolysis Bullosa simplex

Answer 16

Autosomal dominant
Skin fragility
Antibodies to keratins 5 and 14

Question 17

Junctional Epidermoylsis Bullosa

Answer 17

Autosomal recessive
Skin fragility
Antibodies to laminin 332 and BP180

Question 18

Dystrophic Epidermolysis Bullosa

Answer 18

Autosomal dominant and recessive
Skin Fragility
Antibodies to Collagen VII of dermis