SKIN Flashcards
Solar / Acitinic Keratosis
Def’n, Pres, Comp / Prog?
Pre-malignant lesions caused by sun exposure.
PRES:
- Small rough papules or plaques- red or brown
COMP / PROG:
- Risk of SCC proportional to epithelial dysplasia
Albinism
Seen In?
SEEN IN:
- Chediak-Higashi Sx (phagocyte dysfunction)
Pityriasis Rosea
Pres, Course?
PRES:
- Multiple Papules
- “Herald patch” followed days later by “Christmas tree” distribution
Remits spontaneously in 6-8 wks.
Bullous Pemphigoid
Def’n, Pres, IF Finding?
Autoimmune skin disorder with IgG against Hemidesmosomes.
** LESS SEVERE than Pemphigus Vulgaris **
PRES:
- Bullae: Tense. Contain Eosinophils.
IF:
- Linear pattern of antibodies at epidermal-dermal junction
Pemphigus Vulgaris
Def’n, Locations (2),
Pres (2), Histo (2), IF Finding?
Autoimmune skin disorder with IgG antibody against Desmoglein.
** Potentially fatal **
Skin + Oral mucosa.
PRES:
- Bullae: Flaccid + Rupturing
- Nikolsky Sign + (separation of epidermis upon manual stroking of skin)
HISTO:
- Acantholisis
- Bullae (intraepidermal)
IF:
- Ab around epidermal cells in “reticular / net-like pattern”
Dermatitis Herpetiformis
Def’n, Location, Assoc, Pres?
IgA deposits at tips of dermal papillae.
MC Location = Elbows
ASSOC: Celiac Disease
PRES:
- Papules + Pruritic vesicles
Erythema Multiforme -> S-J Sx -> Toxic Epidermal Necrolysis
Def’n, Subtype, Assoc (5, incl 3 drugs), Pres (2), Histo (3)?
H-S rx char by targetoid rash (central necrosis surrounded by erythema) + bullae.
PRES:
- Targetoid rash
- Bullae
Stevens-Johnson Sx: EM with lip / oral mucosa involvement + fever ->
Diffuse sloughing of skin (resembling large burn).
Potential death.
ASSOC:
- Mycoplasma pneumoniae
- HSV
- Autoimmune Disease (ie SLE)
- Cancer
- Drugs: Penicillins, Sulfa drugs, Phenytoin
HISTO:
- Macules
- Papules
- Pustules
Erythema Nodosum
Def’n, Location, Assoc (7)?
Infl lesions of subcutaneous fat.
MC on Ant Shins
ASSOC:
- Strep infections
- Coccidioidomycosis
- Histoplasmosis
- TB
- Leprosy
- Sarcoidosis
- Crohn Disease
Lichen Planus
Def’n, Assoc, Locations (3), Pres (“4 Ps”)?
“Sawtooth inflitrate” of lymphocytes at epidermal-dermal junction.
ASSOC:
- Hepatitis C
Oral mucosa, Elbows, Wrists.
PRES = Purple Pruritic Polygonal Papules
Psoriasis
Def’n, HLA, Location (3), Pres (Sign + 1), Histo (2)?
Excessive proliferation of keratinocytes.
Well-circumscribed red plaques with silvery scaling.
HLA-C.
Scalp, Elbows, Knees.
PRES:
- Auspitz Sign
- Red plaques: well-circumscribed w silvery scaling
HISTO:
- Parakeratosis
- Acanthosis
Acanthosis Nigricans
Def’n, Locations (2), Assoc (2)?
Acanthosis with darkening of skin -> “velvety skin”.
MC on Neck + Axilla.
ASSOC:
- Hyperinsulinemia
- Visceral malignancy
Seborrheic Keratosis
Def’n, Pres (Epi + Sign + 1), Histo?
Benign squamous proliferation.
PRES: Elderly
- Raised, pigmented, greasy / waxy plaques with “stuck-on” appearance
- Leser-Trelat Sign: Sudden appearance of MULTIPLE of these
- ** Indicates underlying malignancy ***
HISTO:
- Horn Cysts: Keratin-filled pseudocysts
Melanoma
Pres, Prognosis?
PRES:
- Brown-black lesion with fuzzy edge
PROG: ** DEPTH of lesion = most important prog factor **
Basal Cell Carcinoma (BCC)
Pres (3 options, 4 subfeatures in 1st)?
PRES:
- “Pearly Pink Papule” with:
- Rolled edges
- Central ulcerated “crater”
- “Palisading” nuclei
- Dilated (telangiectatic) surrounding vessels
- Nonhealing Ulcers with infiltrating growth
- Scaling Plaque
Squamous Cell Carcinoma
Precursor, MC Locations (4), Assoc, Pres, Biopsy Finding?
PRECURSOR = Solar / Actinic Keratosis
MC Locations = Face, Lower Lip, Ears, Hands
ASSOC:
- Can be sign of Mature Ovarian Teratoma
PRES:
- Ulcerative red lesion
BIOPSY:
- “Keratin pearls” (Skin Biopsy)
