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Musculoskeletal + skin > Skin > Flashcards

Skin Flashcards

1
Q

Sx of bullous pemphigoid

A

Blisters of the skin most commonly in extremities (Negative Nikolsky sign); oral mucosa is spared (vs. Pemphigus vulgaris)

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2
Q

Etiology of bacterial skin abscess

A

Almost always staph

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3
Q

___lesions are characterized by central, ulcerated crater surrounded by telangiectatic (dilated) vessels

A

Basal cell carcnioima (“pink-pearl-like”)

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4
Q

Superficial skin infection not associated w/ systemic sx

A

Impetigo

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5
Q

Histology of pemphigus vulgaris

A

1) Acantholysis of stratum spinosum keratinocytes
2) “Tombstone” appearance- due to basal layer cells that remain attached to BM via hemidesmosomes

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6
Q

Mutation that drives dysplastic nevi/ melanonva

A

BRAF kinase, which results in loss of CDK inhibitor

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7
Q

Another type of lesion (besides skin) found in pemphigus vulgaris

A

Oral mucosal bullae (blisters)

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8
Q

Present as pigmented raised lesion w/ central darker shade

A

Dysplastic nevi

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9
Q

Melasma and risk factors

A

Hyperpigmentation of cheeks (can be elsewhere); risk factors include pregnancy (“mask of pregnancy”) and OCP use

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10
Q

Presented as pigmented raised lesion w/ central darker shade

A

Dysplastic nevus

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11
Q

_________: condition characterized by auto IgG antibodys against hemidesmosome components, particularly _________

A

Bullous pemphigoid; BP180

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12
Q

Histology of psoriasis (3)

A

1) Acanthosis w/ elongation of rete ridges + dermal papillae
2) Parakeratosis
3) Munro microabscesses

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13
Q

Signs + sx of SJS/TEN

A

Fever, bullae/ skin necrosis, sloughing of skin, involvement of mucous membrane (lip/ oral mucosa)

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14
Q

__________is the most important prognostic factor in predicting metastasis of melanoma, not the size

A

Breslow thickness

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15
Q

Two growth phases of melanoma and main difference

A

1) Radial growth- melanocytes grow horizontally along DE junction; lack metastasizing ability
2) Vertical growth- melanocytes grow vertically into dermis- tumor gains metastatic potential

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16
Q

Premalignant lesoin to squamous cell carcinoma

A

Actinic keratoses; many lesions show dysplastic changes; risk of SCC proportional to degree of epithelail dysplasia

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17
Q

Condition in which there is IgA deposition at the tips of dermal papillae

A

Dermatitis herpetiformis

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18
Q

Presentation of actinic keratosis

A

Small, rough + scaly (“sand-paper like”), red or brownish papules or plaques

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19
Q

Disease associated w/ dermatitis herpetiformis

A

Celiac

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20
Q

Risk factor of development of basal cell carcinoma

A

UVB induced damage- sunlight, albinims, xeroderma pigmentosum

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21
Q

Diseases associated w/ positive Nikolsky sign

A

1) Pemphigus vulgaris
2) Scalded skin syndrome

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22
Q

Infection associated w/ Lichens Planus

A

Chronic hep C

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23
Q

How is scalded skin syndrome + TEN/SJS distinguished from each other?

A

Level of skin separation using histology- separation in SJS/TEN occurs between dermal-epidermal junction (Hemidesmosomes), while scalded skin syndrome involves stratum granulosum w/ spinosum

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24
Q

Presentation of melanoma

A

Mole-like growth w/ ABCDE

Asymmetry, borders irregular, color not uniform, diameter > 6 cm, evolution over time

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25
Q

What embryological tissue derives melanocytes

A

Neural crest

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26
Q

Bacterial infection that involves epidermis, deeper dermis, subcutaneous fat

A

Cellulitis

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27
Q

Presentation of intradermal nevi vs. junctional nevi

A

Intradermal nevi- papules

Junctional nevi- flat macules

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28
Q

Causes of impetigo

A

S aureus, S pyogenes

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29
Q

Rosacea

A

Inflammatory skin disorder characterized by eryhtematous papules + pustuels but no comedones; occurs in ages 30-50 (vs. acne vulgaris)

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30
Q

Well-defined, slightly raised eryhthematous, shiny lesion

A

Erysipelas

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31
Q

Xeroderma pigmentosum

A

Autosomal recessive defect in enzymes necessary for nucleotide excision repair (sunlight can induce formation of pyrimidine dimers, which are normally excised by DNA repair). Increased risk for all 3 types of skin CA

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32
Q

Location of melanin synthesis and precursor molecule involved

A

Melanocytes synthesize melanin in melanosomes, using tyrosine (tyrisinase) as precursor molecule.

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33
Q

6 Ps of Lichens Planus

A

Pruritic, planar, polygona, purple papules + plaques

34
Q

Histology of SJS/TEN

A

Complete separation of epidermis from dermis

35
Q

Type of moles that are associated w/ increased for melanoma `

A

Congenital melanocytic nevi, esp. giant congenital nevi (> 20 cm diameter)

36
Q

Histology of seborrheic keratosis

A

horn cysts (kertain filled cysts) + hyperkeratosis

37
Q

What kind of epithelial junction connects keratinocytes in stratum spinosum?

A

Desmosomes

38
Q

Why there is antibody deposition at the dermal papillae in dermatitis herpetiformis

A

IgA against gluten cross-react w/ reticulin in basement membrane of dermal papillae

39
Q

characterized by well circumscribed, salmon-colored plauqes w/ loosely adherent silvery scale

40
Q

Superficial skin infection involving epidermis + upper dermis

A

Erysipelas

41
Q

Warning signs of necrotizing fasciitis (2)

A

1) Pain out of proportion to acute physical findings
2) Local eryhtema + swelling w/ tenderness beyond confines of infection

42
Q

Eczema

A

Definition: pruritic, erythematous, oozing rash w/ vesicles + edema

43
Q

benign neoplasms of melanocytes

A

Moles (nevus)

44
Q

Classic location of squamous cell carcinoma lesions

45
Q

Pathophysiology of SJS/TEN

A

Drug somehow activates cytotoxic T cells to kill keratinocytes

46
Q

Histology of Lichens planus

A

Inflammatory infiltrate of dermal-epidermal junction w/ “saw tooth” appearance

47
Q

Type of hypersensitivity involved in atopic dermatitis (eczema)

A

Type I hypersensitivity to enviornmental antigens

48
Q

Cause of actinic keratosis

A

Sun exposure; usually in light pigmented individuals

49
Q

Dysplastic nevus syndrome- AD disorder associated w/ LOF of _; pts are at increased risk for melanoma

A

CDK inhibitor, leading to cell cycle dysregulation

50
Q

Cause of cellulitis

A

S. pyogenes, S aureus (less common)

51
Q

Etiology of erythema multiforme

A

Assoicated w/ HSV infection (+ mycoplasma), drugs (e.g. PCN, sulfonamide), autoimmune diseases, malignancy

52
Q

Allele associated w/ psoriasis

53
Q

Immunofluorescence of _ shows IgGs surrounding keratinocytes in a “fish net pattern”

A

Pemphigous vulgaris

54
Q

_ are characterized by small, rough + scaly (sand-paper like), erythematous/brownish papules or plaques

A

Actinic keratosis

55
Q

Histology of basal cell carcinoma

A

Nodules of basal cells w/ peripheral palisading

56
Q

Inflammation of venules in subcutaneous fat results in inflammation of fat –> pain, red nodular areas

A

Erythema nodosum

57
Q

Other risk factors of squamous cell carcinoma besides UVB-induced damage

A

Immunosuppressive therapy, arsenic exposure, chronic inflammation (e.g. non-healing wounds, scar from burns, draining sinus tract)

58
Q

What is the stem cell layer of skin?

A

Stratum basalis

59
Q

Lesler Trelat sign and what it suggests

A

Sudden onset of multiple seborrheic keratosis; suggests underlying carcinoma (esp. GI, lymphoid)

60
Q

Conditions associated w/ acanthosis nigricans (2)

A

1) Insulin resistance (e.g. non insulin dependent DM)

2) GI malignancy especially gastric carcinoma

61
Q

characterized by formation of keratin pearls

A

Squamous cell carcinoma

62
Q

Characterized by increased number of melanosomes (melanocytes are not increased), resulting in increased number of melanin production

A

Freckles (Ephelides)

63
Q

Which organism is involved in acnes vulgaris and how?

A

Propionibacterium acnes within hair follicles produces lipases, which break down sebum, which results in release of proinflammatory fatty acids and inflammation of follicle –> pustule (pimple)

64
Q

Blisters of pemphigus vulgaris vs. bullous pemphigoid

A

Pemphigus vulgaris bullous rupture easily (positive Nikolsky sign) while bullous of bullous pemphigoid do not

65
Q

Histology of dysplastic nevi

A

Irregular melanocytes that form clusters at the DE junction

66
Q

“Coin-like, waxy, velvety, stuck on” lesion

A

Seborrheic keratosis

67
Q

which layer of skin has connective tissue, nerve endings, blood + lymphatic vessels, and adnexal structures?

68
Q

Component and layer that exfoliative toxin A + B of S aureus targets in scalded skin syndrome

A

Desmogleins (desmosomes) of stratum granulosum

69
Q

LOCALIZED loss of skin pigmentation due to autoimmune destruction of melanocytes

70
Q

Type of hypersensitivity associated w/ urticaria

A

Type I hypersesntivity to allergens (re-exposure to allergen results in mast cell dgranulation)

71
Q

Tumor marker associated w/ melanoma

72
Q

Cause of albinism

A

Defect anywhere along pathway from melanin syntehsis to take-up by keratinocytes; most often due to tyrosinase defect (impairs melanin production)

73
Q

Munro abscesses and condition associated

A

Collections of neutrophils in stratum corneum; seen in psoriasis

74
Q

Sx of dermatitis herpteformis

A

Prurutic vesicles + bullae that are grouped

75
Q

White lines on surface of the lesions of Lichens Planus

A

Wickham striae

76
Q

Skin finding of squamous cell carcinoma

A

ulcerated, nodular mass usually on face (classicall on lower lip)

77
Q

Classic location of basal cell carcinoma lesion

78
Q

Characteristics of benign moles

A

Reverse of ABCDE (Asymmetry, Border irregularity, Color variation, Diameter > 6mm, Evolution over time)

79
Q

Targetoid rash + bullae

A

Erythema multiforme

80
Q

_ is characterized by NORMAL melanocyte NUMBER w/ DECREASED melanin PRODUCTION

81
Q

Immunofluorescence of dermatitis herpetiformis

A

Granular IgA deposition at tips of dermal papillae

82
Q

Immunofluorescence of Bullous Pemphigoid

A

IgG antibodeies between dermis + epidermis

Musculoskeletal + skin (12 decks)

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