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Skin conditions Flashcards

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Dermatology Board Prep flashcards
1
Q

What are some broad types of psoriasis?

A
  • Psoriasis vulgaris (plaque)
  • Pustular psoriasis
  • Psoriatic erythroderma
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2
Q

What are the 5 defining features of psoriatic rash?

A
  • erythematous
  • well-circumscribed
  • scaly
  • plaques
  • symmetrical
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3
Q

What are the subtypes of psoriasis vulgaris?

A
  • Guttate
  • Inverse
  • Chronic stable plaque
  • Palmoplantar
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4
Q

What is psoriasis?

A

A chronic immune disorder with polygenic predisposition plus environmental triggers that cause patient to develop plaques due to overproduction and increased turnover of keratinocytes. The disease is T-cell mediated (Th1 response).

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5
Q

What precipitates psoriasis in general?

- What precipitates guttate psoriasis?

A

In general, physical trauma (scratching/rubbing), stress, drugs, alcohol or environmental factors elicit psoriatic lesions.
- GAS infection triggers guttate psoriasis

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6
Q

Which lymphocytes are found in psoriatic lesions?

A

CD8 T-cells

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7
Q

What is intertrigo?

A

Infection (bact/viral/fungal) causing inflammation of the skin folds - developed at the site of broken skin.

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8
Q

What nail changes are seen with psoriasis?

A
  • symmetrical pitting
  • onycholysis
  • subungual hyperkeratosis
  • yellow/brown “oil spot” *pathognomonic
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9
Q

What is acanthosis?

A

Diffuse epidermal thickening.

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10
Q

If a fungal infection is suspected, what test should be done?

A

KOH test!

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11
Q

What is Tinea veriscolour?

A

Infection caused by Malassezia furfur.

Produces red/gray scaly pruritic patches anywhere on skin.

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12
Q

What is “the itch that rashes”?

A

Atopic dermatitis (Eczema)

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13
Q

What is the significance of testosterone with respect to balding pattern in androgenetic alopecia?

A

Testosterone is metabolized (by 5-alpha reductase) to DHT on scalp and this causes balding.

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14
Q

What is the treatment for androgenetic alopecia?

A

finsteride PO, topical minoxidil solution, or hair transplantation

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15
Q

What are exclamation point hairs pathognomonic for?

A

Alopecia areata

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16
Q

What is alopecia areata?

A
  • autoimmune disease;
  • circumscribed circular patch of baldness
  • may be asymptomatic or have paresthesias or tenderness
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17
Q

What is atopy?

A

predisposition to developing allergic hypersensitivity

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18
Q

What causes scarring hair loss?

A
  • Lupus

- Lichen planopilaris

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19
Q

What is the clinical diagnosis for someone who shows repetitive pulling/plucking of his/her hair?

A

Trichotillomania

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20
Q

What is it called when a patient repetitively swallows his/her hair?
- what is the harm in this?

A

Trichophagia

  • may form trichobezoar which can cause partial obstruction of the intestine
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21
Q

What is the term for decrease or complete discontinuance of proliferation of matrix cells of the hair shaft?
- what is a cause for this condition?

A 
Anagen effluvium (ie. loss of growth phase hairs)
 - caused by chemo/radiation
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22
Q

What are the phases of hair growth?

A

Anagen - growth phase;
Catagen - transition phase (club hairs);
Telogen - resting phase.

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23
Q

What is telogen effluvium?

- how long does it take for the hair to grow back?

A

Hair enters the telogen (resting phase) before it should –> escessive hair shedding
- normal regrowth in 6 months

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24
Q

If you see spoon-shaped nails, what is the likely diagnosis?

A

Fe-deficiency

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25
Q

What is the treatment for pemphigus vulgaris?

A

High-dose steroids

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26
Q

What is pemphigus vulgaris?

- how does the main clinical symptom develop?

A

Ab-mediated disorder:

  • Ab targets Ag in desmosomes that connect keratinocytes
  • causes stratum spinosum to lift off of stratum basale
  • forms flaccid bullae that is easily ruptured.
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27
Q

What are the 5 P’s for characterizing lichen planus?

A 
Pruritic 
Purple
Planar
Polygonal
Papules
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28
Q

What is bullous pemphigoid?

A

Ab-mediated blistering disease (of the elderly)

- Ab targets Ag at dermal-epidermal jxn

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29
Q

What are the pathological features of acne?

A
  • Keratin buildup at surface of hair follicles
  • overproduction of sebum from sebaceous glands
  • inflammation in/around hair follicles
  • fibroblast proliferation & collagen deposition
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30
Q

What is the name of the muscle that causes piloerection?

A

arrector pili

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31
Q

What part of the hair follicle is the isthmus?

A

from sebaceous gland entrance to attachment of arrector pili muscle

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32
Q

What part of the the hair follicle extends from the follicular orifice to the sebaceous duct entrance?

A

follicular infundibulum

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33
Q

What are some causes of papulosquamous (ie. papules & plaques with scales) eruptions on the skin?

A
  • psoriasis
  • pityriasis rosea
  • fungal (tinea)
  • nummular dermatitis
    -
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34
Q

What type of skin lesion has rolled borders?

A

Basal cell carcinoma

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35
Q

What type of skin lesion manifests as a translucent nodule or plaque?

A

Basal cell carcinoma

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36
Q

What are the treatment options for basal cell carcinoma?

A
  1. Electrodessication and curettage
  2. Simple surgical excision
  3. Micrographic surgery (simultaneous microscopic analysis)
  4. Radiation
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37
Q

What is the transition stage from actinic keratosis to squamous cell carcinoma called?

A

Squamous cell carcinoma in situ

Bowen’s disease

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38
Q

What are treatment options for actinic keratosis?

A
  1. Liquid nitrogen cryotherapy

2. Topical 5-FU

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39
Q

Which type of skin cancer is most likely to metastasize?

A

Squamous cell carcinoma

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40
Q

What cell type do basal cell carcinomas arise from?

A

Keratinocytes

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41
Q

What cell type do melanomas arise from?

A

Melanocytes

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42
Q

What cell type do squamous cell carcinomas arise from?

A

Keratinocytes

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43
Q

What are the stages of mole development?

- briefly describe each

A
  1. Junctional phase (flat, epidermal, pigmented)
  2. Compound phase (raised, pigmented, both epidermis & dermis)
  3. Dermal phase (raised, loss of hyperpigmetation, dermis)
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44
Q

What causes the development of freckles?

A

Activation of melanocytes.

All typical freckles are caused by sun damage.

45
Q

What causes nevi?

A

Lots of cell division - increased number of melanocytes.

46
Q

What is the most significant predictor of melanoma risk?

A

Number of banal (common) nevi

47
Q

What is the best biopsy method for melanoma?

A

Elliptical excision

48
Q

What is the most important prognostic factor for melanoma?

A

Depth

49
Q

What are the types of melanoma?

A
  • Superficial spreading melanoma
  • Nodular melanoma
  • Lentigo maligna melanoma
50
Q

What type of melanoma develops from a nevus?

A

Superficial spreading melanoma

51
Q

What type of melanoma arises without an onions precursor lesion?

A

Nodular melanoma

52
Q

What type of glands secrete into hair follicles?

A

Sebaceous glands & Apocrine glands

53
Q

What type of gland plays the largest role in thermoregulation?

A

Eccrine glands

54
Q

What is holocrine secretion?

A

Secretions are made in the cytoplasm and are released when the plasma membrane ruptures and the cell dies.

55
Q

What is merocrine secretion?

  • what type of gland uses merocrine secretion?
A

Secretion are excreted from the cell by exocytosis.

Eccrine glands exhibit merocrine secretion.

56
Q

What is apocrine secretion?

A

Secretions are released be membrane budding.

57
Q

Where are apocrine glands located?

A

Axilla, groin,

58
Q

Histologically, what is different about the skin of the nose?

A

Large sebaceous glands.

59
Q

Histologically, what is different about the skin of the back?

A

Thick reticular dermis

60
Q

Histologically, what is different about the skin of the palms and soles?

A
  • Thick stratum corneum
  • numerous eccrine glands
  • nerve end organs
  • glomus bodies
  • no pilosebaceous units
61
Q

What is the name for the thick skin on the palms and soles?

A

Acral skin

62
Q

The dermal papillae interdigitate with what epidermal structures?

A

Rete ridges

63
Q

Where are hemidesmosomes found in the skin?

A

Attaching the keratinocytes in the stratum basale to the basement membrane.

64
Q

What makes the stratum granulosum appear granulated?

A

Keratohyaline granules found in the flattened keratinocytes.

65
Q

What is the embryonic origin of keratinocytes?

A

Ectoderm

66
Q

What filaments are found in keratinocytes?

A

Tonofilaments (composed of keratin intermediate filaments)

67
Q

Where in the skin are melanocytes normally found?

  • what happens in melanoma?
A

Basal layer

  • in melanoma, melanocytes migrate into spinousum & granulosum (melanoma in situ); melanocytes then migrate through basement membrane to dermis (malignant).
68
Q

What is the embryonic origin of melanocytes?

A

Neural crest cells

69
Q

How is melanin synthesized?

A

Tyrosine –> DOPA –> dopaquinone –> melanin

70
Q

What is the difference in dark skinned vs. light skinned individuals?

A

Darker skinned individuals have increased melanogenesis –> increased number of melanin granules but no increase in number of melanocytes.

71
Q

What type of granules are found in Langerhans cells?

- what is their function

A

Birbeck granules

- degradation of Ag & Ag presentation

72
Q

Where in the body are Merkel cells mostly found?

A

Thick skin of palms & soles, mucous membranes of lips & oral cavity

73
Q

What cells are present in the dermis?

A
  • fibroblasts
  • dermal dendritic cells
  • mast cells
  • histiocytes (macrophages)
  • sometimes lymphocytes
74
Q

What connects the lamina densa of the dermis to the basement membrane?

A

Anchoring filaments containing type VII collagen

75
Q

What are the major components of the basement membrane?

A

Laminin & type IV collagen

76
Q

Which part of the dermis contains more elastin fibres?

A

Reticular dermis

77
Q

What is a glomus body?

A

Arteriovenous shunts in fingertips and external ear - surrounded by specialized muscle sphincters that are temperature dependent.

78
Q

What are encapsulated nerve endings responsible for?

A

Sensation of touch

79
Q

What are free nerve endings responsible for?

A

Sensation of pain and temperature

80
Q

What are the components of the pilar unit?

A
  • hair follicle
  • sebaceous gland
  • arrector pili muscle
  • apocrine gland (when present)
81
Q

What is verruca vulgaris?

  • what is usually the cause of it?
A 
Connor warts (raised wart with roughened surface, usually on hand)
 - cause is usually viral (HPV)
82
Q

What is the embryonic origin of the dermis?

A

Mesoderm

83
Q

What happens in bullous pemphigoid?

A

Ab to hemidesmosomes - epidermis tears off the dermis

84
Q

What is the main diffusion barrier in the skin?

- what are the two compartments of this structure?

A

Stratum corneum.

Made of protein-rich corneocytes & lipid-rich intercellular matrix.

85
Q

What is filaggrin?

- what are filaggrin mutations associated with?

A

Filaggrin is a protein (formed from profilaggrin in the keratoahyaline granule) that helps in the assembly of keratin in corneocytes.

Filaggrin mutations are associated with atopic dermatitis.

86
Q

What type of UV radiation causes sunburn?

A

UVB

87
Q

What type of UV radiation penetrates deeper into the skin?

A

UVA

88
Q

What is the affect of UVA radiation?

A

Cytotoxic free radical production.

89
Q

What are the skin’s primary barriers to UV radiation?

A
  • Protein barrier in the stratum corneum

- Melanin barrier dispersed throughout epidermis

90
Q

What are the functions of melanin?

A
  • protect from UV radiation
  • scavenging cytotoxic radicals
  • neurological development
91
Q

What is the life cycle of a melanosome?

A

Synthesized by melanocytes, transported along cell processes (dendrites), phagocytosed by keratinocytes, fusion with lysosomes.

92
Q

Where in the body are glomus bodies found?

A

In exposed areas:

Hands, feet, ears.

93
Q

What is the innervation of eccrine sweat glands?

A

Sympathetic cholinergic.

- will also respond to blood-borne adrenergic stimulation during sweating.

94
Q

What is the name of the condition with absent/defective sweat glands?

A

Ectodermal dysplasia

95
Q

What is erythromelalgia?

A

Mutation in Na+ channel associated with nerve conduction.

96
Q

At what age does pityriasis rosea most commonly present?

A

Age 10-20

97
Q

What is spongiosus?

- what is it associated with?

A

Intraepidermal intercellular edema.

  • seen in eczematous processes
98
Q

What infectious agent is scarlet fever usually linked to?

A

Steptococcus

99
Q

What infectious agent is associated with boils, carbuncles, & faruncles?

A

Staphylococcus

100
Q

What are some dermatological issues that are related to Staph infection?

A
  • farunculosis
  • folliculitis
  • impetigo
101
Q

What age-group is most commonly affected by impetigo?

A

Pre-school aged children

102
Q

What is the most common cause of allergic contact dermatitis?

A

Nickel

103
Q

What is the microscopic description of a wart?

A

vacuolation of keratinocytes in the upper epidermis, a basket weave stratum corneum, and koilocytosis (description taken from week quiz on Medicol)

104
Q

What is the causative agent of roseola infantum?

A

HHV6

105
Q

For which conditions is Wood’s light used as a diagnostic tool?

A
  • Tinea capitus
  • Erythrasma
  • Vitiligo
106
Q

What diagnostic tool is used for suspected scabies infection?

A

Oil microscope

107
Q

What diagnostic test is done for suspected herpes (zoster, simplex, or varicella)?
- what indicates a positive result?

A

Tzank

  • positive result is presence of multi-nucleated giant keratinocytes
108
Q

What diagnostic test is used for suspected syphilis?

A

Darkfield exam

Dermatology (2 decks)

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