Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5 > Skin conditions (not infectious) > Flashcards

Skin conditions (not infectious) Flashcards

1
Q

Psoriasis pathophys

A

Chronic TH1 mediated cutaneous inflammation and hyperproliferation
TH1 cells produce cytokines IL2, TNFa, IL8 which attract and activate neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Histology of psoriasis

A

elongated rete redges
hyper and parakeratosis
neutrophils in epidermis
Auspitz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical features of psoriasis

A

5 cardinal features: plaques, well circumscribed, bright salmon red colour, silevry micaceous scale, symmetric
extensor surfaces over bony prominences
nails: pitting, onycholysis, serous exudate, shedding, subungual hyperkeratosis
increased risk of cardiac events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Guttate psoriasis

A

acute extensive psoriatic papules over trunk and proximal extremities
usually associated with group A strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inverse psoriasis

A

flexural sites
lack scales
bright red, moist, macerated appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pustular psoriasis

A

generalized pustular = fever, leukocytosis, life-threatening

localized - palms and soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Erythrodermic psoriasis

A

entire body

red and scaly, prominent systemic complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dx psoriasis

A

clinical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx psoriasis

A

topical: GCs, tars, salicylic acid
phototherapy: UVB
Systemic (for recalcitrant disease): methotrexate, oral retinoids (acetretin), cyclosporine, biologics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lichen planus pathophys

A

unknown

unrelated to any fungal/lichen infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lichen planus histology

A

dense band-like lymphocytic infiltrate at dermo-epidermal junction
basale destruction
hypergranulosis
hyperkeratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lichen planus clinical features

A

5Ps: papule, pruritis, purple, polygonal, planar (flat-topped)
Wickman’s stria (whitish scale)
Oral mucosal lesions extremely common (lacy white lesions on buccal mucosa)
may be associated with Hep C
slow onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lichen planus Dx

A

clinical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lichen planus Tx

A

1) topical steroid
2) topical retinoids
can use oral antihistamines to relieve severe itch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pityriasis rosea pathophys

A

may be due to human herpesvirus infection; self-limit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pityriasis rosea histology

A

parakeratosis, spongiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pityriasis rosea clinical features

A

herald patch - solitary 2-6 cm scaly plaque
fine collarette scaling along rim of individual lesions
T shirt and shorts distribution
Mimicked by secondary syphilis (do VDRL) and drug eruptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pityriasis rosea Dx, Tx

A

clinical diagnosis

Tx usually not necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Eczema/atopic dermatitis pathophys

A

TH2 mediated cutaneous inflammation, possible S. aureus skin infection
impaired cutaneous barrier function
also allergic contact dermatitis, irritant contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Eczema histology

A

elonged rete ridges
hyper and parakeratosis
epidermal lymphocytes and Langerhans cells
spongiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Eczema clinical features

A

intense pruritis
not well-circumscribed
commonly secondary lesions seen due to rubbing (lichenification), excoriations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Eczema phases

A

infantile - facial and extensor
Childhood - flexural distribution, secondary lesions prominent
adult - improve gradually, may remit

23
Q

Eczema tx

A

aggressive restoration of cutaneous permeability barrier (emollients, moisturizer)
1) topical GC
2) topical immunomodulators
oral antihistamines

24
Q

Acne pathophysiology

A

inflammation of pilosebaceous units associated with formation of comedones
abnormal follicular keratinization, sebum overproduction, overgrowth of follicular bacteria (P. acnes)

25
Q

Acne histology

A

neutrophil infiltration of pilosebaceous unit
plugging of hair follicle with keratin
fibroblastic and collagen proliferation in normal derma structures

26
Q

Acne clinical features

A 
most commonly found in areas of the most sebaceous secretion (face, shoulders, upper back, upper chest)
closed comodones (white heads) and open comedones (black heads)
- closed comedones more likely to give rise to inflammatory lesions
27
Q

Mild acne

A

mostly comedones, few inflammatory lesions, no scars

28
Q

Moderate acne

A

comedones, papules and pustules, no deep cysts or nodules

29
Q

Severe acne

A

cysts or nodules, significant scarring

30
Q

Acne tx

A

1) gentle cleansing BID
2) retinoic acid, antibiotics, benzoyl peroxide, salicylic acid
oral: systemic isoretinoin (retinoic acid)
antibiotics (relapse is common)

31
Q

Rosacea pathophys

A

unknown
papulopustular components centred on the pilosebaceous unit
but underlying abnormalities are vascular, not follicular in origin

32
Q

Rosacea histology

A

inflammatory periadnexal infiltrates
occasional parasitic infestations of follicles (Demodex)
sebaceous hyperplasia

33
Q

Rosacea clinical features

A 
commonly middle-aged
type 1: Erythematotelangiectatic rosacea
2: papulopustular rosacea
3: phymatous rosacea (develop rhinophyma
4: ocular rosacea (conjunctivitis, blephoritis, iritis, keratitis)
34
Q

Rosacea dx

A

clinical

DDx acne vulgaris

35
Q

Tx rosacea

A

avoid triggers - sun, heat, alcohol
laser ablation for telangiectasia
tetracyclines and cold compress for erythema
metronidazole, azaleic acid, systemic antibiotics for papulopustular
systemic tetracyclines and isotretinoin = moderately effective for phymatous rosacea

36
Q

Pemphigus pathophys

A

rare antibody-mediated vs antigen important in allowing keratinocytes to adhere (intraepidermal split)
fluid accumulates in intraepidermal split - clinically apparent fragile bullae

37
Q

Pemphigus histology

A

suprabasal intraepidermal cleft

38
Q

Pemphigus clinical features

A

easily ruptured bullae

flaccid erosions common

39
Q

Pemphigus tx

A

topical/systemic steroids

immunosuppressives (methotrexate)

40
Q

Bullous pemphigoid pathophys

A

antibodies to antigens in basement membrane zone between epidermis and dermis

41
Q

Bullous pemphigoid histology

A

inflammatory infiltrate of eosinophils near dermo-epidermal junction
subepidermal split
full thickness of epidermis above fluid accumulation

42
Q

Bullous pemphigoid histology clinical features

A 
pruritic erythematous plaques
tense bullae (not fragile) with few erosions
43
Q

Bullous pemphigoid treatment

A

better prognosis than pemphigus vulgaris

prednisone; IVIG or rituximab if refractory

44
Q

Drug eruptions pathophys

A

undesirable response to medication at a certain dose

45
Q

Drug eruption clinical features

A

urticaria
maculopapular/morbilliform (measles-like)
localized inflamed plaques that recur at same body site each time patient is exposed

46
Q

Exacerbating factors for psoriasis

A 
Koebner phenomenon
Infections (GAS, HIV)
dry air/skin
stress
alcohol and drugs
- flareup after discontinuation of prednisone
- lithium, beta blockers
- any cutaneous drug eruption
47
Q

Ameliorating factors for psoriasis

A

sunbathing (UVB immunosuppression)

moisturizes

48
Q

Pregnancy - benign skin changes

A

Striae gravidarum
Hyperpigmentation at areola, axillae and genitals
increase or decrease in growth and production of hair
nails usually grow faster
vascular changes - spider telangiectasias, palmar erythema, saphenous, vulvar, or hemorrhoidal varicosities
Preexisting skin conditions may change
Atopic dermatitis/psoriasis may worsen or improve; psoriasis more likely to improve
Fungal infections generally require longer treatment course during pregnancy

49
Q

PUPPP

A

Pruritic urticarial papules and plaques of pregnancy
- intense pruritis, develops in the 3rd trimester and generally first appears on abdomen often along striae and occasionally involves extremities
face spared

50
Q

Prurigo of pregnancy

A

erythematous papules and nodules on extensor surfaces of extremities

51
Q

INtrahepatic cholestasis of pregnancy

A

intrahepatic cholestasis occurring in the 3rd trimester

results in excoriation from scratching with non-specific distribution

52
Q

Pemphigoid gestationis

A

AI skin disorder in mid to late term pregnancies with linkage to HLA-DR3 and DR4
can take variable course although it generally improves in late pregnancy with exacerbations in the immediate postpartum period
pruritic papules, plaques and vesicles evolving into generalized vesicles or bullae
Initial periumbilical lesions may generalize although face, scalp and mucous membranes usually spread

53
Q

Impetigo herpetiformis

A

pustular psoriasis that is a rare skin disorder in the 2nd half of pregnancy
round, arched or polycyclic patches covered with small painful pustules in a herpetiform pattern
most commonly appears on thighs and groin but rash may coalesce and spread to trunk and extremities
face, hands and feet are spared but mucous membranes may be involved

54
Q

Pruritic folliculitis of pregnancy

A

occur in 2nd and 3rd trimester and present as erythematous follicular papules and sterile pustules on abdomen, arms, chest and back
CONTRARY TO ITS NAME purities is not a major feature

5 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions