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Skin > Skin Disorders > Flashcards

Skin Disorders Flashcards

1
Q

Eczema and other variant symptoms

A

Inflammatory Disorder

Spongiotic Dermatitus

Erythema, scale, pruritic (itchy)

Types:

Atopic: occurs in children until adolescence on extensor surfaces. Associated with Asthma and allergic rhintis (runny nose). In older children, on flexural surfaces. The more you scratch the more it rashes.

Contact Dermatitis: caused by irritant or allergic contact.

-Type 4 Hypersensitivity: Antibody against cell surface antigens

Histologically: Spongiosis Epidermal, lymphotic exocytosis, perivascular lymphotytes, histiocytes, and eosinophils in blood vessels. Solar Elastosis also present. Acanthosis. Parakeratosis

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2
Q

Psoriasis symptoms and types

A

Inflammatory Disorder

Erythematous plaques with silvery scale. Pitting on nails, acanthosis (thicking) of epidermis, neutrophils within epidermis, prominent rete ridge.

(4) People Always Net Rockfish:

Psoriasis, pitting nails, plaques, acanthosis, neutrophils, rete pegs and rete ridges prominent

Variants:

Guttate Psoriasis: salmon-pink papules on trunk and extremities.

Pustular: raised bumps filled with white blood cells. Skin around is red.

Erythrodermic: skin looks like it’s been burned. Dangerous in older folks.

Histology: Hyperkeratosis, Acanthosis, Spongiosis, Munro’s Abscesses (neutrophil accumulation in spinous and granular layer), thin suprapapillary plate, eosinophilic infiltrate

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3
Q

Lichen Planus symptoms and types

A

Inflammatory disorder

4 Ps: Pruritic, purple, polygonal, polymorphous papules.

Associated with prior exposure to Hep C; may be autoimmune. Found on ventral wrists and mouth.

Histology: Band-like lymphocytic infiltrate at dermal-epidermal junction. Civatte bodies. Acanthosis, Prominent granular layer, dense stratum corneum ,

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4
Q

Pityriasis Rosea

A

Inflammatory Disorder

Large herald patch followed by Christmas tree pattern plaques, following tension lines.

“Roses are plants and trees are plants”.

Histology: Epidermal spongiosis w/ parkeratotic caps.

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5
Q

System Lupus Erythematosus

A

Malar butterfly macular erythema on face. Anti-nuclear Ab test. Vacuolization of basal layer. Granular IgG along basement membrane zone. Multi-organ involvement

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6
Q

Discoid Lupus Erythematosus

A

Erythematous scaly papules and plaques in sunexposed areas. No systemic concern. Histology: chronic inflammatory infiltrate at Dermal/epidermal junction, basement membrane thickening. Need to protect with sunscreen.

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7
Q

Human Papilloma Virus (warts)

A
  • Viral infection
  • Verruca vulgaris - common warts. Histology: papillomatous epidermal hyperplasia w/ hyperkeratosis and hypergranulosis. Mostly exophytic grownth
  • Verruca plana- flat warts
  • plantar warts: pounded inwards
  • Condyloma accuminatem- genital warts (via HPV 6 & 11)
  • HPV 16 and 18 associated with development of squamous cell carcinoma
  • Histology: squamous epithelial cells undergo structural changes and hyperplasia (become kiloctyes).
  • No reliable treatment
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8
Q

Molluscum Contagiosum

A
  • Viral infection
  • Pox virus
  • Also known as water warts
  • Slightly translucent papules with keratotic center
  • Diffuse in children
  • STD in adults

Histology: Eosinophilic viral inclusions in keratinocytes compress and obscure nucleus

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9
Q

Herpes

A

Herpes Simplex:
-unilateral distribution

HSV1: above the waist. Oral herpes.
HSV2: below the waste. Genital Herpes.

Varicella Zoster Virus:

  • Chicken Pox (first instance of varicella)
  • Zoster (reactivation of varicella); AKA Shingles. Dermatomal Distribution

Histology: epithelial giant cells, multinucleate

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10
Q

Impetigo

A
  • Honey colored rusting
  • Most common in children
  • Bacterial infection typically caused by staph or streptococcus (both are gram positive bacteria)

Histology: Subcorneal neutrophils with bacterial colonies.

Treatment: Penicillin

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11
Q

Syphilis

A
  • Caused by a spirochete (a worm-like spiral-shaped bacteria) called Treponema pallidum.
  • Primary Syphilis: occurs 1 week to 3 months post infection as a chancre (ulcer)
  • Secondary Syphilis: occurs 2-8 weeks after disappearance of primary as body rash. Not always itchy
  • Tertiary Syphilis: 5-10 years after secondary. Cardiovascular syphilis and neurosyphilis. Affects internal organs.

Congenital: if mother doesn’t get it treated.

Test: RPR flocculation test. Used to be VDRL

Treatment: penicillin is a cure.

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12
Q

Tinea corporis

Tinea Capitus

Tinea Cruris

Tinea Pedis

Tinea Facei

Tinea Onychomycosis

Pityriasis (Tinea) Versicolor

Coccidiomycosis (Valley Fever)

A

Fungal Infection.

Corporis: (Body) Ringworm

Capitus: Head

Cruris: jock-itch

Pedis: athletes foot

Facei: Face

Onychomycosis: fungus nails

Pityriasis (Tinea) Versicolor: Small discolored patches on skin.

Valley Fever: wide range of skin lesions. Pulmonary symptoms with very and can have CNS ad joint involvement.

Do not use steroids b/c decrease immune response to fight it.

Test: KOH

Histology: Dermatophytes in the stratum corneum

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13
Q

Lyme disease

A

From ticks that carry Borrelia burgdorferi.

Target shaped bite.

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14
Q

Scabies

A

Itchy contagious disease from mites burrowing in stratum corneum. Itching will kill them.

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15
Q

Urticaria

A

Erythematous wheals with surrounding pallor.
Angioedma - massive localized swelling
Hives

Treatment: antihistamines

Histology: Derma edma. Mediated by IgE on mast cells. Interstitial neutrophils and eosinophis.

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16
Q

Morbilliform Rash

A

Erythamtous papules coalescing into plaques.
Allergic reaction to drugs in adults.

Ex. Water pill allergy

Histology: superficial vasodilation, perivascular lymphocytes.

17
Q

Erythema multiforme

A

Blistering disorder
Target lesions often on palms or soles.
Serious form has mucosal lesion, (SJS)

Triggered by infections. Most commons is by Herpes Simplex.

Inflammatory cascade triggered by Langerhans cells.

Histology: Vacuolization of basal layer with apoptosis

18
Q

Stevens-Johnson Syndrom/Toxic epidermal necrolysis (TEN)

A

Blistering disorder
Widespread blisters on trunk and face.
Erorsion of mucous membrane.
TEN is worse; blisters covering at least 30% of body.

Cause: in adults from allergic drug reaction.

Histology: Appears to be cell mediated immunity against keratinocytes triggered by CD8+ cytotoxic T cells and granulysin.

19
Q

Dermatitis herpetiformis

A
  • Blistering disorder
  • Pruritic groups of blisters on extensor/dorsal surfaces.
  • Associated with gluten-sensitive enteropathy.

Treatment: gluten free diet.

Histology: Papillary dermal neutrophilic microabcesses.
Granular deposits of IgA near DE junction within dermal papilla creating inflammatory response.

20
Q

Melasma

A

Patchy pigment on face.
“Mask of pregnancy”

Histology: pigment in epidermis and/or dermis

21
Q

Vitiligo

A
  • White patches
  • Complete loss of pigment
  • Loss of melanocytes and pigment

Michael Jackson had it.
-Type IV Hypersensitivity - T-cell Mediated Disease

22
Q

Albinism

A
  • Absence of pigment in skin, hair, and nails.
  • Autosomal recessive
  • Melanin still present but it doesn’t work
23
Q

Seborrheic Keratosis

A
  • “Stuck on “ lesions
  • sometimes inflamed or bleeding from picking.
  • Histology: May have keratotic pores or pseudocysts.
  • Variable size.
  • Not related to sun exposure
  • uneven pigmentation
24
Q

Melanoma

A
  • Tumor of melanocytes.
  • Superficial spreading melanoma: most common. Grows on top layer of skin before spreading.
  • Nodular Melanoma: invades bottom layer early, most serious.
  • Mutations with P53 (Tumor Suppressor) or BRAF (oncogene)
  • CDKN2A and CDK4 involved in familial melanoma.

Histology: Large variable nuclei, pagetoid (upward spreading) migration upward in epidermis, and
mitotic figures,

25
Q

Acanthosis Nigrins

A
  • Dark patches in interginous areas and neck.
  • Common in people with obesity, and insulin resistance.
  • May be associated with internal tumors but rarely.
26
Q

Cafe au lait/neurofibromatosis

A
  • Cafe au lait spots are benign light brown macules
  • increase pigment in basal layer.
  • multiple lesions (more than 6) associated with neurofibromatosis (tumors forming on nerve tissue)
  • Benign spindle cell tumor of Schwann cells and fibroblasts.
27
Q

Solar (actinic) elastosis

A

UV light damages collagen and elastic fibers in dermis. Causing skin wrinkling.
aka: Actinic keratosis

28
Q

Bullous Pemphigoid

A

Type II Hypersensitivity: Antibody against cell surface antigens

29
Q

Pemphigus vulgaris

A

Type II Hypersensitivity: Antibody against cell surface antigens

30
Q

Systemic sclerosis

A

Type IV Hypersensitivity - T-cell Mediated Disease

31
Q

Lentigo

A

Histology: exaggeration of rete ridges in lentigo area compared to surrounding normal skin. Melanocyte hyperplasia in basal layer. melanophages found in dermis (melanocytes eated by macrophages) aka pigment incontinence. Dirty sock appearance.

32
Q

Basal Cell Carcinoma

A

Mechanism: involves PTCH mutation (tumor suppressor gene)

Histology: Telangiectasia, invasion of dermis and peripheral palisading at edge of lesion. Stroma retraction at dermal-epidermal layer. Little metastatic risk.

33
Q

Intradermal Nevus

A

Histology: nevus clusters in superficial dermis with maturation with descent.

34
Q

Melanoma

A

Histology: Cluster of atypical melanocytes in dermis and epidermis above basal layer (pagetoid spread). Red nuclei.

35
Q

Squamous cell carcinoma

A

Histology: Keratin Pearls and invading kerotincytes with intercellular bridges in dermis.

36
Q

Actinic Keratosis

A

Crusty scaly growth due to sun damage. Dysplasia is seen in epidermis. Cells have high N:C ratio

Solar elastosis (basis for wrinkling) can be seen: accumulation of bluish elastin

37
Q

Papillomatosis and koilocytes a feature of?

A

HPV infection

Skin (2 decks)

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