test 2 light related disease and pigementation disorders Flashcards

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1
Q

3 patterns of melasma

A

centrofacial

malar

mandibular

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2
Q

texture photoaging?

A

solar elastosis: thickened wringled yellowish skin: forehead and back of the neck

artphy: thin
wrinkles: cutis rhomboidalis nuchae: sun induced wrkinlig on back of neck

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3
Q

what do snow and ice do?

A

reflect UVB, ozone absorbs C

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4
Q

what are the parts of natural protection?

A

stratum corneum and melanin

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5
Q

patient malnourished on INH, long term 5fu, corn diet

A
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6
Q

what is short wave germicidal, absorbed by ozone and made by germicidal lamps?

A

UVC

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7
Q

tyalmost never burn, deeply pigmented; black

A

type VI, 15

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8
Q

who burns easily, tans slightly, fair skinned (blond hair)? spf and type?

A

type II spf 25-30

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9
Q

what are the disadvantages of sunscreen?

A

can’t put on child <6 mos

vit D

irritant and allergic: oxybenzone

systemic toxicity: titanium and zinc

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10
Q

what is the treatment for photoaging?

A

prevention

retinoids (3-6 months): not good for wrinkling or telangectasia + wear sunscreen

resurfacing: peel, dermabrasion, laser: scarring/hypopig

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11
Q

tingling, erythema, then burning erythema, vesicles w/in hours, then bullae, linear streaking, and finally desqumation. the hyperpigmentation may last one year. occurs after useing perfumes, celery parsnip, limes, parsley, wild carrot, fig, hogweed, meadow grass. dx treatment?

A

phototoxicity

find and avoid causative agent, sunscreen, PUVA if persists, top steroids

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12
Q

what light is not filtered out by car, how does physical protection work?

A

uva, scatters and filters light

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13
Q

burns rarely, tans deeply; middle east, asain, black

A

type V spf 15

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14
Q

fair skinned children w/ exposure to sun can get?

A

xeroderma pigmentosum: numerous lesions

type 2 oculocutaneous albinism: large jagged lesions

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15
Q

what is one of the difference in solar lentigo from ephelides (freckles)

A

freckles darkin in the sun, but solar lentigo does not

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16
Q

sometimes burns then gradualy tans moderatelly, mediteranean and hispanic?

A

type III spf 15

17
Q

what is the treatment for pellagra?

A

PO niacin 50-100 mg TID/QID

premedicate w/ ASA prior to attenuate flushing

18
Q

non scarring prurutic rash that is symmetric. papules coalesce into plaques and confluent edema. Papular type is MC (small papules disseminated), and plaque is 2nd MC, butther are 6 other types. Monomorphic recurrent lesion identical to those in previous eruptoins. typcially in v of chest, legs of women, back of hangs, extensor aspect of forearms. HAS PRODROME OF MALAISE CHILLS HA NAUSEA AND HEALS W/O SCARRING

A

polymorphous light eruption

19
Q

treatment for solar lentigo?

A

none, cryo, topical retinoids, laser, combo

20
Q

what are the sun induced damages?

A

texture, vascular, pigmentation, papular

21
Q

what is the MC light induced skin disease? caused by UVA >UVB that typically occurs in first 3 decades in fair skinned females. it’s inversely related to latitude?

A

polymorphous light eruption

22
Q

what is a middle wave that produces harmful waves during summer, affects corneum and superficial layers: leads to sunburn, tan, erythema, pigmentation, and inflammation?

A

UVB

23
Q

vascular changes

A

venous lake: round pruple ectatic vessels, lower lips and ears

24
Q

pigmentation changes?

A

poikiloderma of civatte: red brown reticulated pigmenation w/ telangectaisas and prominent hair follicles, chest and neck

25
Q

what is a long wave, produced by black light, that constant, deeply penetrates dermis and subQ. Chronic exposure leads to CT degeneration and photoaging and photoallergies

A

UVA

26
Q

distribution for pellagra?

A

glove/gauntlet, casal’s necklace or cravat, spares the heel, butterfly, mucous membranes

27
Q

most improant melasma factors?

A

genetic and UV, but also hormonal, thyroid cosmetic, phototoxic and antiseizure meds: phenytoin

28
Q

asymptomatic white spots on arms and legs, has seborrheic keratosis, lentigines, and xerosis in same area

dx, trx

A

idiopathic guttate hypomelanosis

avoid sunlight, sunscreen

elective treatment: tretinoin, low potency roids, LN2, dermabrasion, make up

29
Q

always burns, never tans, celtic/irish red head? what SPF and type?

A

type I spf 25-30

30
Q

how to diagnose and treat polymorphous light eruption (areas covered in winter months vs exposed in sumer months)?

A

delayed onset, characteristic morphology, h/o disappearnace, bx and immunofluorescence studies to r/o SLE in plaque type

phototesting

trx: corticosteroids (topical), protection, desensitization w/ phototherapy, Psoralen UVA, antimalarial drugs (hydroxychloroquine)

31
Q

burns minimally, always tans well, darker hispanics and asians

A

type IV 15

32
Q

rules for SPF use?

A

15-30 x daily

15-30 min before going out

q 2 hrs or after H2O exposure

avoid 10-3

wear dark loose clothing

33
Q

CI to niacin treatment?

A

hypersensitivity, active hepatic dz, peptic ulcer disease, arterial hemorrhage, gout

34
Q

photoaging papular changes?

A

nevi

seborrheic keratosis

yellow papules

favre racouchot: comedones and cysts around the eyes

35
Q

treatment for melasma

A

sun protection, hypopigmenting: hydroquinone,

triluma cream (hydroquinone, tretinoin, fluocinolone): 8 weeks more effective than single agents:

chemical peel, later

tretinoin: slow, but good

36
Q

medications that can cause photoallergic reaction?

A

5-fu

celecoxib, doxy, dapsone, hydrochlorothiazide, itraconazole, oral contraceptives, phenothiazines, salicylates, quinidine, sulfonylureas

37
Q

common in inuit and native americans, onset chilhood, fam hx, intensly itchy papules plaques, noduels that crust. may have actinic chelitis. mc on face. dx treatment

A

actinic prurigo

corticosteroids, protection, PUVA, antimalarial, desensitization w/ therapy

38
Q

niacin deficiency, w/ dermatitis, diarrhea, dementia. begins w/ acute cutaneous phase: bilat, symmetric erythema, sunburn appearance then large bullae and brown scale and black crust. 2nd phase is late cutaneous. lesions are hard rough cracked, blackish and brittle. GOOSE SKIN, LICHENIFICATION, LESIONS HEAL CENTRIFUGALLY

A

pellagra