Unit 4 Dermatology Images

Question 1

• absence of melanocytes
• causes depigmentation

Answer 1

Vitiligo

Question 2

• associated with defects in collagen support structure of dermis

Answer 2

Ehlers-Danlos Syndrome

Question 3

• location: flexor surfaces in adults
• etiology: filaggrin mutation
• associated with asthma and allergic rhinitis
• staph aureus is suggested to exacerbate this disorder
• in children, is on cheecks and extensor surfaces
• eczema is type of atopic dermatitis

Answer 3

Atopic Dermatitis

Question 4

• type of atopic dermatitis

Answer 4

Eczema

Question 5

• etiology: common irritants
• caused by perfume, soap, etc

Answer 5

Irritant Contact Dermatitis

Question 6

• etiology: common allergens
• delayed type hypersensitiviey reaction (type 4)
• diagnosis confirmed with patch testing
• skin biopsy would reveal spongiotic dermatitis
• caused by poison ivy

Answer 6

Allergic Contact Dermatitis

Question 7

• location: lower legs
• etiology: lower extremity edema

Answer 7

Stasis Dermatitis

Question 8

Answer 8

Lichen Simplex Chronicus

Question 9

• same as nummular eczema
• round, annular, scaly plaques
• due to dry skin
• overuse of soap can make this worse

Answer 9

Numular Dermatitis

Question 10

• location: scalp
• etiology: malassezia furfur
• also known as cradle cap
• infection of sebaceous glands

Answer 10

Seborrheic Dermatitis

Question 11

• location: extensor surfaces
• may include arthritis
• may be associated with increased cardiovascular risk

Answer 11

Chronic Plaque Psoriasis

Question 12

Answer 12

Guttate Psoriasis

• associated with strep

Question 13

• skin cancer
• most common
• pearly
• common on nose
• common PATCH1 mutation: most BCC have loss of PATCH1 that normally block SMOOTHENED gene
• tx: mohs surgery, vismoedgib (blocks smoothend gene)

Answer 13

Basal Cell

Question 14

• second most common skin cancer
• occurs more common in immunosupporessed pts
• keratoacanthoma is a type of this cancer
  
  • center crater
  • develop rapidly
• on sunexposed skin, HPV, thermal injury
• actinic keratosis is premalignant skin lesion

Answer 14

Squamous Cell

Question 15

• skin cancer
• common mutation: BRAF
• tx: vemurafinib
• breslow thickness: measurement of depth of tumor
• clark level: layers of skin affected

Answer 15

Melanoma

Question 16

• often associated with immunodeficiency

Answer 16

Kaposi Sarcome

Question 17

• can be treated with beta blockers
• most common benign soft tissue tumor of infants
• GLUT1 positive

Answer 17

Infantile Hemangioma

Question 18

• most common benign vascular tumor in adults

Answer 18

Cherry Angioma

Question 19

• associated with high levels of GLUT-1 expression (a placenta associated marker)
• also called strawberry hemangioma
• often develops rapidly in first 3 months of life
• involution (decrease) common into adulthood (50% by 5, 70% by 7, 90% by 9)

Answer 19

Infantile Hemangioma

Question 20

• associated with glaucoma and seizures
• assocaited with sturge weber in infants with port wine stain in trigemminal nerve

Answer 20

Port Wine Stain

Question 21

• linear plaque on the face or scalp
• yellow-orange
• associated with allopecia
• assocated with mutations in HRAS and KRAS

Answer 21

Nevus Sebaceus

Question 22

• most commonly on face>trunk>extremity
• beign tumor of oil gland

Answer 22

Sebaceus Hyperplasia

Question 23

Answer 23

Acrochordon

Question 24

• benign tumor of adipose tissue
• often soft, movable, painless

Answer 24

Lipoma

Question 25

• from fibroblast
• firm papule
• most common on legs
• dimple sign is characteristic (Fitzpatrick sign)

Answer 25

Dermatofibroma

Question 26

• scar gowth above and beyond original border
• composed of type 3 or type 1 collagen

Answer 26

Keloid Scar

Question 27

• sudden appearance associated with adenocarcinoma of the stomach
• barnicles of life
• appear dark in people with dark complexion- Morgan Freeman

Answer 27

Seborrheic Karatosis

Question 28

• head and neck most common
• similar in color to shade of skin

Answer 28

Intradermal Nevus

Question 29

• flat macules
• palms and soles most common

Answer 29

Junctional Nevus

Question 30

• trunk and proximal extremities
• color brown to black

Answer 30

Compound Nevus

Question 31

• more common in asians and causcasians

Answer 31

Blue Nevus

Question 32

• low risk of progressing to malignant melanoma

Answer 32

Congenital Nevi

Question 33

• usually apparent by 20 years

Answer 33

Dysplastic Nevus

Question 34

• biggest risk factor for melanoma
• familial atypical moles and melanoma
• criteria:
  
  • The occurrence of malignant melanoma in 1 or more first- or second-degree relatives
  • The presence of numerous (often >50) melanocytic nevi, some of which are clinically atypical
  • Many of the associated nevi showing certain histologic features
• CDK2NA mapped to 9p21
• CDK4 mapped to 12q14
• CMM1 mapped to 1p

Answer 34

FAMMM Syndrome

Question 35

• six or more cafe au lait spots
• two or more neurofibromas
• axillary or inguinal freckling (Crowe’s sign)
• first degree relative with disorder
• optic glioma (iris freckles)
• autosomal dominant
• Defect in neurofibromin gene, a tumor suppressor, on chromosome 17 for NF-1

Answer 35

Neurofibromatosis

Question 36

• multiple lesions associated with neurofibromatosis

Answer 36

Cafe au Lait Patch

Question 37

• melassezia furfur is causative agent
• diagnos with KOH

Answer 37

Tinea Versicolor

Question 38

• acquired disease involving antibodies to cell-to-cell adhesion molecules in the stratum spinosum (keratinocytes)
• attacks desmosomes

Answer 38

Permphigus Vulgaris

Question 39

• vitamin cross links tropocollagen together
• this disease is characterized by lack of vitamin C
• SS: keratotic plugging of hairs, corkscrew hairs, hemorrhagic gingivitis

Answer 39

Scurvy

Question 40

• type 2 antibody mediated
• detachment between dermis and epidermis- hemidesomsomes

Answer 40

Bullous Pemphigoid

Question 42

• do not debride
• tx with steroids and immunosuppression

Answer 42

Pyoderma Gangrenosum

Question 43

• associated with hepatitis

Answer 43

Lichen Planus

Question 44

• with internal malignancies, pts tend to have weight loss- most common is stomach cancer
• thickening of the skin
• common causes: obesity, diabetes

Answer 44

Acanthosis Nigricans

Question 45

• filagrin mutation

Answer 45

Icthyosis Vulgaris

Question 46

• honey colored
• associated with bacteria like strep and staph
• can be bullus (staph) or non-bullus (strep/staph)

Answer 46

Impetigo

Question 47

• begins 7-14 days after taking new medication
• located over trunk and extremities

Answer 47

Drug Eruption

Question 48

• inital presentation is chancre
• secondary skin lesions form 4-10 weeks after onset of chancre
• sometimes presents with lymphadenopathy
• moth-eaten alopecia

Answer 48

Syphilis

Question 49

• can also have black dot appearance
• casued by fungus
• test is KOH, dermatophyte test medium (changes colors)
• other types:
  
  • tinia faciei- face
  • tinia barbae- beard area
  • tinia corpus- body
  • tinia pedis- feet
  • tinia manum- one hand two feet syndrome

Answer 49

Tinia Capitis

Question 50

fungus under nails

Answer 50

Onychomycosis

Question 51

• infestation
• burrows and genital nodules
• use mineral oil wet prep for diagnosis

Answer 51

Scabies

Question 52

• fungus

Answer 52

Oral Candidiasis (Thrush)