Chapter 23 Flashcards
(101 cards)
1
Q
What is a macule?
A
flat discoloration
2
Q
What is a papule?
A
elevated dome
3
Q
What is a plaque?
A
flat-topped elevation
4
Q
What is a scale?
A
dry, horny, plate-like growth
5
Q
What is a vesicle?
A
fluid-filled area (less than or equal to 5mm)
6
Q
What is a bulla?
A
fluid-filled area (greater than 5mm)
7
Q
What is a wheal?
A
raised area of edema
8
Q
What is another name for a wheal?
A
hive
9
Q
What are the seven macroscopic terms?
A
macule papule plaque scale vesicle bulla wheal
10
Q
What the four microscopic terms?
A
acantolysis
acanthosis
hyperkeratosis
spongiosis
11
Q
What is acantholysis?
A
loss of keratinocyte adhesion
12
Q
What is acanthosis?
A
epidermal hyperplasia
general
13
Q
What is hyperkeratosis?
A
hyperplasia of the stratum corneum
14
Q
What is spongiosis?
A
intracellular epidermal edema
15
Q
Intracellular epidermal edema is most likely to be seen in which of the following acute inflammatory dermatoses?
a. poison ivy
b. acne
c. urticaria
d. erythema multiform
A
a. poison ivy
(it is a type IV hypersensitivity reaction that causes allergic contact dermatitis - a subcategory of eczema which presents with spongiosis)
16
Q
What are the four types of acute inflammatory dermatoses?
A
urticaria
acute eczematous dermatitis
erythema multiform
acne
17
Q
What macroscopic term can be associated with urticaria?
A
wheals
18
Q
What macroscopic term can be associated with acute eczematous dermatitis?
A
vesicles
19
Q
What macroscopic term can be associated with erythema multiform?
A
macule
possible vescile/bulla
20
Q
What macroscopic term can be associated with acne?
A
papule
21
Q
Urticaria is most commonly due to …
A
allergic reaction (type I hypersensitivity)
22
Q
What are the two types of urticaria involving IgE?
A
IgE-Dependent
IgE-Independent
23
Q
What causes IgE-Dependent urticaria?
A
common allergens
24
Q
What causes IgE-Independent urticaria?
A
adverse drug reactions (opiates, antibiotics)
25
What is the common age in which urticaria can occur?
20-40 (young adulthood)
26
How long does a case of urticaria last?
most develop and fade in a few hours
27
What are the two other subcategories of urticaria?
```
pressure urticaria (chronic idiopathic urticaria)
hereditary angioedema
```
28
What is the term for pressure urticaria as seen with writing on the skin?
dermatographia
29
What is hereditary angioedema?
excessive complement activation that leads to dermal edema
30
What is the deficiency in hereditary angioedema?
inherited C1 esterase inhibitor deficiency
31
What can lead to or trigger hereditary angioedema?
```
trauma
menstruation
physical stress
viral infections
ADR to various meds
```
32
What are characteristics of acute eczematous dermatitis?
red, vesicles, oozing, crusts
33
What is characteristic of chronic eczema?
scaling plaque
34
As time goes on, what are the symptoms/signs of eczema?
starts out itchy with spongiosis and as time progresses it becomes painful with hyperkeratosis
35
What are the types of hypersensitivities that are seen in patients with eczema?
```
type I (atopic dermatitis)
type IV (allergic contact dermatitis)
itchy (trauma over time - can progress to chronic)
```
36
What is the most common form of eczema?
allergic contact dermatitis
37
What immunological response is involved with allergic contact dermatitis?
CD4 + T cells sensitization
38
What is the pattern of distribution of allergic contact dermatitis?
limited to contact site
39
What are the two types of eczema?
allergic contact dermatitis
| atopic dermatitis
40
What is characteristic about atopic dermatitis?
family history (genetic risk), childhood onset, and atopic triad
41
What is atopic triad?
dermatitis, asthma, rhinitis
42
What is the prognosis of atopic dermatitis?
generally improves with age
43
What is the pattern of distribution for eczema in infants, children, and adults?
infant: face primarily along with arms and legs
children: large joints and moving off of face
adult: large joints
44
What is characteristic of the skin lesion that present in erythema multiform?
targetoid appearance (red macule with pale eroded center)
45
What is the difference between erythema multiform and erythema migrans?
erythema migrans has a red center with a white ring followed by a red ring (bull's eye in appearance)
46
Erythema multiform can mimic what other skin condition?
ringworm
47
What type of hypersensitivity is erythema multiform?
type IV
48
What does erythema multiform attack?
the junction of the epidermis and dermis
49
Which form of erythema multiform is more mild and is post infection?
erythema multiform minor
50
Which form of erythema multiform is aggressive and drug-related?
erythema multiform major
51
What are characteristics of erythema multiforom major?
sloughing of epidermis, fluid loss, infection
52
What are the two kinds of erythema multiform major?
Stevens-Johnson syndrome (<30% epidermal sloughing)
| Toxic Epidermal Necrolysis ( equal or >30% epidermal sloughing) - risk for hypovolemic shock
53
Which form of acne is more common?
acne vulgaris
54
Which form of acne is more severe?
cystic acne
55
What are the two presentations of acne vulgaris?
pustule (whitehead)
| comedones (blackhead)
56
What are the two factors that contribute to the cause of acne?
genetics (sebum) and propionibacterium acnes (most common bacteria)
57
When does acne most commonly occur in males?
adolescence
58
When does acne most commonly occur in females?
adulthood
59
What is characteristic of cystic acne?
larger skin lesions filled with pus/edema, pronounced inflammation, and likely to produce scarring
60
Where is baby acne most commonly seen?
cheeks, nose, and forehead
61
When is baby acne most common?
around 2 months
62
What causes baby acne?
idiopathic, possibly from hormonal fluctuations
63
What is a characteristic sign of baby acne?
milium
64
What is milium?
keratin-filled cysts (white)
65
What are the kinds of chronic inflammatory dermatoses?
psoriasis
lichen planus
lichen simplex chronicus
66
What immunological response is involved with psoriasis?
CD8+ T cells
67
What macroscopic terms is associated with psoriasis?
scale
| plaque
68
What autoimmune skin condition deals with epidermal hyperplasia?
psoriasis
69
What is the characteristic sign of psoriasis?
well demarcated lesions with pink-to-salmon color plaques covered by a flaky silver-white scale
70
Where is psoriasis commonly located?
elbows, knees, scalp, lumbosacral region, glans penis, intergluteal cleft
71
What are the treatments for psoriasis?
methotrexate, cyclosporine, and phototherapy (UVB)
72
What does UVB do to help psoriasis?
slows the growth of hyperplasia
73
What are the possible characteristic signs of psoriasis?
Auspitz sign
Koebner phenomenon
oncholysis
74
What is Auspitz sign?
microbleeds from flaking and scratching
75
What is Koebner phenomenon?
plaque formation on site of prior trauma 1-2 weeks after skin injury (from pressure)
76
What is oncholysis?
detachment of nail (seen in roughly 1/3 of psoriasis patients)
77
In what percentage of patients does psoriatic arthritis occur?
5-30%
78
What deformity is seen in patients with psoriatic arthritis?
pencil in cup deformity
79
Which is more common in patients with psoriasis:
| psoriatic arthritis or dactylitis?
dactylitis (occurs in about 35% of psoriasis patients)
80
Where is the pencil in cup deformity usually found?
common in DIP and PIP joints
81
What is dactylitis?
combination from inflammation of joints and surrounding tissues
(also commonly referred to as sausage digits)
82
What autoimmune skin condition has T cells at the dermoepidermal junction?
lichen planus
83
What are the risks of causing/contributing to lichen planus?
various meds, dyes, arsenic, HCV infection, and other conditions
84
What age range does lichen planus usually effect?
middle-aged adults
85
What pattern of distribution is most commonly seen with lichen planus?
symmetrical on extremities
86
What are the 6 P's for lichen planus?
```
pruritic (itchy)
purple
polygonal
planar
papules
plaque (can become scaly when chronic)
```
87
What is a characteristic sign of lichen planus?
Wichkam's striae
88
What is Wickham's striae?
white reticular changes most commonly (70%) seen in oral mucosa
89
What causes lichen simplex chronicus?
chronic rubbing and scratching (occupational, OCD, anxiety/depression)
90
What is involved with lichen simplex chronicus?
epidermal hyperplasia and dermal scarring
91
What is acanthosis nigricans?
asymptomatic hyperpigmentation of skin
92
What is the appearance of acanthosis nigricans?
dark and velvety appearance
93
Where acanthosis nigricans typically found?
body folds/creases, axillae, groin, neck
94
What are possible risks for acanthosis nigricans?
diabetes, obesity, genetics, and cancer (possible paraneoplastic syndrome)
95
What are the three types of infectious dermatoses?
bacterial, fungal, and viral infections
96
What is the most common bacteria to cause impetigo?
staph. aureus
97
What is the appearance of impetigo?
red rash with "honey-colored crust"
98
Who does impetigo most commonly affect?
children, adolescent athletes
99
True or False
| Impetigo is itchy and non-painful.
True
100
What is a dermal abscess?
deeper skin infection (puncture wound or burn injury)
101
What is the bacteria that causes dermal abscesses?
Psuedomonas aeruginosa
