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Flashcards in derm Deck (48):
1

xanthoma

associated with hyperlipidemia or lymphoproliferative malignancies; associated with lipid-laden histiocytes in the dermis

2

cherry/senile hemangioma

small, bright-red papular lesions in 3rd/4th decade; do not regress spontaneously and are always cutaneous

3

strawberry hemangioma

appear in infants; regress spontaneously by 5-8 years of age; bright red near epidermis, more violaceous if deeper

4

cavernous hemangiomas

dilated vascular spaces with thin-walled endothelial cells in the dermis; appear on skin, mucosa, viscera; if on brain/viscera, consider VHL

5

cystic hygromas

lymphatic cysts lined by a thin endothelium; present at birth along neck and lateral chest wall; found in turner/t21 syndrome

6

xerderma pigmentosum

AR mutation that impaires DNA excision repair following UV dmg; pw erythema, scaling, and subsequent hyperpigmentation and lentigo formation in light-exposed areas; skin malignancies develop at 5-6 years of life

7

fanconi anemia

AR, hypersensitivity to DNA cross-linking agents

8

male patten baldness pw, moa, rx

anterior/vertex balding; scalp 5-alpha reducetase activity and the androgenic effects of DHT; finasteride

9

PKU pw, genetics

mental retardation, eczema, mousy body order; AR mutation of phenylalanine hydroxylase

10

PABA-ester sun screen

UVB radiation (290-320) absorbers

11

acanthosis

increase in thickness of stratum spinosum (seen in psoriasis)

12

dyskeratosis

abnormal, premature keratinization of keratinocytes; strongly eosinophilic (seen in SCC)

13

hyperparakeratosis

retention of nuclei in the stratum corneum, incomplete keratinization (normal in mucosa, but abnormal in skin - actinic keratosis)

14

hyergranulosis

excess granulation in the stratum granulosom of the epidermis (seen in lichen planus)

15

spongiosis

intercellular epidermal edema that appears as an increase in the width of spaces between cells; primary histological finding in pt with eczematous dermatitis

16

RBC extravasation into skin/subQ tissues results in formation of what?

petechiae (1 cm); do not blanch as capillaries are not patent

17

thymidine kinase-deficient VCV means? how to treat?

acyclovir-resistent VCV in AIDS pt; rx with foscarnet (pyrophosphate analog viral DNA polymerase inhibitor) or cidofovir (antiviral nucleotide analogue of cytidine monophosphate, does not require viral kinase)

18

marjolin's ulcer

aggressive, ulcerating SCC on area of previous trauma, chronically inflammed or scarred skin

19

isotretinoin moa, SE

inhibits follicular epidermal keratinzation, loosening keratin plugs of comedones; hypertriglyceridemia and teratogenicity

20

stewart-treves syndrome

chronic lymphedema (2/2 axillar LN dissection) predisposes to angiosarcoma

21

lichen planus pw (5 Ps)

polygonal, planar, pruritic, purplish plaques; a.w. hep C

22

xanthelesma pw, histo, a.w.

yellow cutaneous lesion on eyelid; lipid-laden macrophages in superficial dermis; cholestatic processes like obstructive biliary lesions or PBC

23

vitiligo histo

loss of melanocytes, complete absence of melanin pigment

24

albinism histo

melanocytes that do not produce melanin (because of absent/defective tyrosinase)

25

pemphigus vulgaris pw, moa

painful, flaccid bullae and erosions ofskin/mucosal membranes; autoantibodies against desmoglein

26

chronic steroid administration to skin results in:

atrophy/thinning of dermis, a.w. loss of dermal collagen, dring/cracking/tightening, telangiectasias, ecchymosis

27

atopic eczematous dermatitis: histo

intraepidermal vesicles, superficial epidermal hyperkeratosis producing scales, epidermal hyperplasia (acanthosis), chronic inflammatory infiltrate

28

actinic keratosis

erythematous papules with central scale/rought "sandpaper-like" texture; premaligmant (SCC)

29

acantholysis

loss of intercellular connections

30

pemphigus vulgaris

acantholysis forming suprabasal blisters, IgG deposits in reticular pattern around keratinocytes

31

dermatitis herpetiformis: light microscopy

accumulation of PMN on the tips of dermal papillae

32

HPV: light microscopy

cytoplasmic vacuoles in keratinocytes (koilocytosis) and hyperplasia of the epidermis

33

molluscum contagiosum

eosinophilic cytoplasmic inclusions in infected cells

34

androgenetic alopecia inheritance pattern

polygenic with variable penetrance; pattern/severity varies b/w males and females depending on circulating androgen levels

35

dermatitis herpetiformis pw, moa, histo

herpes-like lesion (erythematous, pruritic papules, vesicles, bullae that appear bilaterally and symmetrically on extensor surfaces); IgA antibodies agianst gliadin (wheat protein) that cross-reacts with reticulin, a protein in the epidermal BM; microabscessess containing fibrin and PMN in dermal papillae tips

36

leprosy: tuberculoid vs lepromatous

tuberculoid: positive lepromin skin test, strong TH1 cell-mediate response (IL-2, IFN-gamma, IL-12), macrophages kill organisms and lead to smal number of hypopigmented, well-demarcated plques with decreased sensation; lepromatous: negative lepromin test, Th2 response (IL4, IL-5, IL-10), pw more numerous polry demarcated plaques widespread throughout body)

37

glomus tumor

glomus body: small, encapsulated neurovascular organs surrounded by smooth muscle found in the dermis of the nail beed, pad of finger/toes/ears; role is to shunt/direct blood depending on tempreature to maintain temperature

38

psoriasis moa, histo

CD4/CD8 T cells activate in epidermis result in production of cytokines (TNF, IL-12, IFN-gamma) and keratinocyte growth factors that stimulate keratinocyte proliferation, inflammation,and angiogenesis; histo: hyperparakeratosis, acanthosis, elogation of the rete ridges, reduced/absent stratum granulosum, thinned epidermal cell layer superior to dermal papilla (pinpoint bleeding= Auspitz sign), PMN form spongiotic clusters in the superficial dermis and parakeratotic stratum corneum

39

hyperkeratosis

hyperplasia of the stratum corneum

40

parakeratosis

retained nuclei in the stratum corneum

41

Does AK invade the dermis?

no; but can evolve into SCC

42

brain metastasis: most common cancers

lung cancer, renal cancer, and melanoma

43

apocrine sweat gland causes what lovely finding?

malodorous secondary to bacterial decomposition at the skin surface; present in dermis, subQ fat of breast, axillae, genital regions

44

eccrine/merocrine glands

present in the skin throughout body, except lips/penis; secrete watery fluid rich in salt

45

psoriasis rx

topical vitamin D analogs (calcipotriene) that bind to vita D receptor, a nuclear transcription factor that inhibit keratinocyte proliferaiton and stimulate keratinocyte differentiation

46

melanoma mutation

BRAF is a protein kinase involved in activation of signaling pathway for melanocyte proliferation (BRAF V600E mutation is seen in 40-60% percent of melanoma)

47

urticaria moa

antigen-induced degranulation of focal mast cells throgh IgE antibody sensitation; OR, IgE-independent urticaria develops after exposure to substances that directly stimulate mast cell degranulation (opiates, antibiotics, contrast)

48

breast cancer: skin retraction moa

cancer infiltrates suspensory cooper ligaments