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Flashcards in Derm Deck (51)
1

Acanthosis nigrans

Thickened hyperpigmented zones of skin with a velvet like area usually involving the flexuaral areas( axilia, skin folds of neck, groin,etc)
Benign 80%- ad trait with variable penetrance, associated with obesity and endocrine issues, congenital syndrome; usually appear in childhood or during puberty
Malignant- older adults associated with gastrointestinal adenocarcinoma

2

Acanthosis

Hyperplasia of the stratum spinosum

3

Seborrheic keratosis

Middle aged older adults
Coin like plaques tan to dark brown (vary in size)
Horn like cysts on histo (whorls of keratin)
Leser-trelat sign- large numbers of plaques associated with paraneoolastic syndromes / GI carcinoid

4

Progression of dermatitis

acute (weeping erethymatous rash/spongiosis)--> subactute (crusting over of rash scaling and hyperkeratosis) --> chronic (lichenification from itching, scaling, hyperpigmentation)

5

Atopic dermatitis

Type 1 IgE mediated hypersentivity
Face in kids, flexor surface (antecubital and popliteal fossa) in adults

6

Contact dermatitis

Type IV T cell mediated
Metals (nickle), plants (poison ivy), and chemicals (household cleaners, meds)

7

MC type of contact dermatitis

irritant contact
non immunological rxn; toxic effect of chemical on local skin

8

Girl playing soccer develops rash on legs, face, and arms, what drug is she on and what is this?

contact photodermatitis
Tetracycline (sulfa, thiazides)

9

Ring shaped patches of allopecia on scalp with erythema and scaling

Tinea capitus MC in children
1.) Trichophyton tonsurans
2.) Micosporum canis (Woodlamp + )

10

MC cause of tinea

Trichophyton rubrum

11

MCC diaper rash and onccyomycosis

candida albicans

12

High fever, metal confusion, diarrhea, hypotension, erythematous rash associated with a drug rxn

TSS nafcillin

13

What does actinic keratosis progress to?

Squamous cell carcinoma

14

What is actinic keratosis associated with?

sun (UVB) damage, arsenic

15

Where is psorasis most commonly found?

Scalp and pressure areas like the elbow

16

Development of a rash at areas of trauma

Koebner phenomenon, psoriasis

17

Munro microabcesses

collection of neutrophils in the stratum corneum (associated with psoriasis)

18

Single oval shaped scaly pink patch on trunk that develps into papules on the back that follow line of cleavage

pityriasis rosea
herald patch followed by christmas tree distribution

19

When is psoriasis associated with a destructive arthritis ?

If patient is HLA B27

20

What population do you see scalded skin syndrome in?

neonates
granulosum layer
no scarring

21

Atopic triad

atopic dermatitis
allergic rhinitis
asthma

22

What type of hypersensitivity rxn is pemphigus vulgaris ?

Type II, IgG to desmoglian

23

What do the basal cells look like on histology in pemphigus vulgaris?

tombstones

24

What does the dermal epidermal junction look like in lichen planus?

Sawtooth from lymphocytic infiltrate

25

dermatitis hepatiformis is what type of hypersensitivity rxn?

Type III, IgA and gluten deposition at tips of dermal papilae

26

What type of antibodies are present in dermatitis hepatiformis?

anti-reticulin antibodies

27

What is erythema multiforme called when it involves 2 or more mucous membranes?

SJS

28

How do you get erythema multiforme?

1. Disease (mycoplasma, HSV)
2. Drugs (sulfa, beta lactams, phenytoin)
3. Autoimmune (lupus, preg)
4. Cancer

29

Pathogenesis of acne

Increased keratin of follicular epithelium--> increased sebum production--> propionobacterium acnes / bacterial lipase, cleaves FA and creates further inflammation
most common in adolescents

30

acne roseacea

inflammatory disease of pilocebateous unit of middle aged people
Can be brought on be heat and alcohol
can evolve into rhinophyma

31

How does cellulitis spread?

can cause lymphangiitis by elaboration of hylauronidases that let the s. pyogenes infection spread through the subcutaneous tissue

32

What type of lesion does SLE produce?

skin lesions associated with epidermal atrophy

33

Pathogenesis of SLE

antibodies to epidermal basement membrane or antiDNA antibody anitigen deposition in basement membrane --> degeneration of basal layer at dermal epidermal junction-->lymphoid infiltrate and atrophic epidermis

34

Grenz zone

narrow zone beneath the epidermis in leprotamous leprosy that is free of bacteria , under the grenz zone are fomay macrophages with organisms

35

MCC of inflammation in subcutaneous fat

erythema nodosum

36

MC malignant tumor of the skin

basal cell carcinoma

37

Do basal cell carcinomas metastisize?

No

38

Pearl colored nodule with prominent vascular channels under the surface

basal cell carcinoma

39

MC cancer associated with immumosuppresive therapy

squamous cell carcinoma

40

ulcer at orifice of chronically draining sinus that does not improve with antibiotics

squamous cell carcinoma

41

What is SCC associated with?

XP, immunosuppression, arsenic posioning, sun damage

42

What is a phenotypic marker for underlying adenocarcinoma of the stomach

acanthosis nigrans

43

are freckles pre-malignant?

no

44

flat hyperpigemented lesion of forehead and cheeks in women

pregnancy mask (or OCP use)
melasma/chloasma

45

MC nevi in adults

intradermal nevus
raised papule , pigmented cells only in dermis

46

nevi all over the body

dysplastic nevus syndrome
precursor to maligancy

47

MC type of melanoma

Superficial spreading
mostly women over 50, lower extremities and back MC sites,

48

Malignancy on sun exposed face of elderly people

lentigo maligna

49

MC type of melanoma in blacks

acral lentigenous melanoma
palms, soles, and subungal (don't confuse hematoma)

50

Best system of staging for melanoma

Breslow system
Measured depth
less than 0.76 mm no metastatic potential
greater than 1.7 can metastisize to LNs

51

Hyperpigmented spots on the skin that when scratched become intensely puritic and red

urticaria pigmentosa
pressure causes mast cells to release histamine which sets up a urticarial rxn