Derm Flashcards
Solar elastosis
1) etiology
2) presentation
1) accumulation of abnormal elastin in the dermis, which occurs as a result of the cumulative effects of prolonged and excessive sun exposure (photoaging)
2) extensive bruising + extensive wrinkling + scaly erythematous patches + irregularly shaped brown macules (hyper pigmentation or depigmentation)
Clark staging for melanoma
Level 1 : Melanoma confined to the epidermis (melanoma in situ)
Level 2 : Invasion into the papillary dermis
Level 3 : Invasion to the junction of the papillary and reticular dermis.
Level 4 : Invasion into the reticular dermis
Level 5 : Invasion into the subcutaneous fat.
*So SUBCUTANEOUS is worst prognosis.
Ocular albinism inheritance
x-linked recessive
albinism
o Code: Anna van Slyke: /absence of melanin production by skin melanocytes. Big tyro black dude in corner on a pile of rocks/most common form caused by deficiency of tyrosine hydroxylase or tirosinase (DOPA (tyrosinase) melanin) Tyrion standing on the counter/autosomal recessive. Tyro big black dude stuck in transporter in the desk + /other causes = defective tyrosine transporter + failed neural crest migration. /prone to developing sun-induced skin cancers, including squamous cell carcinomas, basal cell carcinoma, and melanomas. Locust on right of counter dressed as a hipster/example of locus heterogeneity.
o Location: Goeff’s hardware store across the street from UU church
organisms causing Athlete’s foot
o Code: tricyle on top of car + dandy lion on top of a microscope + ellie dressed as a gladiator in the front seat/3 fungi are responsible for the bulk of infections: trichophyton sp. + microsporum + epidermophyton.
o Location: Parked in YHS parking lot
Lentigo
Code: Lenny Pierce: his face looking like below/benign **melanocytic hyperplasia. /lowest risk of malignancy.
Location: Sitting on porch of Desiderio’s house
- scaly, irregular borders, grows bigger with time.
pathognomonic finding for molluscum
viral cytoplasmic inclusions in epidermal cells
Oral hairy leukoplakia T cell count
Hailing on Tim who’s doing lines off bones in road/associated with T cell count
Leukoplakia
o Code: Luke Pierce: mouthful of cigarettes and fishing/more common in smokers. white plaque on mouth/white plaque on oral mucosa for which a more specific diagnosis cannot be rendered (others like hairy are subtypes of leukoplakia). Big pile of carrots behind him/hyperkeratosis. Huge devil fishing next to him/high probability of progressing to oral cancer.
o Location: End of Cousin’s island bridge
Xeroderma pigmentosum
o Coded character: There’s a big spiral DNA in the room and Ivan is prying out playmobile castles with a huge crowbar/defect in nucleotide excision repair. Going endo on side wall into a nuclear bomb/UV-specific endonuclease deficiency. Everyone looks like zombies as below and sun is extremely intense in the room/this prevents repair of pyrimidine dimers because of ultraviolet light exposure. /patients experience recurrent lesions that rapidly progress to cancer. Tyrion is drilling too/autosomal recessive. /predisposes pts to squamous cell carcinoma + basal cell carcinoma + melanoma. His head is burnt red and peeling + looks like below/presentation = photosensitivity + poikiloderma + hyperpigmentation in sun-exposed areas.
o Location: DEMS lab room
endonuclease function
cleave phosphodiester bonds
Erythema multiforme
♣ Coded character: Erin Murray: Put it on Mike Outwin’s stomach + brother blacks + Bennett’s stomach + terry’s + on aloe cat/associated with mycoplasma pneumonia + HSV (most commonly) + drugs (sulfa drugs + penicillin + allopurinol + phenytoin) + cancer + autoimmune disease. Eryn on patio up against wall being attacked by T covered in ivy + T with long hair/autoimmune cell-mediated attack on epithelial cells by CD8+ and CD4+ lymphocytes. They all have targets on their stomachs/erythematous patches with pale + vesicular eroded centers known as “target lesions.” Below lesions all over erin murray’s palms and soles/can involve palms and soles. On her lips too/can be mucosal involvement in severe cases. Carrots attached to balloons all around her head/biopsy = apoptic keratinocytes + lymphocytic infiltrate.
♣ Location: Patio at uinta
drugs associated with Stevens-Johnson syndrome
associated with lamotrigine + phenytoin + ethosuximide + carbamazepine.
Rash associated with SJS
erythema multiforme
UVA and photo aging mechanism
Bunch of Al Qaeda storming room/UVA produces reactive oxygen species, which activate multiple inflammatory cell-surface receptors and nuclear transcription factors. Metal neo from matrix behind desk + miles is weaving bands of collagen fibrils/this leads to decreased collagen fibril production + upregulation of matrix metalloproteinases (including collagenases) that subsequently degrade type I and III collagen and elastin.
Photoaging histology
gradual thinning of the epidermis
photoaging sequela
Huge collagenous crosslinks all over wall/Increased cross linking of collagen
DLE presentation
thick, scaly, discoid plaques that erupt on unexposed skin and may result in scarring
Roseola
♣ Code: field covered in roses/roseola. Rosie Mcdonald holding an infant/usually under 2 yo. Infant is sweating profusely + having a seizure + macular rash like below/presentation = high fevers for a several days + seizures + diffuse macular rash. Brother black on a huge mound of hash + brother black with a hook arm/caused by HHV-6/HHV-7. Rosie Mcdonald is drooling tons of saliva onto the baby/transmitted by saliva. /also called exanthem subitum (exanthema = transient)
♣ Location: NYA lacross field
Other tumor marker for melanoma
HMB-45 (human melanoma black-45)
p16 gene product
cyclin-dependent kinase inhibitor 2A
Primary immunologic response to intracellular pathogens?
CD8+ + NK cells
c-JUN
Transcription factor.
24,25-dihydroxycholecalciferol
deactivated form of vitamin D. When you’re hypercalcemic, 24,25-dihydroxycholecalciferol will be increased.
