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Disease and Defense > Derm Review > Flashcards

Derm Review Flashcards

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1
Q

Fitzpatrick skin types

A 
I- Never tans, always burns
II - Tans with difficulty, usually burns
III - average tanning sometimes burns
IV - easily tans, rarely burns
V - very easy to tan, rarely burns
VI - never burns
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2
Q

Skin pigmentation is due to…

A

Type of melanin produced

Distribution of melanosomes

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3
Q

Dark skin (2)

A

melanosomes larger and distributed individually throughout the cytoplasm of the keratinocyte

Eumelanin (black to brown pigment)

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4
Q

Light skin (2)

A

melanosomes smaller and distributed in clusters above the nucleus in the keratinocyte

-Pheomelanin (yellow to red-brown pigment)

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5
Q

Vitiligo (3)

A
  • Acquired depigmentation
  • complete absence of melanocytes
  • seen in periorifical and acral locations
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6
Q

Hemidesmosomes attach ______ to ______

A

epidermis to dermis (basal cells to basal lamina of dermal-epidermal junction)

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7
Q

Desmosomes attachments between _____ within _______

A

keratinocytes

within the stratum spinosum

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8
Q

Congenital disease of the hemidesmosomes

A

epidermolysis bullosa (EB)

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9
Q

Dystrophic epidermolysis bullosa (EB)

A
  • No collagen 7
  • problem with hemidesmosomes

-extensive dystrophic scarring causing deformity

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10
Q

Acquired problem of hemidesmosomes

A

Bullous Pemphigoid

-antibodies to hemidesmosomes

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11
Q

Epidermolysis bullosa simplex

A

defect in keratin 5 and 14

  • generalized blisters after birth
  • intraepidermal (not as severe scarring as recessive dystrophic variant)
  • Occurs less as patients age
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12
Q

Acquired disease of the desmosomes

A

Pemphigus Vulgaris

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13
Q

Pemphigus Vulgaris

A
  • skin lesions are flaccid bulla
  • abs to desmoglein
  • intraepidermal blisters
  • blisters on skin and oral mucosa
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14
Q

______ and ________ both are due to defects in filaggrin that cause a defect in the skin barrier function

A

Icthyosis Vulgaris and Atopic Dermatitis

skin is always dry

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15
Q

Ichthyosis Vulgaris appears as

A

plate like scales

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16
Q

Papillary dermis

A
  • upper layer
  • thin collagen bundles
  • interlocks with epidermal rete
  • increases strength and surface area
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17
Q

Reticular dermis

A
  • deeper layer
  • thick collagen bundles
  • visible elastic fibers
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18
Q

3 major constituents of the dermis and their functions

A

1) Collagen - forms the tensile strength
2) Elastic fibers - allow for resilience
3) Ground substance - facilitates diffusion

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19
Q

Acquired disorder of elastin

A

Solar elastosis

damaged elastic fibers from UV light

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20
Q

Congenital disorder of elastin

A

Pseudoxanthoma Elasticum

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21
Q

Acquired blistering disorder of DEJ

A

Bullous pemphigoid

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22
Q

Congenital blistering disorder of DEJ

A

Epidermolysis bullosa

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23
Q

What nail finding is associated with HIV and what is it caused by

A

proximal subungual white onychomycosis (basically white nail on the proximal half)

-caused by trichophyto rubrum

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24
Q

alopecia areata

A

autoimmune against hair follicles

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25
Hair growth cycle
1) Anagen (growing hair) 2) Catagen (involuting hair) 3) Telogen (resting hair)
26
Anagen Effluvium
loss of growing hairs (e.g. chemo)
27
Telogen Effluvium
hairs go into resting cycle
28
Dermatitis is the same thing as _________
Eczema
29
Atopic dermatitis located where? Associated with what diseases? defect where?
Due to defect in Filaggrin Associated with asthma and allergic rhinitis On flexor surfaces (skin folds)
30
Seborrheic Dermatitis caused by? symptom? location?
Malassezia furfur Dandruff (psoriasis has a thicker more silver scale) On scalp (aka cradle cap)
31
Psoriasis appearance/symptom location associated diseases
Silver scale, itchy Extensor surfaces Associated with increased risk of CV disease and arthritis
32
Irritant Dermatitis (e.g. intertrigo) is caused by __________
common irritants (fragrance)
33
Stasis Dermatitis
LE edema | On Lower legs
34
Allergic contact dermatitis caused by? what kind of hypersensitivity reaction? how do you diagnose it?
Common allergens Delayed Type IV Hypersensitivity Reaction Diagnosis confirmed with patch testing
35
Type I hypersensitivity reactions
- anaphylactic reactions - IgE ab to specific antigen → histamine release → vasodilation, smooth muscle contraction EX) Urticaria and angioedema (peanut allergy, bee venom)
36
Type IV hypersensitivity reaction
Langerhans cells (APCs) present antigen → make memory T cells that are sensitized to locally deposited antigens Local reaction occurs - does NOT involve antibodies EX) Morbilliform Drug Eruptions, Allergic contact dermatiti
37
Impetigo is typically caused by ______ while erysipelas is usually caused by ______
staph strep
38
Impetigo appearance
honey colored crust, slightly bullous, localized spot
39
Erysipelas appearance
spreading erythema across face, warm, tender, cliff-drop border
40
Tinea Versicolor
Hyper or hypopigmented patches Typically on chest Warm, humid environment Yeast (Malassezia furfur) Short hyphae and spores (spaghetti and meatballs)
41
Scabies
In between fingers | Infestation of the skin
42
Seborrheic Keratosis
“Barnacles of life” Benign skin tumor Clonal proliferation of keratinocytes
43
Intradermal Nevus
in dermis (skin colored), broad base
44
Junctional Nevus
just in DEJ, flat, pigmented
45
Compound nevus
melanocytes in dermis and DEJ
46
Skin Defenses against UV radiation
DNA repair Apoptosis of Cells with DNA damage Defenses against ROS Melanin
47
Actinic Keratosis is a precursoe to _______ derived from a ________
SCC, keratinocyte
48
UVA causes...
dark patches, wrinkles, loose skin, premature aging, DNA damage, melanoma, non-melanoma
49
UVA penetrates ______ due to its ______ wavelength
Penetrates into dermis → damages collagen fibers | Longer wavelength
50
UVB penetrates ______ due to its ______ wavelength
Only penetrates epidermis | Shorter wavelength
51
UVB causes...
sunburn, eye problems, DNA damage, melanoma, non-melanoma
52
UVR effects on the skin (6)
Damage to DNA, RNA, lipids and proteins Pro-inflammatory effects Immunosuppressive effects Induction of innate defenses Induction of apoptosis Vitamin D synthesis
53
Photodermatoses (3)
1) Lupus Erythematosus 2) Dermatomyositis 3) Mixed connective tissue disease (MCTD)
54
Dermatomyositis appearance and presentation
Photodistributed Scalp, periocular and extensor skin sites Periorbital edema, eruption on upper eyelids (heliotrope)
55
Samitz sign
ragged cuticles associated with dermatomyositis
56
Gottron's papules
associated with dermatomyositis on hands, knuckles, elbows, knees, diffuse red papules
57
Gottron's sign
poikiloderma over the knuckles, elbows, knees associated with dermatomyositis
58
Shawl sign
associated with dermatomyositis poikiloderma across back and shoulders
59
Adult onset of dermatomyositis can be associated with...
internal malignancy in patients with DM
60
Neurofibromatosis signs include (5)
Cafe-au-lait Axillary freckling Optic Glioma and Lisch nodules (eyes) Neurofibromas
61
Tuberous Sclerosis signs (3) systemic associations?
genetic disorder Adenoma sebaceum on the face (kinda looks like bad acne) Hypomelanotic macules (on back) Shagreen patch (big red bump) Can involve heart, kidneys (renal cysts)
62
Kaposi's Sarcoma is associated with _____
HIV
63
Pyoderma Gangrenosum
cut doesn’t heal, ulcerates DO NOT debride, AVOID surgery - trauma induces it Oral/topical anti-inflammatory agents preferred
64
Pyoderma Gangrenosum Indicative of what underlying diseases?
IBD Arthritis Monoclonal gammopathy Other hematologic disorders (myelogenous leukemia, myelofibrosis)
65
Lichen Planus appearance associated disease
higher incidence of HepC Purple, polygonal, pruritic papules Wickham’s striae (overlying lace-like white line pattern on surface)
66
Acanthosis Nigricans
Velvety hyperpigmentation of intertriginous surfaces Common in obese patients Stimulates epidermal keratinocytes and dermal fibroblasts to proliferate → skin thickening and looks darker
67
Acanthosis Nigricans associated with what diseases? (5)
Obesity, insulin insensitivity (DM) Endocrinopathies Drugs Internal malignancy - IF they are losing weight Adenocarcinoma of stomach

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