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Year 2 Specialty Medicine > DERM - Vesicular lesions of the skin > Flashcards

DERM - Vesicular lesions of the skin Flashcards

(59 cards)

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1
Q

top to bottom, what are the layers of the skin?

A
  • corneum
  • granulosum
  • spinosum
  • basal
  • basement membrane
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2
Q

the basement membrane is held onto the epidermis by what proteins?

A
  • BPAG1

- BPAG2

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3
Q

loss of what proteins leads to a subepidermal blister?

A
  • BPAG1

- BPAG2

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4
Q

loss of BPAG1 and BPAG2 lead to what type of lesion?

A

subepidermal blister

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5
Q

blisters can be in what layers?

A
  • subcorneal
  • intraepidermal
  • subepidermal
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6
Q

bullous pemphigoid consists of blisters in what layer?

A

subepidermal

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7
Q

what are the cell poor blisters?

A
  • porphyria cutanea tarda
  • electrical / thermal burns
  • toxic epidermal necrolysis
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8
Q

what are the blisters with inflammation?

A
  • bullous pemphigoid
  • dermatitis herpetiformis
  • linear IgA dermatosis
  • bullous lupus erythematosus
  • bullous drug eruption
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9
Q

friction blisters occur in what layer?

A

suprabasal

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10
Q

pemphigus vulgaris and vegetans occur in what layer?

A

suprabasal

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11
Q

herpes simplex and zoster blisters occur in what layer?

A

suprabasal

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12
Q

SSSS occurs in what layer?

A

subcorneal

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13
Q

impetigo occurs in what layer?

A

subcorneal

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14
Q

pemphigus foliaceous occurs in what layer?

A

subcorneal

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15
Q

direct IF consists of Abs against patient’s _______________ skin

A

perilesional

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16
Q

what is the pathogenesis of bullous pemphigoid?**

A

autoantibody against bullous pemphigoid antigens BP180 and BP230 (attach dermis to epidermis)

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17
Q

bullous pemphigoid is a disorder exclusively of the _________

A

elderly (60-80 and over)

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18
Q

what is the clinical picture for bullous pemphigoid?

A
  • prodromal eruption (urticarial / papular lesions)
  • evolves over weeks / months to a generalized bullous eruption
  • moderate to severe pruritis
  • tense bullae arise in normal or erythematous skin**
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19
Q

where is bullous pemphigoid NOT found?

A

mucosal surfaces

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20
Q

what is the term for edema between squamous cells?

A

spongiosus

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21
Q

subepidermal blister with eosinophils - diagnosis**

A

bullous pemphigoid

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22
Q

what is the IF for bullous pemphigoid?

A

linear deposition of IgG and C3 along BM

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23
Q

linear deposition of IgG and C3 along BM - diagnosis

A

bullous pemphigoid

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24
Q

what is the treatment for BP?

Study These Flashcards
A

SYSTEMIC steroids (not topical) or other immunosuppressants

25
what is cicatricial pemphigoid? how is it treated?
- disease of elderly - affects mucosal surfaces - chronic and recurring - scarring - immunosuppressives
26
intensely pruritis dermatosis of pregnancy?
pemphigoid gestationis
27
does pruritis dermatosis of pregnancy spare the umbilicus, or involve it?
involves it
28
what are the features of dematitis herpetiformis?
- papules, vesicles, occasional bullae on erythematous or often urticarial base - extensor involvement (elbows and knees) - associated with celiac disease
29
a patient with celiac disease presents with papules / vesicles on an erythematous / urticarial base on extensor surfaces - diagnosis?****
dermatitis herpetiformis
30
what is the pathogenesis of dermatitis herpetiformis?
antibodies to tissue transglutaminase (TTG): deposit in skin to activate complement with subsequent chemotaxis of neutrophils
31
what serum marker is used to monitor dermatitis herpetiformis?
TTG
32
what is seen on IF in DH?
granular IgA deposition in dermal papillae** (clusters)
33
granular IgA deposition in dermal papillae - diagnosis?
DH
34
grouped vesicles in "cluster of jewels" appearance - diagnosis?
linear IgA bullous dermatosis (LABD)
35
granular IgA deposition along BM** - diagnosis?
LABD
36
PCT is due to decreased activity of what enzyme?
- uroporphyrinogen decarboxylase
37
what builds up in PCT?
- uroporphyrins | - coproporphyrins
38
sporadic PCT is associated with what disease?
Hep C
39
- blisters on light exposed skin particularly hands - tense bullae on normal appearing background diagnosis?
PCT
40
what is the histology of PCT?
cell poor subepidermal blister (non-inflammatory)
41
histology shows cell poor subepidermal blister - diagnosis?
PCT
42
what is the IF in PCT?
superficial blood vessels with circumferential IgG deposition
43
what is the pathogenesis of pemphigus vulgaris?****
formation of autoantibodies to the intercellular layers of the epidermis, leading to spontaneous blistering or fissures resulting from minor trauma
44
PV is more common in what demographic?
Jewish / mediterranean descent age 40-60
45
how does PV differ from BP?
- PV: numerous stages of blisters exists simultaneously - PV: oral mucosa involved - PV: can be fatal
46
antibodies in PV are directed against which proteins? what are their functions?
desmoglein 1 and 3 (form intercellular bridges between squamous cells)
47
where does PV usually start?
oral mucosa
48
what is the gross appearance of PV?
flaccid vesicles on normal skin that often erode and crust from easy rupturing
49
what is the IF appearance of PV?****
"chicken wire" of IgG or C3
50
IF: "chicken wire" of IgG or C3****
PV
51
impetigo is caused by what organisms?
- staph aureus | - strep pyogenes
52
the toxin responsible for SSSS and impetigo targets what protein? what is its function?
- desmoglein 1 | - cell to cell adhesion within uppermost epidermal layers
53
what is the inheritance of hailey hailey disease?
AD
54
hailey hailey disease involves a defect in _______ which leads to __________
- intercellular stores of calcium | - decreased cellular adhesion
55
where is hailey hailey disease seen?
felxural and intertriginous areas - axilla, groin, neck
56
what is the treatment for hailey hailey disease?
tetracycline
57
multiple discrete scaling papules in seborrheic distribution - diagnosis? what is the inheritance?
- darier's disease | - AD
58
darier's disease is due to a defect in _________ which leads to __________
- intercellular stores of calcium | - decreased cellular adhesion
59
presentation: - abrupt onset pruritic crops of lesions on trunk and proximal extremities - reddish small papules with vesicles and erosions
grover's disease

Year 2 Specialty Medicine (36 decks)

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