DERM - Vesicular lesions of the skin Flashcards Preview

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

Flashcards in DERM - Vesicular lesions of the skin Deck (59):
1

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

- corneum
- granulosum
- spinosum
- basal
- basement membrane

2

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

- BPAG1
- BPAG2

3

loss of what proteins leads to a subepidermal blister?

- BPAG1
- BPAG2

4

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

subepidermal blister

5

blisters can be in what layers?

- subcorneal
- intraepidermal
- subepidermal

6

bullous pemphigoid consists of blisters in what layer?

subepidermal

7

what are the cell poor blisters?

- porphyria cutanea tarda
- electrical / thermal burns
- toxic epidermal necrolysis

8

what are the blisters with inflammation?

- bullous pemphigoid
- dermatitis herpetiformis
- linear IgA dermatosis
- bullous lupus erythematosus
- bullous drug eruption

9

friction blisters occur in what layer?

suprabasal

10

pemphigus vulgaris and vegetans occur in what layer?

suprabasal

11

herpes simplex and zoster blisters occur in what layer?

suprabasal

12

SSSS occurs in what layer?

subcorneal

13

impetigo occurs in what layer?

subcorneal

14

pemphigus foliaceous occurs in what layer?

subcorneal

15

direct IF consists of Abs against patient's _______________ skin

perilesional

16

what is the pathogenesis of bullous pemphigoid?****

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

17

bullous pemphigoid is a disorder exclusively of the _________

elderly (60-80 and over)

18

what is the clinical picture for bullous pemphigoid?

- 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****

19

where is bullous pemphigoid NOT found?

mucosal surfaces

20

what is the term for edema between squamous cells?

spongiosus

21

subepidermal blister with eosinophils - diagnosis****

bullous pemphigoid

22

what is the IF for bullous pemphigoid?

linear deposition of IgG and C3 along BM

23

linear deposition of IgG and C3 along BM - diagnosis

bullous pemphigoid

24

what is the treatment for BP?

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