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derm2 Flashcards

1
Q

haematological findings of SLE?

A

haemolytic anemia
thrombocytopenia
leukopenia

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2
Q

antibodies in SLE?

A

ANA
anti-dsDNA
anti-Sm
anti-phospjolipid

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3
Q

derm fidnings in SLE?

A

photodistributed rash
chillblains
livedo reticularis
alopecia

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4
Q

how does SCLE present?

A

widespread photosensitive rash

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5
Q

baby has annular plaques. diagnosis? next tests?

A

neonatal lupus - Ro positive

do ecg as risk of heart block

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6
Q

pt presents with gottrons papule, heliotrope rash, ragged cuticles, and shawl sign. dx? antibody?

A

dermatomyositis

anti-Jo1

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7
Q

pt has dermatomyositis and interstitial lung disease - antibody? other symptoms?

A

anti-MDA5

digital ulcers/iscahemia

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8
Q

antibody associated with dermatomyositis and malignancy?

A

anti-p155

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9
Q

what levels are high with dermatomyositis?

A

CK

ALT

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10
Q

test done for IgA vasculitis?

A

biopsy for direct immunofluorence - perivascular IgA

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11
Q

patient has erythema nodosum and lupus pernio with a dry cough? likely diagnosis? histology?

A

sarcoidosis
LP = purplish rash on face
non-caseating epitheloid granulomas
exclude infection

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12
Q

DRESS diagnostic criteria?

A 
drug reaction with eosinophilia and systemic symptoms
fever ≥38.5
lymphadenopathy ≥2
hypereosinophilia
internal organs involvement
≥50↓ BSA erythema
facial odema
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13
Q

organ most commonly involved with DRESS?

A

liver

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14
Q

onset for DRESS?

A

2-6wks after drugs

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15
Q

name 4 drugs associated with DRESS?

A

ibuprofen
allopurinol
anti-epileptics
amoxicillin

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16
Q

first line tx for DRESS?

A

corticosteroids

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17
Q

pt recently had an allogenic stem cell transplant for AML and is presenting with erythematous rash covering ≥60↓ BSA and diarrhoea. they’ve also been put-on new drugs. Dx? other symptoms?

A

graft versus host disease
scleral icterus
diarrhoea and facial & acral rash make gvhd more likely than DRESS

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18
Q

pathogenesis of gvhd?

A

donor derived t lymphocyte activity against antigen sin inmmunocompromised recipient

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19
Q

causes of pruritus without a rash?

A 
lymphoma, polycythaemia
uraemia
cholestasis
iron excess/deficit
HIV
Hep ABC
cancer
drugs
psychogenic
old age
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20
Q

what can pruritus without a rash lead to?

A

nodular prurigo

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21
Q

pt presents with bleeding gums, corkscrew hairs and petechiae. Upon asking most of their meals are takeout. dx? other symptoms?

A

scurvy
spongy gingivae
follicular hyperkeratosis
perifollicular haemorrhage

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22
Q

pt presents with inflamed lips, desquamation of large areas of their skin and diarrhoea. upon examination they have. hepatomegaly. what are they deficient in? other symptoms?

A 
kwashiorkor - protein deficiency
cachexia
oedema
failure to thrive
cheilitis = inflammation of lips 
soft nails, dry hair
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23
Q

what triad is presenting zinc deficiency?

A

dermatitis, diarrhoea, depression

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24
Q

pt presents with ‘Casals necklace’ rash and painful fissures on their palms and soles. what are they deficient in? other sx?

A

vitamin b3 niacin
dermatitis, diarrhoea, dementia, death
photodistributed erythema
perianal, perioral and genital inflammation

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25
pathogenies of carcinoid syndrome and symptoms?
due to metastases of a malignant carcinoid tumour → serotonin secretion flushing, diarrhoea, bronchospasm, hypotension
26
symptoms of Stevens-Johnson syndrome/toxic epidermal necrolysis?
prodrome - flu like symptoms lesions on trunk ≥ limbs/face macule, blisters, erythema - targetoid blisters merge and detach in karge sheets
27
how to differentiate between SJS/TEN?
SJS | SJS/TEN | TEN BSA detachment ≤10 | 10-30 | ≥30 mortality ≤10| |≥30
28
causes of SJS?TEN?
abx - beta-lactams/sulphonamides allopurinol anti-epileptics nsaids
29
pathogenesis of SJS/TEN?
cell-mediated cytotoxic reaction against epidermal cells
30
3 ddx for SJS/TEN?
SSS thermal burns cutaneous gvhd
31
what can be used to assess severity of sjs/ten?
``` SCORTEN age≥40 epidermal attachment % serum urea glucose bicarb malignancy ```
32
complications of sjs/ten?
``` death blindness dehyrdration hypo/hyperthermia renal tubular necrosis liver and heart failure ```
33
pt has a rash covering more than 90↓ of their BSA. they have a hx of atopic eczema and have recently started some new meds. dx? other sx?
erythroderma cause - eczema, psoriasis, drugs, sezary syndrome edema, tachycardia, risk of sepsis, dehydration
34
how to treat erythroderma?
treat underlying cause restore fluids, electrolytes, circulation and body temp emollients ± steroids and abx
35
derm presentations of ckd?
``` anaemia → mucous pallor and hair thinning excoriations prurigo calciphylaxis half half nails xerosis - dryness ```
36
what derm disease can lead to ckd?
anca associated vasculitis / sle
37
derm presentations of cld?
``` excoriations prurigo muehrckes lines on nails terry's nails palmar erythema spider telangiectasia clubbing jaundice porphyria cutanea tarda ```
38
pt with DM presents with plaques that have a red-brown raised edge and a yellow brown centre. dx? tx?
necrobiosis lipoidica | topical /intralesional steroids
39
derm presentations of DM?
``` necrobiosis lipoidica Terrys nails xerosis granuloma annulare xanthelesma/xanthomata neuropathic ulcers acanthosis nigricans ```
40
2 common derm presentations in acromegaly?
cutis gyrata verticis | acne
41
derm presentations of hiv?
``` morbilliform rash uticaria pruritus erythema multiforme oral/genital ulceration ```
42
derm presentations of ibd?
``` pyoderma gangrenosum orofacial granulomatosis erythema nodosum (panniculitis) aphthous ulceration psoriasis/pemphigoid ```
43
derm presentations of celiac disease?
dermatitis herpetiformis
44
what is hidradenitis suppurativa?
inflamed nodes, sterile abcess, sinus tracts, fistula, hypertrophic scars affects axillary, anogenital & inframmary areas mostly
45
what diseases is pyoderma gangrenous associated with?
IBD leukeamia seronegative arthritis
46
skin diseases associated with malignancy?
dermatomyositis pyoderma gangrenosum erythema gyratum repens paraneoplastic pemphigus (urticaria, vasculitis, prurutis)
47
haemaorhagic docules can indicate what?
metastatic pancreatic carcinoma
48
mucosal melanosis can indicate what?
peutz-jegher syndrome
49
name 3 virulence factors that staph aureus has?
haemolysin leukocidin exfoliative toxin
50
virulence factors of strep pyogenes?
m protein → anti-phagocytic HA capsule erythrogenic exotoxins streptolysins S & O
51
what kind of folliculitis is assoicted w HIV?
eosinophilic
52
recurrent cases of folliculitis is assoicted with what? | tx?
nasal Staph aureus expressing panton-Valentin leukocidin abx - flucloxacillin and erythromycin furunculosis → incision and drainage
53
furuncle vs carbuncle?
furuncle = deep follicular abscess carbuncle = connected adjacent furuncles carbuncle more likely to lead to speticaemia and cellulitis
54
risk factors for developing recurrent furnucles or staphylococcal impetigo?
``` immune defijency : AIDS hypogammaglobulinaemia hyper IgE sybdrome DM ```
55
pathogenies of panton Valentin leukocidin staph aureus?
B pore forming exotoxin | leukocyte destruction and tissue necrosis
56
cutaneous and extracuytaneous signs of panton Valentin leukocidin staph aureus?
cutaneous: recurrent painful abscesses folliculitis cellulitis extra: necrotising pneumonia necrotising fasciitis purpura fulminan
57
risk factors for PVL staph aureus?
``` 5 Cs close contact contaminated items crowding (un)cleanliness cuts and grazes ```
58
PVL staph aureus management?
abx - tetracycline chlorhexiidne body wash nasal mupirocin ointment treat close contacts
59
skin condition associated with hot tubs, swimming pools etc?
pseudomonal folliculitis
60
symptoms and mx of pseudomonal folliculitis?
diffuse truncal eruption of follicular erythematous papule normally no tx severe/recvurrent → oral ciprofloxacin
61
commonest causes of cellulitis?
strep pyogenes | staph aureus
62
what is cellulitis
infection of lower debris and subcutaneous tissue | tender swelling ill defined blanching erythema
63
2 types of impetigo?
non-bullous - strep bulbous - staph → exfoliative toxins a&b → splint epidermis by targeting desmoglein 1
64
severe form of streptococcal impetigo?
ecthyma | punch out ulceration with erythema and thick crust
65
risk factor for SSSS?
neonates/infants | immunocompromised adults
66
pathogenesis of SSSS?
infection at distant site eg conjunctivitis → exfoliative toxin → cannot be removed quickly enough by kidneys → diffuse tender erythema → flaccid bullae → wrinkling and exfoliate → oozing erythematous base
67
what organism causes TSS?
group a staph aureus → pyrogenic exotoxin TSST-1
68
symptoms of TSS?
``` fever hypotension diffuse erythema thrombocytopenia desquamation post erythema gI muscular CNS renal hepatic involvement ```
69
pt has well demarcated brown scaly patches in their intertriginous areas. dx?
erythrasma | (corynebacterium)
70
pt has pitted erosions on their soles. dx? cause? mx?
pitted keratosis corynebacterium clindamycin
71
pt presents with a red swollen hand that has slowly been spreading. he is a fishmonger. dx?
erysipeloid | rf = raw contaminated fish and meat
72
pt presents with a painless necrotic ulcer on his finger. it looks swollen. he is a sheep farmer. dx? what would you find on lymph node exam?
anthrax (bacillus anthracis) | regional lymphadenopathy and pain
73
child presents with a tender superificla bullae on the volar fat pad of their finger. dx? causes?
blistering distal dactylitis | strep pyogenes / staph aureus
74
erysipelas causes? signs and symptoms? mx?
infection of deep dermis and subcutis b haemolytic streptococci / staph aureus prodrome - malaise fever headache erythematous indurated plaque w cliff drop edge ± blistering red streak on face/ limbs → lymphangitis find portal of entry IV abx
75
scarlet fever causes? prodrome? skin sx?
URTI - erythoegnic toxin strep pyogenes sore throat, headache, fever malaise, anorexia blanching tiny pink spots on chest neck axillae → whole. body → sandpaper like texture
76
complications of scarlet fever?
``` otitis sinusitis pneemonia myocarditis heaptitis meningitis rheumatic fevre glomerulonephritis ```
77
presentation of necrotising fasciits? mx?
dusky induration → rapid painful necrosis of skin connective tissue and muscle broad spectrum parenteral abx and surgical debridement ±mri
78
necrotising fasciitis of the scortum?
fournies gangrene
79
initial presentation of Lyme disease? other name? progression?
``` borreliosis erythema migrans → annular erythema multiple smaller secondary lesions neuroborreliosis → facial palsy, aseptic meningitis arthritis carditis ```
80
what's required for diagnosis of borreliosis?
high index of suspicion | serology not sensitive and histopathology is non-specific
81
pt presents with a ulcerated lesion that is panful and they have painful regional lymopahdenopathy as well as fear headache and malaise. they mention they were recently bitten by a rodent (they work at the zoo). dx? causes?
ulceroglandualr form of tularaemia | francisella tularensis
82
presentation of ecythma gangrenosum?cause?
red macule → oedematous → haemorhaggic bullae → ± ulcerate ? form an eschar neutropenic pts pseudomonas aeruginosa
83
difference between ectyhma and ecthyma gangrenosum?
ecthyma → streptococcal infection | EG → pseudomonas aeruginosa
84
primary syphillis presentation?
chancre - painless ulcer with firm indurated border | 1 week later → painless regional lympoahdenopahty
85
presentation of secondary syphilis?
``` ~50n days post chnacre fever, malise, pruritius, irritis rash alopecia mucous patches lymphadenopathy hepatosplenomegaly condylomata lata ```
86
rare manifestation of secondary syphilis?
lues maligna - pleomorphic skin lesions
87
presentation of tertiary syphilis?
summa skin lesions destroyed nasal cartilage CVD neurosyphilis
88
treatment of syphilis?
IM benzylpenecillin | orał tetracycline
89
2 types of leprosy and the difference?
lepromatous - multiple lesions , sensation and sweeting normal tuberculoid - solitary/few lesions, annular, hairless, anhydrotic, numb
90
3 ways cutaneous TB can be acquired?
exogenously contagious endogenous spread haematogenous/lymphatic endogenous spread
91
investigations for cutaneous TB?
interferon gamma release assay histology ZN stain culture / PCR
92
cutaneous manifestations of TB?
``` tuberculous chnacre TB verrucosa cutis scrofuloderma orificial TB - nasal lupus vulgaris military TB tuberculous gumma ```
93
risk factors for molluscum contagiosum? mx?
children immunocmpromiised curettage, imiquimod, cidofovir
94
2 ddx for molluscum contagiosum?
basal cell caricoma | pyogenic granuloma
95
2 types of HSV?
HSV-1 - direct contact w contaminated saliva / secretiions | HSV-2 - sexual contact
96
symptoms of HSV?
recurrent vesicular eruptions favouring orolabial and genital regions tender lymphadenopathy , malaise ulceration, pustules, erosions w scalloped border urinary retention → genital lesions v painful aseptic meningitis
97
what can cause reactivation of HSV?
``` UV stress spontaneous fever local tissue damage ```
98
emergency finding in HSV?
eczema herpeticum → can lead to encephalitis | monomorphic punched out erosions
99
common presentation of HSV in children? misdiagnosis?
herpetic whitlow more common in HSV1 pain, swelling and vesicles on digits misdiagnosed as paronychia or dactylitis
100
common presentation of HSV in wrestlers?
herpes gladiatorium | HSV1 - athletes lesions come into contact with one another
101
cause of neonatal HSV?prresnattion? mx?
exposed during vaginal delivery especially if mother got hsv close to delivery time onset between birth and 2 weeks vesicles → bullae erosions encephalitis → neurological deficits without treatment IV antivirals
102
risk factors severe/chronic HSV? presentation?
immunocompromised patients eg HIV/tx | chronic enlarging ulceration at multiplemsites ±resp/GI tract
103
diagnosis and mx of HSV?
swab for pcr oral acyclovir (or valacyclovir) 200mg 5xday in immunocompetent localised infection or IV 10mg/kg TDS 7-19 days
104
what virus presents in a dermatomal way?
varicella zoster virus
105
causes of hand foot and mouth disease? difference?
coxsackie A16 enterovirus 71 - higher incidence of neurological involvement eg encephalitis spread by oral oral route or oral faecal route
106
presentattion of hand foot and mouth disease?
prodrome - fever, malaise, sore throat | red macules, vesicles and ulcers on buccal mucosa, tongue, palate, pharynx ± hands and feet
107
what causes morbilliform eruptions?
``` measles rubella ebv cmv HHV6&7 ``` leptospirosis rickettsia
108
causes of petechiae/purpura?
``` coagulation abnormailites - ITP, DIC vsculitis infections TEN raynauds HEPb, CMV, rubella ```
109
what is gianotti-crosti syndrome? causes?
acrodermatitis of childhood (1-3yrs) acute symmetrical erythematous papular eruption on face, extremities and buttocks EBV, CMV, HHv6, coxsackie, hep B
110
pt presents with a slapped cheek rash and a reticulated rash on chest and thighs. dx? causes?
erythema infectiosum | parvovirus b19
111
child presents with a fever that's lasted for 4 days and has now got small pink papule on their trunk and head. dx? causes?
``` roseola infants (6th disease) HHV6 and HHV7 ```
112
goat farmer presents with dome shaped, firm bullae on hands and forearms. dx? cause? mx?
orf parapoxvirus self resolving in 4-6 weeks
113
teenager presents hypopigmentation, an erythematous macular eruptoion and some fine scales. They mention it gets wraps in the summer. dx? mx?
``` pityriasis versicolor (superficial fungal) topical azalea ```
114
what is kerion?
inflammatory fungal infection → abscess of the scalp & posterior cervical lymphadenopathy ± secondary infection w staph aureus
115
commonest cause of tinea capitis?
trichophyton tonsurans
116
what are dermatophytes/
fungi that live on keratin
117
causes of tinea pedis? (superficial fungal)
tricophyton rubrum → hyperkeratosis | tricophyton mentagrophytes → vesiculobullous
118
what is the id reaction?
inflammatory reaction distant from the site of a dermatophyte infection urticaria, hand dermatitis, erythema nodosum
119
what is a majocchi granuloma?
follicular abscess when dermatophyte infection penetrates follicular wall into surrounding dermis
120
risk factors for candidiasis?
occlusion, moisture, warm temp, DM
121
presentation of candidiasis?
superficial fungal erythema oedema , thin purulent discharge intertriginous / oral mucosa cause of valvovaginitis
122
risk factors for aspergillosis?
neutropenia | corticosteroid therapy
123
presentations of aspergillosis?
well circumscribed papule with necrotic bases and surrounding erythema can invade blood vessels → thrombosis and infarction can extend into bone, cartilage and fascia
124
disease similar to aspergillosis?
fusarium
125
presentation of mucormycosis? mx?
fever, headache, facial oedema, exophthalmus, orbital cellulitis, cranial nerve dysfunction aggressive debridement antifungal therapy §
126
risk factors for mucormycosis?
``` DM esp w DKA malnutrition uraemia neutropenia steroids /abx burns hiv ```
127
presentations of scabies?
red to flesh coloured pruritic papules interdigital areas, wrists, genitals, axillae burrow of fine white scale - diagnostic hyperkeratosis in Norwegian scabies
128
tx for scabies?
permethrin oral ivermectin 2 cycles
129
lice treteamnts?
permethrin oral ivermectin malathion
130
body Louse prrsenation?
pruritic papules and hyperpigmentation
131
presentation of bedbugs? tx?
itchy weals around a central punctum | treatment only if symptomatic , fumigation of home
132
what is a melanoma?
malignant tumour from melanocytes can be found on mucosal surfaces and uveal tract leading cause of skin cancer deaths
133
rfs for melanoma?
``` family hx, MC1R variants light skin red hair sun exposure immunosuppresiion ≥100/atypical malanocytic nevi ```
134
broad pathogenesis of melanomas?
``` AMPK pathway activated KIT mutations - acral and mucosal NRAS gene BRAF gene - intermittent UV exposure CDKN2A mutations → AMPK & P16 (tumor suppressor) ```
135
immunotherapy for melanoma? indications?
CTLA-4 blockade - ipilimumab (natural inhibitor of T cell activation) (BRAF negative) PDL1 inhibitors eg nivolumab BRAF & MEK inhibitor for mutated oncogene targeted therapy if unresectable or metastatic
136
5 subtypes of melanoma?
``` superficial spreading **most common nodualr lentigo maligna acral lentiginous unclassifiable ```
137
superficial spreading melanoma?
most common in light skinned ppl men → trunk , women → legs hypo/depigmentation = host immune system attacking = regression horizontal growth then vertical
138
nodular melanoma?
trunk, head, neck m≥f usually blue to black nodule only vertical growth
139
lentigo maligna melanoma? can progress to?
≥60yrs chronically sun damaged skin , **face slow growing, asymmetrical, macular, irregular border, brown/black invasive lentigo maligna melanoma
140
acral lentiginous melanoma?
palms, soles, around nails incidence similar across all racial and ethnic groups → represents disproportionate no of melanomas diagnosed in afro-carribenas and asians
141
self detection for melanomas?
``` asymmetry border irregularity colour variegation diameter ≥5mm evolving ```
142
what is garbe's rule?
worried patient about lesion → do not ignore → low threshold for performing a biopsy
143
3 ddx for melanomas?
basal cell carcinoma sebhorreic keratosis dermatofibroma
144
what would indicate poor prognosis for melanoma?
``` breslow thickness ≥1mm male lymph node involvement ulceration age trunk/head/neck ```
145
investigation for melanoma and positive findings?
``` dermoscopy asymmetry multiple colours reticular/globular starburst ``` also consider history and rfs
146
melanoma managemnt?
primary excision down to subcutaneous fat with 2mm peripheral margin wide excision margin determined by breslow depth sentinel lymphoma node biopsy for pT1b+ PET-CT and brain MRI for stage 3 and 4
147
broad tnm staging for melanoma?
T1 ≤1mm T2 1-2mm T3 2-4mm T4 ≥4mm a - no ulceration b - ulceration
148
major prognostic factor for melanoma?
ldh | ↑ = worse prognosis
149
rfs for keratinocyte displasia/carcinoma and types?
pale skin, UV damage actinic keratoses (dysplasia) Bowen's disease (SCC in situ) squamous cell carinoma (±metastasis) basal cell carcinoma (no metastasis, locally invasive)
150
pathogenesis of basal cell carcinoma?
UV radiation tumour cells and mesenchymal stromal cells up regulation of PDGF and its receptors ↑↑ metalloproteinases and collagenases → degrade preexisting dermis → tumour cells spread loss of function in chromosome 8q p53 mutations
151
squamous cell carcinoma pathogenesis?
UV radiation | alterations in p53, CDKN2A, NOTCH1/2
152
most common skin cancer?
basal cell carcinoma
153
rfs for keratinocyte carcinomas?
``` PUVA exposure fair skin genetics nevus sebaceous organ tx & immunosuppression ionising radiation ```
154
what is actinic keratoses?
limited to epidermis head, neck, upper extremities eryhtemaotus macule ± scale → thick papules, hyperkeratosis → ± cutaneous horn
155
what is Bowens disease?
progression form actinic keratoses or de novo → SCC in situ erythematous scaly plaque ± slightly elevated can look like actinic keratoses, psoriasis or eczema
156
treatment for actinic keratoses and Bowens disease?
``` 5-fluorouracil cream cryotherapy imiquimod cread photodynamic therapy curettage and cautery excision ```
157
presentations squamous cell carcinoma?
``` erythematous to skin coloured papule plaque like exophytic hyperkeratotic ulceration ```
158
high risk features of a SCC?
trunk and limbs ≥2cm, head/neck ≥1cm, periorificial ill defined margins rapidly growing immunosuppression previous radiotherapy or chronic inflammation poorly differentiated, Clark level 4/5 beyond subcutaneous fat pernineural, vascular or lymphatic invasion
159
keratoacanthoma?
pseudomaligancy or variant of SCC rapid enlarging papule with keratotic core resolves slowly leaving atrophic core
160
ix for scc?
clinical diagnosis often sufficient ±diagnostic biopsy ±US of regional lymph nodes
161
ddx of scc?
bcc viral wart merkel cell carcinoma
162
mx of SCC?
examine rest of skin and regional LNs excision radiotherapy if unresectable or high risk eg perineurial invasion cemiplimab for metastatic SCC skin monitoring and sun protection advice
163
6 types of bcc?
``` nodular **commonest superficial morpheic infiltrative basisquamous micro nodular ```
164
nodular BCC presentation?
shiny, pearly nodule/papule
165
superficial BCC presentation?
well-circumscribed erythematous macule or the
166
morpheic BCC presentation?
elevated/depressed induration light pink to white extensive local destruction
167
basisquamous BCC presentation?
histological features of BCC and SCC
168
micro nodular vs nodular BCC presentation?
clinically similar | micro nodular more destructive → high rates of recurrence and subclinical spread
169
ix for BCC?
often clinical diganosis sufficient | ±biopsy
170
ddx for BCC?
SCC Merkel cell carcinoma adnexal carinoma
171
BCC treatment?
``` standard surgical excision mohs micrographic surgery -recurrent BCC -agressive eg. micro nodular, invasive, morpheic -critical site bread loafing ``` 5-fluorouracil, imiquimod, photodynamic therapy, curettage, radiotherapy, vismodegib (hedgehog pathway)
172
cutaneous t-cell lymphoma common subtypes?
sezary syndrome | mycosis fungicides
173
stages of mycosis fungicides CTCL?
patch (erythematous, fine scales, ±pruritus) → plaque → tumour stage
174
genes in mycosis fungicides CTCL?
CDKN2A PTEN STAT3
175
examination for MF CTCL?
type and extent of skin lesions palpable of LNs? skin biopsies FBC
176
treatment of MF CTCL?
plaque/patch stage → topical corticosteroids, photo/radiotherapy nodal involvement → systemic chemo brentuximab vedotin
177
ddx for mycosis fungoides?
psoriasis eczema parapsoriasis
178
sezary CTCL presentation?
triad of erythema, sezary cells and lymphadenopathy
179
treatment for sezary CTCL?
extracorporeal photophoresis | ± adjuvant PUVA & topical corticosteroids
180
what is kaposi sarcoma?
HHV8 ±immunosuppression pink patches to dark plaques, nodules, polyps chemo/radiothearpy ≥ surgery
181
what is Merkel cell carcinoma associated with?
polyomavirus
182
Merkel cell carinoma presentation?
solitary rapid growing nodule | firm dome shaped
183
Merkel cell carinoma treatment?
surgery radiation anti PDL1 avelumab anti PD1 pembrolizumab

BRS 2 (12 decks)

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