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Flashcards in Dermatolgy Deck (57):
1

epidermal layers

Californians Like Girls in String Bikinis
stratum Corneum
stratum Lucindum
stratum Granulosum
Stratum Spinosum
Stratum Basalis

2

tight jnxs

zonula occludens
composed of claudins and occludins

3

adherens jnx

zonula adherens
below tight jnx
connects actin cytoskeltons of adjacent cells with CADherins
Ca dependent, ADhesion proteins
loss of E-cad -> mets

4

desmosomes

macula adherens
structural support via keratin interactions
autoAb -> phemphigus vulgaris

5

hemidesmosomes

connects keratin in basal cells to BM
autoAb -> bullous pemphigoid
hemidesmosomes are down bullow

6

macule

flat lesion

7

patch

macule >1cm
birthmark/congenital nevus

8

papule

elevated solid lesion > 1cm
mole/nevus, acne

9

plaque

papule >1 cm
psoriasis

10

vesicle

small fluid containing blister

11

bulla

large fluid containing blister >1cm
bullous pemphigoid

12

pustule

vesicle w/pus
pustual psorisis

13

scale

flaking off of stratum corneum
eczema
psoriasis
SCC

14

crust

dry exudate
impetigo

15

hyperkeratosis

increased thickening of stratum corneum
psoriasis
calluses

16

parakeratosis

hyperkeratosis w/retention of nuclei in stratum corneum
psoriasis

17

spongiosis

epidermal accumulation of edematous fluid in intercellular spaces
eczematous dermatitis

18

acanthrolysis

seperation of epidermal cells
pemphigus vulgaris

19

acanthosis

epidermal hyperplasia (increased spinosum)
acanthrosis nigricans

20

albinism

normal melanocyte number w/decreased melanin production
d/t decreased tyrosinase activity or defective transport
can also be d/t failure of neural crest cell migration
increased risk for skin CA
partial albinism seen in chediak higashi syndrome

21

melasma

hyperpigmentation associated w/prego (mask of prego)
or OCP use

22

vitiligo

irregular areas of complete depigmentation d/t autoimmune destruction of melanocytes

23

acne

obstructive and inflammatory disease of pilosebaceous unit

24

atopic dermatitis

aka eczema
pruitic eruption
commonly on skin flexures
associated w/other ectopic diseases (asthma, allergic rhinitis)
starts on face in infancy
antecubital fossa in adullts

25

melanocytic nevus

common mole benign
melanoma can arise
intradermal nevi are papular
jnx nevi are flat

26

psoriasis

papules and plaques w/silvery scaling
knees, elbows
acanthosis w/parakeratotic scaling
increased stratum spinosum
decreased stratum granulosum
Auspitz sign- pinpoint bleeding spts (exposed dermal papillae)
associated w/nail pitting and psoriatic arthritis

27

rosacea

inflammatory facial skin disorder characterized by erythematous papules and pustules, no comedones
facial flushing
chronic inflammatory changes -> rhinophyma

28

seborrheic keratosis

flat greasy pigmented squamous epi proliferation w/keratin filled cysts (horn cyst)
common in elderly
benign

29

leser-trelat sign

sudden appearance of multiple seborrheic keratoses indicates underlying malignancy (GI, lymphoid)

30

verrucae

warts caused by HPV
soft, tan colored, cauliflower like papules
epidermal hyperplasia, hyperkeratosis, koilocytosis
condyloma acumminatum on genitals

31

urticaria

hives
pruitic wheals that form after mast cell degraulation

32

impetigo

S. aureus or S. pyogens

33

bullous impetigo

usually S. aureus

34

cellulitis

acute, painful spreading infection of deeper dermis and subq
S. pyogens or S. aureus

35

erysipelas

upper dermis and superficial lymp
S. pyogens
well demarcated

36

abscess

S. aureus

37

necrotizing fasciitis

anerobes
S. pyogens
crepitus
bullae and purple color

38

staphylococcal scalded skin syndrome

exotoxin destroys keratinocyte attachements to stratum granulosum destryoing epidermal-dermal jnx
fever and generalized erythematous rash w/sloughing of upper layers of epi that heals completely

39

molluscum contagiosum

poxvirus

40

hairy leukoplakia

irregular white painless plaques on tongue that cannot be scraped off
EBV mediated
HIV and organ transplant recipients

41

pemphigus vulgaris

potentially fatal autoimmune disorder
IgG against desmoglein
flaccid intraepidermal bullae d/t acantholysis
oral mucosa involved
immunofluroescenes -> reticular(net-like) pattern
nikolsky sign +

42

bullous pephigoid

less severe then pemphigus vulgaris
IgG against hemidesmosomes (abs are bullow)
tense blisters containing eos affect skin, but spare oral mucosa
linear pattern at epi-dermal jnx
nikolsky sign -

43

dermatitis herpetiformis

pruitic papules, vesicles, and bullae
elbows
IgA at dips of dermal papillae
celiacs

44

erythema multiforme associaions

M. pneumoniae
HSV
sulfa drugs
beta lactams
phenytoin
CA
autoimmune

45

erythema multiforme

multiple types of lesions
macules, papules, vesicles, target lesions

46

SJS

>30% of skin involved called toxic epidermal necrolysis
SJS-TEN

47

acanthosis nigricans

hyperinsulinemia (DM, obesity, cushings)
visceral malignancy (gastric adenocarcinoma)

48

actinic keratosis

premalignant lesions d/t sun
small, round, erythematous or brownish papules or plaques
SCC risk

49

erythema nodosum

painful inflammatory lesion of subq fat
ant shin
sarcoidosis
coccidiomycosis
histo
TB
strep
leprosy
chrons

50

6 P's of lichen Planus

Pruitic
Purple
Polygonal
Plnar
Papules
Plaques

51

lichen planus

wickham striae
sawtooth infiltrate of lymphocytes at dermal-epi jxn
associated w/hepC

52

pityriasis rosea

Herald patch followed by scaly erthematous plawues often in 'x-mas tree'
resolves in 6-8wks

53

BCC

MC skin CA
sun-exposed areas
locally invasive rarely mets
pink pearly nodules
telangiectasias
rolled borders
central crusting/ulceration
basal cells have pallisading nuclei

54

SCC

2nd MC skin CA
excessive sun exposure
immnosupressed
arsenic
face, lower lip, ears, hands,
locally invasive
may spread to lymph nodes
r w/scale
keratin perals arely mets
ulcerative red lesions

55

keratoacanthoma

variant that grows rapidly (4-6wks)
may regress spontaneously

56

melanoma

significant risk of mets
S-100
HMB-45
activating BRAF kinase mutation
Tx w/vemurafenib (BRAF kinase inhibitor)

57

types of melanoma

superficial spreading
nodular
lentigo maligna
acral lentiginous