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dermatology Flashcards

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1
Q

four primary causes of acne

A

hyperkeratosis
sebum overproduction
propionibacterium acnes proliferation
inflammation

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2
Q

epithelial cell junction that connects epithelial cells to the BM

A

hemidesmosomes

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3
Q

what is this skin disorder?

pruritus associated with asthma or allergic rhinitis

A

atopic dermatitis (eczema)

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4
Q

what is this skin disorder?

allergy to nickel

A

allergic dermatitis

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5
Q

what is this skin disorder?

parakerototic scaling

A

psoriasis

parakerototic scaling: nuclei still in stratum corneum + thickening of stratum corneum

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6
Q

caused by HPV type 2 and 4

A

common warts (verrucae)

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7
Q

layers of the epidermis

A

Come’on Lets Get Sun Burnt
C - stratum Corneum (keratinocytes)
L - stratum Lucidum
G - stratum Granulosum
S - stratum Spinosum (keratinocytes in SS connected by spines = desmosomes)
B - stratum Basale (stem cells + melanocytes here)

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8
Q 
skin cell that:
produces melanin
responsible for skin/eye/hair color
originate from neural crest cells 
located in stratum basale
A

melanocytes

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9
Q

what is located in the dermis?

A

blood vessels

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10
Q

pinpoint bleeding spots from exposure of dermal papillae (vessels here) when scales scraped off is a clinical feature of

A

psoriasis (called Auspitz sign)

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11
Q

cell that has the following roles:
makes collagen (part of ECM), glycosaminoglycans, reticular + elastic fibers, glycoproteins
provides STRUCTURAL integrity
important role in wound healing: secretes backbone of CT
stimulated by tissue damage

A

fibroblasts

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12
Q

protein found in hemidesmosomes

A

integrins

bind to collagen + laminin in BM to maintain INTEGRITY of the basolateral membrane

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13
Q

autoantibodies to integrin in hemidesmosomes results in

A

bullous pemphigoid

BULLOous = BELOW

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14
Q

protein found in desmosomes

A

desmoglein

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15
Q

autoantibodies to desmoglein in desmosomes results in

A

pehmphigus vulgaris

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16
Q

epithelial cell junction that joins adjacent cell membranes and prevents diffusion of fluid (impermeable) across the paracellular space

A

tight junctions

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17
Q

protein found in tight junctions

A

claudins + occludins

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18
Q

epithelial cell junction that connects the actin cytoskeleton’s of adjacent cells using cadherins
located below tight junctions

A

adherens junctions

CADherins = Calcium dependent ADhesion proteins

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19
Q

epithelial cell junction that resists shearing using keratin

found in simple + stratified squamous + muscle tissue

A

desmosome

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20
Q

epithelial cell junction which makes a connexon: a channel protein that allows electrical + chemical communication between adjacent cells
found in cardiac cells: myocytes communicate electrical signal from SA node → AVnode →bundle of His →purkinje system

A

gap junction

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21
Q

soft, tan-colored cauliflower like papules
hyperkeratosis: ↑ thickness of stratum corneum
epidermal hyperplasia
koilocytosis

A 
verrucae = common warts
hands = vulgaris (HPV 2 and 4)
genitals = condyloma acuminatum (HPV 6 and 11)
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22
Q

benign
arises from nevocytes (type of melanocyte)
↑ risk melanoma if congenital or atypical

A

melanocytic nevus

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23
Q

↑ melanin pigment with normal number of melanocytes

A

ephelis (freckles)

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24
Q

pruitic rash on skin flexures
rash worsens with scratching, in dry mo (winter), washing every day (Infant)
starts on face in infants → behind knees, antecubital fossa in adults
associated with atopic diseases: asthma + allergic rhinitis

A

atopic dermatitis (eczema)

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25
type IV hypersensitivity reaction following exposure to allergen pruritic, linear rash at site of contact
allergic contact dermatitis | nickel, poision ivy, neomycin
26
papules and plaques with SILVERY scaling on knees + elbows parakaratosis (nuclei still in stratum corneum) ↓stratum granulosum ↑stratum spinosum + Auspitz sign possible nail pitting, arthritis (1/3 patients)
psoriasis: overproduction of new skin cells
27
treatment for verrucae
salicylic acid - OTC imiquimod: ↑IFN to fight virus liquid N2 in office
28
treatment of psoriasis
``` moisturizers - emollient (oil based) topical: normalize skin cell production →↓ inflammation steroids tar cream vitamin D analogs retinoids phototherapy oral: MTX, cyclosporine (rebound flaure after finish - not given often), retinoids ```
29
treatment for atopic dermatitis (eczema)
mild: moisturizing soap + emollient (oily) mild-mod: calcineurin inhibitors (tracolimus or pimecrolimus) flares: topical steroids open lesion: antibiotics (cover s. aureus + strep) prevent itch: antihistamines if also have asthma/allergic rhinitis: LK inhibitor UV light therapy severe case/major flare: systemic steroids (short term) very severe case (drugs of last resort): MTX, cyclosporine, azathioprine
30
treatment for acne due to hyperkaratosis
vitamin A analogs, such as: topical: retinoic acid, tretinoin oral: isotretinoin
31
treatment for acne due to sebum overproduction
isotretinoin spironolactone (aldosterone antagonist: antiandrogen →↓cortisol, testosterone) OCPs
32
treatment for acne due to propionibacterium acnes proliferation
``` oral antibiotics: erythromycin tetracycline doxycycline minocycline topical: clindamycin benzoyl peroxide (DOC of acne): ↓ bacterial growth ```
33
treatment for acne due to inflammation
steroids
34
flat, greasy, pigmented lesion with "stuck on" or "tortoise shell" appearance
seborrheic keratosis
35
benign flat, greasy, pigmented with squamous epithelial proliferation with KERATIN-FILLED CYSTS (horn cysts) in elderly
seborrheic keratosis
36
sudden appearance of multiple seborrheic keratoses
Leser-Trelat sign | underlying malignancy: GI, lymphoid
37
normal melanocyte number | ↓ melanin production
albinism
38
↓ melancoyte number
vitiligo
39
↓tyrosine activity or defective tyrosine transport → ↓ melanin production
albinism
40
autoimmune destruction of melanocytes → complete depigmentation
vitiligo
41
stimulation of melanocyte → hyperpigmentation well-demarcated macules associated with pregnancy "mask of pregnancy", OCP, HRT resolves in mos.
melasma
42
honey-colored crusting near lips/nose of kid S. aureus or S. pyogenes very contangious
impetigo
43
treatment of impetigo
mild: topical mupirocin severe: oral dicloxacillin or cephalexin (1st gen cephalosporin)
44
painful, rapidly spreading infection of dermis and suq tissue S. aureus or S. pyogenes usually due to break in skin or another infection
cellulitis
45
treatment of cellulitis
non-MRSA (non-purulent): oral dicloxacillin or cephalexin | MRSA (purulent): TMP-SMX or clindamycin
46
tender beyond visible area of infection rapidly spreading celluitis along fascia plane subq crepitus due to methane + CO2 from aneorbic bacteria aneorobic bacteria or S. pyogenes (group A strep)
necrotizing fasciitis | "flesh eating bacteria"
47
treatment of necrotizing fasciitis
immediate surgical debridement to open pressure | IV carbapenem + clindamycin
48
exotoxin A + B destroy keratinocyte attachments in stratum granulosum
staphylococcal scalded skin syndrome | caused by S. aureus
49
fever + generalized erythematous rash SLOUGHING of upper layers of epidermis heals completeley newborns + children
staphylococcal scalded skin syndrome
50
white plaques on tongue | CAN'T be scraped off
hairy leukoplakia
51
white plaques on tongue EBV mediated infection in immunocompromised (HIV +) 5-25% are precancerous lesions
hairy leukoplakia
52
destruction of epidermal-dermal junction
toxic epidermal necrolysis
53
treatment of SSSS
cover s. aureus: nafcillin oxacillin vancomycin
54
separation of epidermis upon manual stroking of skin
+ Nikolsky sign (pemphigus vulgaris)
55
very severe chronic autoimmune skin disorder painful, flaccid (wrinkly) bullae caused by acantholysis (separation of epidermal cells) due to autoantibodies against desmosomes ORAL MUCOSA involved + Nikolsky sign
pemphigus vulgaris
56
IF: reticular pattern of antibodies around epidermal cells
pemphigus vulgaris
57
tense blisters containing EOSINOPHILS NO oral mucosa - Nikolsky sign
bullous pemphigoid
58
IF: linear pattern at epidermal-dermal junction
bullous pemphigoid
59
pruritic vesicles associated with celiac disease
dermatitis herpetiformis
60
skin disorder associated with HIV
hairy leukoplakia
61
skin disorder associated with hepatitis C
lichen planus
62
pruritic papules due to deposits of IgA at tips of dermal papillae worse with gluten intake
dermatitis herpetiformis (not due to HSV infection)
63
blistering skin disorder following an infection or drug reaction pruritic multiple lesions present: macules, papules, vesicles, target lesions
erythema multiforme
64
severe form of stevens-johnson syndrome with >30% of body SLOUGHING off
toxic epidermal necrolysis
65
fever + bulla + necrosis + SLOUGHING (separate epidermis from dermis)+ high mortality rate hypersensitivity reaction to a drug affecting skin + MUCOUS membranes
stevens-johnson syndrome
66
skin disorder with an ↑ risk of squamous cell carcinoma
actinic keratosis
67
thick scaly, crusty, sandpaper-like skin premalignant lesions ( ↑ risk of squamous cell carcinoma) cause by sun exposure (esp fair skinned)
actinic keratosis
68
treatment of actinic keratosis
5-FU | liquid N2
69
hyperpigmented, VELVETY thickening of skin (hyperplasia of stratum spinosum) neck + axilla hyperinsulinemia: diabetes, obesity, cushing syndrome >40 yo: visceral malignancy (gastric adenocarcinoma)
acanthosis nigricans
70
>40 yo with velvety rash on neck or axilla
acanthosis nigricans (with a visceral malignancy)
71
12-20 yo painful, red, inflammatory lesion of subq (both shins) associated with: sarcoidosis, coccidiodomycosis, histoplasmosis, TB, group A strep, leprosy resolves in 3-6 wks
erythema nodosum
72
``` autoimmune skin disorder Pruritic Purple Polygonal Papules Plaques MUCOSA involved ```
5'Ps of lichen Planus
73
sawtooth infiltrate of lymphocytes at dermal-epidermal junction
lichen planus
74
"herald" patch on trunk or back → days later: multiple small patches along ribs ("christmas tree") distribution resolves in 6-8 wks
pityriasis rosea
75
thickened scar around face/chest
keloid
76
skin rash + proximal muscle weakness
dermatomyositis (associated with increase risk of malignancy)
77
rash on palms + soles
2° syphilis rocky mountain spotted fever coxsackie A virus kawasaki disease (desquamation)
78
dermatologic findings in 1-3° syphilis
1°: painless chancre 2°: macuolopapular rash on palms + soles, condylomata lata 3°: gummas
79
acrodynia: peeling of finger tips
kowasaki disease | mercury poisioning
80
skin lesion due to bacillus anthracis
black eschar with necrosis surrounded by edematous ring caused by lethal factor and edema factor

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