dermatology Flashcards Preview

DIT topics > dermatology > Flashcards

Flashcards in dermatology Deck (80):
1

four primary causes of acne

hyperkeratosis
sebum overproduction
propionibacterium acnes proliferation
inflammation

2

epithelial cell junction that connects epithelial cells to the BM

hemidesmosomes

3

what is this skin disorder?
pruritus associated with asthma or allergic rhinitis

atopic dermatitis (eczema)

4

what is this skin disorder?
allergy to nickel

allergic dermatitis

5

what is this skin disorder?
parakerototic scaling

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

6

caused by HPV type 2 and 4

common warts (verrucae)

7

layers of the epidermis

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)

8

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

melanocytes

9

what is located in the dermis?

blood vessels

10

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

psoriasis (called Auspitz sign)

11

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

fibroblasts

12

protein found in hemidesmosomes

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

13

autoantibodies to integrin in hemidesmosomes results in

bullous pemphigoid
BULLOous = BELOW

14

protein found in desmosomes

desmoglein

15

autoantibodies to desmoglein in desmosomes results in

pehmphigus vulgaris

16

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

tight junctions

17

protein found in tight junctions

claudins + occludins

18

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

adherens junctions
CADherins = Calcium dependent ADhesion proteins

19

epithelial cell junction that resists shearing using keratin
found in simple + stratified squamous + muscle tissue

desmosome

20

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

gap junction

21

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

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

22

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

melanocytic nevus

23

↑ melanin pigment with normal number of melanocytes

ephelis (freckles)

24

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

atopic dermatitis (eczema)

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

Decks in DIT topics Class (115):