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Flashcards in Dermis & SubQ Deck (25):
1

Ehlers-Danlos Syndrome (cause, 2 types, sxs, tx)

Genetic: Mutations in collagen or post-translational modifications of collagen
Type 1 (Classic) - hypermobile joints, extensive skin stretch, fragile skin, atrophic or "fish mouth" scars. Normal recoil.
Type IV - may involve blood vessels causing bruising and GI / arterial rupture. No tx, just minimize trauma.

2

Pseudoxanthoma Elasticum (inheritance, onset, sxs)

Autosomal recessive. Appears in first or second decade of life.
Clumped elastic fibers.
Yellow papules of neck, axillae, decreased vision,
CV: claudication (pain in legs w/ walking), high BP, angina, MI

3

Marfan Syndrome (inheritance, cause, sxs)

Autosomal dominant mutation in fibrillin
Skeletal: tall, long limbs / digits, scoliosis, pectus excavatum, flexible joints
Stretch marks on skin.
CV: aortic dilation / dissection, mitral valve prolapse
Eyes: myopia (near-sighted), dystopia lentis (lens displaced), and detached retina

4

Livedo Reticularis (cause, sxs, associated disorders)

Due to hypo perfusion of blood vessels
Reticulate ("net-like") macular erythema
Accentuates w/ cold weather
Benign
Associated w/ autoimmune or coagulation disorders

5

How does vasculitis affect the skin? (4 sxs)

Palpable purpura (Firm red bump that is non-blanching)
Necrotizing livedo reticularis
Ulceration
Leukocytoclastic vasculitis (LCV)

6

Leukocytoclastic vasculitis (LCV) (mechanism, triggers, sxs, tx)

Inflammation of small cutaneous vessels
Palpable purpura, most common on legs
Triggers: medications, infection, CT disease, autoimmune disease
May affect renal vasculature
Tx - treat or remove trigger

7

3 phases of wound healing

Inflammatory
Proliferative
Maturation

8

Keloid (presentation, cause, tx)

Firm scar extending beyond borders of wound
Caused by injury, inflammation, or acne
Tx: avoid injury, intralesional steroids, NOT excision (gets bigger)

9

Local factors that delay wound healing

Vascular insufficiency
Tissue edema
Infection (due to biofilm)
Dry wound bed
Excess granulation tissue
Chronic radiation injury

10

Systemic factors that delay wound healing

Old age, malnutrition, diabetes, CT disease

11

Morphea (sxs)

Affects trunk (mainly), scalp, and extremities
Expanding, erythematous, depressed plaque. Slowly becomes indurated (firm). Central portion becomes hypopigmented w/ lilac-colored rim.
Atrophy and firm scar-like changes
May be linear and associated w/ hair loss or permanent scarring
Inactive lesions are often hyper pigmented

12

Limited Systemic Scleroderma (sxs)

Affects face and distal extremities w/ tight, thickened skin
CREST Syndrome: Calcinosis cutis (Ca deposition in digits), Raynaud's Syndrome (Hypersensitivity to cold weather:
Skin becomes white —> blue —> red), Esophageal dysmotility (choke on liquids), Scleroderma, Telangiectasias (dilated capillaries)

13

Scleroderma (sxs and types)

Fibrosis / thickening of dermis.
Localized includes morphea and linear scleroderma
Systemic includes limited and diffuse scleroderma

14

Morphea (sxs)

Affects scalp, trunk, and extremities
Hypopigmented, depressed plaque w/ lilac-colored rim
Atrophy and firm scar-like changes
May be linear and associated w/ hair loss or permanent scarring
Inactive lesions are often hyper pigmented

15

Diffuse Systemic Scleroderma (location and sxs)

Affects trunk and proximal extremities
Cutaneous fibrosis
Raynaud's syndrome
Systemic: Pulmonary fibrosis, renal insufficiency, cardiac disease
Poor prognosis

16

Panniculitis (cause, sxs, triggers, tx)

Inflammation of fat lobules or fibrous septae in subcutis
Erythema nodosum most common
Tender, erythematous nodules w/ poor-definied borders (due to being deep)
Triggers: OCPs most common, strep infection, medications, sarcoidosis (inflammation of lungs / skin), IBS,
Tx: remove medication, tx infection, rest, elevate limbs, NSAIDS, KI

17

Adnexal structures

Hair, sebaceous (oil) glands, apocrine and eccrine sweat glands.

18

Elastic fibers composed of?

Elastin and fibrillin

19

Livedo Reticularis (cause, sxs, associated disorders)

Due to hypoperfusion of blood vessels, most often due to cold weather.
Reticulate ("net-like") macular erythema
Most common on legs
Benign
Associated w/ autoimmune or coagulation disorders

20

Pyogenic granuloma

Looks like jelly bean of blood popping through skin.
Rapidly growing vascular lesion that often arises at sites of trauma. Proliferating vascular tissue fails to reepithelialize unless the lesion is cauterized or surgically removed.

21

Photoaging

Atrophy (skin thinning), lentigines (large freckles), rhytides (wrinkles), dilated pores, yellow skin / loss of rebound (both due to fractured elastic fibers)

22

Poikiloderma of Civatte

Due to photoaging.
Telangectasias, hyperpigmentation, hypopigmentation, and atrophy.
Most common on lateral neck of "V" of chest.

23

Actinic purpura

Minor trauma leading to focal bleeding into skin due to UV related thinning of collagen in blood vessels.

24

Wound that affects epidermis only

Erosion

25

Wound that affects epidermis and dermis

Ulcer