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D&D > Exam 3 - Dermatology > Flashcards

Exam 3 - Dermatology Flashcards

(62 cards)

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1
Q

Fitzpatrick Skin Types

A 
1 - Never tans, always burns
2 - Hardly tans, usually burns
3 - Average tanning, sometimes burns
4 - Easily tans, rarely burns
5 - Very easy to tan, very rarely burns
6 - Never burns
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2
Q 
Dark skin
(Melanosome distribution and melanin type)
A

Melanosomes larger
Distributed throughout cytoplasm of keratinocyte
Eumelanin: black to brown pigment

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3
Q 
Light skin 
(Melanosome distribution and melanin type)
A

Melanosomes smaller
Distributed in clusters above nucleus of keratinocyte
Pheomelanin: yellow to red/brown pigment

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4
Q

Vitiligo

A

Autoimmune attack against melanocyte
Acquired depigmentation
Absence of melanocytes

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5
Q

Hemidesmosomes

A

Keratinocyte attachment to dermal border
Dermal-epidermal junction
Dz: EB, Bullous Pemphigoid

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6
Q

Desmosomes

A

Keratinocytes attachment to other keratinocytes
Stratum spinosum (epidermis)
Dz: Pemphigus Vulgaris

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7
Q

Recessive Dystrophic Epidermolysis Bullosa

A 
Defect in collagen VII at DEJ (congenital)
Pseudosyndactyly (mitten hand deformity)
Flexion contractures
Increased risk of SCC
Infection
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8
Q

Bullous Pemphigoid

A 
Aquired blistering of DEJ
Antibodies to BP 230 and BP 180
Tense blister (hemidesmosomes)
No MM (No des3)
Often on flexor surfaces
Linear on IMF along BM
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9
Q

Pemphigus Vulgaris

A

Antibodies to desmoglein 1 (skin) and 3 (MM)
Flaccid bulla (intraepidermal blisters)
Desmosomes
Not linear on IMF (obliterated epidermis)

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10
Q

Epidermolysis Bullosa Simplex

A

Defect in keratin 5 and 14
Blisters on hands, feet, and extremities
Manage with age

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11
Q

Icthyosis Vulgaris

A

Filaggrin mutation - NMF loss
Defective skin barrier
Large white scaly appearance

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12
Q

Epithelial Zones

A

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basalis

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13
Q

Dermal Zones

A

Papillary dermis - interlocks with epidermal rete, thin collagen bundles
Reticular dermis - visible elastic fibers, thick collagen bundles

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14
Q

Major Components of Dermis

A

Collagen - strength
Elastic fibers - resilience
Ground substance - facilitates diffusion

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15
Q

Solar elastosis

A

Acquired disorder of elastin

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16
Q

Pseudoxanthoma Elasticum

A

Congenital disorder of elastin

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17
Q

Hair phases

A

Anagen - growing (3 years)
Catagen - transition (3 weeks)
Telogen - resting (3 months)

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18
Q

Seborrheic Dermatitis

A 
cradle cap - scalp
Malassezia furfur (fungus)
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19
Q

Stasis dermatitis

A

lower extremity edema

bilateral

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20
Q

Numular Dermatitis

A

Excess use of soap and dry skin
Red scaly patches
Minimize soap, moisturize, topical steroids

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21
Q

Types of Hypersensitivity Reactions

A

Type I - Anaphylactic rxn (immediate)
Type II - Cytotoxic rxn
Type III - Immune complex rxn
Type IV - Delayed type hypersensitivity rxn

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22
Q

Type I HS

A

Immediate
IgE to antigen
Histamine release
Ex: urticaria and angioedema

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23
Q

Type II HS

A

Cytotoxic
IgG bind and lysis (activates complement)
Ex: ABO mismatch

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24
Q

Type III HS

A

Immune complex
Organ and vessel deposition
Activation of complement - inflammatory damage
Ex: serum sickness

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25
Type IV HS
Delayed Langerhans cells are APC Local rxn w/out antibodies Ex: Drug eruptions, allergic contact dermatitis
26
Allergic contact dermatitis
Delayed type IV rxn | Dx w/ patch testing
27
Psoriasis
Increased risk of CVD Extensor surfaces May include arthritis over joints
28
Atopic Dermatitis
Filaggrin mutation - NMF loss Defective skin barrier Flexor surfaces Associated with asthma and allergic rhinitis
29
Erysipelas
aka St. Anthony's Fire Strep pyogenes Common on face (cliff drop border, non-pitting, pain) Lymphadenopathy
30
Impetigo
``` Non-bullous (80) and bullous (20) High humidity Cutaneous carriage Poor hygine Honey colored crust ```
31
Non-bullous impetigo
Face followed by extremities | Strep pyogenes or staph aureus
32
Bullous impetigo
Anywhere on body | Staph aureus ONLY
33
Cellulitis
``` Extremities (unilateral) Painful erythemia WTT Lymphatic streaking Regional lymphadenopathy Septic danger (staph a, strep p, h. flu) ```
34
KOH Examination of skin
Used with fungal infections Hyphae/arthrospores = Tinea Pseudohyphae/yeast = Candidiasis Short hyphae/yeast (spaghetti/meatballs) = Tinea versicolor
35
Fungal culture test
Dermatophyte Test Medium (DTM) | Sabouraud agar
36
Fungal biopsy stain
PAS w/ diastase | Gomori methenamine silver (GMS)
37
Tinea Versicolor
Warm/humid, post pubertal patients Food: follicular lipids Hyper/hypopigmented macules/patches on chest
38
Scabies
Webspace, flexures, waist, axillary, genital Night, hot bath Burrows and genital nodules
39
Seborrheic Keratosis
"Barnacles of Life" Stuck on appearance Leser-Trelat sign - indication of internal malignancy
40
Malignant Melanoma ABCDE
``` Asymmetry Border irregularity Color variation Diameter >6mm Evolution The ugly duckling ```
41
Skin defenses against UV
DNA repair Apoptosis of cells with damage Defenses against ROS Melanin
42
Actinic keratosis
Common precancer 1/1000 will go on to cancer in a year Usually becomes SCC
43
Basal cell carcinoma
Most common (2nd in IS/IC patients) Pearly and shiny Not usually fatal
44
Squamous cell carcinoma
2nd most common (1st in IS/IC patients) | More invasive than BCC
45
FAMM syndrome
Familial atypical moles and melanoma Malignant melanoma in 1 or more 1/2 degree relatives Numerous atypical nevi 148x risk (biggest RF)
46
UVA
Longer wavelength Penetrates deeper Dark patches, wrinkles, loose skin DNA damage
47
UVB
``` Shorter wavelength Penetrates more shallow Vitamin D synthesis Sunburns Eye problems DNA damage ```
48
6 UV effects on skin
``` Damage to DNA, RNA, lipids, proteins Pro-inflammatory Immunosuppressive Induction of innate defense Induction of apoptosis Vitamin D synthesis ```
49
3 Photodermatoses
Lupus Erythematosus Dermatomyositis Mixed Connective Tissue Disease
50
4 dermatomyositis clinical signs
Heliotrope leading to periorbital edema Samitz sign = ragged cuticles Gottron's papules=extensor lichenoid papules/poikiloderma Shawl sign
51
Dermatomyositis and malignancy
Adult onset is sign of internal malignancy (10-50%)
52
Neurofibromatosis Type I criteria
1. >6 cafe au lait 2. >2 neurofibromas or >1 plexiform neurofibroma 3. Crowe's sign (axillary/inguinal freckling) 4. Optic glioma 5. >2 Lisch nodules 6. Osseous lesion, sphenoid wing dysplasia, cortex thin 7. 1st degree relative with dz
53
Tuberous Sclerosus
Adenoma sebaceum Hypomelanotic macules Shagreen patch
54
Kaposi's Sarcoma
Indication of immunocompromise | Triggered by HHV-8
55
Pyoderma Gangrenosum
Neutrophil overreaction Large skin wound - AVOID I&D = more trauma Usually have underlying AI Dz
56
Lichen Planus
Purple, polygonal, pruritic papules Wickham's striae - overlying lace like pattern Concern for hepatitis C
57
Acanthosis Nigricans signs and mech
Velvety dark patch Usually neck, axillae, dorsal hands Epid keratinocyte and D fibroblast proliferation
58
Acanthosis nigricans associations
``` Familial Obesity Diabetes Endocrinopathies (Cushing's) Drugs (rare) Malignancy (look for weight loss) ```
59
4 drug factors that affect skin absorption
Drug concentration Molecular size Lipophilicity Vehicle composition
60
4 patient factors that affect skin absorption
Barrier disruption Anatomic location Skin hydration (up=up) Occlusion
61
Classifications of topical steroids
Class 1 to Class 7 | More to less potent
62
Examples of topical steroids
Class 1: Clobetasol Class 4: Triamcinolone Class 7: Hydrocortizone

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