Inflammatory Dermatoses I & II (Swick) Flashcards
(42 cards)
what histolopathologic pattern shows inflammation in the subcutaneous adipose tissue?
panniculitis
type of psoriasis that is most common in children and young adults, and is associated with Streptococcal pharyngitis; is characterized by small, round papules/plaques with overlying scales
Guttate psoriasis
Acanthosis (thickening of the skin) with hypergranulosis, band-like lymphoid infiltrate at the basal layer, and saw-toothing of rete ridges are all features of what condition?
lichen planus
clinical category of dermatosis that has palpable or non-palpable bleeding in the skin
purpuric
Which of these is NOT routinely recommended for treatment of atopic dermatitis?
A. UV light therapy
B. Narrow spectrum antibiotics
C. Topical corticosteroids
D. Emollients (moisturizers)
E. Systemic immunosuppressants
B.
Antibiotics should only be used if there is an infection present, and the selected antibiotic should cover both S. aureus and S. pyogenes. Systemic immunosuppressants are used for severe atopic dermatitis, and systemic corticosteroids are not indicated in most patients and NOT appropriate for long term use.
a rare skin condition that is caused by auto-antibodies (BP Ag II) to components of the basal layer hemi-desmosomes; results in large, fluid-filled blisters on flexure surfaces of the skin
bullous pemphigoid
causes cradle cap in infants, and overlying yellow flaky scale lesions in areas of high sebaceous gland concentration in adults
seborrheic dermatitis
*most cases of this are mild but may cause serious infection in patients with HIV infection and certain neural disorders like Parkinson disease
life threatening condition that is characterized by widespread cutaneous blistering, mucosal involvement, and is secondary to medications
toxic epidermal necrolysis (steven’s johnson syndrome); SJS may also be secondary to a mycoplasma infection.
Type of psoriasis with pink-red plaques that have a sillvery-white scale, are sharply demarcated and commonly have symmetric distribution on the extensor surface of extremities
plaque psoriasis
disease that is caused by circulating antibodies to desmosomal proteins and is characterized on histo by intraepidermal blisters and rounding of keratinocytes:
pemphigus vulgaris
an acute, self-limited, and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction associated with certain infections, namely HSV
erythema multiforme (EM)
Which of the following is FALSE regarding a patient presenting with erythema multiforme?
A. Histopathology would show vaculolar degeneration and blistering, as well as parakeratosis
B. Histopathology would show less dense infiltrate than lichen planus and lots of kyskeratotic (apoptotic) keratinocytes
C. This rash most commonly occurs on the hands and feet and is characterized by acral targetoid plaques
D. It is usually secondary to HSV infection away from the site of eruption.
E. It is associated with Stevens Johnson Syndrome when the mucosa is involved
A. There is no parakeratosis with erythema multiforme, therefore no scales. See clinical picture below demonstrating the characteristic 3 zone targetoid plaque:
what histolopathologic pattern shows intercellular (between cells) epidermal edema?
spongiotic
A _____ is a small molecule that can elicit an immune response only when attached to a large carrier such as a protein
hapten
*upon repeat exposure to an allergen, this is the mechanism by which the T cell mediated immune response occurs during allergic contact dermatitis
this disease is usually localized to the head and neck with papulosquamous eruption, scarring, hair loss, and dyspigmentation; ANA is usually negative:
chronic cutaneous (discoid) lupus
Which of these is NOT one of the 4 “P’s of lichen planus?
A. Purple
B. Pigmented
C. Pruritic
D. Polygonal
E. Papules
B
these dermatoses are sharply defined erythematous papules and plaques with overlying scale (surface change)
papulosquamous
*these dermatoses are most often hostpathologically psoriasiform (elongated rete ridges) but may also demonstrate lichenoid dermatitis
type of dermatitis shown below, with elongtated rete ridges, perivascular lympohcytic infiltrate and parakeratosis
psoriasiform dermatitis
Which of the following statements about atopic dermatits is FALSE?
A. It is a common, age related excematous eruption that affects 10-20% of US children
B. It is linked to family history and often improves with age
C. It is seen most often in infants on cheeks and extensor surfaces
D. It is associated with a variety of environmental factors including soaps, allergens, and psychological stress
E. All atopic dermatitis is due to a null mutation in a protein that binds to keratin fibers in epithelial cells
E.
While, 14-56% of all patients with atopic dermatitis carry a null mutation in filaggrin (encoded by the FLG gene) not all atopic dermatitis is due to a filaggrin mutation. Some cases are due to the absence of the sphingolipid ceramide normally expressed in the stratum corneum to form a lipid barrier.
what histolopathologic pattern shows a band-like lymphocytic inflammation & epidermal degeneration?
lichenoid
this disease results in the linear deposition of antibodies to self DNA at the DEJ, resulting in T-cell mediated interface dermatitis
cutaneous lupus (further subdivided into chronic or acute); histopathology shows:
- hyper & parakeratosis
- follicular plugging (see image below - hyperkeratosis filling the follicles)
- band like lymphocyte invasion along the DEJ, especially involving follicles
Which of the following statements regarding Psoriasis is TRUE?
A. Men are more affected than women though it is relatively uncommon in the US.
B. Peak incidence in adults is around age 40-50.
C. It clinically demonstrates ill defined rash on flexure surfaces.
D. It is associated with an increased incidence of metabolic syndrome and genetic polymorphisms.
E. It is usually improved by the use of systemic corticosteroids.
D.
Psoriasis is relatively common in the US (2.2%) with men and women affected equally and peak incidence around age 20-30. It is associated with increased risk of obesity, hypertension, diabetes, MI and elevated C-reactive protein. It is clinically demonstrated by erythmatous scaly plaques and papules on extensor surfaces.
Psoriasis tends to worsen with withdrawal of systemic corticosteroids, which is why they are not routinely used in treatment. Use topicals instead.
a disease of the skin and/or mucous membranes whose cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger; in most patients it spontaneously resolves in 1 year.
lichen planus
*lichen planus is most common in ages 30-60, results from cytotoxic T cell attack at the DEJ, most commonly follows trauma (koebnerization), infections, drug use, and contact irritants.
any condition in which cytotxic CD8+ T cells attack along the dermoepidermal junction (DEJ) causing lympohcytes to aggregate
lichenoid (or interface, depending on number of lympohcytes present) dermatitis
