Lichenifcation & Acantholysis Flashcards Preview

Dermatology - Clinical Medicine IV > Lichenifcation & Acantholysis > Flashcards

Flashcards in Lichenifcation & Acantholysis Deck (49)
Loading flashcards...
1
Q
What is tiny perifollicular papules around hair follicles?
A
keratosis pilaris
2
Q
What causes keratosis pilaris?
A
keratization causing plugging hair follicular
3
Q
Where do you get keratosis pilaris?
A
upper thighs, lateral upper arms and cheeks
4
Q
What is the treatment of keratosis pilaris?
A
moisturizers with ingredients like lactic acid, urea, salicyclic acid (Cerave SA, amlactin)
5
Q
What type of condiation is ichthyosis vulgaris?
A
Autosomal dominant
6
Q
Fine, adherent scale on extremities and trunk with sparing of flexures, larger scale on lower legs, hyperlinear palms and soles
A
Ichthyosis Vulgaris
7
Q
What is the pathology of ichthyosis vulgaris?
A
absent stratum granulosum in some people, decreased or absent profilaggrin, also possible increased adherence of stratum corneum
8
Q
What do pt have ichthyosis vulgaris with (secondary)?
A
malnutrition, infectious disease, sarcoidosis and other paraneoplastic disorders
9
Q
How do you treat ichthyosis vulgaris?
A
reduction of scales as in KP
10
Q
the patient has an itch in a particular location and begins to itch – the itching causes a cascade of itching/ scratching in a cycle which leads to thickening of the skin
A
Lichen Simplex Chronicus
11
Q
When do lichen simplex chronicus pts complain of symptoms?
A
at rest, not when busy
12
Q
What are the histologic findings for LSC?
A
epidermal thickening, hyperkeratosis, acanthosis, spongiosis. Papillary dermal fibrosis with vertical streaking of collagen bundles
13
Q
What is the treatment for LSC?
A
topical steroid, itch prevention, oral snti-puritics including doxepin, phototherapy, psych referral
14
Q
Darkening and thickening of the skin – marker of underlying disease
A
ACANTHOSIS NIGRICANS
15
Q
Where does acanthosis nigricans present?
A
skin folds - axillae, groin, back of neck
16
Q
What are the 7 types of acanthosis nigricans?
A
obesity related, syndromic (Cushings, PCOS), benign(over dorsal hands and feet in AA), drug induced (nicotinic acid, insulin, systemic steroids, hormonal tx), hereditary (autosomal dominant), malignant (stomach CA in 90%), mixed
17
Q
When is acanthosis nigricans itchy?
A
malignancy
18
Q
What is threatment for acanthosis nigricans?
A
topical retinoids for cosmetic apperance, creams with exfoliating properties
19
Q
Chronic inflammatory skin condition that is a T cell mediated auto immune disease
A
lichen planus/ lichen planopilaris
20
Q
Where does lichen planus occur?
A
nails, hair follicles, skin, oral mucosa, vaginal mucosa, penis
21
Q
What can cause lichen planus/lichen planopilaris?
A
stress, genetic predisposition, skin trauma (koebnerization), herpes zoster, hepatitis (self antigen modification on surface of basal keratinocytes), meds such as quinidine, hydrxychloroquine, captopril
22
Q
What is the skin findings for lichen planus?
A
usually symmetrical, scaly papules and plaques, purplish to pink, flat topped, mildly pruritic , may be linea
23
Q
What do you see orally in lichen planus?
A
Wickham Striae
24
Q
What do you see on the scalp with lichen planus?
A
telangectasia, erythemia, scarring
25
Q
What is the dx for lichen planus?
A
get hepatitis hx
biopsy = positive DIF (IG at base of epidermis)
26
Q
What is the treatment for lichen planus?
A
spontaneous resolution, topical steroids, calcineurin inhibitors
27
Q
Transient acantholytic dermatosis
A
Grover's disease
28
Q
Who gets grover's disease?
A
men over 50
29
Q
What can grover's disease be related to?
A
sweat or heat
30
Q
Where do you get grover's disease?
A
back and chest
31
Q
What does grover's disease look like?
A
Multiple tiny uniform perifollicular papules that are itchy
32
Q
What is the treatment for grover's disease?
A
topical steroids, topical aloe/anti-itch meds (AlcortinA gel, Novacort Gel)
33
Q
Rare heriditary blistering disease caused by defective mortar between cells - Chronic acantholytic dermtosis
A
Hailey-Hailey
34
Q
Where do you get hailey-hailey?
A
skin folds, axilla/groin, under breast and butt
35
Q
What do skin lesions look like in hailey hailey?
A
ring-like then clear, sometimes secondarily infected, with malodor and weeping- no scars
36
Q
What makes hailey hailey worse?
A
heat and sweating
37
Q
What is the treatment for hailey hailey?
A
staying dry, avoid overheating, topical steroids, oral TCN
afamelanotide
Can go into remission after years and disease improves over time

38
Q
What is things to know about hailey hailey?
A
gross smell and rare, no good treatment
39
Q
Hereditary and chronic acantholytic dermatosis – autosomal dominant (50% inheritance rate)
A
Darier disease
40
Q
When does darier disease start?
A
adolescence
41
Q
What does skin like in darier disease?
A
Greasy scaly papules over hair bearing areas, flexural folds – malodor is common
Bumpy sebborheic dermatitis
42
Q
What are some clinical presenations of darier diseas
A
small pits on the palms and soles and longitudinal pink nail stripes and V shaped nick at the free edge of the nail is very common
43
Q
What are symptoms exaccerbated by darier disease?
A
sun, heat, bacterial infections
44
Q
What is the treatment for darier disease?
A
Ranges from sun protection, moisturizers for mild disease to topical/oral retinoids for severe disease or even cyclosporine
45
Q
What is the most common type of acanthosis and what is it related to?
A
obesity, insulin resistantce
46
Q
What are the two disease states related to acanthosis nigricans?
A
PCOS and cushings
47
Q
What malignancy is related to acanthosis nigricans?
A
GI tumors (stomach 90%)
48
Q
Who gets a benign variant that doesnt indicate underlying disease in acanthosis nigricans?
A
AA, in hands and feet
49
Q
What is the main clinical manifestation in grover disease?
A
pruritis