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DermJaz > Skin Conditions > Flashcards

Skin Conditions Flashcards

(135 cards)

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1
Q

Autoimmune condition that destroys the melanocytes in the skin

A

Vitiligo

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2
Q

Possible future Treatment for vitiligo =
Works by _____
May potentially cause increased risk of _____

A

Melanotan
Short tripeptide of hormone that stimulates melanin production
Melanoma

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3
Q

MSH excess from pituitary =

A

Nelsons syndrome - hyperpigmentation

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4
Q

AI loss of pilosebaceous units as follicles are attacked

A

Alopecia areata

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5
Q

Inherited DEJ disease 2 types =

A

Epidermolysis bullosa simplex and dystrophic (EBS and EBD)

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6
Q

Acquired DEJ conditions due to auto-antibodies

A

Pemphigoid
Pemphigus
Dermatitis herpetiformis

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7
Q

inherited condition that causes breakdown of the skin barrier due to impaired cholesterol synthesis

A

Steroid sulfatase deficiency X-linked ichthyosis

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8
Q

Psoriatic plaque eruption caused by minor skin trauma =

A

Koebner’s phenomenon

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9
Q

atopic eczema lesions usually contain:

A

Th2, dendritic cells, keratinocytes, macrophages and mast cells

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10
Q

Pemphigus/pemphigoid are examples of type __ hypersensitivity reaction

A

type 2

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11
Q

purpura/rash are examples of type ___ hypersensitivity reaction

A

3

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12
Q

urticaria is a type __ hypersensitivity reaction

A

1

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13
Q

erythema/rash is a type ___ hypersensitivity reaction

A

4

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14
Q

symmetrical skin erupion of sudden appearance - suspect ___

A

drug induced

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15
Q

exanthematous drug reaction is a type __ reaction that is ___ mediated
causes a ____ rash

A

type 4
t cell
widespread symmetrical

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16
Q

drugs that cause exanthematous drug reaction =

A 
penicillins
sulfonamide antibiotics
erythro/streptomycin
allopurinol
anti-epileptics (carbamazepine)
NSAIDs 
phenytoin
chloramphenicol
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17
Q

urticaria is usually a type __ hypersensitivity reaction mediated by ___ after rechallenge
examples of drugs that cause this =

A

1
IgE
beta lactam antibiotics, carbazepine

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18
Q

urticarial reaction on first exposure to the drug is caused by ___
examples of drugs that cause this =

A

mast cells releasing inflammatory mediators

vancomycin, NSAIDs, aspirin, opiates, muscle relaxants, quinolones

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19
Q

drugs that can cause acne as an adverse reaction

A

glucocorticoids, androgens, lithium, isoniazid, phenytoin

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20
Q

AGEP =

(very rare) drugs that cause this adverse reaction =

A

acute generalised exanthematous pustulosis

antibiotics, CCBs, antimalarials

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21
Q

drug induced bullous pemphigoid caused by

A

ACEI, penicillin, furosemide

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22
Q

drug induced linear IgA disease caused by

A

vancomycin

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23
Q

describe the appearance of fixed drug eruptions

A

well demarcated, round/ovoid plaques
red and painful
usually mild and a single lesion
can be eczematous, papules vesicles or urticaria

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24
Q

common locations of lesions of fixed drug eruptions

A

hands, genitalia, lips and occasionally oral mucosa

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25
drugs that can cause fixed drug eruptions
vancomycin, doxycycline, paracetamol, NSAIDs, carbamezepine
26
DRESS stands for ___ | it is a severe cutaneous adverse reaction, drugs that cause =
drug reaction with eosinophilia and systemic symptoms | sulfonamides, anticonvulsants, allopurinol, minocycline, dapsone, NSAIDs, abacavir, nevirapine, vancomycine
27
TEN and SJS are severe cutaneous adverse reactions | drugs that cause them =
Toxic epidermal necrolysis Stevens Johnson Syndrome | sulfonamide Abx, cefalosporins, carbamazepine, phenytoin, NSAIDs, nevirapine, lamotrigine, tramadol, pantoprazole
28
T/F phototoxic drug reactions can occur through windows?
True | Usually UVA or visible light
29
Phototoxic drug reactions are ___ mediated | mechanism behind them = appropriate wavelength hits ___ under surface releasing __+__
non-immunological drug chromophore free radicals and photoproducts
30
acute phototoxic drug reactions =
skin toxicity, systemic toxicity and photodegradation
31
chronic phototoxic drug reactions =
pigmentation, photoaging and photocarcinogenesis
32
typical manifestations of Type 1 hypersensitivity reaction
``` anaphylaxis eczema asthma hives hayfever urticaria angioedema ```
33
dermatological examples of type 4 hypersensitivity reactions
contact dermatitis tubercular lesions graft rejection
34
In type 1 HS reactions: Th2 produces _+_+_ that stimulate B cells to produce ___ which then ___
IL4, 5 and 13 IgE becomes Fce receptor on mast cell
35
In type 1 HS urticaria appears within __ and lasts for __
1hr | 2-6/24 hrs
36
Investigations for suspected type 1 HS reaction
RAST - blood test for specific IgE skin prick and if it is negative = challenge test serum mast cell tryptase level (during anaphylaxis)
37
doses of adrenaline in epipens for anaphylactic shock
``` adults = 300microg kids = 150microg ```
38
Drugs that can be used day to day if have a type 1 allergy
mast cell stabilisers - sodium cromoglicate
39
In type 4 HS skin reactions: ___ T cells cause apoptosis of __ and produce ___+___ causing ____
CD8+ keratinocytes chemokines and cytokines leukocyte recruitment
40
Gold standard test for suspected allergic contact dermatitis
patch test
41
treatment for allergic dermatitis
``` minimise exposure to allergen emollients topical steroids UV phototherapy immunosuppressants ```
42
mode of inheritance of tuberous sclerosis
auto-dom or de novo
43
earliest cutaneous sign of tuberous sclerosis
ash-leaf macule - depigmented
44
pathognomic of tuberous sclerosis
periungal fibromata
45
s+s of tuberous sclerosis
``` infantile seizures longitudinal nail ridging periungal fibromata facial angiofibroma cortical tubers +//- calcification of falx cerebri may => seizures angiomyolipomas bone cysts Shagreen patch enamel pitting ```
46
3 types of epidermolyis bullosa
simplex junctional dystrophic
47
characteristic of simplex epidermolysis bullosa
epidermal light grazes and blisters doesn't cause scarring
48
characteristics of junctional epidermolysis bullosa
blistering and ulcers | may scar
49
characteristics of dystrophic epidermolysis bullosa
dermal and causes scarring | digits shorten causing mitten hands if not bandaged separately
50
EB aquisita is rare and caused by ___
AI against collagen 17
51
cafe au lait spots, axillary freckling, optic glioma, Lisch nodules are characteristic of
NF1
52
filaggrin loss of function mutations can cause:
leratosis pilaris hyperlinear palms ichthyosis vulgaris ( auto dom - fish scaling due to loss of granules in granula layer)
53
filaggrin mutations increase your risk of : (3)
eczema x4 asthma and hayfever x3 peanut allergy x5
54
ratio of melanocytes:basal cells at DEJ
1:10
55
2 components of skin basement membrane
laminin and collagen 4
56
an example of a spongiotic inflammatory skin reaction
eczema
57
elongation of the rete ridges = ___ inflammatory skin reaction
psoriasiform
58
auspitz sign in psoriasis =
pick off plaque and bleeds as vessels are close to surface
59
pemphigus vulgaris is a loss of the integrity of ___
epidermal cell adhesion
60
pemphigus vulgaris basis of AI =
IgG auto-Ig against desmoglein 3 (maintains desmosomal attachments) =>immune complexes> complement and protease > desmosomes disrupted > acanthosis
61
Characteristic of lesions caused by pemphigus vulgaris
fluid filled blisters which rupture to cause shallow erosions
62
bullous pemphigoid causes a ___ blister with no sign of ___
subepidermal | acanthosis
63
AI basis of bullous pemphigoid =
IgG attack hemidesmosomes that anchor basal cells to basement membrane
64
immunofluorescence in bullous pemphigoid shows:
linear IgG and complement around basement membrane | lots of eosinophils
65
histology of bullous pemphigoid shows:
fluid and inflam cells between basal cells and dermal papilla projectinto bulla
66
dermatitis herpetiformis is associated with ___ disease and ___ gene
coeliacs | HLA-DQ2
67
AI bullous disease that causes v itchy symmetrical lesions on elbow knees and buttocks
dermatitis herpetiformis
68
hallmark of dermatitis herpetiformis
papillary dermal microabscesses - deposits of IgA
69
Lichenoid inflammatory skin reactions are characterised by
damage to basal epidermis
70
examples of lichenoid inflammatory skin reactions
lichen planus discoid lupus drug rashes
71
characteristics of lichen planus =
``` ithcy flat topped violaceous papules irregular sawtooth acanthosis hypergranulosis, orthohyperkeratosis melanocytes drop out upper dermal infiltrate of lymphocytes cytoid bodies ```
72
comedones =
build up of keratin and sebum in pilosebaceous units
73
aggravators of rosacea
sunlight alcohol spicy foods stress
74
characteristics of rosacea
recurrent facial flushing visible blood vessels pustules rhinophyma
75
follicular ___ are often present in rosacea
dermodex mites
76
histology of rosacea =
vascular ectasia patchy inflam with plasma cells perifollicular granulomas
77
sites on the body of psoriatic plaques
extensor surfaces | scalp sacrum, hands, feet, trunk, nails
78
auspitz sign is in ___ (condition) | caused by
psoriasis | dilated capillaries in elongated dermal papillae
79
4 subtypes of psoriasis
vulgaris (chronic plaque) guttate palmoplantar pustular erythrodermic/widespread pustular (rare)
80
guttate psoriasis is commonly set off by
strep infection
81
nail signs of psoriasis
pitting dystrophy onycholysis subungal hyperkeratosis
82
systemic factors associated with psoriasis
``` increased systemic inflam markers psoriatic arthritis metabolic syndrome Crohn's cancer depression uveitis ```
83
topical treatments for psoriasis
``` vit D analogues (calcipotriol/calcitrol) coal tar dithranol steroids emollients ```
84
treatments for psoriasis (non-topical)
Phototherapy (UVB narrowband and pUVA) IS - methotrexate biological agents
85
features of mild acne -
scattered papules and pustules - mild atrophic scarring
86
features of moderate acne -
numerous papules and pustules and mild atrophic scarring
87
features of severe acne -
cysts nodules significant scarring
88
topical treatments for acne
benzoyl peroxide retinoids tetracyclines
89
properties of benzoyl peroxide that make it good for acne treatment
keratolytic | antibacterial
90
systemic drugs for acne
antibiotics | isotretinoin
91
type of drug that isotretinoin is and its effect in the Rx of acne
oral retinoid | affects sebaceous gland activity - initially aggravates acne - lots of side effects
92
eye problems that can be ass with rosacea
conjunctivitis | gritty eyes
93
topical treatments for rosacea
metronidazole | ivermectin
94
mech of action of ivermectin in rosacea Rx
decreased dermodex mite population
95
in rosacea there are no ___ on the skin as isnt a disease of pilosebaceous unit
comedones
96
oral Rx for rosacea
tetracycline | isotretinoin low dose if severe
97
Rx for 1 telangiectasia and 2 rhinophyma in rosacea
1 vascular laser | 2 laser shaving/sx
98
Wickham's striae appearance | An example of a ___
white reticular network on | lichenoid eruption
99
shiny flat-topped pink/purple papules and plaques = an example of a __
lichenoid eruption
100
sites that lichen planus typically affects
volar wrist and forearm shin ankles
101
lichen planus usually lasts ___
12-18mnths - burns itself out
102
treatment of severe itch in lichen planus
topical potent steroid, oral if extensive
103
which is deeper and which is more superficial out of bullous pemphigoid and pemphigus vulgaris
``` Deeper = pemphigoiD Superficial = pemphiguS ```
104
bullous pemphigoid causes a split in the __ pemphigus vulgaris in the ___
``` BP = DEJ PV = intra-epidermal ```
105
nikolsky sign = | differentiates between __+__
when rubbed lightly on top the skin slips away +ve = pemphigus vulgaris -ve = pemphigoid bullosa
106
large tense bullae on normal skin with erythematous base = ___ (condition)
pemphigoid bullosa
107
mucosal lesions are unlikely in pemphigoid bullosa/pemphigus vulgaris
pemphigoid bullosa | it's very common in PV
108
flaccid vesicles/bullae that rupture to leave raw area with increased infection risk = ___ (condition)
pemphigus vulgaris
109
PV and BP are ___ and last ___, remission on Rx in ___
self-limiting in months-yrs | 3-6mnths
110
mortality rates for BP and PV
``` PV = high mortality if untreated BP = lower risk ```
111
Ix for BP and PV
biopsy with direct immunofluorescence | indirect immunofluoroscence
112
treatments for BP and PV
systemic steroids IS agents topicals: emollients, steroids, antiseptics tetracycline (BP)
113
treatment for boil with surrounding cellulitis
flucloxacillin PO 1g qds
114
pyoderma gangrenosum is ass with __+__ and usually affects the _+_+_
UC and Crohn's | legs, trunk and stoma
115
patient returns from abroad with a rash that after 1-2 days leads to painful sores =
hand, foot and mouth
116
describe lesions of dermatitis and eczema
itchy, ill-defined, scaly and erythematous
117
acute phase of dermatitis and eczema lesions=
papulovesicular, red, spongiosis, ooze/scale/crust
118
chronic phase of dermatitis and eczema lesions =
lichenification, elevated plaques, increased scaling
119
histology and pathogenesis of contact allergic dermatitis
type 4 hypersensitivity | spongiotic dermatitis
120
histology and pathogenesis of contact irritant dermatitis
spongiotic dermatitis | trauma eg. soap and water
121
histology and pathogenesis of atopic eczema
genes and envnt => inflam | spongiotic dermatitis
122
histology and pathogenesis of drug induced dermatitis
type 1+4 HS reaction | spongiotic dermatitis with eosinophils
123
histology and pathogenesis of photo-induced dermatitis
reaction to UV | spongiotic dermatitis
124
histology and pathogenesis of lichen simplex dermatitis
physical skin trauma eg. scratching | spongiotic dermatitis and external trauma
125
histology and pathogenesis of stasis dermatitis
physical skin trauma - hydrostatic pressure | spongiotic dermatitis and extravasation of RBCs
126
atopic eczema distribution in babies
often wide spread | cheeks and extensors
127
appearance of herpeticum = | caused by __ infected with ___
monomeric punched-out lesions | eczema infected by herpes simplex
128
diagnostic criteria for eczema -
``` itching +>= 3 of: visible+/Hx of flexural rash generally dry skin Hx atopy onset <2yo ```
129
treatments for eczema
``` emollients topical steroids treat infection UVB mainly phototherapy systemic IS ```
130
appearance of discoid eczema
itchy, red, swollen and cracked in circular/oval patches
131
chronic actinic dermatitis causes a photosensitive reaction in ____ = type __ HS
24-72hrs | type 4
132
drug induced photosensitive eczema causes reaction in ___ type of reaction = ___
mins-hrs | exaggerated sunburn
133
stasis eczema is 2ndry to ____ | site = ___ and may lead to ___/___
hydrostatic pressure, oedema, RBC extravasation lower legs ulceration and hyperpigmentation
134
cradle cap in infants or dandruff =
seborrhoeic eczema
135
appearance of pompholyx eczema
spongiotic vesicles on hands/feet

DermJaz (9 decks)

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