Skin Reactions & Vesiculobullous Disorders

Question 1

wheals that are transient, irregular, edematous papules and plaque that are pruritic

Answer 1

urticaria

Question 2

inducible form of urticaria that appears within 6-7 mins and resolves in 15-30 mins

Answer 2

dermatographism

Question 3

what is urticaria with any other body system dysregulation due to an immune response considered?

Answer 3

anaphylaxis

Question 4

a patient presents with pruritic sharply defined wheals that are raised, erythematous, irregular and annular. they become confluent across their arm. what is the diagnosis and 1st line treatment options (3)?

Answer 4

urticaria

2nd gen antihistamine:
loratadine
cetirizine
fexofenadine

Question 5

a patient presents with this skin condition and the first line treatment is not working. what is the diagnosis and what are 3 adjust treatment options?

Answer 5

urticaria

steroids
montelukast
cyclosporine

Question 6

skin reaction to UV radiation

Answer 6

photosensitivity reaction

Question 7

skin changes mimicking normal sunburn changes

Answer 7

sunburn type photosensitivity reaction

Question 8

macules, papules, or plaques similar to eczematous dermatitis

Answer 8

rash - photosensitivity reaction

Question 9

sun exposure causes immune-mediated urticaria

Answer 9

urticarial photosensitivity reaction

Question 10

a patient presents with pain on skin, fever, malaise, erythema, edema, vesicles/bullae and weeping/cracking skin. what is the diagnosis?

Answer 10

photosensitivity reaction

Question 11

what is the treatment for photosensitivity reaction that presents with vesicular, weeping lesions?

Answer 11

cover + keep them clean
with cooling + soothing dressings

Question 12

what is some education to give a patient with photosensitivity reaction? (2)

Answer 12

avoid UV light
wear sunscreen

Question 13

what med can be used for photoallergic reactions?

Answer 13

steroids

Question 14

what is acanthosis nigricans often associated with?

Answer 14

skin tags

Question 15

what does rapid onset of acanthosis nigricans increase the risk of?

Answer 15

malignant etiology

Question 16

acanthosis nigricans without associated endocrine disorder

Answer 16

type 1; hereditary bengin

Question 17

acanthosis nigricans + endocrine disorders associated with insulin resistance and diabetes

Answer 17

type 2; benign

Question 18

acanthosis nigricans associated with obesity, more common in patients with darker pigments and concurrent metabolic syndrome

Answer 18

type 3; pseudo-acanthosis nigricans

Question 19

acanthosis nigricans + use of nicotinic acid in high doses, and other medication

Answer 19

type 4; drug-induced

Question 20

acanthosis nigricans + adenocarcinoma of gastrointestinal or genitourinary tract

Answer 20

type 5; malignant

Question 21

a patient presents with darkening of skin pigmentation + velvety and skin lines accentuated. what is the diagnosis + treatment?

Answer 21

acanthosis nigricans

treat underlying disorder

Question 22

what is the first line diagnostic for acanthosis nigricans? what are the specific diagnostics?

Answer 22

rule out diabetes + prediabetes

fasting/random glucose + HgbA1c

Question 23

a bullous autoimmune disease usually seen in geriatric patients

Answer 23

bullous pemphigoid

Question 24

a patient presents with erythematous pruritic, papular/urticarial lesions with large tense bullae and erosive mucosal lesions. on exam, there is a negative nikolsky sign. what is the diagnosis and treatment (3)?

Answer 24

bullous pemphigoid

refer to derm - steroids, IV immunoglobulin, methotrexate

Question 25

a patient presents with this skin lesion. what is the diagnosis and 2 diagnostics that can be done?

Answer 25

bullous pemphigoid biopsy linear IgG deposits serum IgG antibodies

Question 26

an autoimmune disorder of the skin and mucous membranes due to loss of cell adhesion, leading to faccid bullae and weak surfaces that rupture.

Answer 26

pemphigus vulgaris

Question 27

a patient presents with painful and tender mouth lesions + epistaxis, hoarseness, and dysphagia. what is the diagnosis and treatment (2)?

Answer 27

pemphigus vulgaris refer to derm - steroids + methotrexate

Question 28

a patient presents with erosions with blood and crust. on exam, there is a positive nikolsky sign. what is the diagnosis and treatment?

Answer 28

pemphigus vulgaris refer to derm - steroids + methotrexate

Question 29

a patient presents with these lesions. what is the diagnosis? what are 2 diagnostics that can be done?

Answer 29

pemphigus vulgaris biopsy serum IgG antibodies

Question 30

a biopsy stained with direct immunofluorescence (IF) reveals IgG and compliment C3 deposited in lesional and paralesional skin within the intercellular substance of the dermis. what is the diagnosis?

Answer 30

pemphigus vulgaris