Term
| What do you call chronic, excessive keratin buildup (hyperkeratosis), that results in fish-like scales clinically? |
|
Definition
|
|
Term
| T/F Ichthyosis is an inherited disease. |
|
Definition
| false, it can be inherited or acquired |
|
|
Term
|
Definition
| hives; characterized by localized mast cell degranulation and resultant dermal microvascular hyperpermeability |
|
|
Term
| Urticaria can give rise to "wheals" which are... |
|
Definition
| pruritic edematous plaques |
|
|
Term
| What do you call hives that result from substances that directly incite the degranulation of mast cells? |
|
Definition
| IgE- independent urticaria |
|
|
Term
| Describe the gross appearance of eczema. |
|
Definition
red, papulovesicular, oozing crusted lesions
if persistent develops into raised scaling plaques due to reactive acanthosis and hyperkeratosis |
|
|
Term
| Name some different types of acute eczematous dermatitis. |
|
Definition
| allergic contact dermatitis, atopic dermatitis, drug-related eczematous dermatitis, photoeczematous dermatitis, primary irritant dermatitis |
|
|
Term
| What is erythema multiforme? |
|
Definition
| uncommon self-limited disorder that is likely a hypersensitivity reaction to certain infections and drugs. |
|
|
Term
| What is erythema multiforme associated with? |
|
Definition
| infections (HSV, mycoplasma, etc), drugs (sulfonamides, penicillin, etc.), malignant diseaes (carcinomas and lymphomas), collagen vascular disease (lupus, dermatomyositis, and polyarteritis nodosa) |
|
|
Term
| What does EM look like clinically? |
|
Definition
| clinically an array of "multiform" lesions (macules, papules, vesicles, bullae, and target lesions) |
|
|
Term
| What is the extensive and febrile form of EM known as? What is the worst type of EM known as? |
|
Definition
stevens-johnsons syndrome
toxic epidermal necrolysis |
|
|
Term
| T/F Ichthyosis is an acute inflammatory disorder. |
|
Definition
| false, it is a disorder of epidermal maturation. Urticaria, acute eczematous dermatitis and erythema multiforme are examples of acute inflammatory disorders |
|
|
Term
| T/F Psoriasis is an example of a disorder of epidermal maturation. |
|
Definition
| False, in the powerpoint it is labeled as a chronic inflammatory disorder along with seborrheic dermatitis and lichen planus |
|
|
Term
| What percent of people in the US are affected by Psoriasis? |
|
Definition
|
|
Term
| If you see psoriasis lesions on a patient, you should immediately screen for _______. |
|
Definition
|
|
Term
| What areas are commonly affected by psoriasis? |
|
Definition
| elbows, knees, scalp, lumbosacral areas, intergluteal cleft and glans penis |
|
|
Term
| What lesion is typically described as a well-demarcated, pink plaque covered by a silvery scale? |
|
Definition
|
|
Term
| Are nail changes common in psoriasis cases? |
|
Definition
| yeah they occur in 30% of cases |
|
|
Term
| What form of psoriasis can be life threatening? |
|
Definition
|
|
Term
|
Definition
| when picking off a psoriasis plaque causes bleeding |
|
|
Term
| What is Koebner phenomenon? |
|
Definition
| psoriatic or lichen planus lesions induced by trauma |
|
|
Term
| T/F Psoriasis is more common than Seborrheic dermatitis. |
|
Definition
| False, seborrheic dermatitis is 1-3% of general population; 1-2% have psoriasis |
|
|
Term
| Where does seborrheic dermatitis occur? |
|
Definition
| regions with high density of sebaceous glands (scalp, forehead, external auditory canal, retroauricular area, nasolabial folds, presternal area) |
|
|
Term
| What's the medical name for dandruff? |
|
Definition
|
|
Term
| Seborrheic dermatitis is commonly seen in people with what types of diseases? |
|
Definition
|
|
Term
| What is seborrheic dermatitis? |
|
Definition
| likely a combination of yeast overgrowth and inflammatory response from host |
|
|
Term
| What does lichen planus look like grossly? |
|
Definition
| ithcy, violaceous, flat-topped papules that may coalesce focally to form plaques. papules often highlighted by wht dots or lines (wickham striae) areas of hypergranulosis |
|
|
Term
| Where are lichen planus lesions common? |
|
Definition
| extensors. wrists,elbows, glans penis |
|
|
Term
| what are the inflammatory and noninflammatory blisterig dzs? |
|
Definition
inf: pemphigous vulgaris, bullous pemphigoid
noninf: epidermolysis bullosa, porphyria |
|
|
Term
|
Definition
| bilstering d/o due to auto-Abs against intercellular attachments within the epidermis and mucosal epithelium |
|
|
Term
| How old are patients with pemphigus? |
|
Definition
|
|
Term
| What are the variations of pemphigus? |
|
Definition
| vulgaris, vegetans, foliaceus, erythematosus, paraneoplastic |
|
|
Term
| What is the most common type of pemphigus? |
|
Definition
| pemphigus vulgaris; more than 80% of cases and involves the mucosa and skin, esp points of pressure |
|
|
Term
|
Definition
| a rare form that usually presents with large, moist, vegetating plauqes studded with pustules on the groin, axillae, and flexural surfaces |
|
|
Term
| What is the benign form of pemphigus endemic in Brazil? |
|
Definition
| P. foliaceus aka fogo selvagem |
|
|
Term
| Where is P. FOliaceus most common? |
|
Definition
| scalp, face, chest and back |
|
|
Term
| What is P. Erythematosus? |
|
Definition
| P. Foliaceus that occurs in lupus |
|
|
Term
| Paraneoplastic pemphigus occurs in association with various malignances, most commonly _________. |
|
Definition
|
|
Term
| What are the abs that cause p. vulgaris? |
|
Definition
| IgG abs against desmoglein 3 |
|
|
Term
| Which bullae rupture more easily: those associated with pemphigus or bullous pemphigoid? |
|
Definition
| pemphigus rupture more easily |
|
|
Term
| What population is affected by bullous pemphigoid? |
|
Definition
|
|
Term
| What are the sites of involvement of bullous pemphigoid? |
|
Definition
| inner thighs, flexor forearms, axillae, groin, and lower abdomen |
|
|
Term
| What are the abs that cause bullous pemphigoid? |
|
Definition
| PBAg2 (collagen XVII) and BPAg1 (affects area of hemidesmosomes) |
|
|
Term
| Generation of auto-abs to hemidesmosomes in BP results in... |
|
Definition
continuous linear IgG along basement membrane
fixation of complement
tissue injury by locally recruited PMNs and eos |
|
|
Term
| Describe the lesions of dermatitis herpetiformis. |
|
Definition
| rare; characterized by urticaria and grouped vesicles. lesions are extremely pruritic, bilateral, symmetric and grouped and involve extensor elbows, knees, upper back, and buttocks |
|
|
Term
| What population is predominantly affected by dermatitis herpetiformis? |
|
Definition
| predominantly males; can occur in assoc. with intestinal celiacs diseas and responds to a gluten-free diet |
|
|
Term
| What is the connection between DH and celiacs? |
|
Definition
| IgA against dietary gluten/gliadin cross react with reticulin, a coomponent of the anchoring fibrils. Resultant injury and inflammation produces subepidermal blister |
|
|
Term
| Where is the blister formed in DH? |
|
Definition
|
|
Term
| What is epidermoysis bullosa? |
|
Definition
| non-inflammatory bullae; gp of d/os caused by inherited defects in structural proteins that lend mechanical stability to the skin. Common feature is proclyvity to form blisters at sites of pressure, rubbing or trauma, at or soon after birth |
|
|
Term
|
Definition
| defects of basal cell layer of epidermis from mutations in genes encoding keratins 14 or 5 |
|
|
Term
|
Definition
| blisters that occur in otherwise ihstologically normal skin at the level of the lamina lucida |
|
|
Term
|
Definition
| blisters that develop beneath the lamina densa that is associated with anchoring fibril problems and mutations in type VII collagen. Squamous cell carcinoma can sometimes arise from these blisters |
|
|
Term
| What is the histological description of junctional EB? |
|
Definition
| noninflammatory subepidermal blister at the level of the lamina lucida |
|
|
Term
| What are hte 5 major types of porphyria? |
|
Definition
| congenital erythropoietic porphyria, erythrohepatic protoporphyria, acute intermittent porphyria, porphyria cutanea tarda, mixed porphyria |
|
|
Term
| What are the cutaneous manifestations of porphyria? |
|
Definition
| urticaria and vesicles that heal with scarring and are exacerbated by exposure to sunlight |
|
|
Term
| What do porphyria lesions look like via light microscopy? |
|
Definition
| subepidermal vesicle with associated marked thickening of the walls of superficial dermal vessels. (Serum proteins including Igs, form deposits in walls of vessels) |
|
|
Term
| T/F Acne vulgaris can be induced or exacerbated by drugs. |
|
Definition
|
|
Term
| What are the lesions of noninflammatory acne vulgaris called? |
|
Definition
| open comedones or closed comedones |
|
|
Term
| What is the difference between open and closed comedones? |
|
Definition
open= small follicular papule containing a central black keratin plug
closed= follicular papules without a visible central plug |
|
|
Term
| What types of lesions characterize inflammatory acne? |
|
Definition
| erythematous papules, nodules, and pustules |
|
|
Term
| What percent of the population is affected by rosacea? |
|
Definition
|
|
Term
| Is rosacea more common in men or women? |
|
Definition
|
|
Term
| What are the four stages of rosacea? |
|
Definition
| 1) flushing episodes (pre-rosacea) 2) persistent erythema and telangiectasia 3) pustules and papules 4) rhinophyma |
|
|
Term
|
Definition
| permanent thickening of the nasal skin by confluent erythematous papules and follicular prominence |
|
|
Term
|
Definition
| inappropriate activation of the innate immune system because pts have high cutaneous levels of the endogenou santimicrobial peptide cathelicidin which is an important mediator of the innate immune response |
|
|
Term
| What are the two types of panniculitis? |
|
Definition
| erythema nodosum and erythema induratum |
|
|
Term
|
Definition
inflammatory reaction in subcutaneous adipose tissue that may preferentially affect either/or the CT septa separating lobules of fat or the lobules of fat themselves.
Involves lower legs and has a subacute to chronic course usually |
|
|
Term
| Which is the most common panniculitis? |
|
Definition
|
|
Term
| T/F The presentation of erythema nodosum is usually acute. |
|
Definition
|
|
Term
| Erythema nodosum is often associated with what d/os? |
|
Definition
| infections (beta-hemolytic strep MC), drug administration (sulfonamides, oral contraceptives), sarcoidosis, inflammatory bowel disease, certain malignant neoplasms, idiopathic |
|
|
Term
| What is the clinical presentation of erythema nodosum? |
|
Definition
| poorly defined, exquisitely tender, erythematous plaques. +/- fever and malaise. Over weeks, lesions usually flatten and become bruise-like |
|
|
Term
| If you suspect erythema nodosum then what should you make sure to do on biopsy? |
|
Definition
| generously sample the subcutaneous tissue |
|
|
Term
| What is the histological appearance of early lesions of erythema nodosum? |
|
Definition
| widening of CT septa due to edema, fibrin exudation, and PMN infiltration |
|
|
Term
| What is the histological appearance of late lesions of erythema nodosum? |
|
Definition
| infiltration by lymphs, macrophages, giant cells, and occasional eosinophils associated with septal fibrosis. Vasculitis is NOT present |
|
|
Term
| What population is most commmonly affected by erythema induratum? |
|
Definition
| adolescents and menopausal women |
|
|
Term
| Which panniculitis is regarded as a primary vasculitis? |
|
Definition
| erythema induratum because it affects deep vessels supplying lobules of the subcutis causing subsequent necrosis and inflammation within the fat |
|
|
Term
| What is the gross appearance of erythema induratum? |
|
Definition
| presents as a erythematous, slightly tender nodules that usually go on to ulcerate. |
|
|
Term
| What skin disease was originally considered to be a hypersensitivity response to tuberculosis? |
|
Definition
|
|
Term
| T/F Today, Erythema induratum most commonly occurs without an associated underlying diseae. |
|
Definition
|
|
Term
| T/F Warts are due to infection. |
|
Definition
|
|
Term
| What causes warts and how do you get rid of them? |
|
Definition
| caused by HPV; generally self-limited regressing spontaneously within 6-24 months |
|
|
Term
| What is another name for the common wart? |
|
Definition
|
|
Term
| What's another name for a flat wart? |
|
Definition
|
|
Term
| What's the name for warts that occur on the palm and the sole of the foot and are often confused with calluses? |
|
Definition
| verruca plantaris, and verruca palmaris |
|
|
Term
| What's the name for a venereal wart? |
|
Definition
|
|
Term
| What is the histological description of verrucae? |
|
Definition
| verrucous or papillomatous epidermal hyperplasia and cytoplasmic vaculolization (koilocytosis), producing haloes of pallor surrounding infected nuclei |
|
|
Term
| What is a common, self-limited viral disease of the skin caused by a poxvirus? |
|
Definition
|
|
Term
| How is molluscum contagiosum spread? |
|
Definition
|
|
Term
| Where on the body do molluscum contagiosum lesions show up most often? |
|
Definition
| trunk and anogenital areas |
|
|
Term
| What does molluscum contagiosum look like clinically? |
|
Definition
| pink to skin-colored umbilicated papules |
|
|
Term
| "cupliek verrucous epidermal hyperplasia" describes what skin lesion? |
|
Definition
|
|
Term
| What's another name for molluscum body? |
|
Definition
|
|
Term
| What do you call a superficial bacterial infection of the skin? |
|
Definition
|
|
Term
| What are the two forms of impetigo? |
|
Definition
| impetigo contagiosa and impetigo bullosa |
|
|
Term
| What organism causes impetigo? |
|
Definition
|
|
Term
| What does impetigo look like? |
|
Definition
| erythematous macule, but multiple small pustules rapidly supervene. Pustules break, shallow erosions form, covered with drying serum giving the characteristic "honey-colored crust" |
|
|
Term
| Where does impetigo usually occur on the body? |
|
Definition
| involves exposed skin, particularly face and hands |
|
|
Term
| What is the characteristic microscopic feature of impetigo? |
|
Definition
| accumulation of neutrophils beneath the stratum corneum, often producing a subcorneal pustule |
|
|
Term
| How do bacterial infections result in blisters like in impetigo? |
|
Definition
| bacterial production of a toxin that specifically cleaves desmoglein 1 |
|
|
Term
| Superficial fungal infections are confined to what layer of the epidermis? |
|
Definition
|
|
Term
| Superficial fungal infections are caused by which organisms? |
|
Definition
| dermatophytes which grow in the soil and on animals and produce a number of diverse and characteristic clinical lesions |
|
|
Term
| What do you call spread to or primary infection of the nails with a superficial fungal infection? |
|
Definition
|
|
Term
| What causes tinea versicolor? |
|
Definition
| melassezia furfur (a yeast) |
|
|
Term
| Where does tinea versicolor typically appear? |
|
Definition
|
|
Term
| How do you describe tinea corporis microscopically? |
|
Definition
| mild spongiotic dermatitis and focal neutrophilic abscesses |
|
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