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Derm
Chapter 18
43
Criminology
Professional
06/28/2011

Additional Criminology Flashcards

 


 

Cards

Term
Dermal Induration Important Points:
Presents as ____ or ____ skin
Usually requires a ____
Definition
firm or thickened
biopsy
Term
Scleroderma/Morphea Definition:
Definition
Increase in the number and activity of fibroblasts that produces excessive collagen
Term
_____ – scleroderma localized to the skin
Definition
Morphea
Term
________________________
More diffuse cutaneous fibrosis
Classified as an ‘autoimmune’ collagen vascular disease
Definition
Progressive systemic sclerosis
Term

Scleroderma/Morphea 

History
PSS
•_______ phenomenon most commonly seen initially
–___>____>____
»____caused by vasoconstriction
Skin tightening
Contracture of the fingertips
Difficulty swallowing
Shortness of breath
Joint pain
Definition
Raynaud’s
White -> purple -> red
White
Term

Scleroderma/Morphea

 

Physical Examination
Sharply demarcated _____
–____ lesions – violaceous hue and whitish center
–____ lesions – brown or yellow brown
Most common on ____
Frontal linear scleroderma – _________ -> have to send them to opthamology b/c can affect the eye! Usually treated w/ methotrexate and prednisone
–_____– skin tightening that affects the hands and face
–____– sausage digits
Skin hyperpigmented, telangiectatic
Generalized thickening portends a worse prognosis
CREST syndrome – ....
Definition
plaque
Early
Mature
trunk
en coupe de sabre******
Acroscerlosis
Sclerodactyly

Calcinosis, Raynaud’s syndrome, Esophageal dysmotility, Sclerodactyly, and Telangiectasia
Term

Scleroderma/Morphea

 

Differential diagnosis
–_________
Women get this in vaginal area
–_________
Diabetics get this – hard plaque yellow on chin
No good treatment – can try steroids
Myxedema
Hypothyroidism
Skin feels more doughy than hard
Scleromyxedema
Mucin deposition in the skin
Serum monoclonal immunoglobulin G (IgG) protein (7S)
MCTD (mixed connective tissue disorder)
Overlap syndrome with features of several collagen vascular diseases
Anti-RNP antibodies
Graft-versus-host disease
PCT
Bleomycin
Nephrogenicfibrosingdermopathy
Seen in patients with renal insufficiency that have had gadolinium dye exposure
Definition
LSA (lichen sclerosis et atrophicus)
NLD (necrobiosis lipoidica)

"these are what she told us to know"
Term

Scleroderma/Morphea

 

Laboratory and Biopsy
CBC, UA, renal function tests, CXR, pulmonary function tests, barium swallow
–_____ positive in 95% of patients with PSS
–_______antibodies  – CREST
–_______ antibodies – diffuse slceroderma
Biopsy
Thickened dermis
Increased fibroblasts
Increased size and number of collagen bundles
Definition
ANA
Anticentromere
Scl-70
Term

Scleroderma/Morphea

 

Therapy
Topical, intralesional and systemic steroids
PSS
•_______ – prevents cross linking of collagen
DOC
Requires monthly _____ & ______
»Aplastic anemia and renal insufficiency
Prednisone, azathrioprine, methotrexate – immunosuppressants
Physical therapy
Raynaud’s
•_______
Definition
D-penicillamine
CBC and UA
Calcium channel blockers
Term

Scleroderma/Morphea

 

Course and complications
_____ eventually softens but can take years so give them tx
Residual hypo- and hyperpigmentation common
–____
5-year survival rate of 50-90% depending on visceral involvement
Renal failure and susbsequent HTN common cause of death
Pumlonary fibrosis
Malnutrition from esophageal complications
Cutaneous ulcerations and ischemia
Definition
Morphea
PSS
Term

Scleroderma/Morphea

 

Pathogenesis
Immunologically mediated
Possible link to __________
Treated in Europe with some success
American studies have not confirmed its role
Definition
Borrelia burgdorferi
Term

Granuloma Annlare

 

Defintion
–____ skin lesion
Dermal papules forming annular plaques
Most common on ____ & _____
Center becomes ____
Definition
Asymptomatic
dorsal hands and feet
depressed
Term

Granuloma Annlare

 

Incidence
Most common in ___ & ____
Females ____ males
Definition
children and young adults
>
Term

Granuloma Annlare

 

History
May be mistaken for ____
Definition
tinea corporis
Term

Granuloma Annlare

 

Physical Examination
Shiny ___ papules and ___ plaques that are centrally depressed
May be skin-colored, violaceous, or erythematous
Other variants
•_____
•_____
Definition
dermal
annular
Subcutaneous
Perforating
Term

Granuloma Annlare

 

Differential diagnosis (3)
 
Definition
–Sarcoidosis
–LP
–NLD
Term

Granuloma Annlare

 

Laboratory
–____ associated with generalized GA
Rare association with____
Definition
DM
lymphoma
Term

Granuloma Annlare

 

Biopsy
Necrobiosis (degenerative collagen) in the dermis

 

Histiocytic
and _______ cell infiltrate
Definition
multinucleated giant
Term

Granuloma Annlare

 

Therapy
Topical and intralesional ___
–____ every 4 weeks
–___ & ___
for generalized cases
Definition
steroids
Liquid nitrogen
PUVA and hydroxychloroquine
Term

Granuloma Annlare

 

Course and complications
75% of cases resolve after __years
Definition
two
Term

Lichen sclerosis et atrophicus

 

Definition
–___ inflammatory condition
Sclerotic ___ plaques due to thickening of the superficial dermis with overlying, thin, ___ epidermis
Major ____
Now called ________
Definition
Chronic
white
wrinkled
pruritus
lichen sclerosis
Term

Lichen sclerosis et atrophicus

 

Incidence
Females ___ males
Definition
>
Term

Lichen sclerosis et atrophicus

 

History
Non-genital skin _____ but can be dry and pruritic
Intractable pruritus with ____ involvement
May appear as ____in young females
Definition
asymptomatic
genital
bruises
Term

Lichen sclerosis et atrophicus

 

Physical examination
Non-genital skin
•____ & ___
Initial lesions are ___
Genital skin
Erythema evolves into ___ sclerotic plaque that may erode and scar
Men - ____
Definition
Trunk and extremities
guttate - drop like
hypopigmented
phimosis
Term

Lichen sclerosis et atrophicus

 

Differential diagnosis
Non-genital skin – ___
Genital skin – ____
–____
– biopsy mandatory
 
Definition
morphea
sexual abuse
Early SCC (erythroplasia of Queyrat)
Term

Lichen sclerosis et atrophicus

 

Laboratory and Biopsy

Not associated with ___ disease

Smudgy collagen in the superficial dermis with flattened DE junction

Definition
systemic
Term

Lichen sclerosis et atrophicus

 

Therapy
–____ for genital skin – must slowly taper
–____ for generalized disease
Definition
Ultrapotent steroids
Acitretin
Term

NecrobiosisLipoidica

 

Definition
Well-circumscribed, _____ plaques with a ____ center most common on pre-___ region
Strong association with ___
Definition
yellowish
yellow
tibial
diabetes
Term

NecrobiosisLipoidica

 

Incidence
Female:male ratio ___:___
–____
most commonly affected
 
Definition
3:1
Young adults
Term

NecrobiosisLipoidica

 

History

–____ evolves

May rarely ulcerate and become painful

 

 

 

 

Definition
Slowly
Term

NecrobiosisLipoidica

 

Physical examination
–________ (early) papule that evolves into a plaque
Center becomes atrophic and takes on a ____ hue
Prominent ____
–_____ border
Firm
 
Usually _____
Definition
Brownish-red
yellowish
telangiectasias
Elevated
symmetric
Term

NecrobiosisLipoidica

 

Differential diagnosis (2)

Definition
GA
sarcoidosis
Term

NecrobiosisLipoidica

 

Laboratory

–________ in 2/3 patients

Definition
Glucose intolerance
Term

NecrobiosisLipoidica

 

Biopsy

Layered granulomatous inflammation in the dermis that is parallel to the dermis

Connective tissue _____

–______

 

 

 
of blood vessels
Definition
degeneration
Destruction
Term

NecrobiosisLipoidica

 

Therapy

–____ cessation

Topical and intralesional ___

–______ - slow response to this treatment

Definition
Smoking
steroids
Pentoxifylline (trental)–> "allows for the plateles to squeeze through things a little better – helps blood go to the area"
Term
[image]
Definition
scleroderma/Morphea
Term
[image]
Definition
sclerodactyly
Term
[image]
Definition
Sarcoid - can mimic granuloma annlare
Term
[image]
Definition
Raynaud's Phenomenon
Term
[image]
Definition
Necrobiosis Lipoidica
Term
[image]
Definition
Lichen sclerosis et atrophicus
Term
[image]
Definition
Lichen sclerosis et atrophicus - genital
Term
[image]
Definition
granuloma annlare
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