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Dermatology Chapter 8
chapter 8 derm
54
Anatomy
Graduate
06/07/2011

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Term
Eczema is characterized histologically by intercellular edema called ___.
Definition
Spongiosis
Term
3 types of dermatitis:
Definition
- Acute- vesicles
- Subacute- papules
- Chronic lichenification
Term
Essential dermatitis is a ___ ___ diagnosis in which the underlying ___ cannot be found (allergen/irritant) and it fits no defined ____ such as atopic or seborrheic dermatitis.
Definition
- nonspecific idiopathic
- cause
- pattern
Term
Dyshydrotic eczema aka ___ presents as vesicles on ___, ___, and sides of ___. It is described as ___ __.
Definition
- pompholyx
- palms, soles, and sides of digits
- tapioca pudding
Term
__ __ is generalized dermatitis following localized acute dermatitis.
Definition
Id eruption
Term
___ __ occurs in the elderly. It is common on the lower extremities in the winter due to low humidity.
Definition
Xerotic Eczema
Term
__ ___ presents as oval patches.
Definition
Nummular eczema
Term
Therapy for eczema and dermatitis:
Definition
- topical corticosteroids (mainstay)
- topical immunomodulators (Pimecrolimus and Tacrolimus)these are good for face and intertigenous areas, do not cause atrophy
- astringent dressings for weeping eczema
- antihistamines
- antibiotics for secondary bacterial infections
Term
Contact dermatitis is either __ or __.
Definition
irritant or allergic
Term
70% of contact dermatitis is due to an ___ that has a direct toxic effect (chemicals, acids, alkaloids, water). 30% of contact dermatitis is due to ___, which is a type IV hypersenstivity reaction (nickel, poison ivy/oak/sumac, rubber compounds, medications) .
Definition
- irritant
- allergies
Term
Lady that is OCD and washes her hands way too much will get __ ___ __.
Definition
irritant contact dermatitis
Term
linear streaks of papules and vesicles with indurated plaques and patches.
Definition
allergic contact dermatitis (poison ivy)
Term
Smoke of burning plants can result in confluent severe dermatitis of exposed skin (poison ivy).
Definition
Term
Diaper rash is a form of __ __ __, it spares the __ __.
Definition
- irritant contact dermatitis
- spares the skin folds
Term
With allergic contact dermatitis, short term you can treat with topical corticosteroid but in the long term...
Definition
must discontinue exposure to allergen (nickel)
Term
Treatment for severe and generalized contact dermatitis:
Definition
40 mg Prednisone daily for 10 days
Term
Treatment for milder dermatitis:
Definition
topical steroids/topical immunomodulators with antihistamines as needed
Term
6 types of Eczematous Eruptions:
Definition
- Essential dermatitis
- Contact dermatitis
- Atopic dermatitis
- Seborrheic dermatitis
- Stasis dermatitis
- Lichen simplex chronicus
Term
Atopic dermatitis diagnostic criteria:
Definition
- Pruritus
- typical morphology and distribution
- flexural lichenification in adults and older children
- facial and extensor papulovesicles in infancy
- chronic-relapsing course
- personal or family history of atopic disease (allergic rhinitis, asthma, atopic dermatitis)
Term
Atopic dermatitis usually starts in __ ___.
Definition
young children (2 months - 5 years)
Term
___ is the clinical hallmark of chronic atopic dermatitis.
Definition
Lichenification
Term
Normal distribution for atopic dermatitis in children:
Definition
- face/head
- hands
- groin
- front of knees
- feet
Term
Normal distribution for atopic dermatitis in older children and adults:
Definition
- forehead, lower face
- upper chest
- neck
- back of hands
- wrists
- antecubital and popliteal fossase
Term
atopic dermatitis therapy:
Definition
- moisturizers/bath oil
- topical steroids/immune modulators
- mild soaps
- treatment of any superimposed bacterial infection

severe cases: short course of cyclosporine

(with this condition you don't have normal lipid layer in epidermis, so try to replace it with lotions)

chronic relapsing condition, but many outgrow it by late adolescence
Term
__ __ is a chronic superficial inflammatory process affecting hairy regions of the body, espcially the __, __, and __.
Definition
- Seborrheic dermatitis
- scalp, eyebrows, and face
Term
Seborrheic dermatitis is caused by ___ ___ aka ___ ___. It is associated with Parkinson's disease and AIDs.
Definition
- Pityrosporum Ovale aka Malassezia globosa
Term
Seborrheic dermatitis is characterized by patches and plaques with __ __, mild to moderate __, and a __ ___ ___.
Definition
- indistinct margins
- erythema
- yellowish, greasy scaling
Term
atopic dermatitis therapy:
Definition
- moisturizers/bath oil
- topical steroids/immune modulators
- mild soaps
- treatment of any superimposed bacterial infection

severe cases: short course of cyclosporine

(with this condition you don't have normal lipid layer in epidermis, so try to replace it with lotions)

chronic relapsing condition, but many outgrow it by late adolescents
Term
__ __ is a chronic superficial inflammatory process affecting hairy regions of the body, espcially the __, __, and __.
Definition
- Seborrheic dermatitis
- scalp, eyebrows, and face
Term
Seborrheic dermatitis is characterized by plaques and patches with __ __, mild to moderate ___, and a __ __ __.
Definition
- indistinct borders
- erythema
- yellowish greasy scaling
Term
Distribution of Seborrheic dermatitis:
Definition
- scalp
- eyebrows
- eyelids
- nasolabial creases
- ears
- chest
- intertriginous areas
- axilla
- groin
- buttocks
- inframammary folds
Term
___ is the mildest form of seborrhiec dermatitis in which one sees fine white scales without erythema or pruritis.
Definition
Dandruff
Term
Seborrheic dermatitis therapy:
Definition
- nonprescription and antiseborrheic shampoos containing zinc pyrithione (head and shoulders), selenium sulfide (head and shoulders intensive treatment) or Ketoconazole (must be left on skin for 3-5 minutes before rinsing)
- topical steroids/immune modulators

(avoid high potency steroids on face)

( in lecture he said treat with the topical, then maitenance with antifungal)
Term
__ __ is an eczematous eruption of the lower legs secondary to peripheral venous disease.
Definition
Stasis dermatitis

- Venous incompetence causes increased hydrostatic pressure and capillary damage leading to edema, inflammation, fibrin deposition, tissue hypoxia and overlying skin change.
Term
With stasis dermatitis you will often see __ __ and/or __ __. The involved skin has __ ___ , __ __, petechiae, ___ __, scaling, and/or weeping.
Definition
- varicose veins or pitting edema
- BROWNISH HYPERPIGMENTATION
- DULL ERYTHEMA
- THICKENED SKIN
Term
Stasis dermatitis therapy:
Definition
- prevent venous stasis and edema: supportive hose, compression stockings, lose weight, elevate legs above heart, topical steroids

- can lead to leg ulceration if uncontrolled
- beware of causing allergy with use of topical corticosteroids
Term
Lichen simplex chronicus is aka ___. It is a chronic eczematous eruption of skin that results from scratching. Can be located anywhere within fingers reach, but common on __ of males. Produces a chronic itch-scratch cycle.
Definition
- Neurodermatitis
- scrotum
Term
___ ___ are linear "dug out" lesions everywhere, except the mid-back, where typically neurotic women cannot reach.
Definition
Neurotic Excoriations
Term
__ ___ are self inflicted injuries for secondary gain. They are often ulcerated and have __ or ___ outlines.
Definition
- Factitious dermatitis
- linear or geometric
Term
__ __ __ occurs when a patient is convinced that they are harboring parasites. They often bring in specimens to prove their case. Usually excoriations and ulcerations are seen secondary to picking.
Definition
Delusions of parasitosis
Term
Darier's Disease aka __ ___ is an autosomal ___ ___. This presents as tan, pink, brown rough feeling ___ coalescing into __ __ on seborrheic areas like the __, __, __, and __. These plaques often become secondarily infected.
Definition
- keratosis follicularis
- dominant genodermatosis
- papules
- large plaques
- scalp, face, neck, trunk
Term
With Darier's disease the papules and plaques __ ___ __, they may __, and there is a __ __. A __ is done to confirm the diagnosis.
Definition
- never go away
- smell
- family history
- biopsy
Term
With Darier's disease, the skin biopsy would show __ ___ __ with __ ___.
Definition
- epidermal suprabasalar clefts
- acantholytic keratinocytes
Term
Glucagonoma Syndrome aka ___ __ ___ is a multisystem disorder caused by a __ __ of the __ __ cell.
Definition
- Necrolytic Migratory Erythema
- pancreatic tumor of the islet alpha cell
Term
With Glucagonoma Syndrome/Necrolytic Migratory Erythema you would see periorificial, acral, and flexural erythematous scaling __, __, and __ with associated ___. A skin biopsy would show __ __ __. These people are really sick (weight loss, anemia, diarrhea, diabetes)
Definition
- papules, patches, and plaques
- glossitis
- superficial epidermal necrosis
Term
Langerhans cell histiocytosis formerly known as __ __ is a __ of the Langerhans cells. .
Definition
- Histiocytosis X
- neoplasm
Term
Langerhan cell histiocytosis forms (3):
Definition
- Acute disseminated (Letterer-Siwe Disease)
- Chronic multifocal (Hand-Schuller-Christian disease)
- Localized (Eosinophilic granuloma)
Term
Acute disseminated histiocytosis presents in ___ as ___ __ __. See pink, sometimes hemorrhagic, papules and scaling with slightly eroded patches. Skin biopsy shows proliferation of __ __, stain for __ __ and see __ __ on electron microscopy.
Definition
- infancy
- recalcitrant diaper rash
- Langerhan cells
- S-100
- Birbeck granules
Term
With lichen sclerosis you will see ivory white __ ___, often in the __ area. Treat early to prevent scarring.
Definition
- atrophic patches
- genital area
Term
Pemphigus Foliaceus is a very rare ___ disease similar to pemphigus vulgaris. You will see erythematous scaling with some crusting with ___ __ and ___. No __ __ is seen. Dx with skin biopsy and direct immunoflourescence.
Definition
- flaccid bullae and erosions
- NO mucosal involvement is seen
Term
Wiskott-Aldrich syndrome is a rare __ __ ___ disorder. You will see diffuse erythematous __ and ___ with ___. These kids have recurrent __ __ b/c they have impaired __ __, decreased IgM, increased __ and __, ___, and platelet dysfunction.
Definition
- x-linked recessive
- papules and macules with petechia
- recurrent severe infections
- impaired cell immunity
- increased IgE and IgA
- thrombocytopenia
Term
Inherited zinc deficiency is called:
Definition
Acrodermatitis Enteropathica
Term
With zinc deficiency, you will see ___, ___, and __ dermatitis with ___. Confirm diagnosis with low serum zinc level.
Definition
- perioral, genital, and acral
- diarrhea
Term
Types of idiopahtic eczema:
Definition
- Dishidrotic
- Autosensitization aka Id eruption
- Xerotic
- Nummular
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