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149 Cards in this Set

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Characterize: macule
Flat discoloration < 1 cm
Example: macule
Tinea versicolor
Characterize: patch
Flat discoloration > 1 cm
Example: patch
Tinea versicolor
Characterize: papule
Elevated skin lesion < 1 cm
Example: papule
Acne
Characterize: plaque
Elevated skin lesion > 1 cm
Example: plaque
Psoriasis
Characterize: vesicle
Small, fluid filled blister
Example: vesicle
Chickenpox
Characterize: wheal
Rounded papule or plaque which goes away (evanescent)
Example: wheal
Hives
Characterize: bulla
Small, fluid filled blister
Example: bulla
Bullous pemphigoid
Characterize: keloid
Irregular and raised hypertrophic scar tissue which follows trauma
Characterize: who gets keloids
African-Americans
Example: keloid
Yaws -- caused by treponema pertenue
Characterize: pustule
Pus filled blister
Example: pustule
Acne
Characterize: crust
Dried exudate from a vasicle or bulla
Example: crust
Impetigo
Characterize: hyperkeratosis
Increased thickness of stratum corneum
Example: hyperkeratosis
psoriasis
Characterize: parakeratosis
Increased thickness of stratum corneum, but also with retention of nuclei
Example: parakeratosis
Psoriasis
Characterize: acantholysis
Seperation of epidermal cells
Example: acantholysis
Pemphigus vulgaris
Characterize: acanthosis
Epidermal hyperplasia -- increased production of strutum spinosum
Example: acanthosis
Acanthosis nigricans
Characterize: dermatitis
Inflammation of the skin
Example: dermatitis
Contact or atopic dermatitis
Verrucae: what is the common name
Warts
Verrucae: describe
Soft, tan-colored, cauliflower looking lesions
Verrucae: mechanism
Epidermal hyperplasia, hyperkeratosis and koliocytes
Verrucae: what is it called on the hands and feet
Verruca vulgaris
Verrucae: what is it called on the genitalia
Condyloma aciminatum
Verrucae: what causes genital warts
HPV
Nevocellular nevus: what is it
common mole (aka benign melanocytic nevus)
Nevocellular nevus: benign or malignant
Benign
Urticaria: what is it
Hives
Urticaria: describe
Intensely pruritic wheals that form after mast cell degranulation
Ephelis: what is it
Common freckle
Ephelis: describe
It has a normal number of melanocytes which are producing extra pigment
Atopic dermatitis: what is the common name
Eczema
Atopic dermatitis: decribe
Pruritic eruptions on flexural surfaces
Atopic dermatitis: where
Scalp, neck, inside of elbows, behind knees
Atopic dermatitis: associated with what
Other atopic disease like asthma and allergic rhinitis
Allergic contact dermatitis: what is it
Type IV hypersensitivty reaction that follows exposure to an antigen
Allergic contact dermatitis: what type of hypersensitivty reaction
Type IV
Allergic contact dermatitis: where do lesions occur
At the site of contact
Psoriasis: what is it
Papules and plaques with silvery scale
Psoriasis: where does it occur
Especially on the knees and elbows
Psoriasis: histo process
Acanthosis and parakeratotic scalins
Psoriasis: what skin layers are altered
Acanthosis --> increased strutum spinosum and decreased stratum granulosum
Psoriasis: what is Auspitz sign
Punctuate bleeding that occurs after scraping a psoriatic plaque
Psoriasis: what happens to the nails
Nail pitting
Psoriasis: associated with what other conditions
Psoriatic arthritis
Seberrheic keratosis: describe
Flat, greasy pigmented proliferation of squamous epithelium
They are filled with keratin containing cysts called Horn cysts
Seberrheic keratosis: how do they appear
They look as if they have been pasted on the skin
Seberrheic keratosis: where do they occur
Head trunk and extremeties
Seberrheic keratosis: who gets it
Common neoplasm of older folks
Seberrheic keratosis: benign or malignant
Benign
Seberrheic keratosis: what is the sign of Leser-Trelat?
Sudden and explosive appearance of many seborrheic keratoses indicates an underlying malignancy (esp GI cancers and lympoid cancers)
Albinism: what are the causes
1. Decreased tyrosinase activity leads to normal maloncyte number but with no pigment production (type 1 occulocutaneous albinism)
2. Failure of neural crest migration = no melanocytes
Vitiligo: what is it
Decreased number of melanocytes causes irregular areas of melanin production
Vitiligo: what is the cause
Autoimmune mediated attack on melanocytes
Melasma: what is another name
Mask of pregnancy
Melasma: what is it
Hyperpigmentation that can occur during pregnancy -- appears in well-demarcated hyperpigmented macules or plaques
Melasma: what else can cause it
OCP
Impetigo: what is it
Superficial skin infection
Impetigo: what are the orgamisms
1. S aures
2. S pyogenes
Impetigo: contagious
Hell yes
Impetigo: what is the classic finding
Honey-colored crusting
Cellulitis: what is it
Acute, painful spreading infection of the dermis and suncutaneous tissues
Cellulitis: what causes it
1. S aures
2. S pyogenes
Necrotizing fasciitis: what is it
A deeper tissue infection -- in that fascia
Necrotizing fasciitis: what causes it
1. S pyogenes
2. S aureus
3. Anerobes -- C perfringens, V vulnificus, B fragoides
Necrotizing fasciitis: what is a finding
Creptitus -- from methane and CO2 production (esp C perfringens = gas gengrene)
Necrotizing fasciitis: what is the common name
Flesh eating bacteria
SSSS: what does it stand for
Staphylococcal scalded skin syndrome
SSSS: what is it
Staph exotoxin called exfoliatin destroys keratinocyte attachments (desmoglein) in the stratum granulosum
SSSS: characterize
Fever + generalized erythematous rash with sloughing of upper layers of the epidermis
SSSS: who gets it
Newborns and children
Pemphigum vulgaris: how serious
Potentially fatal
Pemphigum vulgaris: what type of disorder
Autoimmune
Pemphigum vulgaris: what antibodies
IgG antibodies against desmosomes (an anti-epithelial cell antibody) (against desmoglein 1 and 3)
Pemphigum vulgaris: immunoflourescence
Antibodies around cells of the epidermic in a reticular (netlike) pattern
Pemphigum vulgaris: physical findings
Acantholysis -- intraepidermal bullae involving the skin, gums and oral mucosa
Pemphigum vulgaris: what is nikosky's sign
Seperation of the epidermic upon munaul stroking of the skin
It is posiitive in pemphigus vulgaris
Bullous pemphigoid: what type of disorder
Autoimmune
Bullous pemphigoid: what antibodies
IgG antibodies against hemidesmosomes in the BM -- the antibodies are against collagen
Bullous pemphigoid: immunoflourescence
Linear pattern -- lineal because the BM lights up
Bullous pemphigoid: histology of blister
Contains immune cells -- esp eosinophils
Bullous pemphigoid: how does it compare to pemphigus
Spares the oral mucosa
It is similar to pemphigus but is less severe
Bullous pemphigoid: nikosky's sign
Negative nikosky's sign
Dermatitis herpetiformis: what is it?
Eruption of pruritic papules and vesicles -- not caused by herpes virus
Dermatitis herpetiformis: what is the dx
Bx with immunoflourescence look for deposits of IgA along the dermal papillae
Dermatitis herpetiformis: what other disease is it associated with
Associated with celiac disease
Erythema multiforme: associated with what infections
1. Mycoplasma pneumoniae
2. HSV
Erythema multiforme: associated with what drugs
1. Sulfa drugs
2. Beta-lactams
3. Phenytoin
Erythema multiforme: associated with what other conditions
1. Cancer
2. Autoimmune disease
Erythema multiforme: what is the mechanism
Possibly deposition of IgM immune complexes (type III) in the superficial microvasculature of the skin and oral mucosa
Erythema multiforme: presentations
Multiple types of lesions -- macules, papules, vesicles and target lesions
Erythema multiforme: what is a target lesion
Red papules with central clearing
Stevens-Jonshon: what usually causes it
An adverse drug reaction
Stevens-Jonshon: what is the typical presentation
1. Fever
2. Bulla formation
3. Necrosis and sloughing of the skin
Stevens-Jonshon: what is a more severe form
Toxic epidermal necrolysis
Stevens-Jonshon: what is the outlook
It has a high mortality rate
Lichen-planus: what are the 4 P's
Pruritic, purple, polygonal papules/plaques
Lichen-planus: histology
Sawtooth infiltrate of lymphocytes at the dermal-epidermal junction
Lichen-planus: what disease is it associated with
Hepatitis C
Actinic keratosis: what are they
Premalignant lesions caused by sun exposure
Actinic keratosis: describe them
Small, rough, erythematous or brownish papules
Actinic keratosis: what is a cutaneous horn
It really is a big ass horn growing out of someone's skin
Most of these are sporadic but some are derived from actinic keratoses
Actinic keratosis: what correlates with risk of carcinoma
Degree of epidermal hyperplasia correlates with risk of carcinoma
Actinic keratosis: what layer is affectes
Hyperplasia of the spinosum
Actinic keratosis: associated with what other conditions
1. Hyperinsulinemia
2. Visceral malignancy
Acanthosis nigricans: what layer is affected
Hyperplasia of the stratum spinosum
Acanthosis nigricans: associated with what conditions
1. Hyperinsulinemia
2. Visceral malignancy
Erythema nodosum: what are they
Inflammatory lesions of the subcutaneous fat
Erythema nodosum: where does it usually occur
Usually on the anterior shins
Erythema nodosum: associated with what conditions
1. Coccidiomycosis
2. Histoplasmosis
3. TB
4. Leprosy
5. Streptococcal infections
6. Sarcoidosis
Pityriasis rosea: describe the lesions
Mutiple papular eruptions
Pityriasis rosea: what is it associated with
Sometimes proceeded by a URI
Pityriasis rosea: what is the progression
1. Starts with a single lesion called a "herald patch" -- called this because it foretells what is to come
2. Followed by a full body eruption that characteristiacally follow the rib line -- Christmas tree distribution
Pityriasis rosea: tx
It remits by itself
Strawberry hemangioma: what is the frequency
1/200 births
Strawberry hemangioma: when does it occur
First few days of life
Strawberry hemangioma: what happens to it
It grows rapidly and then spontaneously regresses
Cherry hemangioma: when do they occur
First appear between 30-40
Cherry hemangioma: what happens to them
They stay put (don't go away)
Sqaumous cell carncinoma: how common
Quite
Sqaumous cell carncinoma: associated with what
1. Sunlight exposure
2. Arsenic exposure
3. Osteomyelitis??
Sqaumous cell carncinoma: where does it appear
Hands and face
Sqaumous cell carncinoma: how aggressive
Locally invasive but rarely metastasizes
Sqaumous cell carncinoma: how else can it arise
Not sure I really understand this but…
Osteomyelitis can cause a chronic draining sinus of the bone which can then lead to SCC
Sqaumous cell carncinoma: histo
Keratin pearls
Sqaumous cell carncinoma: what is the precursor lesion
Actinic keratosis
Sqaumous cell carncinoma: what is a strange variant
Keratoacanthoma -- is a follicular originated form of SCC which grows rapidly (5 weeks) and regresses spontaneously (5 weeks)
Basal cell carcinoma: where on the body and associated with what exposure
Areas of the body which have been the most sum exposed
Basal cell carcinoma: how aggressive
Locally invasive but NEVER metastasizes
Basal cell carcinoma: desribe the lesion
Rolled edges with central ulceration that sometimes bleeds -- pearly papules with friable telangiectasias
Basal cell carcinoma: histo
Nests of cells within dermis with lots of peropheral pallisading
Melanoma: how aggressive
Very -- likes to metastasize
Melanoma: what is the tumor marker
S-100
Melanoma: what is the precursor lesion
Dysplastic nevus
Melanoma: describe the lesion
Multi-colored (tan, red, brown) and irregular plaque. Border appears hazy and irregular with pigmentary variation
Melanoma: what are some risk factors
1. Sunlight exposure
2. Being fair skinned
3. Family history
4. Having many moles
Melanoma: what histo finding correlates with risk of metastasis
Depth of lesion