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98 Cards in this Set

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  • Back
histology in acanthosis nigricans
hyperkeratosis and proliferation of melanocytes
common drugs causing hyperpigmentation
minocycline, amiodarone, chloroquine, gold, chlorpromazine, bleomycin, 5-FU, daunorubicin
what causes erythrasma?
corynebacterium
among what patients is erythrasma common?
diabetics and in warm climates
slowly enlarging area of pink or brown macular patches predominately affecting flexor surfaces
erythrasma
what happens with wood's light in erythrasma
lesions fluoresce coral pink or red owing to porphyrins released by bacteria
rx for erythrasma
topical or oral erythromycin
persistent scratching in eczema causes what?
lichenificaiton
cause of bullous pemphigoid
autoantibodies to BP1 and BP2 foudn in basement membrane of skin
prodromal erythematous, papular lesions that turn into large, tense, pruritic bullae filled with serous/bloody fluid -> deep erosions and crusts
bullous pemphigoid
where is bullous pemphigoid usually seen?
upper arms and thighs
nikolsky's sign in bullous pemphigoid?
negative
what does immunostaining show in bullous pemphigoid?
fluorescence at dermal-epidermal junction
tx for bullous pemphigoid
topical steroids or oral steroids
cause of pemphigous vulgaris
autoantibodies against desmocollins and desmogleins (transmembrane desmosomal glycoproteins) in the epidermis
shallow, painful erosions and blisters on epidermal and mucosal surfaces
pemphigus vulgaris
age of onset of bullous pemphigoid
usually >60
age of onset of pemphigus vulgaris
40-60
pressing normal appearing skin with sliding mortion separates epidermal layer from dermis and rubs skin off
nikolsy's sign
nikolsky's sign in pemphigus vulgaris
positive
what is pemphigus vulgaris associated with?
epistaxis, hoarseness, weakness, malaise, weight loss
what does immunologic staining show in pemphigus vulgaris?
autoantibodies agains epidermal intercellular material
increased serum levels of antibodies to desmoglein 1 and 3 correlate with disease activity in what?
pemphigus vulgaris
treatment for pemphigus vulgaris
oral steroids; plamapheresis; lesions should be cared for as burns
what type of hypersensitivity reaction is contact dermatitis
type IV
what should you think about in a pt with recurrent erythema multiforme?
HSV infection
raised erythematous plaques expand laterally to form target lesions
erythema multiforme
what percent of body does erythema multiforme affect?
<10%
immune-mediated cutaneous disorder that is due to drugs, infection, vaccinations, or malignancy
erythema multiforme
skin biopsy shows perivascular lymphocytes (mostly T cells) and necrotic keratinocytes
erythema multiforme
drugs that can cause erythema nodosum
OCPs, NSAIDs
painful, erythematous bilateral pretibial nodules without ulceration
erythema nodosum
what virus is lichen planus associated with?
HCV
acute or chronic, flat-topped, purple, polygonal pruritic papules with overlying network of white lines
lichen planus
where is lichen planus seen?
inner wrists and lower legs
network of white lines overlying papules in lichen planus
wickham's striae
nail findings in psoriasis
oil spots, pitting, onycholysis
what is psoriasis?
t-cell mediated inflammatory disorder that leads to epidermal hyperproliferation
classic location of joint stiffness in psoriatic arthritis
DIP
what histologic finding is classic for psoriasis?
munro microabscesses - neutrophils in stratum corneum
thickened epidermis with absent granular cell layer and preservation of nuclei with hyperkeratotic stratum corneum
psoriasis
what is seborrheic dermatitis thought to be caused by?
pityrosporum yeast
yellowish, greasy, erythematous scaling patches and plaques seen on scalp, ears, face
seborrheic dermatitis
what percent of BSA does stevens johnson syndrome involve?
<10%
what percent of BSA does TEN involve?
>30%
commonly implicated agents in SJS, TEN
sulfa drugs, carbamazepine, phenytoin, valproic acid, phenobarbitol, quinolones, cephalosporins, allopurinol, corticosteroids, aminopenicillins
morbilliform rash evolves into coalescing red macules and flaccid blisters with full-thickness epidermal loss
SJS/TEN
leating cause of mortality in SJS, TEN?
sepsis - staph aureus early, then GNRs, e.g. pseudomonas late
SJS skin biopsy
perivascular mononuclear infiltrate; degeneration of basal layer
TEN skin biopsy
full thickness, eosinophilic epidermal necrosis with cell-poor infiltrate with predominance of macrophages and dendrocytes and strong immunoreactivity for TNF-alpha
defect in vitiligo
loss of melanocytes
hot tub folliculitis caused by what bug?
pseudomonas
what causes piyriasis versicolor
malassezia furfur
small, scaling hyper- or hypopigmented macules that tend to enlarge and sometimes coalesce
tinea versicolor
contagious, autoinoculable skin infection caused by staph or strep
impetigo
what causes bullous impetigo
coag + staph that produce exfoliatin, a toxin
topical mupirocin effective against what cause of impetigo?
coag + staph
what color do nits fluoresce under woods lamp
blue
rx for lice
permethrin shampoo or cream
maculopapular rash that spreads from head down; swelling of suboccipital and postauricular nodes; low-grade fever, malaise, arthralgias
rubella
what disease should you think of if you see large molluscum contagiosum lesions?
HIV
2-5mm discrete, dome-shaped, shiny papules, frequently with central umbilication
molluscum contagiosum
where are molluscum contagiosum lesions most often seen in kids? in adults?
kids - trunk, extremities, face
adults -perianal, perigenital areas
how do you make diagnosis of molluscum contagiosum
express contents of papule and apply giemsa or wright's stain - look for large inclusion or molluscum bodies
causes of necrotizing fasciitis
group a strep, mixed aerobic/anaerobic bacteria, c. perfringens
fournier's gangrene
necrotizing fasciitis of perineal region
with what virus is pityriasis rosea associated?
HHV-6
diffuse eruption fo round-oval erythematous papules and plaques covered with find, cigarette paper white scale
pityriasis rosea
christmas-tree pattern on trunk with classic herald patch
pityriasis rosea
pruritis that worsens at night and with hot showers
scabies
organism that causes scabies
sarcoptes scabiei
treatment for scabies
5% permethrin cream
time frame for VZV treatment with acyclovir
within 72 hours of appearance of lesions
treatment for lichen sclerosis
short-term, high potency topical glucocorticoids or hydrochloroquine
benign epithelial tumor with 'stuck on' appearance
seborrheic keratitis
sign of leser-trelat
numerous seborrheic keratoses acutely erupt - can be a sign of underlying malignancy, e.g. gastric CA
most common type of melanoma
superficial spreading
type fo melanoma that arises rapidly
nodular
type of melanoma that is more common in asians and AAs
acral-lentiginous
melanoma with flat, 'geographic' shape; brown/black with stain-like appearance
lentigo maligna
type of melanoma that appears on palms, soles, mucous membranes, nails
acral-lentiginous
sezary's syndrome
peripheral blood involvement in mycosis fungoides
lion-like facies
mycosis fungoides
type of cell associated with mycosis fungoides
T cell
locations affected by warfarin-induced skin necrosis
breasts, butt, thighs, abdomen: pain, then bullae formation, necrosis
what causes hereditary angioedema
C1 inhibitor deficiency
target lesions
erythema multiforme
lace-like or fishnet immunofluorescence
pemphigus vulgaris
rapidly growing flesh-colored lesion with central crater that contains keratinous material, classically on face
keratoacanthoma
treatment for keratoacanthoma
nothing - lesion involutes spontaneously in a few months
rx for dermatitis herpetiformis
dapsone (or gluten free diet)
lithium can precipitate/exacerbate what skin problem?
psoriasis
cause of measles
paramyxovirus
herpes on hand
herpetic whitlow, increased risk in health care worksers
treatment for mild acne
topical retinoids
treatment for papular/inflammatory acne
oral antibiotics
treatment for nodulocystic and scarring acne
isotretinoin
dry, rough skin with horny plates over extensor surfaces of limbs
ichthyosis