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