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1289 Cards in this Set

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SLE criteria
4 skin:
butterfly rash
CCLE
photoeruption
oral ulcers

Neuro
Immune
ANA
Kidney
Serositis
Heme
Arthritis
Urticarial Vasculitis 70% afflicted are
women
Schnitzler’s Syndrome:
episodes of urticarial vasculitis that occur in association with monoclonal IgM M
Nodular Vasculitis Women between
30 and 40
Livedoid Vasculitis (Atrophie Blanche)Associated with
arteriosclerosis or stasis
Erythema induratum:
form of nodular vasculitis associated with M. Tuberculosis
Urticarial Vasculitis tx
dapsone, H1 blockers, indomethacin, colchicine
Erythema Elevatum Diutinum tx
Dapsone
Nodular Vasculitis tx
NSAIDs, colchicine, systemic steroids
Livedoid Vasculitis tx
Aspirin, dipyridamole, colchicine, low-dose heparin, systemic glucocorticoids, and low molecular weight dextran, nifedipine, pentoxyfylline
Cryoglobulinemia Type I aasoc w
b-cell malignancy such as myeloma or lymphoma CLL and Waldenstrom’s macroglobulinemia
Type II (Mixed Cryoglobulinemia) etiol
Monoclonal IgM rheumatoid factor complexed with polyclonal IgG
Type II (Mixed Cryoglobulinemia) dzs
Multiple myeloma,Waldenstrom’s, CLL, rheumatoid arthritis, Sjogren’s, Hepatitis C
Type III (Mixed Cryoglobulinemia) Often complement activated and complement levels are
lower
Type III (Mixed Cryoglobulinemia) assoc with
1. what CTDs
2. what GI dz
3. what virus
SLE, RA, Sjogren’s, infectious mononucleosis, CMV infection, primary biliary cirrhosis, Hepatitis B
None
Essential Mixed Cryoglobulinemia
Cryoglobulins and the manifestation of symptoms without an identifiable connective tissue, neoplastic, or
Cryofibrinogenemia Associated with
malignancy, thromoembolic disease, diabetes, pregnancy, oral contraception, pseudotumor cerebri
ACANTHOSIS NIGRICANS among obese children
28%
ACANTHOSIS NIGRICANS in Native Americans
32%
ACANTHOSIS NIGRICANS adult patients treated for obesity
74%
ACANTHOSIS NIGRICANS Associated Conditions
Insulin resistance,Lipodystrophies (Lawrence-Seip syndrome)
ACANTHOSIS NIGRICANS Type A Syndrome:
severe acanthosis nigricans, hirsutism, clitoromegaly, and masculine habitus
ACANTHOSIS NIGRICANS Type B Syndrome: occurs when and in whom, what ctd assoc?
AN after teenage years with less extensive involvement, with often underlying SLE
None
ACANTHOSIS NIGRICANS Drugs:
testosterone, nicotinic acid, diethylstilbestrol, oral contraceptives, triazinate, glucocorticoids,
LIPODYSTROPHY partial Begins on
face, spreads downward, stopping at any level
LIPODYSTROPHY partial onset, sex
female, and usually begins before age 15
None
LIPODYSTROPHY partial Laboratory
Hypertriglyceridemia Decreased serum complement (C3), Increased C3 nephritic factor (immunoglobulin that binds Factor H, an inhibitor of C3,)
Generalized Lipodystrophy Congenital
(Seip-Lawrence Syndrome)
Generalized Lipodystrophy Acquired
(Berardinelli-Seip Syndrome)
Generalized Lipodystrophy Mental retardation?
common
Generalized Lipodystrophy assoc skin condition?
Eruptive xanthomas may appear
Sweets labs normal vs malignancy assoc
Malignancy-associated Sweet’s: anemia, normal or low neutrophil count and abnormal platelet count
Sweets Can be associated with intestinal infection with
yersinia enterocolitica
Sweets Associated Diseases
AML; lesions may precede diagnosis of leukemia;
Sweets how many lesions suggest malignancy?
20
EAC associations
malignancy, dermatophyte
EED positiive skin test to?
Markedly positive skin tests to intradermally injected streptokinase-streptodornase
EED lab
IgA (mainly) or IgG or IgM monoclonal gammopathies or even myeloma
EN 70% have associated _ that may pesist for years?
arthropathy
EN infections:
strep, tb yersinia, blasto, viruses
Sarcoidosis Remember, hilar adenopathy and erythema nodosum also present in
lymphoma, tb, streptococcal infectionsand fungal infections
Mastocytosis provoked by
alcohol, aspirin, narcotics, contrast agents (iodinated), insect stings, exercise, or infections
Mastocytosis Most common skin manifestation in children and adults
Urticaria pigmentosa
Mastocytosis Obtain 24 hour urine for
5-hydroxyindoleacetic acid (5-HIAA) and urinary metanephrines
Mastocytosis Mast cell leukemia: survival
less than 6 months
CUTANEOUS SARCOIDOSIS skin lesions in ?%
25
CUTANEOUS SARCOIDOSIS Nonspecific lesion:
erythema nodosum, alopecia, erythroderma, subcutaneous nodules, erythemamultiforme, itching ichthyotic dryness, dystrophic calcifications, and verrucous outgrowths
CUTANEOUS SARCOIDOSIS subq variant
Darier-roussy sarcoidosis
CUTANEOUS SARCOIDOSIS labs
hyper CA (vitD3 overproduced), ACE level
CUTANEOUS SARCOIDOSIS Intradermal injection of homogenized tissue from sarcoidosis patient
Kveim Test
CUTANEOUS SARCOIDOSIS Treatment
steroids, antimalrials, immunosuppressive
EPS Patients with
Down’s Syndrome, heritable connective tissue disorders (Ehlers-Danlos Type IV, osteogenesisimperfecta,Marfan’s Syndrome, Rothmund-Thomson, scleroderma, and acrogeria)
EPS drug inducer
imperfecta,Marfan’s Syndrome, Rothmund-Thomson, scleroderma, and acrogeria)
EPS location
Nape and sides of neck, upper extremities
Pregnancy hair changes
Increased anagen, decreased telogenTelogen effluvium: 1-5 mos. Post-partum, stopping within 15 mos.;
Pregnancy chadwick sign
blue vagina
Pregnancy goodell sign
blue cervix
Pregnancy Tumors
granuloma gravidarum, glomagiomas, leiomyomas, desmoid (rectus adb) NF
Pregnancy Melanoma prognosis
diagnosis during pregnancy associated with thicker tumors; same prognosis
Pregnancy Pemphigoid Gestationis
BP
Cholestasis of Pregnancy trimester
3
Cholestasis of Pregnancy 50% associated with
uti
Cholestasis of Pregnancy perinatal risk
low vit K- bleeding
Cholestasis of Pregnancy Fetus:
premature labor (common), fetal distress, perinatal death
Cholestasis of Pregnancy Treatment
CholestyramineUrsodeoxycholic acid
impetigo herpetiformis” aka
Pustular Psoriasis of Pregnancy
impetigo herpetiformis” trimester
Late 1st trimester to 3rd trimester
impetigo herpetiformis” Fetus at risk for
placental insufficiency
impetigo herpetiformis” lab
hypoCA, leukocytosis
pruritus association of malignancy and generalized itching is rare, with the exceptions of
hodgkins, PCV
SCLEREDEMA Skin involvement may be preceded by
prodrome of low-grade fever, malaise, myalgia, arthralgia
SCLEREDEMA types
I-post infection (strep get ASO) II monoclonal gammopathy 3-diabetes
Apocrine Glands Stain with
GCDFP-15keratin AE1 (stains ducts), CAM 5.2, EMA
Eccrine Glands Stain with
S100, CEA, CAM 5.2
Sebaceous Glands on eyelid
Meibomian and Wolf
Sebaceous Glands (on penis),
Tyson
Sebaceous Glands nipple
Montgomery
Hair Follicle Infundibulum = portion above insertion of
sebaceous duct;
Hair Follicle Isthmus = portion between insertions of
sebaceous duct and arrector pili; trichilemmal keratinization;
Hair Follicle dsg in inner root sheath and innermost part outer root sheath
dsg1
Hair Follicle Trichilemmal carcinoma stains with
keratin 17 and c-erb-b2
Hair Follicle Proliferating trichilemmal cyst stains with
cytokeratin 7
STAINS Nerve fibers black
Bodian
STAINS DNA magenta
Feulgen
STAINS Fontana Masson
Melanin
STAINS Foote’s or Snook’s
Reticulin fibers black
STAINS Mast cell granules purple
Giemsa
STAINS Leishmania
Giemsa
STAINS Mast cell granules red
Leder
STAINS Masson Trichrome
Collagen blue/green, muscle/nerve/keratin red
STAINS Methyl-green Pyronin
RNA pink, DNA green
STAINS Perls (Prussian Blue)
Iron/hemosiderin bright blue
STAINS PTAH (Phosphotungstic Acid Hematoxylin)
Stains fibrin
STAINS PTAH stains inclusions in
infantile digital fibromatosis
STAINS Amyloid
congo red, crystal violet, thioflavin T, orcein-giemse
STAINS Calcium
Von Kossa (blue-black)• Alizarin red (red)
STAINS Elastic Tissue
verhoeff von giesen, gomoris aldehyde fuchsin
STAINS Osmium tetroxide
fat
STAINS Sudan black
fat
STAINS Oil red O
fat
STAINS Scarlet red
fat
STAINS Mucin
Colloidal iron (blue)• Mucicarmine (pink)
STAINS Ochronosis
Cresyl violet or methylene blue stains the pigment black
STAINS Spirochetes
Silver stains like Warthin Starry or Dieterle or Steiner
Darier’s Disease (Keratosis Follicularis) path
Column of parakeratosis above a focus of acantholytic dyskeratosis (corps ronds and grains)
Grovers path
dariers, hailey-hailer, spongiotic, PV
PP targets
Intercellular and linear DEJ antibodies against desmoplakins (250 kDa, 230 kDa bullous pemphigoid antigen1), envoplakin (210 kDa), periplakin (190 kDa), 170 kDa antigen, PV Ag (130 kDa)
Squamous Cell Carcinoma, Adenoid Type Also called
acantholytic SCC
Warty Dyskeratoma Can look exactly like
Darier’s,
Acrospiroma 3 variants
hidroacanthoma simplex, poroma (connected), Hidradenoma (not connected)
Apocrine Hidrocystoma path
The cyst lining shows apocrine-type decapitation secretionouter myeepithelial, inner columnar epi cells
Bronchogenic Cystpath
pseudostrat, goblet cells
Eccrine Hidradenoma, Eccrine Acrospiroma, Nodular Hidradenoma (has ducts) path
Biphasic cellular population: round cells with eosinophilic cytoplasm and oval vesicular nucleus or cells withclear cytoplasm with small dark eccentrically located nucleus
Cylindroma origin
apocrine
Brooke-Spiegler syndrome:
multiple trichoepitheliomas, cylindromas, spiradenomas
Hidradenoma Papilliferum path, location
Papillated projections into cystic spaces, decapitation secretionVulvar area
Morpheaform Basal Cell Carcinoma (BCC) stains BCCs diffusely
Bcl-2
Nevus Sebaceus of Jadassohn tumors
trichoblastoma thought to be the most common, followed byRubinstein-Taybi, Gardner’s (cyst-like pilomatricomas), Turner’s,
Multiple pilomatricomas seen in
Rubinstein-Taybi, Gardner’s (cyst-like pilomatricomas), Turner’s,sarcoidosis, sternal cleft and coagulation defects, myotonic dystrophy (Steinert’s)
3 keys to immunodef in kids
1. FTT 2. Diarrhea, 3. Pneumonia. If no to all three no immunodef.
Bleeding diathesis imunodef
WA
thrush after 2?
very worrisome..HIV
Ataxia telangectasia gene/function
ATM / PI3k
Ataxia telangectasia inherited
AR
Ataxia telangectasia associated cancers
breast, lymphoma
Ataxia telangectasia screening breast ca?
dont use mammogram- DNA repair defect
Ataxia telangectasia telangectasias where?
bulbar first
Ataxia telangectasia besides ataxia, telang. what other cut findings?
progeroid (90%), freckling, GRANULOMAS
Ataxia telangectasia labs
elevated Alpha-FP, CEA
Ataxia telangectasia pneumonic?
Ataxia A-T low AGE 2....AGE for decr A,G,E
Ataxia telangectasia imaging if needed use what
MRI not CT
CGD enzyme
NADPH Oxidase
CGD inheritence
AR most
CGD May present mimicking what in kids
foll occlusion triad
CGD osteomyelitis. what organism
serratia
Chronic mucocut candidiasis 4 skin findings
nails thick, paronychia, thrush, plaques/patches periorificially
Chronic mucocut candidiasis dz assoc with CMC
KID syndrome, multiple carbox def, zn def, EEC
Cartilage Hair Hypoplasia enzyme
RNA RNP endonuclease
Cartilage Hair Hypoplasia presents as
short limbed dwarfism, sparse hair, doughy skin
Cartilage Hair Hypoplasia people
amish, finnish
Cartilage Hair Hypoplasia very susceptible to
varicella
Cartilage Hair Hypoplasia increased risk of
NHL, BCC
Leukocyte adhesion def. TYPE 1 gene
CD18 encoding beta2integrin
Leukocyte adhesion def. TYPE 1 blocks what, like what drug?
LFA-ICAM like efalizumab
Leukocyte adhesion def. TYPE 1 perinatally
blocks umbilical separation
Leukocyte adhesion def. TYPE 1 TYPE 2 enzyme
GDP fucose synthesis
Bruton's inheritenc?`
xlr 90%
Bruton's gene
btk
Bruton's incr suscepti to?
HBV, enterovirus
Bruton's skin
eczema
Bruton's wierd viral reaction
dermatomyositis from echovirus
Hyper IgM inheritence & gene
XLR, CD40 ligand
Hyper IgM Zonana?
ED + hyperIgM
Hyper IgM skin
oral ulcers, warts
CVID what type of GI infection prevails?
giardia
IgA Deficiency 50% have what
anti IgA ab
HyperIgD gene/enzyme
mevalonate kinase
HyperIgD presents like what other illness?
JRA - periodic fever, arthralgias
Duncans aka
Ilinked lymphoproliferative dz
Duncans gene
SH2 DIA
Duncans pathogenesis (problem)
humoral and T cell response to EBV
Duncans death from?
70% B cell lymphoma
Hyper IgE aka
job Buckley
Hyper IgE skin
eczema (severe) corase facial features, retained primary teeth, recurrent infections
Hyper IgE IgE level in HyperIgE
>5-10,000
Wiskott-Aldrich gene/inheritence
xlr, WASP
Wiskott-Aldrich WASP function
ASSEMBLY FOR VESCLE TRANSPORT, PLATELET FORMATION
Wiskott-Aldrich 3 CLINICAL FINDINGS
bleeding diathesis (only immunodef with bloody diarrhea), atopic dermatitis, recurrent infections
Wiskott-Aldrich 26% develop
lymphomas
DiGeorge Sx mutation
TBX1
DiGeorge Sx kids present with
neonatal tetany
DiGeorge Sx pneumonic
CATCH22 Cardiac, Abnormal facies, Thymic hypoplasia Cleft palate Hypocalcemia
ChediakHigashi gene
LYST
ChediakHigashi die from
90% lymphoproliferative
ChediakHigashi lymphoproliferative dz triggered by EBV. dont confuse with
Duncans
ChediakHigashi tx with __ corrects microtubule function but does not prevent accelerated phase
ascorbic acid
HYPERLIPOPROTEINEMIAS pneumonic
1(5)432 was a CVIL year
HYPERLIPOPROTEINEMIAS type I enzyme
apoCII
HYPERLIPOPROTEINEMIAS Tuberous Xanthoma systemic findings?
biliary cirrhosis
HYPERLIPOPROTEINEMIAS Eruptive Xanthoma drugs causing
estrogen therapy, corticosteroids, isotretinoin, acitretin
Plane Xanthoma Frequently associated with biliary
cirrhosis, biliary atresia, myeloma, HDL-deficiency, monoclonal gammopathy, lymphoma, leukemia, serum lipoprotein deficiency, xanthomas following erythroderma, RA, Acquired C1 esterase deficiency
Palmar Xanthoma Xanthoma striata palmaris: diagnostic of ?
type III dysbetalipoprotinemia (broad beta disease)
Supplementation required in rubeola (200,000
vit A
Vitamin D Deficiency: only skin manifestation
alopecia
Vitamin B1 (Thiamine) Deficiency only skin manifestation
Edema (beri beri)
Vitamin B2 (Riboflavin) Deficiency aka
Oral-ocular-genital syndrome
Vitamin B12 Deficiency sx
Glossitis, Hyperpigmentation resembles Addison’s Disease,
Vitamin C Deficiency (Scurvy) sx
Perifollicular petechiae, Subungual, subconjunctival, intramuscular, and intraarticular hemorrhage
Hartnup disease what is it
(impaired absorption of tryptophan)
Hartnup disease drugs causing
INH, azathioprine, 5-FU
Biotin Deficiency what enzyme deficiencies?
Multiple carboxylase deficiency• Holocarboxylase synthetase deficiency
Zn deficiency labs
low AP (zn dependent), low Zn
Essential Fatty Acid Deficiency Similar dermatitis to that of
zinc and biotin deficiency
Essential Fatty Acid Deficiency skin
Widespread erythema and intertriginous weeping eruption• Hair becomes lighter in color
Essential Fatty Acid Deficiency labs
• Ratio of eicosatrienoic acid to arachidonic more than 0.4 diagnostic of EFA deficiency
Iron Deficiency skin
Koilonychia, glossitis, angular cheilitis, pruritus, and telogen effluvium
Iron Deficiency Plummer-Vinson:
"microcytic anemia, dysphagia, and glossitis seen nearly entirely in middle-aged women;
Selenium Deficiency hair, nails
Hypopigmentation of the skin and hair• Leukonychia and Terry’s nails occasionally
Lycopenemia
Excessive ingestion of red foods like tomatoes, beets, chili beans, and various fruits leads to reddish
Necrobiosis Lipoidica % diabetics
0.30%
Histiocytosis X spectrum
Letterrer-Siwe: baby, mastoid osteolysis (only site), fatal, cut 80%; HSC: early childhood, DI, cut 30% (cranium osteolysis); EG benign; HP (CSHR), babies but heals
Pagetoid Reticulosis aka
Woringer-Kolopp if localized
MF Prognosis
Involvement of 10% or less with patch disease: median survival of 12 years• Tumors, erythroderma, or node involvement: median survival 2-3 years
Pyo Gangrenosum 50% have associated disease, most commonly
IBD
Pyo Gangrenosum other assoc dzs
leukemia, myeloma, monoclonal gammopathy (IgA), polycythemia, chronic active hepatitis,HCV, HIV, SLE, pregnancy, and Takayasu’s Arteritis
PAPA
pyogenic arthritis, pyoderma gangrenosum, severe cystic acne
Pyo Gangrenosum what kids predisposed?
Children with congenital deficiency of leukocyte-adherence glycoproteins
Trichilemmoma Proliferation of
outer root sheath
Rasmussen’s syndrome: multiple trichoepitheliomas, cylindromas, and milia
multiple trichoepitheliomas, cylindromas, and milia
Rombo syndrome:
multiple trichoepitheliomas, milia, vermiculate atrophy, BCC, peripheral vasodilation
Herpes gestationis can be indistinguishable from BP on biopsy but on DIF
linear C3 not so much IgG
Cicatricial Pemphigoid (CP) ab
Anti-epiligrin
Porphyria Cutanea Tarda (PCT) path
Festooning of dermal papillae• “Caterpillar bodies”
Porphyria Cutanea Tarda (PCT) dif
DIF with IgG, IgM, IgA, C3 at DEJ and around vessels
Juvenile colloid milium is histochemically indistinguishable from
amyloid
sx with macular and lichen amyloid
men iib
Papular Mucinosis (lichen myxedematosus) ka scleromyxedema on path
In scleromyxedema variant, fibroblasts are numerous (increased in number)More cellular than pretibial myxedema
Pretibial Myxedema Associated with
Grave’s disease and thyroid acropachy
Scleromyxedema Associated with paraproteinemia, generally
IgG lambda
Fixed Drug Eruption versus PLEVA
PLEVA has parakeratosis and lacks the eosinophils of either fixed drug or LyP
Minocycline-induced Pigmentation 3 types:
blue-black in scars on the face, blue-gray on legs, muddy-brown on sun-exposed areas;
Minocycline-induced Pigmentation The blue-black color in scars on the face stains like
hemosiderin (Perls-positive)
Minocycline-induced Pigmentation Blue-gray on legs stains like
iron and melanin (stains with Perls and Fontana Masson)
Minocycline-induced Pigmentation Muddy-brown color on sun-exposed areas shows
melanin-fontana masson
Alpha-1-Antitrypsin Deficiency Panniculitis type of panniculitis, and findings on path
lobular, with ft necrosis
Erythema Induratum (Nodular Vasculitis) type of paniculitis
lobular
Erythema Induratum (Nodular Vasculitis) characteristic feature
Vasculitis (often at dermal/SC junction) with endothelial swelling
Lipodermatosclerosis aka
Lipomembranous Panniculitis)
Pancreatic Panniculitis path
Lobular panniculitis, fat necrosis with “ghost cells” having no nuclei
Polyarteritis Nodosa path
Septal panniculitis with medium-sized vessel vasculitis• Inflammation tightly localized around vessel
Atrophie Blanche aka
(Segmental Hyalinizing Vasculitis)
Atrophie Blanche path
In fully established plaques there is epidermal atrophy with scleroderma-like scarring
afx staining
cd68 alpha 1 antitrypsin, muscle specific actin
DF staining
fctor XIIIa, stromeolysn +
DFSP cd34+, what else is
giant cell fibroblastoma
DFSP come from what translocation?
translocation results in the fusion of two genes:collagen type I alpha 1(COL1A1) and platelet-derived growth factor B-chain (PDGFB)
Epithelioid Sarcoma locations
forearms, young adults
Epithelioid Sarcoma stains
vimentin +, low mol wt cytokeratin +
Gian cell epulis exacyly like what but more superficial
iant cell tumor tendon sheath
giant cell tumor tendon sheath unique appearing cells
osteoclast like
keloids, what syndrmes get lotsof keloids
Rubinstein-Taybi, Noonan’s, and Turner’s syndromes
clinical and gene Birt-Hogg-Dube
Triad of fibrofolliculomas, skin tags, and trichodiscomas…folliculin
clinical and gene Cowdens
Multiple trichilemmomas, sclerotic fibromas (storiform collagenoma), acral keratoses, oral fibromas• Increased risk of breast/thyroid cancer. PTEN
clinical and gene Ichthyosis Vulgaris
profillagrin
Multiple JXGs are associated with
NF1, CML
reticulohistiocytosis clinical sign by nail
“coral bead sign”,
Coccidioidomycosis microscopic
Spherules (which contain and can collapse to release endospores Õ 10-80 microns)
HSV aka for cowdrsy A bodies
lipschutz
Leishmaniasis vs histo on path
histo has tiny halo, no kinetoplast
lichen striatus path
Low power shows a nearly empty dermis, but deep dermis shows a dense infiltrate around the adnexalstructures Õ very unique to this entity
Perniosis similar to what on path
pmle
Pityriasis Lichenoides et Varioliformis Acuta (PLEVA) path
parakeratosis, necrotic keratinocytes, papillary edema, lymphocytes, RBCs
Pityriasis Lichenoides et Varioliformis Acuta (PLEVA) versus LyP, versus EM
lyp has eosinophils. EM doesn’t have parakeratosis
PMLE path
spongiosis, lymphocytes, ppillary edema, deeper infiltrate than SCLE
PMLE
Leukemia Cutis most commo type
AML
Leukemia Cutis Neoplastic cells stain positive for
Leder, lysozyme, myeloperoxidase
Lymphoma Cutis path and staining
cd20+, bottom heavy, epidermis spared
LyP path
wedge shaped, PLEVA like, more atypical cells, eos and neuts
LyP types
A: Type A: CD30-positive; B: MF type with sezary cells
Mantle Cell Lymphoma translocations
bcl-1 (Cyclin D1) positive [t(11;14) translocation involving bcl-1 and the immunoglobulinheavy chain gene]
Mantle Cell Lymphoma versus CLL staining
Lack CD 23 (unlike CLL)
Mantle Cell Lymphoma chain restriction
Often has lambda light chain restriction
MF staining
CD4+ cells in the epidermis that have often lost CD5 and CD7
Subcutanous Panniculitis-like T-cell Lymphoma die how?
can have fatal hemophagocytic syndrome1. Alpha-beta T-cells that are CD 8+, more indolent clinically
Subcutanous Panniculitis-like T-cell Lymphoma two groups
1. Alpha-beta T-cells that are CD 8+, more indolent clinically2. Gamma-delta T-cells that are CD 56+, more aggressive (fatal) with systemic hemophagocytosis
CD10
follicular B cell lymphoma
CD16
NK cells
CD 19,20
B cells
CD 23
CLL (- Mantle cell)
CD 30
anaplastic large cell, LyP, Hodgkins
CD 57
T cells with NK activity
CD 138
plsma cells
BCL-1
mntle cell
bcl-2
NODAL follicular center cell (primary is bcl2 negative), BCCs
bcl-6
follicular cell lymphoma
stains desmoplastic melanoma
s100+, Mart 1 negative
spitz versus reed
reed is in epidermis,, spitz has no epidermal involvement
leiomyoma gene defect
fumarate hydratase
leiomyoma stains
desmin, SMA
celular neurothekeoma s100?
negative
granular cell tumor
s100+, vimentin+, NSE +
traumatic neuroma path
acral, haphazard nerve fascicles
Breast metastatic stains
cea+ CK7 +
Pagets of the breast stains
CEA+, EMA+, CAM 5.2+ Alcian blue pH 2.5
Angiosarcoma em
weibel-Palade
bacilary angiomatosis path, stain for organsms
blue clouds, Warthin-Starry
Intravascular Papillary Endothelial Hyperplasia aka
Massons
Intravascular Papillary Endothelial Hyperplasia path
Thrombosed vessel (circular space with pink fibrin within) with papillated fronds projecting into the center;the fronds are lined by a single layer of endothelial cells
Intravascular Papillary Endothelial Hyperplasia
the fronds are lined by a single layer of endothelial cells
Kaposi's staining
Spindle cells are CD34-positive and focally positive for CD31; Ulex – positive; Factor VIII positive
Chloroma cancer
acute grnulocytic leukemia
Chloroma green color from?
myeloperoxidase
Chloroma stain
chloracetate esterase-positive
Merkel stains
ck20, NSE
Merkel vs metastatic oat cell
negative ck20
sclerotic fibroma syndromes
cowdens, gardners
pseudoepitheliomatous hyperplasia don’t forget what..besides infections
bromoderma/halogenoderma
Asteroid Body
sporotrichosis OR• Stellate inclusions seen in sarcoid, berylliosis
Comma-shaped Body
em: benign cephalic histiocytosis
donovan body
Granuloma inguinale
Dutcher Body
Pseudo”-nuclear inclusions secondary to collections of immunoglobulin in the cytoplasm that push into thenucleus of plasma cells
Guarnieri Body
smallpox
Negri Body
rabies
Russell Body
• Inclusions secondary to collections of immunoglobulin in the cytoplasm of plasma cells• Seen in rhinoscleroma, granuloma inguinale, syphilis
Russell Body
• Seen in rhinoscleroma, granuloma inguinale, syphilis
Zebra Body
Seen on electron microscopy in mucopolysaccharidoses
AML stains
CD43 myeloperoxidase CD15
NXG v XG
NXG in fat necrosis larger foamy cells
Mixed tumor skin aka
pleomorphic adenoma (in parotid gland)
matt how long is the program?
3 years
Pityriasis Versicolor (Tinea Versicolor) most common cause of TV),
M. globosa (
Pityriasis Versicolor (Tinea Versicolor) Woods lamp
(+) pale yellow fluorescence
Tinea Nigra Palmaris organism
Phaeoannellomyces werneckii
White Piedra Trichosporon beigelii, new nomenclature:
Trichosporon ovoides and T. inkin
White Piedra Trichosporanosis organism
Trichosporon asahii
Ectothrix organsism
M. canis, M. audouinii, M. distortum, M. ferrugineum, and sometimes M.
Endothrix “Black Dot Ringworm” organisms
T. rubrum, T. gourvilli, T. yaounde, T. tonsurans, T. schoenleinii, T. soudanense, T. violaceum
Kerion Most frequently due to
M. canis, T. tonsurans, T. verrucosum, T. mentagrophytes
Tinea Corporis the most frequently recovered organisms
T. rubrum, T. mentagrophytes, M. canis, T. tonsurans
Majocchi’s Granuloma associated with what organism
T. rubrum,
Tinea Barbae Inflammatory:
T. mentagrophytes, T. verrucosum
Tinea Barbae Abscess:
M. canis
Tinea Barbae Verrucous granulomatosis:
E. floccosum
Tinea Cruris organisms
E. floccosum, T. rubrum, T. mentagrophytes
Tinea Faciei organisms
T. rubrum, T. mentagrophytes, T. concentricum, M. canis
Tinea Manuum organisms
T. rubrum, T. mentagrophytes, E. floccosum
Tinea Pedis Moccasin type:
E. floccosum, T. rubrum
Tinea Pedis Vesicular type:
T. mentagrophytes
Distal Lateral Subungual Onychomycosis
T. rubrum
Proximal Subungual Onychomycosis
T. rubum
Proximal White Subungual Onychomycosis an AIDS markjer (not superficial white)..what is the organism?
T. rubrum
White Superficial Onychomycosis
T. mentagrophytes,
colony morphology E. floccosum
khaki-colored colony,
colony morphology M. audouinii
mouse fur - grey or tan
colony morphology M. canis
white fluffy, fur-like colony with yellow periphery and feathery border. Pee in the snow
colony morphology M. gallinae
white colony becoming pink with age. Reverse strawberry
colony morphology M. gypseum
powdery colony,
wierd fungal stuff (+) wedge shaped areas in hair shaft
T. mentagrophytes
wierd fungal stuff makes pigment on cornmeal agar
(+) T. rubrum, (–) T. mentagrophytes
wierd fungal stuff Niacin
T. equinum
wierd fungal stuff Histidine
T. megninii
wierd fungal stuff Inositol and thiamine
T. verrucosum
wierd fungal stuff Urease Test
(+) red - pink T. mentagrophytes
colony morphology T. mentagrophytes
fluffy white
colony morphology T. rubrum
reverse nondiffusible red,
colony morphology T. concentricum
white, waxy colony turns amber or coral red and deeply folded, cerebriform
colony morphology T. violaceum
heaped purple colony;
Scytalidium dimidiatum causes?
Dematiaceous organism causing dermatomycoses of the soles and toe webs, paronychia, and
SUBCUTANEOUS MYCOSIS list them
sporo, mycetomas, chromoblasto, lobo,
SUBCUTANEOUS MYCOSIS sporo on path
cigar bodies”
SUBCUTANEOUS MYCOSIS ruke for all eumycetoma and actinomycetoma pellet colors
"FAN of Boyd - Red pellets". All starting with FA o rN and boydii are white. Pelletieri is red.
SUBCUTANEOUS MYCOSIS common actinomycetoma organism
nocardia
SUBCUTANEOUS MYCOSIS chromoblastomycosis organisms
Fonsecaea pedrosoi (most common), Fonsecaea compacta, Rhinocladeilla aquaspersa, Phialophora verrucosa,
SUBCUTANEOUS MYCOSIS chromo path
“copper
SUBCUTANEOUS MYCOSIS lobo path
“chain of coins” or “brass knuckles”
dimoprhic fungi causing systemic disease list them
histo, blasto, coccidio, paracoccidio, penicilliosis
Histoplasmosis Endemic to
Ohio,Mississippi,Missouri River Valleys,
Histoplasmosis high risk animals
bat, bird (especially starling), and chicken droppings
Histoplasmosis non specific skin
Toxic erythema, erythema multiforme or erythema nodosum
Histoplasmosis specicifc skin findings
macules, papules, nodules, ulcers (oral and rectal), molluscum like
Histoplasmosis runs from assymptomatic to bad bad. Treatment:
Itraconazole drug of choice for disseminated disease
Histoplasmosis AIDS patients tx:
Itraconazole or Amphotericin B followed by itraconazole, ketoconazole or fluconazole
Blastomycosis aka
Gilchrists
Blastomycosis area
Ohio and Mississippi River Valley, Great Lakes area,
Blastomycosis Gilchrist’s Disease:
primary cutaneous blastomycosis;
Coccidioidomycosis aka
(California Disease, San Joaquin Valley Fever)
Coccidioidomycosis non specific skin findings
erythema nodosum, erythema multiforme, toxic erythema
Coccidioidomycosis like all the dimorphic fungi, how dfo you get it
Asymptomatic and self-limited respiratory tract infection is common
Paracoccioidomycosis aka
Brazilian Blastomycosis, South American Blastomycosis)
Paracoccioidomycosis Endemic area:
Brazil (80% of reported cases),
Pityriasis Versicolor (Tinea Versicolor) most common cause of TV),
M. globosa (
Pityriasis Versicolor (Tinea Versicolor) Woods lamp
(+) pale yellow fluorescence
Tinea Nigra Palmaris organism
Phaeoannellomyces werneckii
White Piedra Trichosporon beigelii, new nomenclature:
Trichosporon ovoides and T. inkin
White Piedra Trichosporanosis organism
Trichosporon asahii
Ectothrix organsism
M. canis, M. audouinii, M. distortum, M. ferrugineum, and sometimes M.
Endothrix “Black Dot Ringworm” organisms
T. rubrum, T. gourvilli, T. yaounde, T. tonsurans, T. schoenleinii, T. soudanense, T. violaceum
Kerion Most frequently due to
M. canis, T. tonsurans, T. verrucosum, T. mentagrophytes
Tinea Corporis the most frequently recovered organisms
T. rubrum, T. mentagrophytes, M. canis, T. tonsurans
Majocchi’s Granuloma associated with what organism
T. rubrum,
Tinea Barbae Inflammatory:
T. mentagrophytes, T. verrucosum
Tinea Barbae Abscess:
M. canis
Tinea Barbae Verrucous granulomatosis:
E. floccosum
Tinea Cruris organisms
E. floccosum, T. rubrum, T. mentagrophytes
Tinea Faciei organisms
T. rubrum, T. mentagrophytes, T. concentricum, M. canis
Tinea Manuum organisms
T. rubrum, T. mentagrophytes, E. floccosum
Tinea Pedis Moccasin type:
E. floccosum, T. rubrum
Tinea Pedis Vesicular type:
T. mentagrophytes
Distal Lateral Subungual Onychomycosis
T. rubrum
Proximal Subungual Onychomycosis
T. rubum
Proximal White Subungual Onychomycosis an AIDS markjer (not superficial white)..what is the organism?
T. rubrum
White Superficial Onychomycosis
T. mentagrophytes,
colony morphology E. floccosum
khaki-colored colony,
colony morphology M. audouinii
mouse fur - grey or tan
colony morphology M. canis
white fluffy, fur-like colony with yellow periphery and feathery border. Pee in the snow
colony morphology M. gallinae
white colony becoming pink with age. Reverse strawberry
colony morphology M. gypseum
powdery colony,
wierd fungal stuff (+) wedge shaped areas in hair shaft
T. mentagrophytes
wierd fungal stuff makes pigment on cornmeal agar
(+) T. rubrum, (–) T. mentagrophytes
wierd fungal stuff Niacin
T. equinum
wierd fungal stuff Histidine
T. megninii
wierd fungal stuff Inositol and thiamine
T. verrucosum
wierd fungal stuff Urease Test
(+) red - pink T. mentagrophytes
colony morphology T. mentagrophytes
fluffy white
colony morphology T. rubrum
reverse nondiffusible red,
colony morphology T. concentricum
white, waxy colony turns amber or coral red and deeply folded, cerebriform
colony morphology T. violaceum
heaped purple colony;
Scytalidium dimidiatum causes?
Dematiaceous organism causing dermatomycoses of the soles and toe webs, paronychia, and
SUBCUTANEOUS MYCOSIS list them
sporo, mycetomas, chromoblasto, lobo,
SUBCUTANEOUS MYCOSIS sporo on path
cigar bodies”
SUBCUTANEOUS MYCOSIS ruke for all eumycetoma and actinomycetoma pellet colors
"FAN of Boyd - Red pellets". All starting with FA o rN and boydii are white. Pelletieri is red.
SUBCUTANEOUS MYCOSIS common actinomycetoma organism
nocardia
SUBCUTANEOUS MYCOSIS chromoblastomycosis organisms
Fonsecaea pedrosoi (most common), Fonsecaea compacta, Rhinocladeilla aquaspersa, Phialophora verrucosa,
SUBCUTANEOUS MYCOSIS chromo path
“copper
SUBCUTANEOUS MYCOSIS lobo path
“chain of coins” or “brass knuckles”
dimoprhic fungi causing systemic disease list them
histo, blasto, coccidio, paracoccidio, penicilliosis
Histoplasmosis Endemic to
Ohio,Mississippi,Missouri River Valleys,
Histoplasmosis high risk animals
bat, bird (especially starling), and chicken droppings
Histoplasmosis non specific skin
Toxic erythema, erythema multiforme or erythema nodosum
Histoplasmosis specicifc skin findings
macules, papules, nodules, ulcers (oral and rectal), molluscum like
Histoplasmosis runs from assymptomatic to bad bad. Treatment:
Itraconazole drug of choice for disseminated disease
Histoplasmosis AIDS patients tx:
Itraconazole or Amphotericin B followed by itraconazole, ketoconazole or fluconazole
Blastomycosis aka
Gilchrists
Blastomycosis area
Ohio and Mississippi River Valley, Great Lakes area,
Blastomycosis Gilchrist’s Disease:
primary cutaneous blastomycosis;
Coccidioidomycosis aka
(California Disease, San Joaquin Valley Fever)
Coccidioidomycosis non specific skin findings
erythema nodosum, erythema multiforme, toxic erythema
Coccidioidomycosis like all the dimorphic fungi, how dfo you get it
Asymptomatic and self-limited respiratory tract infection is common
Paracoccioidomycosis aka
Brazilian Blastomycosis, South American Blastomycosis)
Paracoccioidomycosis Endemic area:
Brazil (80% of reported cases),
Opportunistic pathogenic fungi: list
Aspergillosis, zygomycosis, phaeohyphomycosis, cryptococcus,
Aspergillosis Toxicity due to ingestion of contaminated food:
aflatoxin
Aspergillosis besides a fungal ball in the lung, local necrotic cutaneous infections disseminate disease what else does it cause
otitis externa
Aspergillosis path
45 degree angles
Aspergillosis most common spp
A. fumigatus
Zygomycosis aka
Mucormycosis, Phycomycosis)
Zygomycosis Most commonly:
Absidia, Rhizopus, Mucor
Zygomycosis purulent material is distinctive…how?
Production of black pus
Zygomycosis Risk factors:
neutropenia, diabetes mellitus, metabolic acidosis, trauma, burns
Zygomycosis variant associated with acidotic diabetes;
Rinocerebral zygomycosis:
Zygomycosis Pulmonary Zygomycosis: aka
FUNGOMA
Fusarium (Fusariosis) path
identical to aspergillus
most common fungus in burn pts
fusarium (aspergillus is 2nd)
Phaeohyphomycosis good stain
fontana-masson
Phaeohyphomycosis organisms
alternaria, curvularia, exophiala, bipolaris, wangiella
Cryptococcosis sources
aged pigeon droppings and roosting areas, mouldy fruit,
Cryptococcosis % AIDS pt with ut findings after getting crypto
10-15%
candida oropharyngeal spp
C. dubliniensis
candida mot common spp
C. albicans
candida paronychia spp
parapsilosis
candida spp with fluconazole resistance
C glabrata
Rhinosporidiosis stains red with
mucicarmine
Protothecosis organisms
Prototheca wickerhamii
Protothecosis Worldwide habitat:
stagnant water
Protothecosis causes what is 1/3 of cases
olecrenon bursitis
Protothecosis path
Mature form contains a symmetrical arrangement of endospores = morula,
Protothecosis
8-20 µm (“soccer ball”)
mycology Umbilicated Lesions Seen In
crpto, histo, penicilliosis, cocciioidomycosis
Actinomycosis spp
Actinomyces israelii
Actinomycosis Source of infection is “
endogenous
Actinomycetoma spp
Nocardia brasilensis, Actinomadura madurae, A.
Actinomycetoma Source of infection is
exogenous
Anthrax toxins
Edema toxin = Edema Factor (EF) + Protective Antigen (PA)
Anthrax EF causes gelatinous edema of anthrax skin lesions by
increase cAMP levels
Anthrax LF causes shock and death in disseminated anthrax via
release of tumor necrosis factor-alpha (TNF-a)
Anthrax Treatment:
bioterrorism: cirpo, doy: conventional…PCN
bartonellosis cat scratch spp
henselae
bartonellosis cat scratch vector
cat flea
bartonellosis bacillary angiomatosis
henselae, quintana
bartonellosis trench fever spp
quintana
bartonellosis trench fever vector
pediculus humnus corporis
bartonellosis oroya fever/verruga peruana organism
bcilliformis
bartonellosis oroya fever vector
lutzomyia verrucarum
bartonellosis almost al bartonellas are tx with ees or doxy. Oroya fever is treated with:
CAM (superinfection with salmonella)
Borreliosis lyme disease: spp, vector(s),
burgdorferi, NE: Ixodes dammini (scapularis?) NW: Ixodes pacificus, EUROPE: I ricinus
Borreliosis Relapsing fever: two forms
louse, tick
Borreliosis louse born relapsing fever. Spp, vector
B recurrentis, pediculus humanus
Borreliosis tick born relapsing fever. Spp, vectors
B duttonii, ornithodoros (soft bodied ticks)
botryomycosis organsism
S. aureus, P. aeruginosa, E. coli, and Proteus species
Ecthyma Gangrenosum color
gunmetal grey
Erysipeloid grm+ or grm-
grm+ rod
Glanders organism
Burkholderia mallei
Pitted Keratolysis organism
micrococcus sedentarius
Rat-bite Fever (Haverhill Fever) organism
Streptobacillus moniliformis
Rhinoscleroma organism
Klebsiella pneumoniae rhinoscleromatis
Rhinoscleroma path
Mikulicz cells on histopathology
Rhinoscleroma clincial
plaques on nares
TSS toxin
enterotoxins B,C. TSST-1
SSSS toxins
exfoliative toxins (ET) A,B
Bullous impetigo toxins
ET A,B like SSSS
Scarlet fever enanthem
exudative pharyngitis, strawberry tongue
Scarlet Fever exanthem
“sandpaper” texture, beginning on head and neck, and then
Trichomycosis Axillaris organism
Corynebacterium tenuis
Tularemia Causative Organism:
Francisella tularensis
Viral Infections DNA viruses
herpes, hepadna, adeno, papova (HPV), parvo, pox
Viral Infections which DNA virus is ssDNA
parvovirus (E infectiosum)
Viral Infections what causes handfoot and mouth dz (virus)
picornavirus
Congenital Cytomegalovirus (CMV) trimester(s) highest risk
1,2
Hand-Foot-and-Mouth Disease viruses
Coxsackievirus A16 or enterovirus 71
Herpangina viruses
group A coxsackie
Herpes Simplex - Treatment Acyclovir moa
Guanosine analogue
Herpes Simplex - Treatment Famciclovir moa
Prodrug of penciclovir; increased bioavailability and longer half-life
Herpes Simplex - Treatment Valcyclovir chemical origin
L-valine ester of acyclovir with increased bioavailability
Herpes Simplex - Treatment valcyclovir TK dependent?
yes
Herpes Simplex - Treatment valtrex side effects
kidney clearance, TTP in some pts
Acyclovir-resistant HSV* – Treatment
• Foscarnet – directly inhibits viral DNA polymerase (without requiring phosphorylation by TK)
Ramsay Hunt Syndrome Caused by VZV infection of the
geniculate ganglion
Ramsay Hunt Syndrome triad
external ear/TM + facial paralysis + tinnitus
Verrucous Carcinoma (HPV-associated) 3 kinds
Bushke lowenstein, epithelioma cuniculatum, oral florid papillomatosis
measles type of virus
a paramyxovirus
measles prodrome
• “3 C’s:” Cough, Coryza, Conjunctivitis
parvo B19 three clinic types
kids classic, arthropathy/fever/LAD, papular purpuric gloves and socks
parvo B19 in sickle cell
aplastic crisis
parvo B19 highest pregnany risk
hydrops fetalis, first half of pregnancy
Rubella aka
german measles
Rubella clincial
3 day rash, post auricular LAD
blueberry muffin ddx
TORCH
smallpox incubation
12d
smallpox prodrome
3d with fever, chills etc but some have petechial bathing suit rash
smallpox cytoplasmic eosinophillic inclusions on light microscopy);
guarnieri's bodies
smallpox vaccination complication in atopic pt
eczema vaccinatum
smallpox vaccination in pregnant woman
congenital vaccinia
smallpox vaccination generalized vaccinia in?
kids with isolated IgM deficiency
smallpox versus varicella
vzv in difft stages evolution, mild prodrome
varicella/chickenpox congenital risk highest in
first 20 weeks
varicella/chickenpox cong varicella syndrome
hypoplastic limbs, ocular and CNS
varicella/chickenpox risk in delivery
5 days before and 2 days after delivery:
varicella/chickenpox tx neonatal varicella
VZIG + acyclovir
Leprosy organism
M leprae
Leprosy paucibacilary tx
dapsone 100qd x 6 mo, rifamin 600 qd x 6 mo
Leprosy multibacilary tx
dapsone, rifampin, clofazimine 12 months
Leprosy TT cytokines, lesions, nerves,
TH1, <3 lesions, anesthetic
Leprosy LL cytokines, lesions, nerves
TH2, generalized, no loss of sensation
Leprosy Type 2 Reaction:
erythema nodosum leprosum
Leprosy erythema nodosum leprosum clinically
nodules on extremities and face
Leprosy erythema nodosum leprosum tx
thalidomide
Atypical Mycobacteria “Rapid growers”
M. fortuitum, M. chelonei, M. abscessus
M. Marinum tx
minocycline
TB name of primary cutaneous infection
tuberulous chancre
TB tuberculosis verrucosa cutis
exogenous reinfection (sensitized host with strong immunity)
TB lupus vulgaris-what type of infection
hematogenou or lymphatic spread from distnt site
TB scrofuloderma-type of infectious process
direct spread from underlying TB
TB tuberculous gumma - type of infectious process and in whom?
hematogenous spread in immunosuppressed host
TB tuberculosis cutis orificialis - what type of infection
autoinoculation from visceral TB.
TB TB-multibacillary forms
TB chancre (+/-), scrofuloderma, TB gumma, TB cutis orificialis
TB TB pauci bacillary forms
lupus vulgaris
gonorrhea Recurrent cases may be associated with
complement deficiencies (especially C5-C8)
syphilis Primary: chancre occurs
10d-3 mo
syphilis how long does secondary last?
Lasts 4 to 12 weeks
syphilis Latent timing
Early (< 1 year)
syphilis Congenital: early
“saw-tooth” appearance of metaphysis, “snuffles”, Rhagades (Parrot’s lines), Pseudoparalysis of Parrot, “Syphilitic pemphigus”
Lymphadenopathy (epitrochlear)
Neurosyphilis
None
syphilis Congenital: late (>2 yo)
Mulberry molars, Hutchinson’s teeth (widely-spaced, peg-shaped upper incisors, Saddle nose, Saber shins, Clutton’s joints (non-tender, bilateral swelling of knees), higoumenakis sign, Eighth nerve deafness, Intersitial keratitis, Gummas Hutchinson’s triad
None
chancroid organism and clinical
H ducreyi; tender chancre, inguinal bubo in 50% (this is not groove sign)
chancroid path
school of fish
granuloma inguinale organism
calymmatobcterium granluomatis
granuloma inguinale clinical
subq nodule (pseudobubo) or ulcer then 4 forms: ulcerovegettive/nodular/hypertrophic/cictricial
granuloma inguinale path
donnovan bodies
LGV organism
chlamydia trachomatis L1-3
LGV clinical
painless like syphilis then nodes above and below pouprts (grove sign, can be bilateral). LGrooVe
syphilis VDRL: + when, - when
positive 4-5 wks , negative after tx
syphilis RPR
like vdrl (4-5 weeks + then negative after tx)
syphilis FTA-ABS when +? How long +?
pos by 3rd week, remians positive
syphilis most sensitive test
FTA-ABS
syphilis Serologic test of choice in early primary and congenital syphilis because it is the first to become reactive
Enzyme-Linked Immunosorbent Assay (ELISA)- Captia (IgM) EIA
leishmaniasis old world - all
TIMAd (tropica, infantum, major, aetheopia, donovani)
leishmaniasis new world-all
mexicana, braziliensis, amazonensis, adrianrodrigueznensis
leishmaniasis cut leishmaniasis old and new
(old) TIMA: (new)mex,braz,amaz
leishmaniasis MCL
L. aethiopica (Old World)
leishmaniasis Visceral Leishmaniasis (VL; kala-azar)
L. donovani
leishmaniasis vectors (old and new)
Phlebotomus (Old World)
leishmaniasis Culture
Novy-MacNeal-Nicolle (NNN)
leishmaniasis tx
Pentavalent antimony (sodium stibogluconate)
Winterbottom’s sign
african trypanosomiasis
(Chagas’ Disease) organism
T. cruzi
(Chagas’ Disease) vector
reduviid
Filariasis organism
Brugia malayi, Brugia timori, W banchrofti
Filariasis vector, victor
Aedes, Anopheles, Culex, or Mansonia
Calabar swellings organism?
loa loa (vector mango fly)
loa loa tx
DEC
loa loa and onchocerciasis in common
eye swimmers
onchocerciasis vector + 3 clinicals
simulium (black fly). Clinical: leoprd skin, onchocercal nodules over bony prominences, ocular involvement
onchocerciasis tx
ivermectin
Strongyloidiasis Mode of Infection:
penetration of larvae through skin or mucous membranes, usually from contact with
Strongyloidiasis Cutaneous Strongyloidiasis aka
larva currens
Strongyloidiasis – Disseminated Strongyloidiasis: clinical sign
thumbprint
RMSF organism, vectors (east/west)
r rickettsi. West: dermacentor andersoni and east: dermacentor variabilis
rickettsialpox organsm, vector
akari, liponyssoides sanguineus (mite of house mouse)
epidemic typhus organism, vectors (east/west)
prowazekii, body louse
endemic typhus organism, vector
r typhi, rat flea (xena)
scrub typhus organism, vector
tsutsugamshi, trombiculid
q fever organism, vector
coxiella burnetii, dried tick feces
ehrlichiosis HME organism, vector
chaffeensis. Amblyomma americanum
ehrlichiosis HGE organism, vector
phagocytophilia, ixodes scapularis, pacificus
Sclerema Neonatorum clinical
Often fatal entity• Rapidly progressive, woody hardening of the skin within the first few days of life
Sclerema Neonatorum path
needle-shaped clefts within necrotic adipocytes with little surrounding inflammation
Subcutaneous Fat Necrosis of the Newbor resolution may be associated with
profound hypercalcemia
Pedal Papules of Infancy clinical
Soft, non-tender papules located on the medial aspect of heel
Aplasia Cutis Congenita 3 syndromes
Barts, Setleis (bitemoproal APC, leonine facies, absent eyelashes), adams-olkliver
Adams-Oliver syndrome: clinical
CMTC with Aplasia cutis congenita
Nevus Sebaceus Neoplasms associated:
syringocystadenoma papilliferum > trichoblastoma. BCC < 1%
Acrodermatitis Enteropathica/Zinc color
Brown, orange crusted plaques
Acrodermatitis Enteropathica/Zinc Inherited form:
SLC39A4
Jacquet’s Erosive Dermatitis etiology
Multifactorial etiology: yeast, irritant dermatitis andmoisture
Cystic Fibrosis clinical
Resembles zinc deficiency
biotin deficiency, multiple carboxylase deficiency clinical
Resembles zinc deficiency but affects all biotin
biotin deficiency, multiple carboxylase deficiency Neonatal form: inhertience and defect
AR holocarboxylase synthetase
biotin deficiency, multiple carboxylase deficiency Juvenile form: enzyme
Biotinidase
biotin deficiency, multiple carboxylase deficiency systemic findings
Seizures, vomiting, hypotonia, ataxia 2° lacticacidosis/ketosis
Kawasaki’s Disease 2/3 pts present with confluent, tender erythema in the
perineum
SSS phage
grp II
what kind of virus is coxsackie
ssRNA picornavirus
kawasakis 4 of 5 crietria..list them
1. fever >5 d 2. palmar eryhtema 3. conjuctivitis 4. strawbery tongue/red lips 5. cervical LAD
kawasakis tx
ASA + IVIG
HEPATITIS C VIRUS family
flavi
HEPATITIS C VIRUS : what account for 75% of infections
types 1a, 1b
HEPATITIS C VIRUS : what % of patients will progress to chronic Hepatitis
70
HEPATITIS C VIRUS : cirrhosis will develop in
20-30
HEPATITIS C VIRUS : % cirrhotic patients will develop hepatocellular cancer
4-11%
Cryoglobulinemia : % RF positive
70-90
PCT triggers
alcohol, estrogens, polyhalogenated hydrocarbons, PCT
PCT : mechanism of iron overload exacerbation
formation of free iron radicals and oxidation of UROD
Polyarteritis Nodosa : 2 viral associ
HCV, HBV
HCV : eye findings.
Mooren corneal ulcers
HCV tx
IFNa and ribavirin
Thyroglossal Duct Cyst Remnant of
embryonic duct
Most common cystic abnormality of neck
Thyroglossal Duct Cyst
Thyroglossal Duct Cyst Characteristic histologic feature
thyroid follicles in cyst wall
Multiple endocrine neoplasia (MEN) 2a, aka
Sipple
Multiple endocrine neoplasia (MEN) 2a, clinicals
Medullary thyroid, pheo, parathyroid and cut AMYLOID
MEN 2b/III clinicals
medullary thyroid carcinoma, mucosal neuromaspheochromocytoma, marfanoid features, and gastrointestinal ganglioneuromatosis.
Graves Disease hyper or hypo metabolic state?
hypermetabolic state
Graves Disease Clinical manifestations
hyperthyroidism, goiter, pretibial myxedema
Thyroid dermopathy: aka
pretibial myxedema
Thyroid dermopathy: occurs in which states
hypo/hyper and euthymic
Graves :cut conditions
vitiligo, anetoderma, dermatitis herpetiformis,mid-dermal elastolysis, herpes gestationis, pemphigus vulgaris, and Sweet’s syndrome
hyperthyroidism nails
plummer (curved with distal onycholysis)
hyperthyroidism :pigment associations?
vitiligo
hyperthyroidism : hands?
palmar erytherma
hyperthyroidism : hair?
hypertrichosis
: side effect of potassium idodide therapy
Wolff-Chaikoff effect: inhibiiton of thyorid hormone synthesis
hypothyroidism skin hue
yellow 2/2 carotenemia
hypothyroidism myxedemea type
generalized
hypothyroidism hair
brittle, sparse, increased telogen #
hypothyroidism eyebrows
madarosis
Xeroderma Pigmentosum (XP):UV irradiation induces specific types of DNA damage, primarily,
cyclobutane pyrimidine dimers (CPDs) and 6–4
Xeroderma Pigmentosum (XP):xp types recognizing damaged DNA
XPA,XPE
Xeroderma Pigmentosum (XP):xp types unwinding the coiled DNA
XPB, XPD
Xeroderma Pigmentosum (XP):xp types repairing the localized damaged DNA
endoculeases XPF, XPG
Xeroderma Pigmentosum (XP):most sever variant and inheritence
desanctis cacchione - AR XPA
Xeroderma Pigmentosum (XP):XPB = ercc?
ercc3
Xeroderma Pigmentosum (XP):XPB clinically
pigmentary retinopathy, basal ganglia calcification
Xeroderma Pigmentosum (XP):XPB crosses over with what
Cockayne
Xeroderma Pigmentosum (XP):XPD crosses over with what dz
PIBIDS
Xeroderma Pigmentosum (XP):XPD=ercc?
ercc2
Xeroderma Pigmentosum (XP):XPF=ercc?
ercc4
Xeroderma Pigmentosum (XP):XPG is a homologue of what gene
yeast RAD2
Cockayne Syndrome:inheritence
AR
Cockayne Syndrome:ercc?
ercc8
Cockayne Syndrome:clinical
Cataracts, deafness, pigmentary retinopathy, dental caries., “Wizened” appearance, “bird-headed” facies,“Mickey Mouse” ears
Cockayne Syndrome:early death from
pneumonia
PIBIDS:stands for
photosensitivity (like XPD), ichthyosis, brittle hair, intellect, decreased fertiliy, short
Hutchinson-Gilford Progeria Syndrome:Defect in
lamin A
Werner Syndrome:Defect in
RECQL2
Rothmund-Thomson Syndrome:Defect in
RECQL4 gene defect
Rothmund-Thomson Syndrome:clinical
Poikiloderma, photosensitivity, sparse hair, atrophic nails,
Rothmund-Thomson Syndrome:weird findings
juvenile zonular cataracts, annular pancreas,
Rothmund-Thomson Syndrome:Increased malignancy:
basal cell carcinoma, squamous cell carcinoma, osteogenic sarcoma
Ataxia-Telangiectasia:aka
(Louis-Bar Syndrome)
Ataxia-Telangiectasia:Milder AT-like syndrome due to what mutation
MREII gene defect).
Ataxia-Telangiectasia:Increased malignancy:
leukemia and lymphoma.
Ataxia-Telangiectasia:increased risk of malignancy in heterozygotes
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