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1289 Cards in this Set
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SLE criteria
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4 skin:
butterfly rash CCLE photoeruption oral ulcers Neuro Immune ANA Kidney Serositis Heme Arthritis |
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Urticarial Vasculitis 70% afflicted are
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women
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Schnitzler’s Syndrome:
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episodes of urticarial vasculitis that occur in association with monoclonal IgM M
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Nodular Vasculitis Women between
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30 and 40
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Livedoid Vasculitis (Atrophie Blanche)Associated with
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arteriosclerosis or stasis
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Erythema induratum:
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form of nodular vasculitis associated with M. Tuberculosis
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Urticarial Vasculitis tx
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dapsone, H1 blockers, indomethacin, colchicine
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Erythema Elevatum Diutinum tx
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Dapsone
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Nodular Vasculitis tx
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NSAIDs, colchicine, systemic steroids
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Livedoid Vasculitis tx
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Aspirin, dipyridamole, colchicine, low-dose heparin, systemic glucocorticoids, and low molecular weight dextran, nifedipine, pentoxyfylline
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Cryoglobulinemia Type I aasoc w
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b-cell malignancy such as myeloma or lymphoma CLL and Waldenstrom’s macroglobulinemia
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Type II (Mixed Cryoglobulinemia) etiol
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Monoclonal IgM rheumatoid factor complexed with polyclonal IgG
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Type II (Mixed Cryoglobulinemia) dzs
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Multiple myeloma,Waldenstrom’s, CLL, rheumatoid arthritis, Sjogren’s, Hepatitis C
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Type III (Mixed Cryoglobulinemia) Often complement activated and complement levels are
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lower
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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
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None
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Essential Mixed Cryoglobulinemia
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Cryoglobulins and the manifestation of symptoms without an identifiable connective tissue, neoplastic, or
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Cryofibrinogenemia Associated with
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malignancy, thromoembolic disease, diabetes, pregnancy, oral contraception, pseudotumor cerebri
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ACANTHOSIS NIGRICANS among obese children
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28%
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ACANTHOSIS NIGRICANS in Native Americans
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32%
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ACANTHOSIS NIGRICANS adult patients treated for obesity
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74%
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ACANTHOSIS NIGRICANS Associated Conditions
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Insulin resistance,Lipodystrophies (Lawrence-Seip syndrome)
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ACANTHOSIS NIGRICANS Type A Syndrome:
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severe acanthosis nigricans, hirsutism, clitoromegaly, and masculine habitus
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ACANTHOSIS NIGRICANS Type B Syndrome: occurs when and in whom, what ctd assoc?
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AN after teenage years with less extensive involvement, with often underlying SLE
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None
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ACANTHOSIS NIGRICANS Drugs:
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testosterone, nicotinic acid, diethylstilbestrol, oral contraceptives, triazinate, glucocorticoids,
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LIPODYSTROPHY partial Begins on
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face, spreads downward, stopping at any level
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LIPODYSTROPHY partial onset, sex
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female, and usually begins before age 15
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None
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LIPODYSTROPHY partial Laboratory
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Hypertriglyceridemia Decreased serum complement (C3), Increased C3 nephritic factor (immunoglobulin that binds Factor H, an inhibitor of C3,)
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Generalized Lipodystrophy Congenital
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(Seip-Lawrence Syndrome)
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Generalized Lipodystrophy Acquired
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(Berardinelli-Seip Syndrome)
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Generalized Lipodystrophy Mental retardation?
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common
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Generalized Lipodystrophy assoc skin condition?
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Eruptive xanthomas may appear
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Sweets labs normal vs malignancy assoc
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Malignancy-associated Sweet’s: anemia, normal or low neutrophil count and abnormal platelet count
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Sweets Can be associated with intestinal infection with
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yersinia enterocolitica
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Sweets Associated Diseases
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AML; lesions may precede diagnosis of leukemia;
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Sweets how many lesions suggest malignancy?
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20
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EAC associations
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malignancy, dermatophyte
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EED positiive skin test to?
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Markedly positive skin tests to intradermally injected streptokinase-streptodornase
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EED lab
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IgA (mainly) or IgG or IgM monoclonal gammopathies or even myeloma
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EN 70% have associated _ that may pesist for years?
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arthropathy
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EN infections:
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strep, tb yersinia, blasto, viruses
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Sarcoidosis Remember, hilar adenopathy and erythema nodosum also present in
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lymphoma, tb, streptococcal infectionsand fungal infections
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Mastocytosis provoked by
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alcohol, aspirin, narcotics, contrast agents (iodinated), insect stings, exercise, or infections
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Mastocytosis Most common skin manifestation in children and adults
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Urticaria pigmentosa
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Mastocytosis Obtain 24 hour urine for
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5-hydroxyindoleacetic acid (5-HIAA) and urinary metanephrines
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Mastocytosis Mast cell leukemia: survival
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less than 6 months
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CUTANEOUS SARCOIDOSIS skin lesions in ?%
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25
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CUTANEOUS SARCOIDOSIS Nonspecific lesion:
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erythema nodosum, alopecia, erythroderma, subcutaneous nodules, erythemamultiforme, itching ichthyotic dryness, dystrophic calcifications, and verrucous outgrowths
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CUTANEOUS SARCOIDOSIS subq variant
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Darier-roussy sarcoidosis
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CUTANEOUS SARCOIDOSIS labs
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hyper CA (vitD3 overproduced), ACE level
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CUTANEOUS SARCOIDOSIS Intradermal injection of homogenized tissue from sarcoidosis patient
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Kveim Test
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CUTANEOUS SARCOIDOSIS Treatment
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steroids, antimalrials, immunosuppressive
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EPS Patients with
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Down’s Syndrome, heritable connective tissue disorders (Ehlers-Danlos Type IV, osteogenesisimperfecta,Marfan’s Syndrome, Rothmund-Thomson, scleroderma, and acrogeria)
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EPS drug inducer
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imperfecta,Marfan’s Syndrome, Rothmund-Thomson, scleroderma, and acrogeria)
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EPS location
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Nape and sides of neck, upper extremities
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Pregnancy hair changes
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Increased anagen, decreased telogenTelogen effluvium: 1-5 mos. Post-partum, stopping within 15 mos.;
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Pregnancy chadwick sign
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blue vagina
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Pregnancy goodell sign
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blue cervix
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Pregnancy Tumors
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granuloma gravidarum, glomagiomas, leiomyomas, desmoid (rectus adb) NF
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Pregnancy Melanoma prognosis
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diagnosis during pregnancy associated with thicker tumors; same prognosis
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Pregnancy Pemphigoid Gestationis
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BP
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Cholestasis of Pregnancy trimester
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3
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Cholestasis of Pregnancy 50% associated with
|
uti
|
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Cholestasis of Pregnancy perinatal risk
|
low vit K- bleeding
|
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Cholestasis of Pregnancy Fetus:
|
premature labor (common), fetal distress, perinatal death
|
|
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Cholestasis of Pregnancy Treatment
|
CholestyramineUrsodeoxycholic acid
|
|
|
impetigo herpetiformis” aka
|
Pustular Psoriasis of Pregnancy
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impetigo herpetiformis” trimester
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Late 1st trimester to 3rd trimester
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impetigo herpetiformis” Fetus at risk for
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placental insufficiency
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impetigo herpetiformis” lab
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hypoCA, leukocytosis
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pruritus association of malignancy and generalized itching is rare, with the exceptions of
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hodgkins, PCV
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SCLEREDEMA Skin involvement may be preceded by
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prodrome of low-grade fever, malaise, myalgia, arthralgia
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SCLEREDEMA types
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I-post infection (strep get ASO) II monoclonal gammopathy 3-diabetes
|
|
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Apocrine Glands Stain with
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GCDFP-15keratin AE1 (stains ducts), CAM 5.2, EMA
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Eccrine Glands Stain with
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S100, CEA, CAM 5.2
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Sebaceous Glands on eyelid
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Meibomian and Wolf
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Sebaceous Glands (on penis),
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Tyson
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Sebaceous Glands nipple
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Montgomery
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Hair Follicle Infundibulum = portion above insertion of
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sebaceous duct;
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Hair Follicle Isthmus = portion between insertions of
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sebaceous duct and arrector pili; trichilemmal keratinization;
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Hair Follicle dsg in inner root sheath and innermost part outer root sheath
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dsg1
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Hair Follicle Trichilemmal carcinoma stains with
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keratin 17 and c-erb-b2
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Hair Follicle Proliferating trichilemmal cyst stains with
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cytokeratin 7
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STAINS Nerve fibers black
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Bodian
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STAINS DNA magenta
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Feulgen
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STAINS Fontana Masson
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Melanin
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STAINS Foote’s or Snook’s
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Reticulin fibers black
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STAINS Mast cell granules purple
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Giemsa
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STAINS Leishmania
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Giemsa
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STAINS Mast cell granules red
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Leder
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STAINS Masson Trichrome
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Collagen blue/green, muscle/nerve/keratin red
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STAINS Methyl-green Pyronin
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RNA pink, DNA green
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STAINS Perls (Prussian Blue)
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Iron/hemosiderin bright blue
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STAINS PTAH (Phosphotungstic Acid Hematoxylin)
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Stains fibrin
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STAINS PTAH stains inclusions in
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infantile digital fibromatosis
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STAINS Amyloid
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congo red, crystal violet, thioflavin T, orcein-giemse
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STAINS Calcium
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Von Kossa (blue-black)• Alizarin red (red)
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STAINS Elastic Tissue
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verhoeff von giesen, gomoris aldehyde fuchsin
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STAINS Osmium tetroxide
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fat
|
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STAINS Sudan black
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fat
|
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STAINS Oil red O
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fat
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STAINS Scarlet red
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fat
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STAINS Mucin
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Colloidal iron (blue)• Mucicarmine (pink)
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STAINS Ochronosis
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Cresyl violet or methylene blue stains the pigment black
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STAINS Spirochetes
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Silver stains like Warthin Starry or Dieterle or Steiner
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Darier’s Disease (Keratosis Follicularis) path
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Column of parakeratosis above a focus of acantholytic dyskeratosis (corps ronds and grains)
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Grovers path
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dariers, hailey-hailer, spongiotic, PV
|
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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)
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Squamous Cell Carcinoma, Adenoid Type Also called
|
acantholytic SCC
|
|
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Warty Dyskeratoma Can look exactly like
|
Darier’s,
|
|
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Acrospiroma 3 variants
|
hidroacanthoma simplex, poroma (connected), Hidradenoma (not connected)
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|
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Apocrine Hidrocystoma path
|
The cyst lining shows apocrine-type decapitation secretionouter myeepithelial, inner columnar epi cells
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Bronchogenic Cystpath
|
pseudostrat, goblet cells
|
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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
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Cylindroma origin
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apocrine
|
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Brooke-Spiegler syndrome:
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multiple trichoepitheliomas, cylindromas, spiradenomas
|
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Hidradenoma Papilliferum path, location
|
Papillated projections into cystic spaces, decapitation secretionVulvar area
|
|
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Morpheaform Basal Cell Carcinoma (BCC) stains BCCs diffusely
|
Bcl-2
|
|
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Nevus Sebaceus of Jadassohn tumors
|
trichoblastoma thought to be the most common, followed byRubinstein-Taybi, Gardner’s (cyst-like pilomatricomas), Turner’s,
|
|
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Multiple pilomatricomas seen in
|
Rubinstein-Taybi, Gardner’s (cyst-like pilomatricomas), Turner’s,sarcoidosis, sternal cleft and coagulation defects, myotonic dystrophy (Steinert’s)
|
|
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3 keys to immunodef in kids
|
1. FTT 2. Diarrhea, 3. Pneumonia. If no to all three no immunodef.
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Bleeding diathesis imunodef
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WA
|
|
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thrush after 2?
|
very worrisome..HIV
|
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Ataxia telangectasia gene/function
|
ATM / PI3k
|
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Ataxia telangectasia inherited
|
AR
|
|
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Ataxia telangectasia associated cancers
|
breast, lymphoma
|
|
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Ataxia telangectasia screening breast ca?
|
dont use mammogram- DNA repair defect
|
|
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Ataxia telangectasia telangectasias where?
|
bulbar first
|
|
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Ataxia telangectasia besides ataxia, telang. what other cut findings?
|
progeroid (90%), freckling, GRANULOMAS
|
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Ataxia telangectasia labs
|
elevated Alpha-FP, CEA
|
|
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Ataxia telangectasia pneumonic?
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Ataxia A-T low AGE 2....AGE for decr A,G,E
|
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Ataxia telangectasia imaging if needed use what
|
MRI not CT
|
|
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CGD enzyme
|
NADPH Oxidase
|
|
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CGD inheritence
|
AR most
|
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CGD May present mimicking what in kids
|
foll occlusion triad
|
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CGD osteomyelitis. what organism
|
serratia
|
|
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Chronic mucocut candidiasis 4 skin findings
|
nails thick, paronychia, thrush, plaques/patches periorificially
|
|
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Chronic mucocut candidiasis dz assoc with CMC
|
KID syndrome, multiple carbox def, zn def, EEC
|
|
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Cartilage Hair Hypoplasia enzyme
|
RNA RNP endonuclease
|
|
|
Cartilage Hair Hypoplasia presents as
|
short limbed dwarfism, sparse hair, doughy skin
|
|
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Cartilage Hair Hypoplasia people
|
amish, finnish
|
|
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Cartilage Hair Hypoplasia very susceptible to
|
varicella
|
|
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Cartilage Hair Hypoplasia increased risk of
|
NHL, BCC
|
|
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Leukocyte adhesion def. TYPE 1 gene
|
CD18 encoding beta2integrin
|
|
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Leukocyte adhesion def. TYPE 1 blocks what, like what drug?
|
LFA-ICAM like efalizumab
|
|
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Leukocyte adhesion def. TYPE 1 perinatally
|
blocks umbilical separation
|
|
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Leukocyte adhesion def. TYPE 1 TYPE 2 enzyme
|
GDP fucose synthesis
|
|
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Bruton's inheritenc?`
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xlr 90%
|
|
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Bruton's gene
|
btk
|
|
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Bruton's incr suscepti to?
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HBV, enterovirus
|
|
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Bruton's skin
|
eczema
|
|
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Bruton's wierd viral reaction
|
dermatomyositis from echovirus
|
|
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Hyper IgM inheritence & gene
|
XLR, CD40 ligand
|
|
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Hyper IgM Zonana?
|
ED + hyperIgM
|
|
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Hyper IgM skin
|
oral ulcers, warts
|
|
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CVID what type of GI infection prevails?
|
giardia
|
|
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IgA Deficiency 50% have what
|
anti IgA ab
|
|
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HyperIgD gene/enzyme
|
mevalonate kinase
|
|
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HyperIgD presents like what other illness?
|
JRA - periodic fever, arthralgias
|
|
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Duncans aka
|
Ilinked lymphoproliferative dz
|
|
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Duncans gene
|
SH2 DIA
|
|
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Duncans pathogenesis (problem)
|
humoral and T cell response to EBV
|
|
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Duncans death from?
|
70% B cell lymphoma
|
|
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Hyper IgE aka
|
job Buckley
|
|
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Hyper IgE skin
|
eczema (severe) corase facial features, retained primary teeth, recurrent infections
|
|
|
Hyper IgE IgE level in HyperIgE
|
>5-10,000
|
|
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Wiskott-Aldrich gene/inheritence
|
xlr, WASP
|
|
|
Wiskott-Aldrich WASP function
|
ASSEMBLY FOR VESCLE TRANSPORT, PLATELET FORMATION
|
|
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Wiskott-Aldrich 3 CLINICAL FINDINGS
|
bleeding diathesis (only immunodef with bloody diarrhea), atopic dermatitis, recurrent infections
|
|
|
Wiskott-Aldrich 26% develop
|
lymphomas
|
|
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DiGeorge Sx mutation
|
TBX1
|
|
|
DiGeorge Sx kids present with
|
neonatal tetany
|
|
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DiGeorge Sx pneumonic
|
CATCH22 Cardiac, Abnormal facies, Thymic hypoplasia Cleft palate Hypocalcemia
|
|
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ChediakHigashi gene
|
LYST
|
|
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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
|
esp: breast cancer
|
|
|
Ataxia-Telangiectasia:atatxia at 1 year old, telangectasia ye, but what immunodeficiency?
|
thymic hypoplasia with defect B-cells and decrease number of T-cells,
|
|
|
Ataxia-Telangiectasia:lab abnormality?
|
CEA
|
|
|
Bloom Syndrome:gene
|
recql3
|
|
|
Bloom Syndrome:clinical
|
prenatal growth deficiency, photosensitivity, midfacial telangiectasia, dyspigmentation,
|
|
|
Fanconi Anemia:skeletal
|
radial ray defects
|
|
|
Fanconi Anemia:why anemic?
|
All marrow elements are usually affected, resulting in anemia, leukopenia, and thrombocytopenia
|
|
|
Dyskeratosis Congenita:similarity with naegeli?
|
absnt dermatoglyphs
|
|
|
Ichthyosis Vulgaris:gene/product
|
filligrin/profilligrin.
|
|
|
XL ichthyosis:associations (3)
|
corneal opacities, cryptorchidism, prolonged labor
|
|
|
Epidermolytic Hyperkeratosis:aka
|
(Congenital Bullous Ichthyosiform Erythroderma)
|
|
|
Epidermolytic Hyperkeratosis:gene defects
|
K1,10
|
|
|
Epidermolytic Hyperkeratosis:if in epidermal nevus
|
Localized forms may affect germline...risk for babies
|
None
|
|
Lamellar Ichthyosis:at birth
|
Collodion baby, ectropion, eclabion, alopecia
|
|
|
Nonbullous Congenital Ichthyosiform Erythroderma):defects
|
transglutaminase-1 gene, 12R-lipoxygenase gene, and the lipoxygenase-3 gene
|
|
|
Nonbullous Congenital Ichthyosiform Erythroderma):birth
|
Collodian baby (90%)
|
|
|
Harlequin Fetus:inheritence
|
ar
|
|
|
Restrictive Dermopathy:clinical
|
Tight, restrictive adherent skin at birth associated with fixed, pinched facies.
|
|
|
Erythrokeratoderma Variabilis:genes
|
connexins 31 and 30.3
|
|
|
Netherton Syndrome:triad
|
IL, atopy, trichorrhexis invaginata
|
|
|
Keratitis, Ichthyosis and Deafness Syndrome (:gene
|
cx26
|
|
|
Sjogren-Larsson:eye
|
gistening white dots
|
|
|
Refsum Disease:genes in adult and kids
|
phytanoylCoa. Kids: PEX1,2
|
|
|
Refsum Disease:nevi?
|
yellow nevi
|
|
|
Refsum Disease:clinical
|
retinitis pigmentosa, ataxia, polyneuritis, deafness, cardiomyopathy
|
|
|
Refsum Disease:bone
|
4th metatarsal shortening
|
|
|
Chondrodysplasia Punctata:XR type. Gene
|
arylsulfatase E
|
|
|
Chondrodysplasia Punctata:XR type clinical
|
Ichthyosis, hypogonadism, and anosmia
|
|
|
Chondrodysplasia Punctata:contiguous gene syndrome
|
Xlinked ichthyosis, kallman
|
|
|
Conradi-Hunermann Syndrome):inheritence
|
XD variant of condrodyplasia punctata
|
|
|
Conradi-Hunermann Syndrome):gene
|
EBP
|
|
|
Conradi-Hunermann Syndrome):clinical
|
ichthyosis and erythroderma along Blaschko’s lines, follicular atrophoderma,
|
|
|
Rhizomelic Chondrodysplasia Punctata:genes for each of the 3 types
|
type 1: PEX7; type 2 DHAPAT; type 3: alkyl-AP synthetase
|
|
|
chondrodysplasia punctata:AD variant unique feature
|
Koala bear facies
|
|
|
Acrokeratosis Verruciformis of Hopf:gene
|
ATP2A2 gene mutation (allelic to Darier disease)
|
|
|
Darier Disease (Keratosis Follicularis):gene
|
SERCA2 Ca(2+)-ATPase
|
|
|
Darier Disease (Keratosis Follicularis):nails
|
red or white longitudinal streaking of nails with distal V notching.
|
|
|
Pachyonychia Congenita:associations types 2
|
natal teeth, steatocystoma multiplex, epidermal inclusion cysts
|
|
|
Steatocystoma Multiplex:gene
|
k17
|
|
|
Nail-Patella Syndrome:lmx1b. Nails?
|
triangular lunula
|
|
|
Nail-Patella Syndrome:systemic
|
renal, absent patella, iliac horns
|
|
|
Vorners:defect. Epidermolytic?
|
k9. Yes.
|
|
|
Vorners:appearance
|
sharply demarcate
|
|
|
Unna Thost:epidermolytic?
|
nonepidermolytic
|
|
|
Unna Thost:genes
|
k1,16
|
|
|
mosaib K16 mutation:clinically
|
unilateral palmoplantar verrucous nevus
|
|
|
keratoderma hereditaria mutilans:aka, gene
|
vohwinkles, cx26 (loricrin without deafness)
|
|
|
keratoderma hereditaria mutilans:gene
|
starfish keratosis, pseudoainhum, linear plaques on knees, bilateral deafness
|
|
|
striated ppk:gene
|
dsg1
|
|
|
Howell-Evans:type of ppk
|
nonepidermolytic
|
|
|
Mal de meleda:clinical
|
erythematous ppk, hyperhidrosis
|
|
|
Mal de meleda:transgrediens or no?
|
yes
|
|
|
Papillon-lefevre:type of ppk
|
erythematous ppk
|
|
|
HAIM Munk:gene
|
cathepsin C
|
|
|
HAIM Munk:clinical
|
papillon lefevre with onychogryphosis, pes planus
|
|
|
Naxos:heart defect, gene
|
right sides conduction, plakoglobin
|
|
|
Carvajal:heart defect, gene
|
left dilated cardiomyopathy, desmoplakin
|
|
|
Olmsted Syndrome:clinical
|
Sharply defined PPK with periorificial, keratotic lesions +/- pseudoainhum,
|
|
|
Anhidrotic Ectodermal Dysplasia:inheritence and genes (two type)
|
XR: EDA; AD: EDAR
|
|
|
Ectodermal Dysplasia (Margarita Island Type):gene
|
Cell-cell adhesion molecule/herpes virus receptor, PVRL1 gene mutation
|
|
|
Ectodermal Dysplasia (Margarita Island Type):alelic to
|
Allelic disorder to the Zlotogora-Ogur syndrome
|
|
|
Ectodermal Dysplasia/Skin Fragility Syndrome:aka
|
McGrath
|
|
|
Ectodermal Dysplasia/Skin Fragility Syndrome:defect
|
Plakophilin-1
|
|
|
Menkes Kinky Hair Syndrome:hair
|
Pili torti (occ. trichorrhexsis nodosa)
|
|
|
Menkes Kinky Hair Syndrome:systemic
|
severe neurological deterioration secondary to copper accumulation, Wormian bones
|
|
|
Papular Atrichia:Defect in human homolog of
|
mouse hairless gene
|
|
|
OCA type 1:product
|
tyrosinase
|
|
|
Yellow mutant:type 1B (OCA1 is type 1A). Gene?
|
tyroinase-clinical improve over time.
|
|
|
OCA type 2:gene
|
P gene
|
|
|
OCA:most common form
|
OCA2
|
|
|
Brown OCA:what tye OCA is it?
|
OCA3
|
|
|
Brown OCA:gene
|
TRP-1
|
|
|
Chediak-Higashi Syndrome:accumulation of what?
|
ceroid-like material
|
|
|
Chediak-Higashi Syndrome:die from
|
accelerated phase
|
|
|
McCune-Albright Syndrome (:aka
|
(Polyostotic Fibrous Dysplasia)
|
|
|
McCune-Albright Syndrome (:gene
|
GNAS
|
|
|
JEB:genes for 1 herlitz, 2 nonherlitz, 3 pyloric atresia
|
1. Lam5 2. Lam5,collXVII, 3. A6b4
|
|
|
NF2:eye
|
juenile posterior subcapsular cataracts
|
|
|
NF3:clinical
|
larger café au laits, palmar NFs, acoustin neuromas
|
|
|
NF5 :clinicl
|
segmental
|
|
|
NF6:clinical
|
café au lait macules only (>6)
|
|
|
TS:oral (2)
|
dental pits, ginigval fibromas
|
|
|
Gorlin:brain
|
medulloblastoma, meningiomas
|
|
|
Muir Torre:clinical
|
sebaceous, KA, BCC
|
|
|
Carney:4 tumors
|
Psammomatous melanotic schwannomas. Atrial myxomas. Sertoli cell tumors, pheos
|
|
|
Carney:NAME
|
nevi, atrial myxomas, myxoid tumors, ephilides
|
|
|
Carney:LAMB
|
lentigines, atria myxomas, mucocutaneous myxomas, blue nevi
|
|
|
Petuz-Jeghers:GI cancers?
|
slight increase
|
|
|
Petuz-Jeghers:other cancers
|
Breast, sertoli, thyroid, uterine, ovarian sex chord.
|
|
|
Brooke-Spiegler syndrome):triad
|
TE, cylindromas, milia
|
|
|
Pilomatrichoma:2 syndromes
|
1. Myotnic dystrophy 2. Rubenstein taybi (CREB)
|
|
|
Gaucher:product
|
B-glucocerebrosidase
|
|
|
Fabry:a-galactosidase
|
a-galactosidase
|
|
|
fucosidosis:product
|
L-fucosidase
|
|
|
fucosidosis:looks like
|
Fabry's
|
|
|
Hartnup:enzyme
|
tryptophan
|
|
|
Hartnup:clinical
|
like pellagra
|
|
|
Prolidase def:clinical
|
lower leg ulceration
|
|
|
Alkaptonuria:enzymes
|
HGO
|
|
|
Wilson:nail
|
blue lunula
|
|
|
Tyroinemia II:clinical
|
painful ppk
|
|
|
Hurler:a-L-iduronidase
|
Dermal melanocytosis. corneal clouding, dysostosis multiplex,
|
|
|
Hunter:Iduronidate sulfatase
|
Iduronidate sulfatase
|
|
|
Hunter:clinicl
|
pebbly skin lesions on scapula
|
|
|
EDS gravis:defect
|
Col V
|
|
|
EDS mitis:defect
|
Col V
|
|
|
EDS hypermobile:defect
|
col III
|
|
|
EDS vascular:defect
|
Col IV
|
|
|
EDS kyphoscoliosis:defect
|
lysyl hydroxylase
|
|
|
EDS arthrochalasia:defect
|
Col1alpha1, alpha2
|
|
|
EDS dermatosparaxis:defect
|
ADAMTS2
|
|
|
Cutis Laxa:defect AR, AD
|
AR FBLN5; AD elasti
|
|
|
Cutis Laxa:AR form versus AD form
|
AR only skin findings (no pulmonary, vascular etc)
|
|
|
Pseudoxanthoma Elasticum:oral
|
Yellowish papules on lip mucosa,
|
|
|
Pseudoxanthoma Elasticum:eye
|
Angiod streaks, blue sclera
|
|
|
Osteogenesis Imperfecta:defect
|
COL1A1 gene defect
|
|
|
Tuberous Sclerosis:earliest cutaneous finding,
|
Hypopigmented macules
|
|
|
Tuberous Sclerosis:oral
|
dental pitting
|
|
|
Fabry’s Disease:accumulation of what in vascular
|
globotriaosylceramide,
|
|
|
Fabry’s Disease:renal failure is due to accumulation of
|
ceramide trihexoside
|
|
|
Birt-Hogg-Dube Syndrome:Triad of
|
trichodiscomas, fibrofolliculomas and acrochordons
|
|
|
Birt-Hogg-Dube Syndrome:tumors
|
bilateral renal tumors, Periodic surveillance of patients and their relatives for renal cell carcinoma is recommended
|
|
|
Nail-Patella Syndrome:LMX1B gene, which encodes a transcription factor involved in
|
collagen synthesis
|
|
|
Nail-Patella Syndrome:eye
|
hyperpigmentation of the papillary margin of the iris (Lester iris)
|
|
|
Pseudoxanthoma Elasticum (PXE):ABCC6 gene, which encodes the
|
MRP6 protein (functions as efflux pump)
|
|
|
Pseudoxanthoma Elasticum (PXE):ABCC6 expressed where?
|
expressed in hepatocytes and renal cells
|
|
|
Pseudoxanthoma Elasticum (PXE):eye
|
Bruch’s membrane of the eye (angioid streaks)
|
|
|
Pseudoxanthoma Elasticum (PXE):Histopathology:
|
fragmented elastic fibers in the mid and deep reticular dermis
|
|
|
metaststaic calcification:It can manifest in the skin what 2 ways?
|
benign nodular calcifications (calcinosis cutis) or as a more serious condition
|
|
|
NFD:cell immunostain
|
CD34+ more than scleroderma
|
|
|
Pseudo-PCT:drugs
|
PLANT: pyridxoine, lasix, amiodarone, naproxen, tetracycline
|
|
|
Hereditary Hemorrhagic Telangiectasia:mutations in
|
ENG or ACVRLK1 genes encoding endoglin and ALK
|
|
|
Blue Rubber Bleb Nevus Syndrome:gene
|
VMCM1
|
|
|
Malignant Atrophic Papulosis of Degos:path
|
epidermal atrophy overlying wedge-shaped dermal necrosis and mucinous degeneration
|
|
|
Malignant Atrophic Papulosis of Degos:Systemic:
|
GI bleeding, cramping, perforation,
|
|
|
Gardner’s Syndr:Epidermoid cysts in 5% of cases.
|
100%
|
|
|
Gardner’s Syndr:other tumors besidesd EIC colon
|
desmoid tumors, osteomas of mandible/maxilla,supranummery teeth
|
|
|
Gardner’s Syndr:early sign
|
MRP6 protein (functions as efflux pump)
|
|
|
Muir Torre:Triad of
|
sebaceopus, BCC, KA
|
|
|
Peutz-Jeghers Syndrome:have mutations in
|
STK11 gene, which encodes a serine threonine
|
|
|
Peutz-Jeghers Syndrome:Systemic:
|
Hamartomatous intestinal polyps with intussusception
|
|
|
Peutz-Jeghers Syndrome:other cancers besides some colonc cancers
|
breast, ovarian, and testicular cancer
|
|
|
Wermers’s syndrome”::aka
|
MENI
|
|
|
“Sipple’s Syndrome”::aka
|
MEN Iia
|
|
|
Wasserman-Froebose (sp?):aka
|
MEN Iib (or III)
|
|
|
MEN I:clinics
|
Ps: parathyroid, pancreatic, pituitary, prolactinomas
|
|
|
MEN I:what happens in the stomach?
|
peptic ulcer from zollinger ellison
|
|
|
MEN Iia:cutanous
|
amyloid
|
|
|
MEN Iib:clinical
|
medularry thyroid, mucosal neuromas, marfanoid, pheochromo (3M plastics)
|
|
|
Bowel-Associated Dermatosis-Arthritis Syndrome:etiology
|
Involves bowel bacterial overgrowthÕ complement activation with subsequent deposition of
|
|
|
DH:HLAs
|
B8, DQ2, DR3
|
|
|
DH:Cutaneous findings are due to autoantibodies to
|
transglutaminase
|
|
|
DH:% with symptoms of their gluen enteropathy?
|
20%
|
|
|
DH:antibody target for GI problem
|
gliadin
|
|
|
Erythema Nodosum:more Crohns or UC?
|
UC
|
|
|
Pyoderma Gangrenosum:more crohns or UC?
|
uc
|
|
|
Polyarteritis Nodosa:more assoc with crohns or UC?
|
Crohns
|
|
|
NF1:brain
|
UFOs (well, really UBOs) in basal ganglia
|
|
|
NF1:eye
|
lisch
|
|
|
BCNS:PTCHed function
|
Inactivating PTCH mutations leads to loss of inhibition of smoothen (SMO)
|
|
|
BCNS:brain
|
Systemic: falx cerebri calcifications, ageneis of the corpus callosum,
|
|
|
BCNS:brain tumor?
|
medulloblastoma,
|
|
|
BCNS:chest wall?
|
bifid ribs, pectus deformity
|
|
|
Ataxia-Telangiectasia (AT):ATM encodes what?
|
phosphatidylinositol 3-kinase-
|
|
|
Ataxia-Telangiectasia (AT):malignant neoplasms,
|
(B-cell lymphomas and T-cell chronic
|
|
|
Ataxia-Telangiectasia (AT):immune defect?
|
impaired humoral (absent IgA, E..reduced IgG
|
|
|
Incontinentia Pigmenti:inheritence
|
X-linked dominant,
|
|
|
Incontinentia Pigmenti:gene function
|
NEMO: activates NFkB thereby protecting against TNF a induced apoptosis.
|
|
|
Piebaldism:Systemic:
|
cerebellar ataxia, mental retardation, deafness
|
|
|
KID Syndrome (Keratitis-Ichthyosis-Deafness):what gene encodes cx26?
|
GJB2
|
|
|
IBIDS Syndrome:XPD is which ERCC? XPB?
|
XPD ERcc2; XPB ERCC3
|
|
|
Sjorgen-Larsson Syndrome:Clinical triad of
|
congenital ichthyosis, di- or tetraplegia, mental retardation
|
|
|
Sjorgen-Larsson Syndrome:what kind of -plegia?
|
di or tri
|
|
|
Sjorgen-Larsson Syndrome:eye
|
perifoveal glistening white dots,
|
|
|
Bjornstad’s Syndrome:clinical
|
pili torti and deafness
|
|
|
Menkes Disease:Diagnosis made by
|
Diagnosis made by
|
|
|
Cockayne Syndrom:mutation of unknown gene results in inability to repair
|
cyclobutane dimers induced by UV
|
|
|
Cockayne Syndrom:brain
|
basal
|
|
|
Refsum Disease:heart defect?
|
atrioventricular and bundle branch block, cardiomyopathy,
|
|
|
Refsum Disease:Diagnosis made by
|
elevated serum phytanic acid
|
|
|
Refsum Disease:Treatment:
|
dietary restriction of phytanic acid: dairy
|
|
|
HAIRAN syndrome:
|
#VALUE!
|
|
|
Approximately a% of NLD patients have diabetes or glucose intolerance. Conversely, only b% of DM have NLD:
|
a=20, b-3
|
|
|
Diabetic Bullae or Bullosis Diabeticorum:Clinical timing
|
rapid onset of painless tense blisters on the hands and feet
|
|
|
Erosio interdigitale blastomycetica:bug?
|
candida
|
|
|
erythrasma:bug?
|
(Corynebacterium minutissimum).
|
|
|
DM:this occurs in uncontrolled diabetics with ketosis.
|
Rhinocerebral mucormycoses
|
|
|
Marfan’s Syndrome:defect
|
fibrillin1
|
|
|
Marfan’s Syndrome:clinical
|
Striae distensae on pectoral, deltoid, buttock, thighs, breasts,
|
|
|
Marfan’s Syndrome:heart valves
|
MVP
|
|
|
Marfan’s Syndrome:lense dislocation
|
upward
|
|
|
Cutis Laxa:aka
|
generalized elastolysis
|
|
|
Cutis Laxa:Type III is what ?
|
acquired
|
|
|
Cutis Laxa:acquired form: what drugs?
|
pencicillamine
|
|
|
Osteogenesis Imperfecta:mutation in
|
COL1A1 or COL1A2
|
|
|
Homocystinuria:deficiency of
|
cystathionine beta synthase,
|
|
|
Homocystinuria:lens?
|
downward
|
|
|
Noonan’s Syndrome:hair
|
woolly hair,
|
|
|
Noonan’s Syndrome:4 skin things
|
muliple melanocytic nevi, lymphedema, ulerythema ophyrogenes, keratosispilaris atrophicans
|
|
|
Noonan’s Syndrome:loaded
|
pilaris atrophicans
|
|
|
Noonan’s Syndrome:systemic -heart
|
Hypertrophic cardiomyopathy,
|
|
|
Noonan’s Syndrome:genitals
|
cryptorchidism
|
|
|
Noonan’s Syndrome:gene
|
ptpn11
|
|
|
Werner’s:gene
|
WRN (Recql2)
|
|
|
LEOPARD:gene
|
ptpn11
|
|
|
LEOPARD:genitals
|
hypoplasia,cryptorchidism
|
|
|
LAMB::?
|
Lentigines (face and mucoas), Atrial myxoma (complicated by CHF, angina, pulmonary edema, and embolic events),Mucocutaneous myxoma, Blue nevi (spares hand and feet)
|
|
|
LAMB::blue nevi spare what
|
hands and feet
|
|
|
NAME:?
|
Nevi, Atrial myxomas,Myxoid neurofibromata, Ephilides and Endocrine neoplasms
|
|
|
Carney cancers:
|
breast adenomas, psammamatous schwannomas
|
|
|
Naxos Disease:heart
|
Arrhythmogenic right ventricular cardiomyopathy
|
|
|
glucagonoma:% metastatic at diagnosis
|
75%
|
|
|
Porphyria Cutanea Tarda:Photosensitivity in porphyria caused by absorption of UVR what wavelength
|
soret 400-410
|
|
|
heme synthesisproducts
|
All people having urine can pp: ALA, PBG, HMB, UPCIII/I, CPIII, PPPIX, PPIX
|
|
|
PCT:enzyme
|
UPD
|
|
|
sideroblastic anemia (x-linked):enzyme
|
ALA synth
|
|
|
ALAd-deficient porphyria:enzyme
|
ALAd
|
|
|
AIP:enzyme
|
PBD
|
|
|
CEP:enzyme
|
UPC
|
|
|
Hereditary copropoporhyria :enzyme
|
CPO
|
|
|
Variegate porphyria:enzyme
|
PPO
|
|
|
EPP:enzyme
|
ferro
|
|
|
mitochondrial steps in porphryia:
|
1st:ala-synth and last 2: PPO, ferrochelatase
|
|
|
If heme inadequate, ? synthetase activity increases:
|
dALA synthetase
|
|
|
PCT:Urine
|
uroporphyrins:coproporphyrins 3:1
|
|
|
PCT:stool
|
low copro
|
|
|
Hepatoerythropoietic Porphyria:enzyme
|
UPD homozygote
|
|
|
Hepatoerythropoietic Porphyria:urine - color and ratio
|
Dark, red urine at birth..3:1
|
|
|
CEP vs HEP:rbcs
|
CEP has elevated uroporphyrins in the RBC’s, and HEP doesn’t, but HEP has elevated RBCprotoporphyrins
|
|
|
Acute Intermittent Porphyria:clinical
|
colic..no skin lesions
|
|
|
Acute Intermittent Porphyria:cancer risk
|
liver
|
|
|
Acute Intermittent Porphyria:test and eponym for test
|
elevated PBG (wtason schwarz)
|
|
|
Hereditary copropoporhyria :attacks of
|
Attacks of neurological and GI symptoms like AIP
|
|
|
Hereditary copropoporhyria :stool
|
Fecal coproporphyrin always increased
|
|
|
Hereditary copropoporhyria :urine
|
Urinary copro, ALA, and PBG increased only during attacks
|
|
|
porphyrias::aggravating drugs
|
barbiturates, estrogen, griseofulvin, sulfonamides, alcohol, pregnancy
|
|
|
VP:clinical
|
like PCT + AIP (hereditary CP is similar)
|
|
|
VP:stool
|
proto > copro
|
|
|
VP:urine
|
coproporphyrins increased over uroporphyrins (inverse of PCT)
|
|
|
VP:flourescence
|
626
|
|
|
Erythropoietic Protoporphyria:Immediate burning of skin on sun exposure. Whats the porphyrin?
|
protoporphyrin IX absorbs in the Soret band
|
|
|
Erythropoietic Protoporphyria:spectrum
|
visible light through window glass can precipitate symptoms;
|
|
|
only oxidized porphyrin in the heme pathway:
|
protoporphyrin IX
|
|
|
Erythropoietic Protoporphyria:urine
|
normal
|
|
|
Erythropoietic Protoporphyria:rbcs
|
protoporphyrin elevated
|
|
|
Hypertrichosis languinosa acquisita: cancer
|
Lung carcinoma
|
|
|
Acquired ichthyosis: cancers
|
"Hodgkins lymphoma, Õ
|
|
|
glucagonoma:% metastatic at diagnosis
|
75%
|
|
|
PP: cancers
|
Non-Hodgkins lymphoma, Chronic lymphocytic leukemia Thymoma Castleman’s tumor Sarcoma
|
|
|
PP antigens
|
desmoplakin (250KD), envoplakin (210KD), BPAg-1(230 KD), periplakin (190 KD), desmogleins 3 and 1.
|
|
|
Dermatomyositis:cancers in men
|
gastric carcinoma and lymphoma
|
|
|
Acquired ichthyosis: cancers
|
Hodgkins lymphoma, breast and lung carcinoma
|
|
|
Anagen:% hairs in phase
|
90
|
|
|
Catagen:% hairs in phase
|
1%
|
|
|
Telogen:%hairs in phase
|
10%
|
|
|
Pili Torti:5 syndromes
|
ACQUIRED; Menkes; Bjornstads; Crandalls; Bazex DC
|
|
|
Menke’s:ingeritence
|
X-linked recessive,
|
|
|
Menke’s:gene
|
atp7a (MNK)
|
|
|
Menke’s:arteries
|
tortuous
|
|
|
Menke’s:lips
|
cupids bow
|
|
|
Menke’s:CNS
|
seixzures
|
|
|
Menke’s:hair (3)
|
pili torti, monilithrix, trich nodosae
|
|
|
Bjornstads:clinical (2)
|
Pili torti + sensorineural deafness
|
|
|
Bjornstads:clinical (3)
|
Pili torti + deafness + hypogonadism
|
|
|
Trichorrhexis Nodosa:6 syndromes
|
acquired; arginosuccinic aciduria; citrullinemia; menkes; PIBIDS; Nethertons
|
|
|
Argininosuccinic aciduria:labs (2)
|
low serum arginine, hyperammonemia
|
|
|
Argininosuccinic aciduria:very strange hair finding besides t nodosa
|
red flourescence of hair
|
|
|
Marinesco-Sjögren:cns
|
Cerebellar ataxia, mental retardation
|
|
|
Marinesco-Sjögren:eyes
|
Bilateral congenital cataracts
|
|
|
Marinesco-Sjögren:bones
|
(kyphoscoliosis, pes planovalgus)
|
|
|
Marinesco-Sjögren:genitals
|
Hypergonadotropic hypogonadism
|
|
|
Netherton’s syndrome:triad
|
Ichthyosis linearis circumflexa, atopy, trichorrhexis nodosa
|
|
|
Monilethrix:mutations in hair keratins
|
hHB6 and hHB1
|
|
|
Monilethrix:have some features similar to what other syndrome?
|
ED syndactyly, cataract, nail/teeth abnormalities
|
|
|
Rothmund-Thomson Syndrome:gene
|
RECQL4
|
|
|
Rothmund-Thomson Syndrome:aka
|
(Poikiloderma Congenitale)
|
|
|
Rothmund-Thomson Syndrome:hair
|
sparse
|
|
|
Rothmund-Thomson Syndrome:eyes
|
juvenile cataract
|
|
|
Rothmund-Thomson Syndrome:ballsticles
|
hypogonadism
|
|
|
Rothmund-Thomson Syndrome:skin
|
poikiloderma
|
|
|
Cloustons:whats normal
|
teeth, sweat
|
|
|
Chondrodysplasis Punctata:acquired type?
|
warfarin embryopathy
|
|
|
Tricho-rhino-phalangeal Syndrome:gene
|
TRPS1gene
|
|
|
Tricho-rhino-phalangeal Syndrome:nose
|
pear shaped
|
|
|
Ectrodactyly-ectodermal Dysplasia-Clefting:other defects besides EEC
|
genitourinary
|
|
|
Trichodentoosseous Syndrome:gene
|
distal-less homeobox-3 gene (DLX3)
|
|
|
Trichodentoosseous Syndrome:hair
|
Curly hair that tend to straighten by 2nd or 3rd decade
|
|
|
Trichodentoosseous Syndrome:teeth
|
Enamel hypoplasia, dental pits like TS
|
|
|
Trichodentoosseous Syndrome:bones
|
Increased bone density
|
|
|
Noonan Syndrome:hair line
|
low set posterior
|
|
|
Noonan Syndrome:lungs
|
pulm stenosis
|
|
|
Noonan Syndrome:neck
|
webbed
|
|
|
Cornelia de Lange Syndrome:hair line
|
low set
|
|
|
Cornelia de Lange Syndrome:eyebrows
|
unibrow
|
|
|
Cornelia de Lange Syndrome:skin
|
cutis marmorata
|
|
|
Cornelia de Lange Syndrome:systemic defect
|
heart
|
|
|
Klippel-Feil:hair line
|
low set posterior
|
|
|
Klippel-Feil:eyes
|
Strabismus, nystagmus,
|
|
|
Klippel-Feil:mouth/perioral
|
cleft palate, bifid uvula
|
|
|
Tuberous Sclerosis:spontaneous mutation rate
|
75%
|
|
|
Klippel-Feil:hair/eyes/mouth
|
low set hairline / strabismus / bifid uvula and cleft palate
|
|
|
Vogt-Koyanagi-Harada:triad
|
(Poliosis, Uveitis, Deafness, Vitiligo)
|
|
|
Vogt-Koyanagi-Harada:etiology
|
Autoimmune reaction to uveal melanin
|
|
|
Telogen Effluvium:causes
|
Endocrine (post-partum, thyroid disease), Nutritional (kwashiorkor), Drug (coumadin, heparin, ACE inhibitors, beta blocker, lithium, oral contraceptives, retinoids), Stress (illness, anemia, surgery)
|
|
|
Telogen Effluvium:drug causes
|
BALD = beta blockers, ACEi, Lithium, DIC panel (OCP, coumadin, heparin). You like it
|
|
|
Anagen Effluvium:what heavy metals
|
Mercury (contaminated seafood, antiseptic, fungicide), thallium
|
|
|
Anagen Effluvium:why did Adrian get it killing cucharachas?
|
Boric acid (insecticides)
|
|
|
Androgenetic Alopecia:classifications men and women
|
"(Hamilton-Norwood classification). Type VII is the most handsome. Wom,en: (Ludwig
|
|
|
Androgenetic Alopecia:enzyme
|
Type II 5-alpha reductase activity
|
|
|
Wooly hair nevus:eye?
|
persistent papillary membrane or retinal abnormality
|
|
|
Papular Atrichia:gene
|
Hairless gene
|
|
|
Papular Atrichia:developing when?
|
developing shortly after birth
|
|
|
Icthyosis Follicularis, Atrichia, Photophobia (IFAP):exists
|
it exists, just make a note of it
|
|
|
Follicular Degeneration Syndrome:path
|
premature desquamation of the inner root sheath with fibrosis
|
|
|
LPP:path
|
lymphohistiocytic infiltrate around the isthmus of the follicle associated with fibrosis and atrophy
|
|
|
Parry-Romberg syndrome:3 things
|
(linear morphea, progressive facial hemiatrophy, exophthalmos)
|
|
|
scarring alopecia and generalized KP:what is this syndrome?
|
Keratosis Follicularis Spinulosa Decalvans
|
|
|
Inflammation, boggy induration, crust, pustules on scalp:suppurative follicuiltis on path..what is this syndrome?
|
Folliculitis Decalvans
|
|
|
Aplasia Cutis Congenita:Association with
|
trisomy 13, Adams-Oliver syndrome, BARTS
|
|
|
Epidermolytic Hyperkeratosis:
|
Dehydroepiandrosterone (DHEA):
|
|
|
Androgens in Women:adrenal, ovary
|
Androstenedione:
|
|
|
Androgens in Women:Testosterone: comes from
|
ovary, adrenal, extraglandular conversion of androstenedione and dehydroepiandrosterone
|
|
|
Androgens in Women:Adrenal androgen regulated by
|
adrenocorticotropin
|
|
|
Androgens in Women:Ovarian androgen regulated by
|
luteinizing hormone
|
|
|
Hirsutism without virilization/:drugs
|
phenytoin, minoxidil, diazoxide, cyclosporin, hexachlorobenzene
|
|
|
Tumors:Rapid onset of hair growth with or without accompanying virilization: what cancers
|
Adrenal adenomas and carcinomas, Arrhenoblastoma, Kruckenberg tumors of ovary
|
|
|
Congenital Adrenal Hyperplasia (CAH):Types of CAH
|
21-hydroxylase deficiency (95% of cases), 11 b-hydroxylase deficiency, 3 b-hydroxysteroid dehydrogenase isomerase deficiency
|
|
|
hirsutism:lab levels if abnormal
|
DHEA > 8000 ng/ml or serum testosterone > 2 ng/ml
|
|
|
PCOS:labs
|
LH hypersecretion, Prolactinemia
|
|
|
CAH:labs
|
#VALUE!
|
|
|
PCOS:tx
|
Glucophage
|
|
|
PCOS:glucophae tx: avoid in who?
|
pts with kidney or liver dz
|
|
|
Generalized Congenital Hypertrichosis Lanuginosa:can be acquired in utero. How?
|
fetal hydantoin and fetal alcohol syndrome
|
|
|
Ambras Syndrome:3 things
|
hair on face, facial dysmorphism, dental anomalies
|
|
|
nails:Rates of growth: fingernail – ?mm/mo., toenail – ?mm/mo.
|
Rates of growth: fingernail – 3mm/mo., toenail – 1 mm/mo.
|
|
|
Absent lunula:
|
multiple myeloma, yellow nail syndrome
|
|
|
anonychia:
|
nail patella, coffin-siris, a couple weird onychodystrophy syndromes
|
|
|
Blue lunula:
|
Wilson’s, argyria, hemochromatosis, ochronosis
|
|
|
Blue lunula:drugs
|
busulfan, quinacrine, mercury followed by sunlight, AZT, antimalarials, minocin, silver nitrate, phenolphthalein, PUVA, 5FU, blacks (normal variant)
|
|
|
nails:Darier’s disease
|
v- nicking, alternative red/white longitudinal bands
|
|
|
nails:dolichonychia…what is it
|
long nails
|
|
|
nails:dolichonychia…in who?
|
the ehlers, marfans grouping
|
|
|
nails:what is elkonyxis
|
large pits
|
|
|
Habit tic:trauma to what?
|
cuticle
|
|
|
heller's median canaliform dystrophy:trauma to what?
|
proximal nail
|
|
|
koilonychia:list some inherited dzs
|
LEOPARD, ED, PIBIDS
|
|
|
koilonychia:list some acquired forms
|
plummer-vinson, hemochromatosis
|
|
|
Lindsays:half and half…caused by
|
chronic renal failure
|
|
|
Mee’s lines:causes
|
arsenic, RF, leprosy, any systemic dz
|
|
|
lindsays:true or not?
|
nail bed edema
|
|
|
Melanonychia striata:drug
|
AZT, minocin?
|
|
|
Muehrcke’s lines:systmic dz
|
nephrotic syndrome, low albumin, liver dz
|
|
|
Muehrcke’s lines:true or not?
|
no
|
|
|
Mee’s lines:true or not?
|
yes, true leukonychia
|
|
|
Onychomadesis:what is it
|
shedding of nail, beginning proximally
|
|
|
pachyonychia:which variant has amyloid?
|
type IV
|
|
|
Plummer’s nails:caused by
|
Onycholysis from hypothyroidism
|
|
|
Dorsal pterygium:seen in
|
LP, crosclerosis, Lesch-Nyan, GVHD
|
|
|
Ventral pterygium::aka
|
pterygium inversum unguis
|
|
|
Ventral pterygium::seen in
|
Systemic sclerosis, congenital
|
|
|
Red lunulae:seen in
|
AA, CTD, carbon monoxide, AZA
|
|
|
Terry’s nails:what is it
|
All BUT distal 2mm evenly white
|
|
|
Terry’s nails:seen in
|
cirrhosis
|
|
|
Lateral invasion + paronychia:organisms
|
Hendersonla toruloidea, scatylidium hyalinum
|
|
|
Armadillo Family:Plaque proteins that function in adhesion, name some
|
b-catenin, plakoglobin, plakophilin
|
|
|
desmosomes :have what 3 common proteins in all desomosomes
|
desmoplakin, plakoglobin, plakophilin, then either dsg1 or 3 or desmocollin depending on level
|
|
|
desmosomes :unique components, dependent on level
|
desmocollin, dsg 1(160) dsg 3(130)
|
|
|
mutation:desmoglein 1
|
striate ppk type 1
|
|
|
mutation:E-cadherin
|
gastric cancer
|
|
|
autoimmunity:desmoglein 1
|
pf, ritters
|
|
|
autoimmunity:dsg 1,3
|
pv
|
|
|
autoimmunity:dsg 3 only
|
mucosal pv
|
|
|
mutated in lamellar ichthyosis:
|
Transglutaminase 1:
|
|
|
antigen for dermatitis herpetiformis:
|
Transglutaminase 3:
|
|
|
Intermediate Filaments (IF):Type I (k#s and chromosome)
|
acidic keratins 9-20, chromosome 17
|
|
|
Intermediate Filaments (IF):Type II (keratins and chromosomes)
|
basic keratins 1-8, chromosome 12
|
|
|
Intermediate Filaments (IF):Type III
|
vimentin, glial fibrillary acidic protein (GFAP), desmin, peripherin
|
|
|
Intermediate Filaments (IF):Type IV
|
neurofilaments
|
|
|
Intermediate Filaments (IF):Type V
|
nuclear lamins
|
|
|
mutations in:keratin 1
|
.ichthyosis hystrix
|
|
|
mutations in:keratins 1/10
|
epidermolytic hyperkeratosis (EHK)
|
|
|
mutations in:keratins 1/16
|
nonepidermolytic PPK
|
|
|
mutations in:keratin 2e
|
ichthyosis bullosa of Siemens
|
|
|
mutations in:keratins 3/12
|
corneal dystrophy of Meesmann
|
|
|
mutations in:keratins 4/13
|
white sponge nevus of Cannon
|
|
|
mutations in:keratins 5/14
|
.epidermolysis bullosa simplex variants
|
|
|
mutations in:keratins 6a/16
|
pachyonychia congenita type 1
|
|
|
mutations in:keratins 6b/17
|
.pachyonychia congenita type 2
|
|
|
mutations in:keratin 9
|
.epidermolytic PPK
|
|
|
mutations in:lamin a
|
progeria
|
|
|
left ventricular cardiomyopathy with woolly hair and striate PPK:mut
|
desmoplakin1
|
|
|
target::desmoplakin I and II
|
.Stevens-Johnson syndrome
|
|
|
Adherens Junction:what proteins
|
E-cadherin, P-cadherin, alpha- and beta-catenin, vinculin and radixin; also plakoglobin like desmosomes
|
|
|
where are these weird proteins?:desmocalmin (keratocalmin), desmoyokin, band 6 protein
|
in the desmosome
|
|
|
Focal Contact:proteins
|
integrins, vinculin
|
|
|
Hemidesmosome:Cell membrane spanners:
|
alpha6beta4-integrin, Bullous Pemphigoid Antigen 2 (BPAg2 = type XVII collagen)
|
|
|
GABEB:now non-herlitz JEB or JEB mitis (vs letalis). Defect
|
BPAG2
|
|
|
JEB:herlitz mut
|
Lam 5
|
|
|
EBS:with muscular dystrophy
|
plectin
|
|
|
herpes gestationis:target
|
BPAg2-NC16A
|
|
|
.cicatricial pemphigoid:target
|
BPAg2-C terminal domain, laminin 5
|
|
|
Contains entactin (nidogen) in a complex with collagen IV:what is it?
|
lamina dense
|
|
|
Bullous Pemphigoid (BP):?% have oral involvement;
|
20%
|
|
|
Bullous Pemphigoid (BP):IgG subtype
|
IgG4
|
|
|
Drug-induced BP::classically cited inciting drug
|
lasix
|
|
|
Drug-induced BP::classically cited inciting drug is lasix, but ___ drugs and __-containing drugs may be more common; like?
|
sulfa…thiol. (thiol: captopril, penicillamine, gold thiosulfate)
|
|
|
Drug-induced BP::Two other disorders can present clinically like BP but have different target autoantigens, they are?
|
anti p105, anti p200
|
|
|
Chronic Bullous Disease of Childhood (CBDC):target
|
97 kDa antigen that is a part of BPAg2
|
|
|
Chronic Bullous Disease of Childhood (CBDC):course
|
disease tends to resolve spontaneously,
|
|
|
cictricial p:targets in form with mucosal and skin lesions:
|
BPAG2. form associated with malignancy: laminin 5 (=epiligrin, BM600, kalinin, nicein)
|
|
|
cictricial p:ocular form:
|
B4 integrin
|
|
|
cictricial p:form associated with malignancy:
|
laminin 5
|
|
|
Drug-induced CP::drugs
|
like BP. Sulfa and thiol-containing
|
|
|
CP :almost all have mucosal. If it doesn’t?
|
Brunsting-Perry pemphigoid:
|
|
|
DH:HLA types
|
DQ2, B8, DR3
|
|
|
DH:what % have abnormal jejunal bx?
|
90%
|
|
|
EB simplex:types
|
Weber cockayne; koebner; dowling meara
|
|
|
hemidesmosomal EB:
|
GABEB (bpag2), plectin (ebs with MD)
|
|
|
enamel hypoplasia is more characteristic of:which eb subtypes
|
JEB
|
|
|
EB:exuberant granulation tissue charactersitic of which subtype
|
herlitz JEB
|
|
|
EB:clumped tonofilaments are seen on electron microscopy in the __ subtype of EB
|
downling meara
|
|
|
EB:recessive dystrophic EB is secondary to a what kind of mutation exactly
|
premature stop codon
|
|
|
HG:onset
|
second or third trimester or postpartum period
|
|
|
HG:effects on Neonate
|
may be premature or be small for gestational age;
|
|
|
HG:75% of patients have a circulating HG factor
|
just know it
|
|
|
Linear IgA Disease:target
|
LAD-1) (97 kDa) (part of BPAG2)
|
|
|
Linear IgA Disease:drug induced
|
vancomycin amiodarone, lasix, IL2, IFN gamma, phenytoin, atorvastatin
|
|
|
PP:targtes
|
500 desmo (250) BPAG1 (230) envo (210) peri (190) unknown (170) DSG1 (160) DSG 3 (130)
|
|
|
PP:cancers
|
non-Hodgkin’s lymphoma (42%), chronic lymphocytic leukemia (CLL), Castleman’s (6%), sarcoma (6%), thymoma (6%)
|
|
|
PP:
|
#VALUE!
|
|
|
PF:why don’t neonates get it often?
|
they have dsg3 support in upper epidermis, like adult oral mucosa.
|
|
|
Pemphigus Vegetans:2 types:
|
Neumann type, Hallopeau type (begins with pustules);
|
|
|
PV:IIF
|
monkey
|
|
|
porphyrias:nm; gallstones associated with
|
erythropoietic protoporphyria;
|
|
|
porphyrias:no porphyrins in urine in
|
erythropoietic protoporphyria;
|
|
|
Acropustulosis of Infancy:onset usually
|
3–6 months,
|
|
|
Acropustulosis of Infancy:disappears by age
|
3-4 years old;
|
|
|
Hertoghe’s:
|
thinning of lateral eyebrows in atopic dermaitits
|
|
|
only milia of newborn:
|
crystallina. The only miliaria of newborn as it take several days to get miliaria rubra
|
|
|
Transient Neonatal Pustular Melanosis:lasts
|
1-2 weeks?
|
|
|
Gold:Patients allergic to gold often also react to
|
nickel and cobalt
|
|
|
Imidazolidinyl Urea:aka
|
Germall 115 = Tristat
|
|
|
Imidazolidinyl Urea:what is it
|
A preservative, a formaldehyde-releaser
|
|
|
Imidazolidinyl Urea:Cross-reacts with
|
formaldehyde and diazolidinyl urea
|
|
|
Methylchloroisothiazinolone:aka
|
Kathon CG = 5-chloro-2-methyl-4-isothiazolin-3-one
|
|
|
common allergen in leg ulcers:
|
lanolin
|
|
|
Neomycin:Cross-reactivity with other
|
aminoglycosides; allergy to bacitracin often coexists
|
|
|
Para-Phenylenediamine:found in
|
dyes, inks, photodeveloping solutions, textile dyes
|
|
|
Para-Phenylenediamine:Cross-reactivity with
|
azo- and aniline dyes, procaine, benzocaine,
|
|
|
Para-Tert-Butylphenol Formaldehyde Resin:Found in
|
shoes, watch straps, do-it-yourself glues, plywood, insulation,
|
|
|
Quaternium-15:acts as a
|
A preservative, a formaldehyde-releaser
|
|
|
Rosin (Colophony):A.k.a.
|
abietic acid
|
|
|
Thimerosal:Preservative in
|
vaccines (e.g. hepatitis), eyedrop solutions, cosmetics, nasal sprays
|
|
|
Thimerosal:Cross-reactivity with (2)
|
piroxicam. Also mercury or due to the thiosalicylic acid component
|
|
|
Thiuram Mix:found in
|
rubber (prevents degradation),
|
|
|
Includes garlic, onions, chives:
|
Family Alliaceae
|
|
|
Most important allergen in garlic is:
|
diallyl disulfide
|
|
|
Causes black dot dermatitis:
|
pentadecacatechol
|
|
|
celery, fennel, hogweed, parsnip:
|
Apiaceae
|
|
|
fig tree:
|
Moraceae
|
|
|
Rutaceae:
|
citrus (lime, bergamot orange, lemon, rue)
|
|
|
These families can cause phototoxicity:
|
apiaceae, moraceae, rutaceae
|
|
|
Clinically see chronic lichenification of face/neck/hands/arms (light-exacerbated):a plant family
|
Family Asteraceae
|
|
|
Family Asteraceae:Allergen is
|
sesquiterpene lactone
|
|
|
lavender, thyme, spearmint:
|
Family Lamiaceae
|
|
|
spearmint (:allergen
|
carvone
|
|
|
Spandex contains:
|
mercaptobenzathiazole
|
|
|
acid permanent waves:allergen
|
Glyceryl thioglycolate
|
|
|
dermatitis near nails:
|
Tosyl sulfonamide formaldehyde resin and ethyl acrylate
|
|
|
tests for Class A corticosteroid allergy:
|
Tixocortol pivalate
|
|
|
Class B and D corticosteroid allergy:
|
Budesonid
|
|
|
tea tree:name of plant
|
Melaleuca plant
|
|
|
Latex allergy – can cross-react with:
|
avocado, banana, chestnut, kiwi
|
|
|
irritant:Amaryllidaceae
|
calcium oxalate Includes daffodil, narcissus, hyacinth
|
|
|
Amaryllidaceae:
|
Includes daffodil, narcissus, hyacinth
|
|
|
Araceae:
|
dumb cane plant (Dieffenbachia),
|
|
|
dumb cane plant (Dieffenbachia),:irritant
|
calcium oxalate
|
|
|
croton plant, spurges:
|
Euphorbiaceae
|
|
|
Euphorbiaceae:irritant
|
phorbol esters
|
|
|
Ranunculaceae:includes
|
buttercups and marigolds
|
|
|
Ranunculaceae:irritant
|
protoanemonin (buttercups and marigolds)
|
|
|
visible light:wavelengths
|
400-760 nm).
|
|
|
The red portion is at the upper/lower end of the visible spectrum:
|
upper (760)
|
|
|
UVB converts __ in the skin to previtamin D:
|
7-dehydrocholesterol
|
|
|
__ in natural sunlight is the main contributor to erythema.:
|
UVB
|
|
|
Immediate pigment darkening fades within minutes after exposure. It is brought on by:
|
UVA and visible light.
|
|
|
Delayed tanning becomes visible about 72 hrs after __ exposure.:
|
UVB…. UVA contributes to a lesser extent
|
|
|
which is more efficient at inducing DNA damage? UVA or UVB:
|
UVB B for bad
|
|
|
most effective in producing pyrimidine dimers,:UVA or UVB
|
UVB
|
|
|
pmle versus solar urticaria:onset
|
hours for urticaria, days for pmle
|
|
|
Fluorescent UVA bulbs used for phototesting or PUVA therapy have a peak emission at:
|
352
|
|
|
renal trqnsplant fold incr risk for scc:
|
36
|
|
|
windows filter out what wavelength?:
|
uvb, not uva
|
|
|
pmle versus solar urticaria:uva or uvb or visible
|
uva and b
|
|
|
actinic purigo versus pmle?:
|
actinic pruigo begins in children, goes away by adolescence. May persist into the winter. Not as clearly related to sun exposire. Lesons are excoriated.
|
|
|
actinic pruigo:tx
|
thalidomide.
|
|
|
solar urticaria:spexctrum of reactivity
|
uva uv and visible
|
|
|
Chronic actinic dermatitis:sun exposed or protected
|
BOTH
|
|
|
Chronic actinic dermatitis:Some patients may show allergic contact dermatitis to what
|
the Compositae oleoresins.
|
|
|
photoallergy:classic chemical in soaps that used to cause it
|
halogenated salicylanilides,
|
|
|
photoallergy:common causes (4)
|
PABA, benzophenones, dibenzoylmethanes (parsol 1789), cinnamates
|
|
|
– Blue-gray pigmentation on sun-exposed areas –:drugs
|
amiodarone, chlorpromazine, TCAs
|
|
|
PUVA:most common psoralens used
|
8-MOP
|
|
|
PUVA:actual name brand used
|
oxaralen ultra (liqui filled caps)
|
|
|
PUVA:oxsoralen dose
|
0.4-0.6 mg/kg 1-1.5 hours before
|
|
|
contact urticaria:lisyt 3 families
|
hevea, aliaceae (esp celery), urtica dioica (stinging nettle), euphorbaciae (spurg nettle)
|
|
|
daffodils:family
|
narcissus
|
|
|
daffodils:cause?
|
irritant dermatitis (oxalates)
|
|
|
moast common cause of irritant dermatitis in florists:
|
daffodils…oxaltes
|
|
|
buttercup:family
|
ranunculaceae
|
|
|
poinsetta:family
|
euphorbiacaea (spurges also in this family)
|
|
|
euphorbiacaea:irritant (2)
|
phorbol esters, latex
|
|
|
irritant in:Ranunculaceae
|
Ranunculin
|
|
|
irritant in:Solanaceae
|
Chili pepper, Capsaicin
|
|
|
irritant and member of this family:Alliaceae
|
garlic, thiocyantes
|
|
|
irritant and member of this family:Brassicaceae
|
Mustard, radish, Thiocyanates like garlic
|
|
|
irritant and member of this family:Ananas comosus
|
pineapple, bromelin
|
|
|
irritant and member of this family:Lilaceae
|
hyacinth, ca oxalte
|
|
|
colophony :comes from
|
Pinus palustris tree
|
|
|
colophony :found in
|
Rosin, medications,mascara, adhesives,bandages, varnish, wax, paper products, dental cement
|
|
|
Alliaceae:members, allergen
|
garlic, onion, chive. Diallyl disulfide (thiocyante is an irritant)
|
|
|
“strimmer dermatitis”:causes
|
cow parsley, wild chervil, hogweed)
|
|
|
4 families phytophoto:
|
apiaceae, rutaceae, moraceae, fabaceae
|
|
|
Moraceae:
|
fig tree
|
|
|
Fabaceae (Leguminosae):
|
scruf pea
|
|
|
orf:length
|
6 weeks
|
|
|
erysilpeothix:kind of bacterium
|
grm negative rod
|
|
|
erysilpeothix:most commonl what farm animal
|
pigs
|
|
|
anthrax:the majority of naturally occuring dz is what form
|
cutaneous
|
|
|
anthrax:culture tip
|
with dacron tips
|
|
|
Cat-Scratch Disease:organism
|
b henselae
|
|
|
Cat-Scratch Disease:what can happen around the eye
|
LAD, conjuctivitis: occuloglandular sx of parinaud
|
|
|
Bacillary Angiomatosis:organism
|
b henselae
|
|
|
Brucellosis:aka
|
malta fever
|
|
|
Brucellosis:kind of bacterium
|
grm neg rod
|
|
|
glanders:tx
|
surgical excision
|
|
|
glanders:lymphatic drainage route called
|
farcy buds
|
|
|
dog versus cat bites:orgnism
|
p. mulocida (cats) dogs: P. canis
|
|
|
Lycosidae:spider, toxin
|
wolf, histamine
|
|
|
hidippus:spider, toxin
|
jumping, hyaluronidase
|
|
|
hobo spider:name
|
Tegenaria agrestis
|
|
|
Megalopyge opercularis:
|
puss caterpillar),
|
|
|
The venom from honeybee contains:
|
phospholipase A.
|
|
|
Black flies are vectors for:
|
onchocerciasis and tularemia.
|
|
|
Anopheles causes :
|
malaria.
|
|
|
Aedes causes :
|
yellow fever and dengue.
|
|
|
Mosquitoes prefer :
|
black skin, young skin, warm to cool skin, and scented skin. bright colors and elevated carbon dioxide concentrations.
|
|
|
Pulex irritans,:
|
The human flea,
|
|
|
Romana’s sign:
|
is unilateral eyelid swelling at the site of the bite of the assassin bug.
|
|
|
Lytta vesicatoria,:
|
the spanish fly or blister beetle
|
|
|
Lytta vesicatoria,:what is derived from it?
|
cantharadin
|
|
|
head lice:Resistance patterns have led to decreased efficacy of
|
permethrin 5% cream, pyrethrins, and lindane.
|
|
|
head lice:if resistant, use what
|
Malathion 0.5% continues to be effective.
|
|
|
Maculae cerulea can be seen in severe cases:
|
pubic lice
|
|
|
live in the folds of clothing,:
|
Pediculus humanus var. corporis, or body lice,
|
|
|
United States Ticks:list 5
|
Ixodes scapularis (aka dammini), I. pacificus, Ambylomma americanum, D. andersonii, D. variabilis
|
|
|
Lyme Disease::onset of the classic erythema migrans eruption.
|
Approximately 7 to 14 days incubation
|
|
|
Southern Tick-Associated Rash Illness::tick
|
lone-star tick, Amblyomma americanum,
|
|
|
Tick Paralysis::tick
|
Dermacentor
|
|
|
Tick Paralysis::lower motor neuron paralysis occurring
|
4–7 days after attachment,
|
|
|
Babesiosis: caused by intracellular RBC parasite, Babesia microti; transmitted by larvae of:
|
I. Dammini.
|
|
|
Erlichiosis:tick
|
I scapularis (dammini)
|
|
|
Lyme Borreliosis:organism
|
Borrelia burgdorferi
|
|
|
Lyme Borreliosis:vectors
|
Ixodes dammini, I. pacificus, Amblyomma americanum (lone star)
|
|
|
Relapsing Fever:organisms
|
Borrelia duttonii, B. hermsii,
|
|
|
Relapsing Fever:vectors
|
Ornithodoros moubata
|
|
|
RMSF:organism
|
r rickettsia
|
|
|
RMSF:vectors
|
D. andersoni, D variabilis, A. americanum
|
|
|
Tularemia:organism
|
F. tularensis
|
|
|
Tularemia:vectors
|
D andersoni, D variabilis
|
|
|
Ehrlichiosis:tick
|
rhipicephalus sanguineus
|
|
|
Dermanyssus is the most common class.:of?
|
fowl mites
|
|
|
glyciphagus:?
|
cheese mite
|
|
|
Acarus:?
|
grain mite
|
|
|
Trombicula:
|
chigger (harvest mite)
|
|
|
vector of rickettsial pox.:-2
|
Ornithonyssus bacoti (tropical rat mite), and Allodermanyssus sanguineus (housemouse mite)
|
|
|
baker’s itch:
|
Acarus (grain mite)
|
|
|
carriers:Hedgehogs
|
Trichophyton mentagrophytes. European hedgehogs may transmit M. marinum or M. avium-intracellulare.
|
|
|
carriers:flying squirrel,
|
Toxoplasma gondii, r. prowazekii (epidemic typhus)
|
|
|
carriers:chinchilla
|
Trychophyton mentagrophytes, Microsporum gypseum,
|
|
|
carriers:cockatoo
|
Cryptococcus neoformans
|
|
|
jellyfish, Portuguese man of war, sea anemones, coral, hydrozoa:family
|
Cnidarians
|
|
|
hydrozoa:a member of this cnidarian group
|
Portuguese man of war
|
|
|
nematocysts in jellyfish:"fix" them so they don’t fire anymore
|
vinegar
|
|
|
Cutaneous Larvae Migrans:dogs
|
Ancylostoma caninum
|
|
|
Cutaneous Larvae Migrans:cats
|
A braziliensis
|
|
|
source:Anthralin
|
Vouacopoua araroba tree.
|
|
|
source:Antimalarials
|
Cinchona officinalis in Lojan rainforests.
|
|
|
source:Cantharadin
|
Lytta vesicatoria (blister beetle). Aka spanish fly
|
|
|
source:Pyrethrin
|
chrysanthemum flower (compositae family).
|
|
|
? of patients allergic to penicillins may also exhibit similar allergic reactions to cephalosporins5
|
10
|
|
|
has been associated with an increased incidence of serum sickness in children6 (cephalosporin)
|
cefaclor
|
|
|
products, calcium, and iron or zinc salts7
|
tet more than doxy/mino
|
|
|
the only tetracycline for use in patients with renal failure8
|
doxy
|
|
|
tetracyclins: which is most common causes of fixed drug eruption
|
tet
|
|
|
the most phototoxic of all the tetracyclines. the most phototoxic of all the tetracyclines.
|
Demeclocycline and doxycyclin
|
|
|
Macrolides list em
|
CELL...clarithro, erythro, azithro, some Ls
|
|
|
abx: Cholestatic hepatitis is associated with
|
EES
|
|
|
abx: Fluoroquinolones spectrum, specifically
|
Mycobacterium species, gram-negative infections, particularly Enterobacteriaceae
|
|
|
abx: fluoroquinolones absorbed better or worse with antacids?
|
worse.
|
|
|
abx: Only drug bactericidal to M. leprae
|
Rifampin
|
|
|
abx: clindamycin MOA
|
50s
|
|
|
abx: macrolide mOA
|
50s
|
|
|
abx: Clindamycin spectrum
|
Particularly effective against anaerobic and gram-positive organisms,
|
|
|
which tetracyclin is impaired by the ingestion of dairy
|
tatrecycline
|
|
|
has been associated with an increased incidence of serum sickness in children6 (cephalosporin)
|
cefaclor
|
|
|
products, calcium, and iron or zinc salts7
|
tet more than doxy/mino
|
|
|
the only tetracycline for use in patients with renal failure8
|
doxy
|
|
|
tetracyclins: which is most common causes of fixed drug eruption
|
tet
|
|
|
the most phototoxic of all the tetracyclines. the most phototoxic of all the tetracyclines.
|
Demeclocycline and doxycyclin
|
|
|
Macrolides list em
|
CELL...clarithro, erythro, azithro, some Ls
|
|
|
abx: Cholestatic hepatitis is associated with
|
EES
|
|
|
abx: Fluoroquinolones spectrum, specifically
|
Mycobacterium species, gram-negative infections, particularly Enterobacteriaceae
|
|
|
abx: fluoroquinolones absorbed better or worse with antacids?
|
worse.
|
|
|
abx: Only drug bactericidal to M. leprae
|
Rifampin
|
|
|
abx: clindamycin MOA
|
50s
|
|
|
abx: macrolide mOA
|
50s
|
|
|
abx: Clindamycin spectrum
|
Particularly effective against anaerobic and gram-positive organisms,
|
|