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113 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Taking amoxicillin and get a rash?
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Have infectious mononucleosis caused by EBV
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EBV = HHV-4
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What's the most common cause of Erythema Multiforme? (EM)
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HSV & Mycobacterium penumoniae
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Causes of SJS?
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Bactrim
Allopurinol Anti-Convulsants |
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Most common cause of fixed drug reaction?
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Pseudoephedrine
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fixed drug rxn = a singular lesion
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What drugs cause cutaneous lupus?
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HIPP:
hydralazine isoniazid prcainamide phenytoin |
it's not HIPP to have SLE
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What type of hypersensitivity is Allergic Contact Dermatitis? What's the most common material to cause it?
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Type IV
Nickel |
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What are the DNA viruses?
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HHAPPPy (6)
- herpes - hepadna (HBV) - adenovirus - parvovirus - papilloma (HPV) - pox |
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What is Hutchinson's Sign?
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Nasal involvement of VZV (HHV3) AND a sign of subungual melanoma
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HHV3?
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Varicella Zoster Virus
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HHV4?
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EBV
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HHV5?
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CMV
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What's the Tx for VZV that has nasal involvement?
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IV Acyclovir
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this involvement is called Hutchinson's Sign
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What causes a blueberry muffin baby?
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- CMV (HHV5 - one of the TORCH group of perinatal infx's)
- Rubella (3rd Dz) |
blueberry muffin baby is d/t extramedullary hematopoiesis in infants
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What virus & variants cause common warts?
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HPV 1, 2, 4
these are the most common strains |
common warts = verruca vulgaris
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What virus & variants cause flat warts?
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HPB 3, 10
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flat warts are skin colored to pink and are slightly raised
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What virus & variants cause genital warts?
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HPB 6, 11
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genital warts = condyloma acuminata
they are small, cauliflower-like lesions |
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What virus & variants cause premalignant warts?
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HPV 16, 18
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aka bowenoid papulosis
they are hyperpigmented and on the external genitals |
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What are the colors of the light spectrum?
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ROYGBIV
red orange yellow green blue indigo violet |
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What is a common e.g. of a physical sunscreen?
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Zinc Oxide
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physical sunscreens = both UV's
chemical = one or both |
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What effect does UVB have on the skin? What is it associated w/?
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Direct damage to DNA --> forming pyrimidine dimers
associated w/ skin cancer |
UVB wavelengths = 290-320
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What effect does UVA have on the skin? What is it associated w/?
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Indirect damage d/t trans-urocanic acid's absorption --> ROS's (causing single-stranded breaks).
associated w/ aging |
UVA wavelengths = 320-400
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Autoimmune blistering that has flaccid blisters and reticular IF?
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Pemphigus Vulgaris
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Intra-Epidermal bullae = acantholysis
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What kind of Ig's are involved in Pemphigus Vulgaris?
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Anti-Desmosome
(desmogleidin 3) |
Pemphigus vulgaris is potentially fatal; has intra-epithelial flaccid blisters and IF in a reticular pattern.
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AI blistering disease w/ tense blisters & linear IF?
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Bullous Pemphigoid
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Bullous pemphigoid is more common and less severe than pemphigus vulgaris; the blisters are sub-epidermal
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What kind of Ab is seen in Bullous Pemphigoid?
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Anti-Hemidesmosome Ab's
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Bullous pemphigoid has sub-epidermal, tense blisters; linear IF staining; is more common and less severe than pemphigus vulgaris
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Which skin cancers are associated w/ severe, periodic sunburns (especially in childhood)?
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Basal cell carcinoma and Melanoma
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Think vacations at the beach once per year
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Which skin cancer is associated with chronic sun exposure?
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Squamous Cell Carcinoma
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Think people that work in the fields/farmers
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What is the most important feature for prognosis and dx of Melanoma?
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Breslow Depth
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ABCDE of Melanoma?
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Asymmetry
Border irregularity Color variation Diameter > 6mm Evolution |
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Characteristics of BCC?
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Rolled edges
Central ulcer Histo = Peripheral palisading |
BCC is most common skin cancer
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Characteristics of SCC?
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Ulcerative lesions
Chronic/draining sinuses Histo = Keratin pearls |
Precursor = Actinic Keratosis
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What is Keratocanthoma?
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A variant of SCC that spontaneously regresses
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What tumor suppressor mutation is common in non-melanoma skin cancer?
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p53
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Which of the 7 diseases of childhood is not a virus?
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2nd Dz = Scarlet Fever
d/t GAS |
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What is 1st Dz?
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Measles = rubeola
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What is 2nd Dz?
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Scarlet Fever = GAS
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What is 3rd Dz?
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"German Measles" = Rubella
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Most common presentation = conjunctivitis
Can present as blueberry muffin baby |
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What is 4th Dz?
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Duke's Dz (probably a coxackie or echovirus)
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What is 5th Dz?
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Erythema Infectosum = Parvovirus B19
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Causes hydrops fetalis if contracted during pregnancy
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What is 6th Dz?
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Roseola = HHV6 or HHV7
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Infants & toddlers
Fever, then 4 days later you get pink, rosy macules on trunk |
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A toddler that has fever, and 4 days later has pink macules on her trunk?
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Roseola = 6th Dz
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When is VZV contagious?
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from 4 days before exanthem --> all of the lesions are crusted
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Why is VZV dangerous to adults?
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Can lead to varicella pneumonia which has a 15% mortality rate
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What is Hutchinson's sign?
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1) VZV reactivation on nose (occular involvment!)
2) Prox nail fold pigmentation w/ longitudinal melanonychia --> sign of subungual melanoma |
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What causes EM (erythema multiforme)?
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HSV infection, M. pneumoniae
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Why and how do you Tx Kawasaki's Dz?
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Tx = High dose ASA / IVIG
If untreated, 20% progress to cardiac aneurysms |
Kawasaki's = Mucocutaneous Lymph Node Syndrome; Medium size BV inflammation; unknown cause; high fever (>38.3), strawberry tongue
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What is the growing phase of the hair cycle? How many follicles are in that stage @ a given time?
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Anagen
85% of hair @ this stage |
Stages:
- Anagen - Catagen - Telogen - Exogen |
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What are the non-scarring alopecia's?
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The A's and the T's:
- Areata - Androgenic - Trichotillomania - Traction - Telogen Effluvium |
Self induced = trichotillomania and traction
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What are the scarring alopecias?
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The "L's":
- Lupus (discoid lupus) - LPP (lichen planus) |
Signs:
- Dyspigmentation = Discoid LE - Perifollicluar erythema = LPP |
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What type of hair loss is autoimmune?
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Areata alopecia
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Sign = Exclamation point hair loss.
Associated w/ other allergic and atopic conditions = rhinitis, atopic dermatitis, asthma, vitiligo, thyroid dz |
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What is the enzyme targeted in treatment for androgenic alopecia?
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5αReductase
Androgenic alopecia d/t hypersensitive DHT-R's on cells |
Converts T --> DHT
e.g. Finasteride (PROPECIA) |
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Exclamation point hair loss?
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Areata alopecia
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Autoimmune
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Geographic border hair loss?
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Trichotillomania
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Dyspigmentation in areas of hair loss?
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Discoid LE
Central hypopigmentation / peripheral hyperpigmentation |
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Perifollicular erythema in hair loss?
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LPP (lichen planus)
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The 5 P's of lichen plans?
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Pruritic
Planar Purple Polygonal Papules |
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What is paronychia?
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Inflammation of the nail fold
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the nail fold protects the nail matrix (disruption often the cause of disease)
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What is the etiology of acute paronychia?
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Infectious
(usually staph or strep) |
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What is the etiology of chronic paronychia?
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Contact dermatitis
Candida/pseudomonas |
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What systemic disease is associated w/ pits & "oil spots" on nails?
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Psoriasis
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What is onychorrhexis?
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Longitudinal riding that is caused by damage to the matrix.
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Nail presentation of LPP
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What is Dorsal Pterygium?
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Scarring b/w the nail fold and the nail matrix
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Nail presentation of LPP
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What dermatological dz is associated with onychorrhexis & dorsal pterygium?
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LPP
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What systemic dz is associated w/ yellow nail?
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Chronic bronchitis / bronchiectasis
Pleural effusions Lymphedema Sinuses Thyroid Dz |
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What systemic dz is associated w/ clubbing?
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COPD
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What systemic dz is associated w/ Koilonychia?
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Fe-def anemia, Hemocrhomatosis
Hypothyroid Psoriasis LPP |
Koilonychia = spoon-shaped
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What systemic dz is associated w/ Beau's lines? (transverse depressions)
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Trauma
Acute bouts of systemic dz |
Width of the depressions relate to the length of the illness/stress
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What causes telogen effluvium? What characterizes it?
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Severe episodes of stress.
Described as hair that "falls out by the root" |
Skips the retraction stage of catagen, so goes straight to telogen and when finally at exogen, entire hair falls out.
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What systemic dz is associated w/ entire white nail?
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Terry's Nail:
- Cirrhosis - CHF |
Can actually be normal.
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What systemic dz is associated w/ multiple transverse white bands?
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Muerhrcke's nail:
- Hypoalbuminuria |
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What systemic dz is associated w/ "half & half nails"?
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Uremia (CKD)
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What systemic dz is associated w/ green nails?
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Pseudomonas
d/t pyocyanin |
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How does diet affect acne pathogenesis?
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High GI diet --> increased IGF-1 --> increased keratocyte growth --> form follicular plug
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This stage is retention hyperkeratosis
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What are the 2 contributors to microcomedone development?
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1) retention hyperkeratosis
2) androgens |
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Comedome?
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Overactive/clogged sebaceous gland
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Open = blackhead
Closed = whitehead |
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Types of Rosacea?
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POPE:
Papulopustular Ocular Phymatous Erythematotelangiectactic |
POPE Benedict wears Rose Red Prada shoes = Rosacea types
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Tx of Rosacea?
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TOP = Metronidazole, Sulfur
Immunomodulators |
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What causes most tinea capitis?
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Trichophyton tonsurans
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Lymphadenopathy on scalp
Erythema & scale Alopecia |
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What is 2-Feet, 1-Hand syndrome?
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Tinea mannum
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Develops in the hand that scratches the foot/toe nails w/ tinea pedis or onychomycosis
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How do you Dx and Tx Onychomycosis?
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Dx = PAS
Tx = Terbinafine (systemic) |
Presents w/ tinea pedis
Thickening nail, yellowing, and subungual debris |
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What causes tinea nigra?
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Hortae weneckii
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Sometimes it's confused w/ melanoma
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What causes tinea versicolor?
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Malassezia furfur
(produces dicarboxylic acid that inhibits melanogenesis) |
Presents as well-circumscribed, brown/tan/pink papules to plaques w/ scale
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Perleche / Angular chelitis?
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Candidiasis of the angles of the lips
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Candidiasis of the angles of the lips?
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Perleche / Angular chelitis
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Candidiasis that causes red papules w/ satellite lesions under a diaper?
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Diaper Dermatitis / Intertrigo
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What are possible etiologies of vulvovaginitis?
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Abx
OCP Pregnancy OB/DM |
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What is person at risk for who has their hands wet a lot of time?
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Paronychia d/t candida
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Of what is chronic mucocutaneous candidiasis a sign?
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A defect in cell-mediated immunity
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How does Ketoconazole work & what do you use it for?
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Inhibits lanosterol 14α demethylase
PO = tinea versicolor |
Interferes w/ P450 detoxification
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How does Terbinafine work and what do you use it for?
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Inhibit squalene eposidase
PO = onychomycosis |
Rarely causes fulminant hepatitis
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How do you treat tinea versicolor?
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Ketoconazole (PO)
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How do you treat Onychomycosis?
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Terbinafine (PO)
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How does Nystatin work and what does it treat?
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Binds ergosterol & forms a pore
Use for Candidiasis of lips (oral, vaginal) |
The pores formed cause K+ leakage
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How does Griseofulvin work and what is it used for?
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Interferes w/ microtubule function
Used for tinea capitis |
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How does fluconazole work and what is it used to tx?
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Inhibits ergosterol synthesis
PO for oral thrush and vaginal candidiasis |
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How do you treat tinea capitis?
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Griseofulvin
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How do you treat oral thrush?
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Fluconazole (or Nystatin PO)
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How do you treat vaginal candidiasis?
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Fluconazole (or PO Nystatin)
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Causative agent for: Furuncle
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Staph aureus
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Infection of SQ fat
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Causative agent for: Carbuncle
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Staph aureus
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Infection of SQ fat
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Causative agent for: SSSS
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Staph aureus
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Affects the stratum granulosum
Babies |
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Causative agent for: Ecthyma
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GAS (pyogenes)
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Infection of the dermis
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Causative agent for: Erysipleas
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GAS (pyogenes)
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Infection of the lymph nodes
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Causative agent for: Necrotizing Fasciitis
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GAS (pyogenes) + anaerobes
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Causative agent for: Impetigo
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Staph > GAS
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Causative agent for: Cellulitis & Folliculitis
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Staph aureus and GAS (pyogenes)
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What kind of AI reaction is Psoriasis?
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T-Cell Mediated
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The pustules (in pustular) are sterile
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What are the types of Psoriasis?
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Plaque (80%)
Guttate (20% - S. aureus) Pustular |
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What diseases are associated w/ Psoriasis?
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CVD
Psa = psoriatic arthritis |
Psoriasis precedes PsA
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Tx for Psoriasis?
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TOP = Steroids, VitD, Retinoids, Coal
Systemic = Photo Tx, Cyclosporin, MTX, HU |
Face is usually spared, so that led to the idea of using UV tx on affected areas
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Characteristics of full thickness wounds?
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ALL epidermis & dermis
NO adnexal structures Epithelialization from Edges Contracts |
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Characteristics of Partial Thickness Wounds?
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ALL Epi/ PART of dermis
Adnexa present Epithelialization from the Adnexa Minimal contraction |
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What kind of dressing leads to better/faster healing and less pain/infection?
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Occlusive Dressing.
Why? |
Less dessication means:
- easier cell migration - GF's and matrix materials available - e- gradient is maintained |
