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126 Cards in this Set
- Front
- Back
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What are the 5 layers of the epidermis progressing from basal layer upward?
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Basal Cell layer, Stratum Spinosum, Stratum Granulosum, Stratum, Lucidum (only present on acral surfaces-plams and feet, Stratum Corneum (absent on mucosal surfaces)
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Collegen, blood vessels, sebacous glans hair follicles, sweat glans and elastic tissue are all contained within which skin layer?
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Dermis
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Pemphigus Vulgaris is a disease targeting _________.
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Desmosomes
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Bullous pemphigoid is a disease targeting _________.
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Hemidesmosomes
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What disease is characterized by a positive Nikolsky's sign ( blister extending laterally with pressure)?
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Pemphigus Vulgaris
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Ig is linear and deposited along the basement membrane in ________while it is deposited between kertinocytes in ______.
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Bullous pemphigid; pemphigus Vulgaris
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What is the Tx for Pemphigus Vulguaris?
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Systemic steroids/immunosupression (e.g. prednisone, methotrexate)
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What is the Tx for Bullous pemphigid?
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topical steroids and immune suppression
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What pruitic vesicular disease with IgA triggered neutrophil activation and grouped vesicles and papules is associated with gluten enteropathy?
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Dermitis Herpatiformis
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Melanocytes are located in what epidermal layer?
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Basal cell layer (they make up 5-10%)
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What Fitzpatrick skin type would a pale, white person with red hair and blue eyes who always burns be in?
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Type I
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What Fitzpatrick skin type would a dark skin person who never burns be in?
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Type VI
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What is in the name of the disease in which there is a genetic mutation in the enzymes important for melanin production despite there being a normal number of melanocytes?
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Albinism
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What disease is characterized by well demarcated patches of depigmentation due to an acquired autoimmune loss of melanocytes?
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Vitiligo
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What process is characterised by tan well-demarcated patches due to increased melanogenesis?
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Melasma
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A KOH prep test is done in the presence of any ______ (lesion type).
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Scale (and Pustule). KOH looking for a fungal infection
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Tzanck prep is used in the presence of ______ (lesion type) to asses for _______(infection type).
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Vesicle; Herpes
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In a ______ biopsy, you obtain all 3 layers of the skin.
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Punch
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What do you call a discolored lesions, not raised or depressed, < 5mm?
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Macule
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What do you call a discolored lesions, not raised or depressed, > 5mm?
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Patch
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What do you call a circumscribed solid elevation < 5mm?
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Papule
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What do you call a circumscribed solid elevation > 5mm?
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Plaque
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What do you call a circumscribed, evanescent, edematous papule or plaque that is slightly reddened?
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Wheal
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What do you call a circumscribed solid elevation that is deeper than it is wide?
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Nodule
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What do you call a circumscribed fluid filled elevation < 5mm?
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Vesicle
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What do you call a circumscribed fluid-filled elevation > 5mm?
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Bulla/e
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What do you call a circumscribed pus-filled elevation < 5mm?
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Pustule
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What do you call a circumscribed pus-filled elevation >5mm?
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Lake of pus
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What do you call an abnormal, fluid-containg sac with a membranous lining?
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cyst
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What do you call a thickened and indurated, tight skin section?
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Sclerosis
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What do you call the thickening of the stratum corneum of the skin?
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Hyperkeratosis
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A wearing away of the skin with partial thickness is known as _____ whereas with full thickness, its known as _______.
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Erosion; Ulcer
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What is Telangiectasia characterized by?
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Dilated blood vessels
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The accentuation of skin markings due to chronic scartching is known as _________.
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Lichenification
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"Generalized", "Flexural", "Mucosal" are all examples of descriptions of _______.
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Distribution (6 ft)
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"Arcuate Archiform", "Annular", "Reticulate", "Grouped" are descriptions that are examples of ________.
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Configuration/Pattern/Arrangement
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Inflammation of the pilosebacous unit is known as ________.
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Acne Vulgaris
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The pathogenesis of Acne is characterized by what 4 things?
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1. Sebacceous Gland Hyperplasia and Seborrhea
2. Altered follicular growth and differentiation of keratinocytes 3. P. acnes colonization(causing inflammtion) 4. Inflammation, Imune response (CD4 lymphocytes invade follicular wall, neutrophil migration and duct rupture from lipids, conrneocytes & bacteria) |
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White heads are _____ comedos and black heads are ____ comedos
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closed; open
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Which acne medication targets all 4 major pathogenic factors?
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Isoretinoin/ Accutane
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Acne lesions localized ot the lowere face with asudden onset in a woman may benefit from what treatment?
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Anti-androgens (spironolactone) and OCPs (Yaz, Orthotricyclen) which both target sebacous gland enlargement, sebum production and gland hyperplasia
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What are some of the side effect of Accutane?
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Teratogenic, phosotsneisitivty, dry skin, acute pancreatitis, severe headaches, mood swings, dperession, elevated LFTs, anemia, thrombocytopenia
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What medication should everyone with any type of acne be on?
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Topical Retinoids (target follicular growth and differentiation)
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How do you ultimately distinguish between Acne and Rosacea?
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Rosacea has no comodones.
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Who is rosacea most common in?
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White adults (40-50) w/ fair skin
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What skin disease is characterized by permenant enlargment of the skin due to chornic inflammtion and enlargement of sebacous glands and soft issue (ultimatley due to vascular hyperreactivity) and rhinophyma (enlarged nose)?
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Rosacea-Phymatous type
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What type of Rosacea is characterized by reccurent flushing and blushing after eating spicy food, hot beverages, EtOh or UV exposure?
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Erythematotelangiectactic
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UVA (320-400) penetrates the _____.
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dermis
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UVB (280-320) penetrated the _____.
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epidermis
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Sunburn and cancer is cause by _____ (UV type) wheras premature aging and wrinkling is cause by ______.
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UVB; UVA
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Sunscreen that reflect UVB and leave a white residue are known as ______.
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physical blockers (e.g zinc/titanium oxide)
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Sunscreen that absorbs UVA are known as ______.
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chemical blockers (e.g. pamiate A/O, oxybenzone)
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What do you call the category of diseases that have eruptions with erythematous scaling papules and plaques?
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Papulosquamous diseases
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What are infectous causes of papulosquamous diseases?
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tinea corporis, tina versicolor, secondary syphillis
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Tinea Coporis is an dermatophyte infection cause by _________ fungi.
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keratinophylllic (e.g. trichophyton, microsporum, epidermophyton)
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Ring worm, jock itch and athlete's foot are examples of what kinds of papulosquamous disease?
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Tinia coporis (body)
tinea capitis (ring worm, on head so get a deeper dermatophytosis with spored in and outside shaft) tinea cruris (jock itch) |
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How do you treat tinea coporis?
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Topical antifungals (e.g. ending in "-asole") and treat Tinea Capitis, folliculitis and onchomycosis with Systemic antifungals
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Nystatin is an anti fungal that is NOT effective against ________.
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dermatophytes
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Terbinafine and Tolnaftate are topical antifungals that are NOT effective against _______.
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Candida
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What disease is characterized by an overgrowth of common yeast and presents with fine powdery scales that under KOH look like "spaghetti and meatballs"?
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Tinea Versicolor
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The Herald patch of Pityriasis rosea , usually found on trunk is pink, annular with scale accentuation at edge and typically ______ the eruptions of other scaly papules in a "fir tree" pattern
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preceeds
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What papulosquamout disease is associated with an immunologic reacion of helper T-cells along the basal layer of the epiermis w/ a possible link to HCV?
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Lichen Planus (violaceous flat-topped polygonal papules w/ gret or white streaks on flexor wrists, trunk, thighs, shinds and dorsal hands)
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What are the 5 "P"s of Lichen Planus?
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Purple, Polygonal, Pruritic, Papule, Planar
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What disease is characterized by loose, dry, moist, greasy scales effecting the scalp, nasolabial folds, eyebrows, eyelids, sternum and inguinal region , looking like dandruff (not as itchy as dandruff though)?
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Seborrheic Dermatitis
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Selenium Sulfide shampoo, tar shampoo, with corticosteroid creams are a treatment for what papulosquamous disease?
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Seborrheic Dermatitis
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Cutaneous T-Cell Lymphoma a neoplastic cell cancer with mature CD3+/4+45RO+/8- memory T cell phenotype is an example of a ____________.
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papulosquamous disease
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__________ is often caused by medciations like vitamins, laxatives, NSAIDS, penicillin, bacitracin, ACE inhibitors, food resulting in the activation of mast cell and release of histamine resulting in an itchy wheal.
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Urticaria
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What are the three categories of Chronic (>6 wks) Urticaria?
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Cholinergic Urticaria ("goosebump" look), Solar or Cold Urticaria, Urticarial Vasculitis
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Non-sedating anti-histamines are used in the treatment of _________.
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Urticaria
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What skin lesion is characterized by 3 zones of color, on the face or acral surfaces and primarily cause by HSV infection?
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Erythema Multiforme
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Steve-Johnson Syndrome, characterized by dusky r red-dusky flat lesion and epidermal detachment on face and trunk in addtion to muscoal involvment, fever and painful skin, is most often caused by __________.
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Medications
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Steven Johnson Sydrome is considered Toxic Epidermal Necrolysis when _____ of body surface area is affected?
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30%
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Xanthomas are assciated with an ___________.
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elevated cholesterol panel
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What skin disorder has lipid-laden histiocytes in dermis or tendons is associated with it?
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Xanthoma
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What are the 5 main subtypes of Xanthomas?
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1. Xanthelasmas- flat yellow papules on eyelids not as tightly assoc. w/ chol.
2. Eruptive xanthomas- red-yello papules/plaques on extensors assoc. w/ elevated TG ("goosebump look") 3. Tendon Xanthomas- assoc w/ elevated cholesterol 4. Tuberous xanthomas- yeallow papules on elbows and buttocks assoc. w/ elevated Chol and TG 5. Plane Xanthoma (due to monoclonal Ig gammopathy) |
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in every Kaposi Sarcoma lesion you will find ______.
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HHV type 8, KS often in immuno supressed like HIV *remember pick of black man's nose macule)
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if you find Erythema Nodosum on a patient presenting in an atypical fashion (such as on the back of the calf) what test should you order?
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PPD looking for TB
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Velvety hyperpigmented plaques and papules in intertrigiouns areas that are often associated with insulin resistance and obesity are known as _________.
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Acanthosis nigricans
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Well demarcated red plaques, thick, plate-like , silvery scale, favorsing extensor surfaces characterize what disease?
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Psoriasis
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In the case of very explosive psoriasis, you need to test for what infection?
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HIV
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What types of drugs make psoriasis worse?
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Anti-hypertensive: B-blocker, ACE-inhibitos; Lithium; Anti-malairials
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Cw6 causes Type ____ psoriasis.
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I
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Cw3 causes Type ____ psoriasis
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II
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PSORS1 is located on chromosome_____ and PSORS2 is located on chromosome ___.
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6; 17q
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Histology of what disease is characterized by hyperkeratosis (thickened stratum conreum), acanthosis (thickened stratum spinosum), dilates vessles in dermal papillae and neutrophils in stratum corneum?
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Psoriasis
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Overexpression of what cytokines are implemented in psoriasis?
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IL-12; IFNy; TNF-a
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80% of psoriasis cases are subtype _______________.
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Chronic plaque psoriasis (scaly , erythematous plaque, sharply demarcated, with a thick silvery scale on extensors-elbow,knees,glutealcleft,scalp)
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The appearance of psoriasis lesions at the site of injury is known as what?
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Koebner phenomenon
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Oil spotting pathgnumonic for ______________.
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Psoriasis
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Small, Raindrop-like lesions, on a child who has just had strep is mostly like psoriasis of what type?
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Guttate psoriasis
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What 2 types of psoriasis require hospitalization?
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Psoriatic erythroderma (infection, hypothermia, malnutirion, fluid and electrolyte shifts) and Generalized pustular psoriasis (resulting from too many neutrophil in stratum corneum)
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What subtype of psoriasis is seen almost exclusively in smokers and rarer?
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Plantar pustular psoriasis (on instep is pathognomonic)
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What are the 5 types of psoriatic Arthritis?
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Asymmetric Oligoarthris (“sausage digits”, most common) Symmetric polyarthritis, DIP joints only, Ankylosing Spondylitis, Arthritis Mutilans
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With psoriasis, for <15% of SA of body, mainstay of treatment is _______ and for >15% the mainstay for Tx is____________.
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Topicals (corticosteroids, Vit D analogs); Phototheraphy when ANA negative (full body narrow UVB, PUVA) , Oral agents (Acitretin-teratogen like Isoretinin, Methotraxate-heptotoxic,, Cyclosporin-works fast) , Biologics (anti t-cell/tnf/il12
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Atopic dermatitis, characterized by abnormal TH2 response and decrease water retention and skin lipids and filagrin defects is more likely to be seen in a patient with a history of what?
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Asthma and Rhinitis
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With contact dermatitis, what test distinguishes Irritant dermatitis (due to direct skin irritation--more common) from Allergic dermatitis (immunologic rxn triggered by substance)?
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Patch testing
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What type of Excema/Dermatitis subtype is extremely pruritic o the hands and feet of aults where they have bulla/vesicles that appear on the lateral aspects of their fingers?
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Dyhydronic Dermatitis
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Besides topical steroids, what should treatment for Stasis Dermatitis (eczematous eruption on the lower legs from venous insufficiency) include?
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edema prevention-- compression stockings, elevation, weight loss
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Chronic eczematous dermatitis from excessive scartching and rubbing causeing hyperpigmented leathery plaques and in which tx calls for "breaking the itch cycle" is know as__________.
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Lichen Simplex Chronicus
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What is the "atopic triad" of atopic dermatitis include?
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asthma, hay fever, atopic dermatitis
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What corticosteroid vehicle should be used to additionally improve hydration and is maximally penetrant in the skin?
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Ointment- bestfor thick skin or avoiding allergic reaction to perservatives.
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use _____ (level of intensity) potency corticosteriod for face and genitalia and occluded skin.
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Low
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Gel,lotion and cream cortiocsteroids are best used for __________.
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Acute Vesicular Eruptions
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Foam, spray and shampoo corticosteroids are best used fro what type of lesion?
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Scalp eruptions
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Skin atrophy and Acne are Side effets for what type of drug?
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Corticosteroids
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Superhigh potency steroids are preferred in areas of _______ skin.
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thicker (i.e hands, feet)
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Order top 3 skin cancers by prevalence.
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Basal cell, squamous cell, melanoma
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What type of skin cancer has a perly pink papule with central depression that is slow growing , locally destructive and often mistaken for a pimple or sore?
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Basal Cell Carcinoma
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What type a skin cancer might cause a patient to complain of feeling as though they have a scar but they dont know what from?
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BCC- mopheaform
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What type of skin cancer appears as a "punched out" re plaque/nodule with a gritty scale and early nodular appearance often arising from a preeexsisting actinic keratoses?
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Squamous Cell Carcinoma
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What type of SCC is rapid growing with low metastatic risk that often have spontaneous remission?
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Keratoacanthoma
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What type of SCC is slow growing, flat with silvery scale and is linked to arsenic exposure and esophageal cancer?
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Bowen's disease
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What are the ABCDEs of moles?
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Asymmetry, Border Irregularity, Color, Diameter, Evolution(changes)
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What type of moles are more likely to develop in to melanoma?
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Dysplastic/Atypical Nevi
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The least agrressive form of melanoma is ______ whereas the most agressive form is_______.
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Lentigo malinga; Nodular melanoma
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The type of melanoma most common in non-causcasians but least-common overall is _______.
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Acral Lentiginous
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What is the most important prognostic factor for Melenoma?
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Breslow depth
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What treatment has the higherst cure rate for melanoma?
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Mohs surgery
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What are ephilid?
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freckles
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Whereas ephilid are due to _____ sun exposure, Solar lentigo are due to ____ sun exposure.
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acute; chronic
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Normal moles are known as what?
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Melanocytic Nevi
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What do you call a benign "pasted on" papule with barnacle appearance found on back, chest and cleavage lines?
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Seborreic Keratosis (Dermatousis Papulosa Nigra when on the face and Stucco keratoses when chalky looking and on the feet)
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All warts/ verruca vulgaris are cause by what virus?
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HPV
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What is best characterized by smooth dome-shaped pink or white papules that are common and childhood and caused by DNA poxvirus (often see in the summer with kids swimming in public pools)?
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Molluscum Cantagiosm
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The difference between a hypertrophic scar and a keloid is that a keloid___________.
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extends beyond the margins of the original lesion
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How do you tell the difference between an Epidermal Inclusin Cyst and a Lipoma?
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An epidermal Inclusion Cyst will have a central plug
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