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176 Cards in this Set
- Front
- Back
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What is PPAR gamma?
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Peroxisome proliferator activated receptor
Member of nuclear hormone receptor superfamily Thiazolidinediones are PPAR gamma ligands used to control diabetes May be useful in treatment of metastatic melanoma May increase risk for heart failure Initiates gene transcription by forming heterodimer with RXR |
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What is ingenol mebutate?
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Derived from Euphorbia peplus
3 day course has shown equal efficacy for AK's as efudex & aldara Causes cellular necrosis |
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What condition has elevated IL22 levels produced by IL22 T cells?
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atopic dermatitis
Both psoriasis & AD have increased IL22; in psoriasis IL22 produced by IL17 cells |
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Efficacy of vaccinations during and after treatment with etanercept
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Pneumococcal vaccines: normal Ab response since B-cell mediated
T-cell dependent Ab: tetanus booster; response may not be sufficient, suppressed immune response for at least 6 wks after treatment No live vaccines: live attenuated zoter or live attenuated flumist |
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IL18
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Produced by macrophages, dendritic cells, keratinocytes
mediator of autoimmunity Higher serum levels in patients with LE, increase w/ disease activity |
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Major causative agent of non-bullous CIE in Japan?
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ABCA12
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Gene mutated in acral peeling skin syndrome?
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transglutaminase 5
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Gene defect in Leguis syndrome?
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SPRED 1
Genetically distinct but similar to NF1 CALM, axillary freckling, macrocephaly More benign; look for LD, ADHD, speech delay |
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MC association with CMTC?
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body asymmetry (hypotrophy or hypertrophy)
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What is posterior reversible encepholopathy syndrome?
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HA, visual disurbances, focal neuro deficits, altered mental status
Often assoc wtih HTN, immunosuppression, eclampsia Can complicate GAS infection in children Appears 1-3 wks after pharyngitis, 3-6 weeks after impetigo |
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M types associated with acute post strep GN following pyoderma?
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2, 49, 55, 57, 60
(1, 12 when follows pharyngitis) |
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Initial trigger of inflammation in LPP due to?
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abnormal functioning of PPAR gamma
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Side effect of thiazolidinediones
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Peripheral edema--can lead to CHF
Weight gain Induces cytochrome P450 |
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Risk factors associated with poor prognosis in primary anaplalstic large cell lymphoma?
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age>60
absence of spontaneous remission mltifocal skin lesions extensive single-limb involvement & localization on head & neck |
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Association b/t vitamin D and NMSC
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Higher vitamin D, lower NMSC
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Risk factors associated with SCC in HS?
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HPV-16, smoking, anogenital location in men
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NSAID that may have antitumor effects?
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Celecoxib
BCC formation linked with COX activity Trend toward reduced tumor burden in celecoxib treated Gorlin's group |
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MCC of death in TEN/SJS?
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Infection
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2 factors in TEN/SJS associated with increased risk for bloodstream infections?
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age > 40, BSA>30%
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Best skin prep to avoid surgical site infections?
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Chlorhexidine gluconate and alcohol had lower overall rate of infections c/w poviodone-iodine
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Chromosomal loci identified by FISH to differentiate malignant and benign melanocytic lesions
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Nevoid melanoma had clonal abnormalities in chromosomes 6 and 11, most commonly a gain in 6p25
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Promising new immunologic therapy for melanoma
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autologous melan-a/mart-1 specific cytotoxic t cell clones
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Most noteworthy change in 2009 melanoma staging?
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Now includes mitotic rate; most significant correlation with survival was identified at threshold of >1/mm3
In one large study, mitotic rate second only to tumor thickness in predicting survival |
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In 2009 melanoma staging, what pattern of IHC staining can alone define stage 3
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detection of melanoma cells in LN by IHC staining alone is now sufficient for stage 3 status
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Worrisome features that differentiate atypical spitzoid melanocytic tumors from classic Spitz
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minimal to no maturation
absent or few Kamino bodies mitotic figures present at the base More than half occurred on extremities, median mitotic rate 3/mm3 |
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Course of animal-type or epitehlioid melanocytomas
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Heavily pigmented melanocytic lesion ddx includes epithelioid blue nevus and animal-type malnoma
Indolent course in younger patients with lower risk of SLN positivity, low likelihood of distant mets |
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Gene defect in severe neonatal cutis laxa associated with impaired pulmonary, GI, GU, MS, and dermal development
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LTBP4: latent form of tranforming factor beta binding protein
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MC autoimmune ds in pts with HCV
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thyroid ds
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High prevalence of antibodies agst which infection is seen in pts with B cell NHL
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HCV
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Gold standard for evaluating venous anatomy
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Color duplex ultrasound scanning
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Androgenic steroid with fibrinolytic properties; useful in lipodermatosclerosis
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stanazolol
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potential cause of toxic alopecia in the workspace
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borax
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Cause of diffuse melanosis from melanoma
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Increased alpha-MSH, hepatocyte GF, and endothelin-1
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Lab associations with impetigo herpetiformis
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hypocalcemia or low serum vitamin D
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HPV association with verrucous carcinoma of the foot
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HPV 16
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Glomangiomas express what?
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vimentin
smooth muscle actin |
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Association with interstitial granulomatous dermatitis with cords and arthritis
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ANA
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Mutation and TOC in cerebrotendinous xanthomatosis
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sterol-27-hydroxylase gene
TOC: chenodeoxycholic acid |
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Secondary causes of oxalosis
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ehtylene glycol poisoining
IV glycerol ESRD |
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Most sensitive and specific T-cell deletion marker for diagnosis of MF
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deletion of CD7
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Earliest known transcription marker for melanocytes?
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MITF (microphthalmia transcription factor)
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Pigmented papules and nodules on legs in onchocerciasis
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Sowda
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Main causative organism in gm negative toe web infection
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pseudomonas
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What molecule targeted by tacrolimus is highly expressed in keloids?
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Gli-1
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T-cell migration into epidermis
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CLA on T cells binds E or P selectin on endothelial cells; LFA-1 on T-cells binds to ICAM1 to allow adhesion; integrins modulate transmigration
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MC symptom of cardiac SLE
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pericarditis
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Symptoms of adult T-cell lymphoma/leukemia
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"HOTS"
hypercalcemia osteolytic bone lesions T-cell leukemia splenomegaly CD3+/CD4+/CD7- caused by HTLV1 |
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Gold standard for detecting autoAb in chronic urticaria
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basophil histamine release assay
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MC location for solitary reticulohistiocytoma
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head/neck
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Diagnostic tests for leish
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Montenegro test, kinetoplast PCR, culture with Nicolle-Novy-Macneal medium
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Only proven tx for trichotillomania in controlled studies
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clomipramine
Newer anecdotal reports of N-acetylcysteine |
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Medium of excimer laser
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xenon-chrloride
308nm |
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apparent association with chronic pigmented purpura
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odontogenic infections
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Potent vasodilator in normal skin
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PGE2
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Best criteria to diagnose Sezary syndrome
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> 1000 Sezary cells/mm3 on Sezary prep
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Best treatment for chronic paronychia
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topical steroids
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Retinoid receptors targeted by tretinoin and adapalene
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Tretinoin: RAR alpha, beta, gamma
Adapalene: RAR beta, gamma |
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MC SE of spironolactone
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menstrual irregularity
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MC hair manifestation in IP
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vertex alopecia
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MC extracutaneous manifestation of IP
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partial anodontia (also the MC dental abnormality)
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Gene defect in anhidrotic ectodermal dysplasia with immunodeficiency
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NEMO
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Cofactor for gamma-glutamyl carboxylase
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Vitamin K (phytomenadione)
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MCC of tinea corporis gladiatorum
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T tonsurans (40%), T rubrum (40%)
Head/neck/arms MC location |
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What is Riga Fede disease
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benign ulcerative granulomatous process occurs as result of repetitive trauma on oral mucosa by front teeth
Sign of developmental anomaly/neuro disorder |
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MC location for desmoplastic melanoma
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sun exposed areas of head/neck
>50% are amelanotic |
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Exaggerated mental crease
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PXE
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Edema of upper eyelids may be presenting sign of what?
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graves disease
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Treatment for mucocutaneous L. braziliencis
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IV sodium stibogluconate
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Cutaneous manifestation of multiple myeloma
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follicular spicules and multiple ulcers
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Location for primary mucinous carcinoma
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Usually around eyelids
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MCC of fixed drug eruption
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sulfonamides
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MCC of fixed drug eruption on genital mucosa
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cotrimoxazole
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MCC of fixed drug eruption on the lips
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naproxen/oxicams
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MC location for fixed drug eruption from dipyrone
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trunk and extremities
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Describe how CO2 is carried?
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7% in plasma
23% in hemoglobin 70% in form of bicarbonate ions |
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MC smallpox vaccination complication
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autoinoculation
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Independent serologic markers seen in amyopathic dermatomyositis
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anti-p155, anti-Se
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Cutaneous finding associated with increased incidence of malignancy in DM
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vasculitis
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Infection associated with PLEVA
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Strep pharyngitis
Tx with UVB and e-mycin |
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Study to differentiate ACD from ICD
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reflectance confocal microscopy
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MOA for low dose UVA1 in acrosclerosis
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Induction of collagenase, reduction of collagen production
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Keloids show increased levels of epidermal expression of what?
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VEGF
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SE of gemcitabine
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scleroderma-like changes
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HPV associated with disseminated large cell acanthoma
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HPV6
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Treatment for glossodynia
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Olanzapine
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What is exacerbated by interferon alpha treatment of HCV?
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psoriasis
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COX2 inhibitor that can cause purpuric eruption, F, malaise
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Valdecoxib
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Neurologic cause of anogenital pruritus
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degenerative changes in lower spine, treated effectively with paravertebral blocks
Other causes: contact, LP, fungus, perianal fissure |
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Hoarseness due to excess granulation tissue on vocal cord can be SE of what med?
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isotretinoin
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Macromelanosomes are seen in what ds
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NF-1
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Endocrine abnormality in NF-1
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autoimmune thyroiditis
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Most specific eye finding in NF-1
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Lisch nodule (as opposed to optic glioma)
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Gene defects in congenital generalized lipodystrophy
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AGPAT2, seipin (BSCL2)
treat with leptin replacement |
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MC systemic cause of complex aphthosis
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IBD
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Polymorphism in what enzyme is associated with androgenetic alopcia
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ornithine decarboxylase
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MC lymphoproliferative d/o associated with sarcoid
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Hodgkin's
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Ds associated with HCV patients on ribavirin and IFN alpha
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sarcoidosis
IFN alpha likely culprit |
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Increase of what receptor is seen in HTLV/adut T cell leukemia/lymphoma
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Increased IL2 receptor expression (CD25)
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Vaccinations using aluminum hydroxide as an adjuvant may cause what?
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cutaneous lymphoid hyperplasia
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4 common skin findings in Proteus
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epidermal nevi (develop in 1st month of life), vascular malformations, subcutaneous lipomas, cerebriform CT nevi
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Gene involved in AD transmission of DSAP
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SSH1, ARPC2: both play a role in assembly and disassembly of actin filaments
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Most reliable method for diagnosis of cutaneous leisch
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PCR
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Persistent cutis marmorata associated with what 3 disorders?
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trisomy 18
Downs Cornelia de Lange |
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Two drugs to cause livedo
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amantidine, minocycline
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MC associated disease with EBA
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Crohns
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Useful markers of disease activity in PAN
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serum beta-FGF, VEGF
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Triad of Felty's syndrome
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arthritis, leukopenia, splenomagaly
Also see therapy resistant leg ulcerations Develops in 1% of RA patients |
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MC nail finding in RA
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onychorrhexis
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Antiviral protein expressed in pityriasis lichenoides, VZV, and cytotoxic CD8 T cell lymphoma of skin
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MxA
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Association with ptergium inversum unguis
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Stroke
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Halo nevi are typical finding in which syndrome
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Turner's
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Fava-Neto reaction to diagnose what?
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Paracoccidioidomycosis
Immunologic reaction to polysaccharide antigens of paracocci cell |
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Elevated levels of what in men with mild to severe acne
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serum 17-hydroxyprogesterone levels
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Low levels of what are associated with risk of melanoma progression/poor prognosis
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coenzyme Q
also low in pancreatic, breast, lung CA |
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MC skin d/o in HIV patients
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folliculitis
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Window glass blocks which UV wavelength?
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Blocks UVB
Transmits UVA and visible light |
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Protein expressed in human scalp anagen but weak in catagen
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heat shock protein-27
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HLA associated with vulvovaginal gingival syndrome
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Severe variant of lichen planus
HLA DQB1*0201 0201 present in 80% |
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Most sensitive and cost effective method of diagnosing onychomycosis
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KOH with chlorazol black
PAS stain was most sensitive but least cost effective |
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Virus associated with malignancy in immunosuppressed
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EBV
Associated with hypermethylation of p16 |
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Associations with childhood lipodystrophy
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Autoimmunity (MC: DM or JRA)
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Rare but characteristic SE of glatiramer acetate (used for MS)
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Localized panniculitis
MOA: stimulates production of myelin basic protein |
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Syndromes associated with pheochromocytoma
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NF1
VHL MEN2 |
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Carbamazepine-induced SJS/TEN in Han Chinese
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HLA-B1502
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Combination of HLA B5701, HLA DR7, and HLA DQ3 is 100% predictive of hypersensitivity reaction to?
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abacavir
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Retinoic acid-induced capillary leak syndrome associated with which d/o
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acute promyelocytic leukemia
psoriasis PRP |
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MC abnormality with CMTC
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limb atrophy
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Good prognostic factor in primary cutaneous B cell lymphoma
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bcl6
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Poor prognostic factors in primary cutaneous B cell lymphoma
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bcl2, mum1, oct2
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Increased expression of what in Spitz nevus vs melanoma
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p16, p27
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MC oral finding in TS
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dental pits
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In kids, antiphospholipid syndrome most commonly secondary to what?
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SLE
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MC skin finding in antiphospholipid syndrome
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livedo reticularis
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Keratin decreased in circumscribed acral hypokeratosis
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K2e
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Common dermoscopic finding of DF
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linear irregular crypts
homogenous bluish pigmentation (c/w hemosiderotic variants) |
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First line empiric tx for M. Marinum
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Clarithromycin
JAAD Sep 07 |
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Photodermatosis signicantly higher in AfAm c/w Caucasians
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PMLE
C/w Caucasians porphyria and solar urticaria rarely occur in AA |
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MC site for HSV1 latency and HSV2 latency
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HSV1: trigeminal nerve
HSV2: sacral ganglia |
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Exam of choice for HSV encephalitis
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PCR
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Alternative therapy for calciphylaxis
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Bisphosponates
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Causes of carotenoderma
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Hypothyroidism, DM (impaired conversion of beta-carotene into retinol)
Kidney dysfunction decreased excretion Liver dysfunction: impaired conversion of beta-carotene into retinol |
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Causes of xanthoderma besides carotenoderma
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Multiple myeloma
quinacrine, phenol, methylenedianiline, dipyridamole ecess, dihydroxyacetone |
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Infections associated with IL12 and IL23 deficiency
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Salmonella, Mycobacterium
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Addition of what med to valayclovir may decrease incidence of post-herpetic neuralgia
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gabapentin
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MC topical antiobiotic to cause anaphylaxis
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bacitracin
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MCC SJS/TEN
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allopurinol
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Biologic dressing for wounds with light to moderate exudates
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hydrocolloids, foams (malodorous)
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Biologic dressing for dry/painful wounds
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hydrogel
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Biologic dressing for wounds with moderate to heavy exudates, bleeding wounds
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alginates, hydrofibers
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What is Galli-Galli disease?
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rare acantholytic variant of Dowling-Degos disease with reticulate hyperpigmenation on flexures and scaly erythematous papules on flexures and trunk
AD, K5 mutation |
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Gene defect in infantile systemic hyalinosis
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AR, capillary morphogenesis protein 2 (CMG2)
Joint contractrues, osteopenia, short starture, protein losing enteropathy, gingival hypertrophy, increased infections Perianal nodules, pearly papules on face |
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Clinical features of Merkel cell CA (AEIOU)
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asymptomatic, expanding rapidly, immune suppression, older than 50, UV-exposed area in fair skinned person
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Marker for advanced MF
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CA27.29
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80% of peds pts receiving this med (in addition to etoposide and cyclophosphamide) develop erythema that progresses to desquamation and hyperpigmentation
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thiotepa
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MC location for primary cutaneous adenoid cystic carcinoma
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scalp
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Reservoir for Leishmania mexicana in Texas
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burrowing wood rat (Neotoma micropus)
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Fetal risk with PR in pregnancy
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Premature delivery
Neonatal hypotonia Possibly fetal death, esp in 1st 15 wks |
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Peak UV absorption for ecamsule
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345nm
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Peak UV absorption for avobenzone
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360nm (true UVA filter)
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Clinical features in H-syndrome
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cutaneous hyperpigmented, hypertrichotic, indurated patches associated with hearing loss, short stature, cardiac anomalies, HSM, scrotal masses, hypogonadism
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HPV subtypes found in some nevus sebaceus
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6, 16, 33
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MCC drug-induced DM
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hydroxyurea
other common causes: statins, cyclophosphamide |
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Sunscreens with higher level of UVA protection c/w other sunscreens
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avobenzone, octocrylene
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Cardinal feature of juvenile PRP
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palmoplantar hyperkeratosis
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MCC sepsis in TEN
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S. aureus, Pseudomonas
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MC malignancy associated with hypertrichosis lanuginosa acquisita in men vs women
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Men: lung #1, colorectal #2
Women: colorectal #1, breast or lung #2 |
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Causes of acquired ichthyosis
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MC malignancy: Hodgkin's lymphoma
Exhaustive list including NHL, MM, meds (statins, cimetidine, clofaz), inflammatory ds (SLE, DM), nutritional ds |
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preferred test for HSV encephalitis
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PCR
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Treatment for febrile ulceronecrotic Mucha Habermann disease
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Methotrexate
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Catharsis
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Emotional release. hypothesis maintains that "releasing" aggressive energy (through action or fantasy) relieves aggressive urges.
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At what level does trichilemmal keratinization begin?
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isthmus (no granular layer formed)
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Disorders associated with trichorrhexis nodosa
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1) arginosuccinic aciduria: arginonsuccinate lyase deficiency, low arginine, high citrulline
2) citrullinemia: argininosuccinic acid synthetase deficiency in type 1, SLC25A13 mutation in type 2; |
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Gene mutation associated with non photosensitizing variant of TTD?
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C7orf11
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Gene mutation in Bjornstad syndrome
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BCS1L Gene: encodes an ATPases necessary for assembly of complex III in the mitochondria
Pili torti (scalp only), sensorineural deafness by age 4 |
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Gene defect in woolly hair and skin fragility syndrome not associated with cardiac abnormalities?
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desmoplakin
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Solid tumor MC associated with Costello syndrome
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rhabdomyosarcoma
HRAS mutation Sparse, curly hair Growth deficiency MR Coarse facies Outgoing Personality |
