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Derm

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Question
Answer
Autoimmune disorders with cutaneous signs   SLE, dermatomyositis, scleroderma, vasculitides  
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endocrine disorders with cutaneous signs   diabetes  
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immune disorders with cutaneous signs   dermatitis herpetiformis, urticaria/angioedema, sarcoidosis  
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metabolic disorders with cutaneous signs   xanthelasma  
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>__% of patients with SLE have skin findings   85  
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subset of patients with __ have cutaneous, but not systemic disease   lupus erythematosus  
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3 categories of skin manifestations of SLE   acute cutaneous, subacute cutaneous, chronic cutaneous (discoid lupus)  
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aka discoid lupus   chronic cutaneous lupus  
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other dermatologic manifestations of SLE   alopecia and oral ulcers  
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__ is very common in those with lupus, sun exposure may trigger acute lesions   photosensitivity  
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localized or generalized face, scalp, upper extremities (malar or butterfly rash), papules, papular urticaria, scaly plaques, discoid lesions, bullae, palmar erythema   acute cutaneous LE (ACLE)  
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scaly plaques are more commonly associated with __LE   subacute cutaneous LE  
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discoid lesions are more commonly associated with __ LE   chronic cutaneous LE  
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__% of patients with SCLE have SLE   50  
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typically start as small erythematous papules with scale, associated with anti-Ro and anti-La antibodies,   annular or papular (psoriaform) lesions associated with SCLE  
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__% of SLE patients have discoid lesions   25  
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non-specific lesions/rashes associated with SLE   lupus profundus (lupus panniculitis), vasculitic lesions (purpura), livedo reticularis, urticaria  
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one of the idiopathic inflammatory myopathies; heliotrope is classic cutaneous lesion   Dermatomyosistis  
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considered pathognomonic of dermatomyositis   Gottron's papules  
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slightly raised pink, dusky red or violaceous papules over the dorsal sides of the MCP/PIP and or DIP joints, can occur over wrists elbows or knees (pathognomonic for dermatomyositis)   Gottron's papules  
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macular rash over posterior shoulders/neck. seen in dermatomyositis   shawl sign  
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macular photosensitivity rash over anterior neck, can aslo occur on face or scalp. associated with dermatomyositis   V sign  
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nail findings of dermatomyositis   periungual erythema, telangiectasias, cuticle overgrowth  
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systemic sclerosis   scleroderma  
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localized scleroderma   morphea, linear scleroderma  
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localized plaques or linear, band-like distribution, most common in women, peak age of onset 20-50, rarely progresses to systemic disease   localized scleroderma  
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sclerodactyly, Raynaud's phenom, sclerosis of face, scalp, trunk, periungual and mat-like telangiectasia, pigmentation abnormalities, calcinosis cutis   systemic scleroderma  
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erythematous or violaceous macular rash of eyelides, peri-orbital area, often accompanied by edema; DM   Heliotrope  
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scleroderma epidemiology   F>M; 20-50 yrs  
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systemic,immunologic,genetic disease manifesting in skin and/or joints   psoriasis  
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psoriasis lesions:   Red scaling papules coalesce to round-oval plaques  
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psoriasis epidemiology   2.1% of US adults (4.5M); 1M psoriatic arthritis; 200K new cases/yr  
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Psoriasis most common sites   scalp, elbows, legs, knees  
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Psoriasis common findings   Chronic plaque; Erythroderma; Pustular; Guttate; Intertriginous  
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Most common type of psoriasis   plaque psoriasis: erythematous oval plaques, distinct borders, w/silver-white scale  
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Drugs that exacerbate psoriasis   Lithium; Beta-blockers; Antimalarials; Systemic steroids  
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Factors that flare psoriasis:   Strep infxn; Injury or trauma; Drugs; Low humidity; Emotional stress; Overtreatment  
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Guttate psoriasis   Small papules of short duration (weeks to months); Usually children and young adults; often after strep  
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Most common type of psoriatic arthritis   asymmetrical arthritis  
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Psoriasis etiology   T-cell-mediated hyperproliferation of epidermis -> inflammation of epidermis / dermis -> keratinocyte hyperproliferation  
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Psoriasis: associated conditions   CVD, depression, lymphoma  
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Silvery scaling plaques on extensor sensors. Ausptiz sign, Koebner phenomena; sausage fingers   Psoriasis  
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Rat bite erosions on X-ray   Psoriatic arthritis  
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Psoriasis: 5 variants =   plaque, pustular, guttate, inverse, erythrodermoid  
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psoriasis tx   topical steroids & vit D; coal tar / ASA preps; topical retinoid prn; for severe: cyclosporine, MTX, PUVA  
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von Zombusch syndrome   pustular psoriasis: emergency; diffuse pustules coalesce => lakes of pus; fever, malaise, high WBC  
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erythrodermoid psoriasis =   generalized, over most of skin; hypermetabolic state requiring hospitalization  
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psoriasis mgmt   Acitretin (0.5mg/kg; teratogen) vs MTX / Csteroid vs retinoids.  
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psoriasis tx categories   Topical (tar & CS, vit D & A/retinoid); phototherapy (UVB); MTX; cyclosporin A; Biologics (alefacept / efalizumab)  
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pemphigus vulgaris etiology   bullous autoimmune dz; IgG Ab => acantholysis => loss of cell-cell adhesion  
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pemphigus vulgaris S/S   oral mucosa lesions precede skin by 6-12 mos; pain (no itch); Nikolsky sx  
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pemphigus vulgaris tx   systemic tx: prednisone + immunosuppressives, azathioprine +/- MTX  
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Pemphigus may be side effect of what med class?   ACEI  
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