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Musculoskeletal
FA complete review Dermatology
| Question | Answer |
|---|---|
| What are the 3 layers of the skin? | - Epidermis - Dermis - Subcutaneous fat (hypodermis, subcutis) |
| What are the divisions of subcutaneous fat? | Hypodermis and subcutis |
| What are epidermis layers form surface to base? | Stratum Corneum Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basale |
| With lather of the epidermis is "keratin" found? | Stratum Corneum |
| What protein is associated with Strum Corneum? | Keratin |
| Which areas of body have the most prominent Stratum Lucidum? | Palms and soles |
| Which layer of the epidermis are desmosomes found in? | Stratum Spinosum |
| Which epidermis layer is the stem cell site? | Stratum Basale |
| Which the innermost layer of the Epidermis? | Stratum Basale |
| Which is the outermost (top; closest to surface) layer of the Epidermis? | Stratum Corneum |
| Which epidermis layers is most prominent in the palms of hands and soles of feet? | Stratum Lucidum |
| What protein/structures are found in the Stratum spinosum? | Desmosomes |
| Any condition with a deficiency or alteration to the Desmosomes, would be evident in which layer of the epidermis? | Stratum Spinosum |
| What is a common mnemonic used to remember the order (surface to base) of all layers of the epidermis? | Californians Like Girls in String Bikinis Corneum Lucidum Granulosum Spinosum Basale |
| List of Epithelial cell junctions: | 1. Tight junction 2. Adherens junction 3. Desmosome 4. Gap junction 5. Hemidesmosome |
| What is another name for Tight junction? | Zonula occludens |
| The zonula occludens is the same as: | Tight junctions |
| What are other ways to refer to Adherens junctions? | Belt desmosome and zonula adherens |
| What other ways to refer to Desmosomes? | Spot desmosome, and macula adherens |
| What is the common name for macula adherens? | Desmosomes |
| What is the purpose of Tight junctions? | Prevents paracellular movement of solutes |
| The Tight junctions are composed of which proteins? | Claudins and occludins |
| Claudins and Occludins compose with epithelial cell junction? | Tight junctions |
| Prevention of paracellular movement of solutes is the role of the: | Tight junctions |
| Below tight junction, forms a "belt" connecting actin cytoskeleton adjacent cells with Cadherins. | Adherens junctions |
| What is the protein or "glue" used in adherens junctions to attach adjacent cells? | Cadherins |
| The Cadherins (proteins) are involved in which Epithelial cell junction? | Adherens junctions |
| What is promoted by the loss of E-cadherin? | Metastasis |
| What is a way, involving epithelial cell junctions, that promote metastasis? | The loss of E-cadherin |
| What is the overall role of the Adherens junctions? | To form a connection among adjacent actin cytoskeletons of adjacent cells |
| Why is the Adherens junction often referred as Belt desmosome? | Forms a 'belt' connects actin cytoskeletons of adjacent cells with cadherins |
| What are Cadherins? | Ca2+ - dependent adhesion proteins |
| What is the main role of Desmosomes? | Structural support via intermediate filament interaction |
| What disease or condition is associated with Desmosomes? | Pemphigus vulgaris |
| Pemphigus vulgaris involves which type of Epithelial cell junction? | Desmosomes |
| Autoantibodies to Desmoglein ----> | Pemphigus vulgaris |
| What protein is attacked by the autoantibodies which then cause Pemphigus vulgaris? | Desmoglein |
| Autoimmune disease involving the Macula adherens? | Pemphigus vulgaris |
| Gap junction are: | Channel proteins called connexons permit electrical an chemical communication between cells |
| What epithelial cell junction allow for eltictial and chemicla commnction among cells? | Gap junctions |
| What are the channel proteins used by Gap junctions? | Connexons |
| Connexons are associated in which Epithelial cell junction? | Gap junctions |
| What is the role of Connexons? | Permit electrical and chemical communication between cells |
| Hemidesmosomes are on the Apical or Basolateral side(surface) of the epithelial cell? | Basolateral |
| Tight junctions are close to the Apical or Basolateral surface of the epithelial cells? | Apical |
| What is the purpose of Hemidesmosomes? | Connects keratin in basal cells to underlying basement membrane |
| Which epithelial cell junction is known to connect keratin to the basement membrane? | Hemidesmosomes |
| What condition is produced by attacking the Hemidesmosomes by autoantibodies? | Bullous pemphigoid |
| In Bullous pemphigoid, which is the affected epithelial cell junction? | Hemidesmosome |
| Which condition is due to antibodies affecting the keratin connection in basal cells to the underlying basement membrane? | Bullous pemphigoid |
| What are integrins? | Membrane proteins that maintain integrity of balateral membrane by binding o collagen, laminin, and fibronectin in basement membrane |
| Where are integrins found in the epithelial cell, apical o basolateral surface? | Basolateral |
| To which structure (proteins) are integrins attached to in the basement membrane? | Collagen, laminin, and fibronectin |
| Laminin is a protein in the basement membrane of epithelial cells that is often used by which structural protein? | Integrins |
| What are the characteristics of a Macule/ | Flat lesion with well-circumscribed change in skin color < 1 cm |
| Flat lesion, well circumscribed change in skin color, < 1 cm | Macule |
| What are examples of Macules? | Frecke, and labial macule |
| A freckle is an example of a ______________. | Macule |
| What is the lesion (or term) for a macule > 1 cm? | Patch |
| 3 cm macule is referred as a _____________. | Patch |
| What is a common example of a Patch? | Large birthmark (congenital nevus) |
| A large birthmark, such as a congenital nevus, is an example of what dermatologic lesion? | Patch |
| WHat are the characteristic of Papule? | Elevated solid skin lesion < 1 cm |
| Elevated solid skin lesion of < 1 cm in size | Papule |
| What are common examples of Papules? | Mole (nevus) and Acne |
| Acne is a common example of a _______________________. | Papule |
| A mole is an example of which dermatologic lesion? | Papule |
| Papule > 1 cm. | Plaque |
| Is a plaque, larger or smaller, than a Papule? | Larger |
| What is a Plaque? | Papule > 1 cm |
| What is the most common example of a Plaque? | Psoriasis |
| Psoriasis is a example of which dermatologic lesion? | Plaque |
| What is a vesicle? | Small fluid-containing blister < 1 cm |
| Is a vesicle size of extend, larger or smaller than 1 cm? | Smaller |
| What conditions are associated with vesicle dermatologic lesions? | Chickenpox (varicella), and shingles (zoster) |
| Shingles is associated with what type of dermatologic lesion? | Vesicle |
| Large fluid-containing blister > 1 cm | Bulla |
| A large vesicle is known as a ___________________. | Bulla |
| What condition is seen with Bullae? | Bullous pemphigoid |
| What is the name of a vesicle that if fulled with pus? | Pustule |
| What is a pustule? | Vesicle contains pus |
| What is a common condition associated with Pustules? | Pustular psoriasis |
| What is a Wheal? | Transient smooth papule or plaque |
| Transient smooth papule or plque | Wheal |
| What condition is seen with Wheals? | Hives (urticaria) |
| What is a Scale? | Flaking off of stratum corneum |
| Which layer of epidermis gives rise to scales? | Stratum Corneum |
| What are common examples of scales? | Eczema, psoriasis, and SCC |
| Eczema is an example of what type of macroscopic dermatologic lesion? | Scale |
| Squamous cell carcinoma of the skin is an example of what type of dermatologic lesion? | Scale |
| What is the definition of Crust? | Dry exudate |
| Dry exudate is referred as ________________. | Crust |
| What is the most common example of a crust? | Impetigo |
| What type of dermatologic lesion is impetigo? | Crust |
| What are the characteristics of hyperkeratosis? | Increased thickness of stratum corneum |
| Increased thickness of the Stratum corneum. | Hyperkeratosis |
| What are examples of Hyperkeratosis? | Psoriasis and calluses |
| Calluses are an example of what kind of microscopic dermatologic condition? | Hyperkeratosis |
| What is Parakeratosis? | Retention of nuclei in stratum corneum |
| What important condition is seen with Parakeratosis? | Psoriasis |
| Which layer of the epidermis involves Parakeratosis? | Stratum Corneum |
| What is the definition of Hypergranulosis? | Increased thickness of stratum granulosum |
| Increased thickness of epidermal Stratum granulosum. | Hypergranulosis |
| What condition is associated with Hypergranulosis? | Lichen planus |
| Lichen planus is characterized by what dermatologic condition? | Hypergranulosis |
| Which epidermal layer is increased in thickness in Lichen planus? | Stratum granulosum |
| What is Spongiosis? | Epidermal accumulation of edematous fluid in intercellular spaces |
| What is a condition seen with Spongiosis? | Eczematous dermatitis |
| Term used for epidermal accumulation of edematous fluid in intercellular spaces. | Spongiosis |
| What is the definition of Acantholysis? | Separation of epidermal cells |
| What is an example condition associated with Acantholysis? | Pemphigus vulgaris |
| Autoantibody condition that is closely associated with Acantholysis? | Pemphigus vulgaris |
| Separation of epidermal cells. | Acantholysis |
| What is Acanthosis? | Epidermal hyperplasia (increased spinsum) |
| What is an example disease or condition seen with Acanthosis? | Acanthosis nigricans |
| Epidermal hyperplasia of the Stratum spinosum | Acanthosis |
| Which epidermal layer is affected by Acanthosis? | Stratum Spinosum |
| What are common Pigmented Skin disorders? | 1. Albinism 2. Melasma (chloasma) 3. Vitiligo 4. Seborrheic dermatitis |
| What pathogenesis of Albinism? | Normal melanocyte number with decreased melanin production due to a decreased tyrosinase activity or defective tyrosine transport. |
| What are the two causes of decreased melanin production in Albinism? | 1. Decreased tyrosinase activity or, 2. Defective tyrosine transport |
| Albinism represents an increased risk for: | Skin cancer |
| Hyperpigmentation associated with pregnancy or OCP use. | Melasma |
| What is another term used for Melasma? | Chloasma |
| What is Melasma? | Hyperpigmentation associated with pregnancy or OCP use |
| A pregnant woman notices a darkening of the skin patches. Dx? | Melasma |
| What is Vitiligo? | Irregular patches of complete depigmentation |
| What is the cause of Vitiligo? | Autoimmune destruction of melanocytes |
| Skin pigmentation condition due to autoimmune destruction of melanocytes. | Vitiligo |
| What is a Seborrheic dermatitis? | Erythematous, well-demarcated plaques with greasy yellow scales in areas rich in sebaceous glands, such as scalp, face, and periocular region. |
| What areas of the body are often affected in Seborrheic dermatitis? | Areas rich in sebaceous glands, such as scalp, face, and periocular region. |
| Which neurodegenerative condition is associated with Seborrheic dermatitis? | Parkinson disease |
| A person with Parkinson disease is often affected by which dermatological condition? | Seborrheic dermatitis |
| What pathogen is possibly associated in development with Seborrheic dermatitis? | Malassezia spp |
| What are common treatment options for Seborrheic dermatitis? | Topical antifungals and corticosteroids |
| What are some common causes of Acne? | 1. Increased sebum/androgen production, 2. Abnormal keratinocyte desquamation, 3. Cutibacterium acnes colonization of the pilosebaceous unit, and, 4 .Inflammation of papules/pustules |
| What are treatment options of acne? | Retinoids, benzoyl peroxide, and antibiotics |
| Which bacteria is often causative of acne development? | Cutibacterium acnes |
| What is a comedone? | Pilosebaceous unit |
| What is the former name of Cutibacterium acnes? | Propionibacterium |
| Common skin disorder of multifactorial etiology, often involving sebum? | Acne |
| What is another name of Atopic dermatitis? | Eczema |
| Eczema is also known as: | Atopic dermatitis |
| What is Atopic dermatitis? | Pruritic eruption, commonly on skin flexures |
| What are common associations of Atopic dermatitis? | 1. Atopic disease (asthma, allergic rhinitis, and food allergies) 2. Increased serum IgE |
| What gene is often mutated in Eczema? | Filaggrin |
| What condition is highly associated with mutations in filaggrin gene? | Atopic dermatitis |
| What function is interrupted by a filaggrin mutation? | Skin barrier dysfunction |
| Atopic dermatitis in infants is present most commonly in: | Face |
| Eczema in children and adults is often seen in what body area? | Antecubital fossa |
| Type IV hypersensitivity reaction that follows exposure to allergen. | Allergic contact dermatitis |
| What type of hypersensitive is Allergic contact dermatitis? | Type IV |
| What common skin disorder is characterised by lesions that occur at site upon contact with the material? | Allergic contact dermatitis |
| What are common examples of material that develop Allergic contact dermatitis? | Nickel, poison ivy, neomycin |
| What is the medical term of a common mole? | Melanocytic nevus |
| Intradermal nevus are ________________. | Papular |
| What is the term used for flat macules? | Junctional nevi |
| What is Pseudofolliculitis barbae? | Foreign body inflammatory facial skin disorder characterized by firm, hyperpigmented papules and pustules that are painful and pruritic. |
| What are common sites of Pseudofolliculitis barbae? | Cheeks, jawline, and neck |
| What is a common skin disorder that is associated of shaving ("razor bumps")? | Pseudofolliculitis barbae |
| Which population is most often affected by Pseudofolliculitis barbae? | African-American males |
| Papules and plaques with silvery scaling, especially on knees and elbows. Dx? | Psoriasis |
| What is the definition of Psoriasis? | Papules and plaques with silvery scaling, especially on knees and elbows |
| What are microscopic dermatologic conditions associated with Psoriasis? | Acanthosis with Parakeratotic scaling. |
| What are clinical features/signs of Psoriasis? | 1. Acanthosis with Parakeratotic scaling 2. Munro microabscesses 3. Increased stratum spinosum 4. Decreased stratum granulosum 5. (+) Auspitz sign |
| What non-dermatologic features are associated with Psoriasis? | Nail pitting and psoriatic arthritis |
| What is Auspitz sign? | Pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off |
| A (+) Auspitz sign. Dx? | Psoriasis |
| What is the definition of Rosacea? | Inflammatory facial skin disorder characterized by erythematous papules and pustules, but no comedones. |
| What is rhinophyma? | Bulbous deformation of nose |
| What is a possible adverse result of Phymatous rosacea? | Rhinophyma |
| Associated with facial flushing in response to external stimuli, such as alcohol or heat. Dx? | Rosacea |
| What is Seborrheic keratosis? | Flat, greasy, pigmented squamous epithelial proliferation with keratin-filled cysts (horn cysts). |
| "stuck on" looking keratin-filled cysts. Dx? | Seborrheic keratosis |
| What are common places with Seborrheic keratosis occur? | Head, trunk, and extremities |
| Common skin benign neoplasm of older people. | Seborrheic keratosis |
| Seborrheic keratosis is (+) for what clinical sign? | Leser-Trélat sign |
| WHat is the Leser-Trelat sign? | Sudden appearance of multiple seborrheic keratoses, indicating an underlying malignancy. |
| (+) Leser-Trélat sign. Dx? | Seborrheic keratosis |
| Common name for Verrucae? | Warts |
| What pathogen causes verrucae (warts)? | Low-risk HPV strains |
| What is the description of verrucae? | Soft, tan-colored, cauliflower-like papules |
| Soft, tan-colored, cauliflower-like papules. | Verrucae |
| What is the result of epidermal hyperplasia, hyperkeratosis, and koilocytosis? | Verrucae |
| What verrucae condition is associated with warts in the anus or genital? | Condyloma acumintum |
| Which part of body does Condyloma acuminatum appear on? | Anus and genitals |
| Common name of Urticaria | Hives |
| What is urticaria? | Pruritic wheals that form after mast cell degranulation |
| How urticaria characterized by? | Superficial dermal edema and lymphatic channel dilation |
| Which skin condition is characterized with superficial dermal edema and lymphatic channel dilation? | Urticaria |
| What skin condition is formed after mast cell degranulation? | Urticaria |
| List of Vascular tumors of the skin: | 1. Angiosarcoma 2. Bacillary angiomatosis 3. Cherry hemangioma 4. Cystic hygroma 5. Glomus tumor 6. Kaposi sarcoma 7. Pyogenic granuloma 8. Strawberry hemangioma |
| Rare blood vessel malignancy typically occurring in the head, neck, and breast areas, in elderly, on sun-exposed areas. Dx? | Angiosarcoma |
| Angiosarcoma is: | A rare blood vessel malignancy (vascular tumor of skin) that occurs in the head, neck, and breast aras of elderly in sun-exposed areas. |
| What are common associations to the development of Angiosarcomas? | Radiation therapy and chronic postmastectomy lymphedema |
| Which vascular tumor of skin is highly associated with vinyl chloride and arsenic exposures? | Hepatic angiosarcoma |
| A person with Hepatic angiosarcoma, is likely to have been exposed to what material? | Vinyl chloride and arsenic |
| Hx of postmastectomy lymphedema and radiation therapy, raises suspicion of which vascular tumor of skin? | Angiosarcoma |
| Which patients are often seen with Bacillary angiomatosis? | AIDS patients |
| What is Bacillary angiomatosis? | Benign capillary skin papules found in AIDS patients |
| Pathogen causative of Bacillary angiomatosis in AIDS patient? | Bartonella spp |
| Bacillary angiomatosis is often mistaken by which other vascular skin tumor? | Kaposi sarcoma |
| What is the distinguish infiltrate of Bacillary angiomatosis from Kaposi sarcoma? | Bacillary angiomatosis has a NEUTROPHILIC infiltrate |
| What type of infiltrate is seen in Bacillary angiomatosis? | Neutrophilic |
| Neutrophilic or Lymphocytic infiltrate in Bacillary angiomatosis? | Neutrophilic |
| Neutrophils or Lymphocytic infiltrate in Kaposi sarcoma? | Lymphocytic |
| Cherry hemangioma is: | Benign capillary hemangioma of the elderly. Does not regress. Increase frequency with age |
| Benign capillary hemangioma of the elderly. Dx? | Cherry hemangioma |
| Bening capillary hemangioma of infancy. Dx? | Strawberry hemangioma |
| What is a Cystic hygroma? | Cavernous lymphangioma of the neck |
| Cystic hygroma is highly associated with which condition? | Turner syndrome |
| A patient with Turner syndrome is at high risk of developing which Vascular tumor of the skin? | Cystic hygroma |
| Cavernous lymphangioma of the neck. | Cystic hygroma |
| What is a Glomus tumor? | Bening, painful, red-blue vascular skin tumor, commonly found under the fingernails |
| How does a Glomus tumor aries? | From modified smooth muscle cells of the thermoregulatory glomus body |
| Benign, painful, red-blue tumor, commonly found under fingernails. | Glomus tumor |
| Painful or Painless. Glomus tumor? | Painful |
| What is Kaposi sarcoma? | Endothelial malignancy most commonly of the skin, but also mouth, GI tract, and respiratory tract. |
| What are the viral associations of Kaposi sarcoma? | HHV-8 and HIV |
| Other than the skin, what other areas may be affected, rarely, by Kaposi sarcoma? | Mouth, GI tract, and respiratory tract |
| What condition may be mistaken instead of Kaposi sarcoma? | Bacillary angiomatosis |
| Polypoid lobulated hemangioma that can ulcerate and bleed. Dx? | Pyogenic granuloma |
| What are associations of Pyogenic granuloma development? | Trauma and pregnancy |
| What is Pyogenic granuloma? | Polypoid lobulated capillary hemangioma that can ulcerate and bleed. |
| What age is associated with Strawberry hemangioma? | Infancy |
| Strawberry hemangioma features: | 1. Appears in infancy 2. Grows rapidly 3. Spontaneous regression by 5-8 years old |
| At what is a Strawberry hemangioma commonly spontaneously regressed? | 5-8 years old |
| List of BACTERIAL skin infections: | 1. Impetigo 2. Erysipelas 3. Cellulitis 4. Abscess 5. Necrotizing fasciitis 6. Staphylococcal Scalded Skin Syndrome |
| What are the most common bacteria that cause Impetigo? | S. aureus and S. pyogenes |
| What is impetigo? | A very superficial skin infection; highly contagious, and honey-colored crusting, caused by S. aureus and/or S. pyogenes |
| Bullous impetigo: | Impetigo + bullae caused by S. aureus |
| What structures of the skin are involved in the development of Erysipelas? | Upper dermis and superficial lymphatics |
| What is the organism that causes Erysipelas? | S. pyogenes |
| Infection involving the upper dermis and superficial lymphatics, due to a S. pyogenes infection. | Erysipelas |
| How is Erysipela (infection) presented? | Well-defined, raised demarcation between infected and normal skin |
| What is cellulitis? | Acute, painful, spreading infection of deeper dermis and subcutaneous tissues |
| Which organism are often associated with Cellulitis development? | S. aureus and S. pyogenes |
| How is the most common way that Cellulitis develops? | Starts with skin from trauma or another infection |
| What is an abscess? | Collection of pus from a walled-off infection within deeper layer of skin. |
| What is the most common organism that causes an skin abscess? | S. aureus |
| What layers or parts of the skin are affected in Cellulitis? | Deeper dermis and subcutaneous tissues |
| Deeper tissue injury, usually from anaerobic bacteria or S. pyogenes, which shows pain out of proportion to exam findings. | Necrotizing fasciitis |
| What is the key finding or feature to identify and diagnose Necrotizing fasciitis? | Pain may be out of proportion ito exam findings |
| Necrotizing fasciitis result in ----> | Crepitus from methane and CO2 production |
| What gases are developed or associated in Necrotizing fasciitis? | Methane and CO2 production |
| What important Necrotizing fasciitis feature is due to the production of Methane and CO2 gases? | Crepitus |
| Bacterial skin conditions associated with "Flesh-eating bacteria" | Necrotizing fasciitis |
| Clinical exam findings of Necrotizing fasciitis: | 1. Pain out of proportion to exam 2. Crepitus 3. Bullae and a purple color to the skin |
| What is a skin infection that is considered a surgical emergency? | Necrotizing fasciitis |
| What skin bacterial condition is due to an Exotoxin that destroys keratinocyte attachments in the S. granulosum only? | Staphylococcal Scalded Skin syndrome |
| Which epidermal layer is affected in Staph Scalded Skin syndrome? | Stratum Granulosum |
| How is Staphylococcal SS syndrome clinical presented? | Fever and generalized erythematous rash with sloughing of the upper layer of epidermis that heals completely. |
| What sign is associated with Staphylococcal Scalded skin syndrome? | (+) Nikolsky sign |
| What is the Nikolsky sign? | Separation of epidermis upon manual stroking of skin |
| SSSS is seen in adults often with ___________________ ________________. | Renal insufficiency |
| What is destroyed by Toxic epidermal necrolysis? | Epidermal-dermal junction |
| List of Viral skin infections: | 1. Herpes 2. Molluscum contagiosum 3. Varicella zoster virus 4. Hairy Leukoplakia |
| Which strains of herpes virus cause skin infection? | HSV-1 and HSV-2 |
| Common presentations of herpes skin infections: | Herpes labialis, Herpes genitalis, and, Herpes whitlow |
| Herpes whitlow infection affects the _____________. | Fingers |
| What is Molluscum contagiosum? | Umbilicated papules caused by Poxvirus |
| Cna Molluscum contagiosum be sexually transmitted? | Yes, although is mostly seen in children |
| What conditions are caused by Varicella zoster virus? | Chickenpox and Shingles |
| How does Varicella present clinically? | Multiple crops of lesions in various stages from vesicles to crusts |
| What is Zoster? | Reactivation of the virus in dermatomal distribution |
| Reactivation of VZV in dermatomal distribution. | Zoster |
| What is the key or classic rash distribution of reactivation of VZV? | Dermatomal |
| Irregular, white, painless plaques on lateral tongue that cannot be scrapped off. | Hairy leukoplakia |
| What virus is associated with Hairy leukoplakia? | EBV |
| Which type of patients are most seen with Hairy leukoplakia? | HIV-(+) and organ transplant patients |
| Unscrapable and precancerous white plaques on tongue? | Hairy leukoplakia |
| List of Blistering skin disorders: | 1. Pemphigus vulgaris 2. Bullous pemphigoid 3. Dermatitis herpetiformis 4. Erythema multiforme 5. Stevens-Johnson syndrome |
| What is Pemphigus vulgaris? | Potentially fatal autoimmune skin disorder with IgG antibody against desmoglein. |
| What is desmoglein? | Component of desmosomes, which connect keratinocytes in the stratum spinosum |
| What are findings of the immunofluorescence of Pemphigus vulgaris? | Antibodies around epidermal cells in a reticular (net-like) pattern |
| Clinical features of Pemphigus vulgaris: | Flaccid intraepidermal bullae caused by acantholysis; Oral mucosa is involved Type II hypersensitivity reaction |
| What type of hypersensitivity reaction is seen in Pemphigus vulgaris? | Type II |
| Is Pemphigus vulgaris positive or negative for Nikolsky sign? | (+) Nikolsky sign |
| How is the acantholysis described in Pemphigus vulgaris? | Separation of keratinocytes, resembling a "row of tombstones". |
| Histological description of acantholysis in Pemphigus vulgaris | "row of tombstones" |
| IM net-like (reticular) pattern. Pemphigus vulgaris or Bullous pemphigoid? | Pemphigus vulgaris |
| What is more severe, Bullous pemphigoid or Pemphigus vulgaris? | Pemphigus vulgaris |
| What is the cause of Bullous pemphigoid? | Type II hypersensitivity reaction: involves IgG antibody against hemidesmosomes |
| What is the clinical profile of Bullous pemphigoid? | Tense blisters containing eosinophils affect skin but space oral mucosa |
| Which, Bullous pemphigoid and Pemphigus vulgaris, spares oral mucosa? | Bullous pemphigoid |
| What are the immunofluorescence findings in Bullous pemphigoid? | Linear pattern at epidermal -dermal junction |
| Which blistering skin disorder is an autoimmune disorder that attacks the hemidesmosomes? | Bullous pemphigoid |
| Tense blisters + no oral involvement + (-) Nikolsky sign | Bullous pemphigoid |
| Immunoforce reveals a linear pattern at epidermal-dermal junction. Dx? | Bullous pemphigoid |
| What causes Dermatitis herpetiformis? | Deposits of IgA at tips of dermal papillae |
| What dermatological conditions are seen with Dermatitis herpetiformis? | Pruritic papules, vesicles, and bullae, most often in the elbows |
| What autoimmune disease is associated with Dermatitis herpetiformis? | Celiac disease |
| What is the common treatment for Dermatitis Herpetiformis? | Dapsone and gluten-free diet |
| A kid gets severe stomach aches when consumes gluten-containing foods. What skin condition may be also present in the patient? | Dermatitis herpetiformis |
| Deposits of IgA at tips of dermal papillae + Celiac disease. Dx of skin? | Dermatitis herpetiformis |
| How is Erythema multiforme presented? | Multiple types of lesions, such as macules, papules, vesicles, target lesions due to infection, drugs or autoimmune diseases. |
| What are some causative associations of Erythema multiforme? | - Infeactions - Drugs - Cancers - Autoimmune disease |
| What infections are associated with Erythema multiforme? | Mycoplasma pneumoniae and HSV |
| What drugs are associated with developing Erythema multiforme? | Sulfa drugs, B-lactams, and Phenytoin |
| What are characteristics of Stevens-Johnson syndrome? | Fever, bullae formation and necrosis, sloughing of skin at dermal-epidermal junction, and high mortality rate. |
| What is a more severe form of Stevens-Johnson syndrome (SJS)? | Toxic epidermal necrolysis (TEN) |
| What is the most common causative association for Stevens-Johnson syndrome? | Adverse drug reaction |
| What is Acanthosis nigricans? | Epidermal hyperplasia causing symmetric, hyperpigmented thickening of skin, especially in axilla and/or neck. |
| What areas of body are most affected by Acanthosis nigricans? | Axilla and/or neck |
| What are associations with Acanthosis nigricans? | 1. Insulin resistance 2. Visceral malignancy |
| Epidermal hyperplasia causing symmetric, hyperpigmented thickening of skin. | Acanthosis nigricans |
| What is Actinic keratosis? | Pre-malignant lesions caused by sun exposure. |
| How is Actinic keratosis presented? | Small, rough, erythematous or brownish papules or plaques |
| Actinic keratosis raises risk for: | Squamous cell carcinoma of the skin |
| What is Erythema nodosum? | Painful, raised inflammatory lesions of subcutaneous fat (panniculitis), usually on anterior shins. |
| What are associated conditions of Erythema nodosum? | Sarcoidosis, Coccidioidomycosis, histoplasmosis, TB, streptococcal infections, leprosy, and inflammatory bowel disease. |
| What part of the body is most likely to be affected by Erythema nodosum? | Anterior shins |
| Painful, raised inflammatory lesions of subcutaneous fat on the anterior shins. Dx? | Erythema nodosum |
| What are the 6 P's of Lichen Planus? | Pruritic Purple Polygonal Planar Papules lichen Planus |
| What virus is associated with Lichen planus? | Hepatitis C |
| How is mucosal involvement in Lichen Planus presented clinically? | Wickham striae (reticular white lines) and hypergranulosis |
| What is a key finding at the dermal-epidermal junction in Lichen Planus? | Sawtooth infiltrate of lymphocytes |
| What are Wickham striae associated skin disorder? | Lichen planus |
| "Herald patch" followed days later by other scaly erythematous plaques, often in a "Christmas tree" distribution on trunk. Dx? | Pityriasis rosea |
| What skin condition is seen with pink plaques with collarette scale? | Pityriasis rosea |
| "Christmas tree" distribution on trunk or erythematous plaques. Dx? | Pityriasis rosea |
| Self-resolving in 6-8 weeks epidermal rash with "festive" distribution. Dx? | Pityriasis rosea |
| What condition is first seen with a "Herald patch" and later with a very unique erythematous rash distribution? | Pityriasis rosea |
| Acute cutaneous inflammatory reaction due to excessive UV radiation | Sunburn |
| What is caused by a sunburn? | DNA mutations, inducting apoptosis of keratinocytes |
| What is the result of the DNA mutations caused by Sunburns? | Induction of apoptosis of keratinocytes |
| What are the two types of UV radiation? | UVB and UVA |
| UVB is dominant in: | Sunburn |
| UVA is dominant in : | Tanning and photoaging |
| Increased exposure to UVA and UVB increase risk for: | 1. Skin cancer 2. Impetigo |
| What is the most common example of a first degree burn? | Sunburn |
| Which burn classification are: Painful, erythematous, and blanching? | First- and Second-degree burns |
| What is the burn classification of a burn that is superficial, though epidermis only? | First-degree burn |
| Second-degree burn is described as: | Partial-thickness burn though epidermis and dermis |
| In a second-degree burn the skin is: | Blistered and usually heals without scarring |
| Description of the a Third-degree burn: | Full-thickness burn thought epidermis, dermis, and hypodermis |
| If the burn goes through all 3 main layers of the skin, it si a: | Third-degree burn |
| Description of the skin in a Third-degree burn? | Skin scars with wound healing |
| How is a Third-degree burn described clinically? | Painless, waxy or leathery appearance, non-blanching |
| What is the most common type of skin cancer? | Basal cell carcinoma |
| What are common physical features of Basal cell carcinoma? | Waxy, pink, pearly nodules, commonly with telangiectasias, rolled borders, and central crusting or ulceration |
| Which type of skin cancer appears at times with non-healing ulcers with infiltrating or as a scaling plaque | Basal cell carcinoma |
| What is the key characteristic of the nuclei of Basal cell carcinoma? | Palisading |
| Which type of skin cancer is seen with "palisading" nuclei? | Basal cell carcinoma |
| Which skin cancer is seen with telangiectasias? | Basal cell carcinoma |
| Waxy, pink, pearly nodules, commonly with telangiectasias, rolled borders, and central crusting or ulceration. Dx? | Basal cell carcinoma |
| Which areas of body are often found with BCC? | Sun-exposed areas |
| Which skin cancer is locally invasive, rarely metastasis, and palisading nuclei? | Basal cell carcinoma |
| What is the second most common skin cancer? | Squamous cell carcinoma |
| How is Squamous cell carcinoma of the skin development associated with? | Excessive exposure to sunlight, immunosuppression, chronically draining sinuses and occasionally arsenic exposure. |
| What body areas are most often seen with SCC of skin? | Face, lower lop, ears, and hands |
| Which lip, lower or upper, is often affected by SCC of skin? | Lower lip |
| What is a common clinical characteristic of SCC of skin? | Ulcerative red lesion with frequent scale |
| Which skin cancer is seen with ulcerative red lesions with frequent scale? | Squamous cell carcinoma |
| What are the key histologic findings of Squamous cell carcinoma of the skin? | Keratin "pearls" |
| Which skin cancer is often seen with histological finding of keratin "pearls"? | Squamous cell carcinoma |
| What are two conditions of the skin often seen in SCC of skin? | 1. Actinic keratosis 2. Keratoacanthoma |
| What is Actinic keratosis? | A scaly plaque, is a precursor to squamous cell carcinoma |
| What is Keratoacanthoma? | Variant of SCC of skin, that grows rapidly (4-6 weeks) and may regress spontaneously over months |
| What is a common skin tumor with a significant risk of metastasis? | Melanoma |
| What are the main three types of skin cancer? | 1. Basal cell carcinoma 2. Squamous cell carcinoma 3. Melanoma |
| What is the main tumor maker for melanoma? | S-100 |
| (+) S-100. Dx? | Melanoma |
| What condition of Melanoma correlates with risk of metastasis? | Depth of tumor (Breslow thickness) |
| What is the name given of depth of tumor of Melanoma? | Breslow thickness |
| What are the ABCDE of Melanoma? | Asymmetry Border irregularity Color variation Diameter > 6mm Evolution over time |
| What are the 4 types of Melanoma? | - Superficial spreading - Nodular - Lentigo maligna - Acral lentiginous |
| Melanoma acral lentiginous is most common among which populations? | African-Americans and Asian |
| What is the common mutation associated with Melanoma development? | BRAF kinase |
| What is the primary treatment of Melanoma? | Excision with appropriately wide margins |
| Which type of Melanoma is benefited with treatment with Vemurafenib? | Melanoma with a BRAF V600E mutation |
| What is the MOA of Vemurafenib? | BRAF kinase inhibitor |
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rakomi
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