Term
| With papilosqusmous diseases, a scale represents thickened __ __ aka __. The elevation of papules and plaques results from thickening of the epidermis, known as ___ or underlying dermal inflammation. |
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Definition
- stratum corneum
- hyperkeratosis
- acanthosis |
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Term
| Psoriasis etiology is unknown. Presents as ___ demarcated erythematous ____ surmounted by silvery ___. |
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Definition
- sharply demarcated
- papules
- scales
2-5% of Caucasians have this |
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Term
| Psoriasis onset is usually ___ and in early ___. |
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Definition
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Term
| If psoriasis onset is sudden with multiple guttate lesions, it was likely preceeded by a ___ ___ infection. |
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Definition
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Term
| Sudden onset large plaque psoriasis can be related to ___ infection. |
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Definition
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Term
| __% of psoriasis patients have a family history. __% concurrence b/w identical twins> suggests environment also plays a role. Maintenance of the disease state strongly linked to a __ __ ___ __ resulting in increased epidermal cell turnover and proliferation. Thus, much treatment is targeted at stopping T-cells and thier production of cytokines. |
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Definition
- 35
- 80
- TH1 cell driven process |
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Term
|
Definition
Sharply demarcated erythematous papules and plaques surmounted by white or silvery scale.
Intertriginous areas have no scale but are red and sharply defined.
Nail involvement is usually present and characterized by pitting and onycholysis.
Pustular psoriasis is a rare variant |
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Term
| Psoriasis shows Auspitz sign, what is this? |
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Definition
| appearance of punctate bleeding when psoriasis scales are scraped off |
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Term
|
Definition
- scalp
- elbows
- knees
chronic in nature |
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Term
|
Definition
| trauma to skin can induce new psoriasis/spread psoriasis to traumatized area |
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Term
| 3 drugs that aggravate psoriasis: |
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Definition
- NSAIDs
- beta blockers
- lithium |
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Term
| Psoriasis histology shows hyperkeratosis, decreased granular layer, ___ with elongation of the ___ and infiltration of neutrophils forming ____ __ in the __ __. |
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Definition
- acanthosis with elongation of the rete
- Munro's microabscesses in the stratum corneum |
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Term
| Dx of psoriasis typically clinical, biopsy usually not necessary. Therapy includes: |
|
Definition
- topical steroids and immunomodulators (mid potency and higher)
- Tar and Anthralin preparations
Calcipotriene (Vitamin D derivative)
nbUVB and PUVA
Biologics (Humira, Enbrel, Raptiva, Remicade)
Methotrexate
Acitretin (Soriatane)
Cyclosporine |
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Term
| psoriatic arthritis classically effects ___ and __ __ joints ___. This is a potentially crippling manifestation of psoriasis and an indication for __ therapy. |
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Definition
- DIP
- small medium joints
- assymetrically
- systemic therapy |
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Term
| Psoriasis is chronic life long condition, typically better in the ___, worse in the ___. |
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Definition
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Term
| 3 genera of dermatophytes (fungus)include __, __, and ___. These all feed on __ in the __ __ and never invade below the ___. |
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Definition
1. Trichophyton
2. Microsporum
3. Epidermophyton
- keratin
- stratum corneum
- epidermis |
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Term
| For ANY SCALY PATCH, you should do a ___ __ b/c tinea/dermatophytes vary in appearance. |
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Definition
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Term
| synonyms for fungal skin infections: |
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Definition
- dermatophytosis
- tinea
- ringworm |
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Term
| Dermatophyte infections appear most commonly as scaling erythematous __,__, and ___, which often have a serpigenous or worm-like border. |
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Definition
| - papules, plaques, patches |
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Term
| Usually seen as a round patch with a clear center and a scaling border. One or several lesions may be present. |
|
Definition
tinea corporis
KOH SCRAPING IS DONE AROUND THE EDGES NOT IN THE CENTER |
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Term
| Patients with tenia curis (jock itch) often also have __ __. Tenia curis may not be annular, but border is ___, ___, and there is ___. The ___ is almost never involved. |
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Definition
- tenia pedis
- elevated, serpiginous, and there is scaling
- scrotum almost never involved |
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Term
| differential for tinea curis: |
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Definition
- candida: bright red, SATELLITE PAPULES AND PUSTULES- distinguish it from tinea
- intertrigo- simple irritant dermatitis due to moisture
- psoriasis
- sebrrheic dermatitis
- erythrasma |
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Term
| Erythrasma caused by ___ ___ can result in a groin rash. This will fluoresce __ under ___ light. |
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Definition
- corynebacterium minutissimum
- coral
- Wood's light |
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Term
| #1 most common bodily location for dermatophyte: |
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Definition
|
|
Term
| Tinea pedis presents in the following 3 clinical forms: |
|
Definition
- Interdigital- macerating scaling process b/w toes, common in patients with sweaty feet
- Diffuse plantar scaling: usually asymptomatic, common in elderly,soles appear dry with diffuse scaling extending onto sides of feet (mocassin distribution)
- Vesiculopustular- least common, instep of feet, roof of vesicles should be scraped for KOH prep |
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Term
| Tinea mannum usually occurs in a patient who already had tinea pedis. Usually occurs only in one hand giving name "one hand two feet syndrome". See scaly hands. |
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Definition
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Term
| Usually an erythematous, asymmetric eruption on the face with a sharply demarcated serpiginous border. |
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Definition
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Term
| fungus in beard is called? |
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Definition
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Term
| If in doubt about something being a fungus, do a __ __ or culture it. |
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Definition
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Term
| Therapy for dermatophyte infections: |
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Definition
Topical anti-fungals: Oxistat, Naftin, Ertaczo, Lamisil etc…
Apply 1-2 times daily until clear and then continue for 1-2 more weeks to try and prevent recurrence. |
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Term
| After clearance of chronic tinea pedis, for suppressive therapy use antifungal ___ such as __ ___. This can be used indefinitely. |
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Definition
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Term
| If dermatophyte infection is widespread or resistant, use ___ meds such as __, __, __, or __. |
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Definition
- systemic meds
- Ketoconazole
- Fluconazole
- Terbinafine
- Griseofulvin |
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Term
| Which antifungal should be given to kids? |
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Definition
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Term
| Dermatophyte infections of hair bearing areas or nails require an __ medication. |
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Definition
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Term
| Pityriasis Rosea is an ___ _____ inflammatory dermatosis of unknown origin characterized by ___, minimally elevated patches, papules, and macules mainly located on the ___. |
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Definition
- acute self-limiting
- oval
- trunk |
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Term
| With __ __, sometimes a generalized eruption is preceeded by a few days with a single larger lesion called the __ __. |
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Definition
- Pityriasis Rosea
- herald patch |
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Term
| Christmas tree pattern on trunk: |
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Definition
| Pityriasis Rosea (may have pruritis) |
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Term
| With Pityriasis Rosea, you should always consider testing for ___, especially if the palms or soles are involved or the patient is ill. |
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Definition
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Term
| Pityriasis Rosea should resolve on its own in 8 weeks. Biopsy is non-specific and therapy usually not necessary, though ___ or ___ can be used to speed resolution. |
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Definition
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Term
| Pityriasis Rosea is usually in a __ ___ person and is more common in ___. |
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Definition
- young healthy person
- women |
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Term
| pityriasis rosea distribution: |
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Definition
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Term
| Secondary syphilis is known as the ___ __ and is caused by the spirochete ___ ___. It is most commonly seen as diffuse __ papules and plaques on the __ , __, and ___. You may also see ___ plaques in the mouth, condylomata on the genitals, and alopecia on the scalp. |
|
Definition
- great imitator
- Treponema Pallidum
- scaly
- trunk, palms, and soles
- white |
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Term
| screening tests for syphilis: |
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Definition
- RPR (rapid plasma reagin)
- VDRL (veneral disease research laboratory) |
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Term
| Follow positive screenings of syphilis with a confimatory __ __ ___ __ test. |
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Definition
| - FTA-ABS test (Fluorescent Treponema Antibody- Absorption) |
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Term
| ___ is doc for syphilis. For primary and secondary syphilis in immunocompetent host, give a single intramuscular injection of __ __. |
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Definition
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Term
| HIV positive patients being treated for syphilis require __ injections for __ weeks. |
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Definition
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Term
| If patient is allergic to penicillin and has syphilis, treat with ___ for __ weeks. |
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Definition
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Term
| When being treated for syphilis, many patients experience a febrile reaction called ___ ___ __ that occurs with onset of therapy. This lasts for about 1 day. |
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Definition
| Jarisch-Herxheimer reaction |
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Term
| With therapy for syphilis, the patient's __ and ___ should significantly decrease, but their ___ will always be positive. |
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Definition
|
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Term
|
Definition
| - spreading to organs in secondary syphilis> hepatitis, bone/joint disease, nephritis, CNS dysfunction |
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Term
| Mycosis fungoides is a __ __ __ ___. There is a proliferation of ___ __ __ __ in the __, which can migrate to the epidermis. |
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Definition
- cutaneous T-cell lymphoma
- malignant helper T cells
- dermis |
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Term
| With mycosis fungoides an eruption occurs ___ over a course of years. Lesions are __ shaped, brown to violaceous in color, ___ in distribution and located on the __ and __ __ area. |
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Definition
- slowly
- irregular
- assymetric
- trunk
- swim suite area |
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Term
| With mycosis fungoides, you may also see ___, which is reticulate hyperpigmentation, hypopigmentation, and erythema with telangiectasia. |
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Definition
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Term
| As Mycosis Fungoides advances first __ then ___ appear and frequently __. |
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Definition
- first plaques
- then nodules
- ulcerate |
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Term
| If mycosis fungoides leave the skin and enters the blood it is called ___ ___, this is a late leukemia variant. |
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Definition
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Term
| mycosis fungoides has great prognosis if found early, but often misdiagnosed. if progresses to sezary syndrome> very poor prognosis. |
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Definition
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Term
| To diagnose mycosis fungoides, numerous ___ ___ are needed overtime to confirm diagnosis. T-cell receptor gene re-arrangement studies are used to determine monoclonality (high false negative rate |
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Definition
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|
Term
Mycosis fungoides (MF): Usually a chronic, smoldering disease with slow progression over many years. Excellent prognosis if treated in early patch stage, but relapses are common.
Mean survival in Sezary/systemic involvement patients is 2 years.
Treatment for MF localized to the skin:
1.) Topical steroids
2.) nbUVB or PUVA
3.) Topical nitrogen mustard
4.) Electron beam therapy
With systemic disease (Sezary) – topical modalities plus chemotherapy is used. |
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Definition
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|
Term
First see a dark purplish-red plaque which accumulates scale as it matures. This scale can be removed to reveal small, spiny projections: carpet tacking.
Older lesions appear, depressed, atrophic plaques – usually with hypopigmentation in the center and a hyperpigmented rim. |
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Definition
| Discoid lupus erythematosus |
|
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Term
| discoid lupus occurs on the __ or __ . |
|
Definition
| head or neck (on test will talk about scarring on head and neck) |
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Term
| what 3 lab tests should always be done for SLE: |
|
Definition
- CBC
- UA
- antinuclear antibody (ANA) |
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Term
|
Definition
| Distribution favors sun-exposed areas (face, upper trunk, arms) and the scalp is frequently involved with scarring alopecia. |
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Term
| discoid lupus can be diagnosed by: |
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Definition
Diagnosis can be established by biopsy, both with and without direct immunofluorescence.
(biopsy the edge, not middle) |
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Term
| DLE therapy for limited disease includes __ __ and __/__ ___. |
|
Definition
- sun protection
- topical/intralesional steroids |
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Term
| If DLE is extensive or recalcitrant, first line agents include __ or ___. |
|
Definition
- chloroquine
- hydroxychloroquine= Plaquenil- can cause eye problems so do opthalmic exam
The course of disease is chronic and usually controllable, but remember that scarring is permanent.
The risk of developing SLE in the future is about 5-10%. |
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|
Term
| Pityriasis rubra pilaris is a chronic idiopathic disorder with ___ __ ___ and ___, yellowish/pink___ that are __demarcated plaques with islands of ___ skin. There is painful ___ of palms and soles. |
|
Definition
- scalling follicular papules
- confluent yellow-pink patches
- well-demarcated
- ISLANDS OF NORMAL SKIN
- fissuring |
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|
Term
| Treat pityriasis rubra pilaris with __ __ like ___. |
|
Definition
| oral retinoids like Acitretin |
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|
Term
| generalized eruption of scaling with islands of normal skin: |
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Definition
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|
Term
| Icthyosis is a group of ___ characterized by ___ at __ or shorty thereafter. |
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Definition
- genodermatoses
- scaling
- birth |
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Term
| All types of icthyosis result from __ __ resulting in abnormal __ __. The three types of itchyosis are: |
|
Definition
- genetic mutations
- epidermal cornification
- Icthyosis vulgaris
- Lamellar Icthyosis
- X-linked Icthyosis |
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Term
| X-linked icthyosis results from ___ of the __ __ gene. It results in dirty appearing __ __ __ on the ___ __ and __. Often have history of failure of labor to begin or progress. Associated with __ __ and ___. |
|
Definition
- deletion
- steroid sulfatase gene
- large brown scales
- extensor extremities and trunk
- corneal opacities
- cryptorchidism |
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Term
| Acquired icthyosis begins in ___ and is associated with ___ like __, __ __ like __, and drugs like retinoids. |
|
Definition
- adulthood
- malignancies like lymphoma
- metabolic diseases like hypothyroidism |
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|
Term
| Acquired icthyosis is an instant marker for workup since may indicate cancer. These are fish like scales on extremities. |
|
Definition
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