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130 Cards in this Set
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- Back
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Name the two HLAs associated with Behcet's Disease
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HLA-B51 and HLA-DRW2
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What organ system is most frequently affected with neutrophilic infiltrates in Sweet's?
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Pulmonary
Then, bone (multifocal sterile osteomyelitis) and eye (peripheral ulcerative keratitis) |
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Most frequent association with Sweet's?
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Myelogenous leukemia or pre-leukemia
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Most frequent association with atypical PG or Bullous PG?
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assoc with hematologic disease (pre-leukemia, myeloid dysplasia, or AML)
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Most frequent association with PG?
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IBD (UC > Crohn's), Arthritis (seroneg, symmetric), Hematologic diseases
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Autoantibody associated with juvenile dermatomyositis
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Anti-MJ and Anti-PMS1
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Autoab assoc with pulmonary disease and the antisynthetase syndrome in DM
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Anti-Jo-1
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Autoab assoc with amyopathic dermatomyositis
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Anti-CADM-140
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Autoab assoc with malignancy-assoc myositis
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anti-p155 and anti-p155/p140
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Autoab assoc with myositis-overlap syndromes
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U1RNP, Ku, PM-Scl
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What comprises anti-synthetase syndrome?
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Interstitial lung disease
Myositis Polyarthritis Raynaud's phenomenon Fever Mechanic's hands |
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What medication can cause vasculitis of the earlobes?
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Levamisole
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What is unique about Levamisole?
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Can cause vasculitis, particularly of the earlobes (purple earlobes); Levamisole is an antihelminthic medication - has been found laced in cocaine
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Mechanism of ipilimumab
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Fully humanized monoclonal Ab to CTLA-4 protein - used in Melanoma
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What is CTLA-4 ?
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CTLA-4 protein suppresses T-cells - there for Ipilimumab upregulates immune response thru DISINHIBITION.
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EM images of laminated inclusion bodies is commonly seen in what?
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Amiodarone use
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Eye findings and skin findings in Gardner's
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CHRPE
Confluent EICs |
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Ginkoba cross reacts with what plant/nut?
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Cashews
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The allergen in hair wash can have two contaminants that act as allergens -- what are they?
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Hair wash contains cocamidopropyl betaine -- the two contaminants are
1) amidoamine 2) d-mapa (dimethylpropylamine) |
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Zyrtec is the slow release form of what drug? What is the allergen in zyrtec?
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Zyrtec is slow release atarax;
the back bone is: ethylenediamine, which can cause a recall dermatitis (note: ethylenediamine is also found in mycolog) |
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What stains the capsule in crypto?
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Mucicarmine
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What CN muscle closes the eyelid? vs opening it?
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CN 3 - holds it up
CN 7 - pulls it down |
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M/C of onychomycosis in kids? in adults?
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T. rubrum in kids
T. mentag in adults |
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Name some formaldehyde releasing agents?
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aspartame
q15 sodium hydroxymethylglycinate |
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What foods have gluten in them?
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BROW
Barley Rye Oats Wheat (rice is okay) |
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Fong's syndrome aka?
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Trauner-Rieger
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What Dz is associated with eruptive DF's?
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Leukemia
SLE HIV |
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What are wallace's lines?
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lateral aspect of feet; determines line of transgrediens
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Voight's and Futcher's lines?
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Same lines
they are pigmentary demarcation lines along the arms and legs; delineate dorsal vs ventral |
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Use of Permethrin not used in patients with what allergy? What about elimite?
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Permethrin: Daisy (toxicondendron)
Elimite - has formaldehyde in it |
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What Merkel Cell stain indicates a bad prognosis?
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CD44
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What is the allergen in Aquaphor?
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Bisbolol = a sesquiterpene lactone that cross reacts with compositae
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Under wood's lamp -- how does C. Tenuis fluoresce? T. mentag?
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C. tenuis - fluoresces orange
T. mentag - fluoresces white |
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What allergen is in Derma-smoothe?
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Balsam of Pine
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What are the allergens in colophony?
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(glues in resin:)
Abietic Acid Abitol Coniferal alcohol (fragrance) |
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What substance creates a brown tatoo?
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Iron
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What is the enzyme defect in Reed Syndrome? The assoc malignancy?
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Fumarate Hydratase
Renal CA |
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What is the #1 cause of allergic dermatitis in chronic venous stasis?
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Balsam of Peru (in moisturizers and wound dressings)
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How many complement groups are in Fanconi's?
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12 complement groups
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What type of dermatitis can be caused by antibuse?
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recall dermatitis
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What can co-react with neomycin? vs. neosporin?
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Tobramycin can cross react with Neomycin
Bacitracin co-sensitizes with neosporin |
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What causes 'soccer shins'?
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p-tert formal resin & diakyl thiourea (rubber accelerators)
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What is the allergen in wrinkle-free products?
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ethylene melamine formaldehyde
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Allergen in paper products?
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methyldibromoglutaryl nitrle
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What is the allergen in compositae plants?
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(ex., is yarrow)
allergen is sequiterpine lactone, cross reacts with PPD |
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What antibodies are assoc with DH?
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anti-reticulum
anti-gliadin anti-endomysin |
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What lung findings in Birt-Hogg-Dube?
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80% have lung cysts
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Name some signs of secondary lues?
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split papules
necklace of venus ollendorf sign le grande verole (balanitis of follman is a primary sign) |
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Name examples of umbelliferae plants?
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fennel
false bishop weed hogweed |
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Name some elastin stains
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Gomori's
Orcein-giemsa VVG (oil red-o stains fat) |
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What drug can cross link TNF-alpha?
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Infliximab
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M/C age for H.S.?
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2nd and 3rd decade
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Best test for TB?
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IFN-gamma
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Erlenmyer flask deformity is seen in what disease?
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Gaucher's
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What causes bulb sorter's dermatitis?
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Oxalate crystals (ex., daffodils)
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Tomatoes has what two allergens?
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coniferal alcohol
cinnamic alcohol |
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What metal does not go through latex gloves?
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chromium
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What should pt's with Balsam of Peru avoid in their diet?
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Tomatoes
Soda (benzoate) Chocolate |
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What nutritional requirement does malasessia have?
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Olive Oil
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Heck's Dz is assoc with what HPV types?
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HPV 7, 13, 32
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What is the allergen in onions?
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allyl disulfide
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What drug as SLE like reaction, but not SCLE?
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Hydralazine does not have SCLE reactions -- it has SLE reactions
(terbinafine can cause SCLE rash) (phenytoin can have SLE rash) |
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What is a cutaneous side effect seen with hydroxyurea?
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Lateral lower leg ulceration
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Name some cutaneous findings in Madelung's Disease?
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horse collar sign
b/l symmetric lipomatosis Upper respiratory cancers |
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Name some of the nutritional requirements of the trichophyton group
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Tonsurans (on wet prep has a 'ton' of balloons that weigh a 'ton')
Tonsurans verrucosum is "very greedy" and needs Inosityl & Thiamine |
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m/c site for leish?
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face
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males with bad severe acne have elevations of what hormone?
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17-hydroxy progesterone
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what steroid class does budesonide cross react with?
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buDesoniDe (D2 class)
Class A - hydrocortisone Class C - desoximethasone Class D1 - clobestasol Class D2 - bedesonide |
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Who has lower risk of SCC -- heart or renal tx pts?
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renal tx patients have lower risk of skin ca than heart tx patients
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Defect in white sponge nevus?
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K 4 and K13
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Eponym for Eosinophilic Fasciitis?
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Shulman Syndrome
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Wavelength of UVA-1
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340-400nm
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Wavelength of UVA-2
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320-340nm
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What are two characteristics of venous malformations that increases risk of localized intravascular malformations?
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Size & presence of phleboliths
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Classic Hand-foot Syndrome (aka erythrodysesthesia) is most common with which chemotherapeutic agent?
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cytarabine
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What type of hair defect is seen in Netherton Syndrome?
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Trichorrhexis invaginata (aka Bamboo hair). sometimes pili torti or trichorrhexis nodosa is seen.
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Cause of flagellated hyperpigmentation
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Bleomycin
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Name for rash in Gluten Enteropathy
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Dermatitis Herpetiformis
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Starting steroid dose for hemangioma
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3mg/kg starting dose
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Another name for Acquired Perforating Dermatosis
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Perforating Folliculitis
Kyrle's Disease Acquired perforating collagenosis |
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What type of patients tend to get Acquired Perforating Dermatosis?
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patients in renal failure; 4-10% of patients on dialysis get this
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S-100 stains what things?
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schwann cells, chondrocytes, histiocytes, langerhans cells, eccrine cells, melanosomes
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"SCHLEM" |
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Pigment casts in scalp bx indicates what dz?
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Trichotillomania
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Genetics of Cylindroma of the skin
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AD
Chromosome 16q CYLD gene "turban tumor" |
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Brooke's syndrome
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multiple cylindromas + multiple trichoepitheliomas
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Types of SKs
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Hyperkeratotic
Acanthotic Irritated Reticulated Clonal F? = Melanocytes proliferation |
HAIR CF |
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Name three stains for Mast cells
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Leder Stain (n-chloracetate esterase)
Giemsa stain or Toluidine Blue (metachromatic stain for mast cells) CD117 - aka ckit protein (on chromosome 4q12) Other minor stains: CD 45 (Leukocyte common antigen), CD 43, CD 68, MCG 35 |
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Name good fungus stains
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PAS stain
PAS-D stain GMS - silver methenamine |
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Nothing Slide Acronym
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VITAMIN A E
Vitiligo Ichthyosis Tinea Argyria Minocycline/Mastocytosis (TMED) I Normal Anetoderma Ehlers-Danlos |
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Cellular histiocytoma type DF versus Dermatofibrosarcoma protuberans?
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DFSP = Factor XIII neg, CD34 pos
Cellular histiocytoma = Factor XIII pos, CD 34 neg |
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Suppurative granuloma DDx?
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Infections (bacteria, mycobacteria, fungal, cocci (30microns), blasto)
Acne Halogenoderma (usu has hyperplastic epidermis) FB reaction |
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Cell poor subepidermal blister DDx?
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PCT
pseudo-PCT JEB cell-poor BP low perfusion state EPP (hyalinization usu seen) |
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Clear Cell DDx?
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Clear cell hidradenoma
Eccrine Acrospiroma (usu no palisading seein) Tricholemmoma Clear cell Acanthoma |
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Evolution of the Poroma (according to Barnett):
Describe the entities according to the level of the eccrine duct |
Epidermis/Acrosyringium:
hidroacanthoma simplex (Borst-Jaddassohn) Ductal: Poroma Eccrine: Dermal Duct Tumor Deep Dermal: Eccrine Acrospiroma (nodular hidradenoma) |
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According to Dr. Barnett... how to differentiate the different sebaceous gland disorders?
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Sebaceous hyperplasia -- central follicle surrounded by sebaceous glands, more glands/ducts than basaloid cells
Sebaceoma -- islands of cells in the dermis, more basaloid than sebaceous glands, cystic features seen Sebaceous Adenoma: more basaloid cells (usu 50=50) Sebaceous carcinoma: bad cells, bizarre looking/atypical cells, over 50% basaloid cells |
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What percentage of MF pt's have associated alopecia mucinosa?
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10%
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LSA appearing slide -- Histologic DDx?
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LSA
radiation dermatitis morphea (usu has normal epidermis) |
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What is POEMS? What vascular lesion is associated with POEMS?
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Polyneuropathy
Organomegaly Endocrine d/o M-protein Skin changes Associated with glomeruloid hemangioma |
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List types of hemangioma?
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Tufted
Capillary Targetoid Glomeruloid Microvenular |
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DDX for superficial and deep infiltrate?
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PMLE
Lupus Lymphoma's Jessner's EAC |
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Nevus cells + inverted triangle appearance
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Deep Penetrating Nevus
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Merkel Cell stains? DDx of small round blue cells?
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CK20+
TTF negative DDx: small cell ca of the lung merkel cell neuroblastoma lymphoma melanoma |
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Barnett-ism:
What are the types of MF? |
MF
Granulomatous slack skin Pagetoid reticulosis (woringer-koloff) Kettron-Goodman MF m/c subset is CD4+, CD7neg |
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Where is Lupus profundus usually found? and what malignancy is it related to?
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Lupus profundus -- deep lupus -- usu on UE (shoulder)
It is related to subcutaneous T-cell lymphoma. |
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Stain for Granular cell tumor
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S100+
(pustular ovoid bodies of Milan) |
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What four things help differentiate Radiation Dermatitis from LSA?
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1) stellate fibroblasts
2) ectatic blood vessels (bizarre looking) 3) radiation elastosis (similar to solar elastosis except through the entire dermis) 4) loss of adnexal structures ---------------- LSA & Radiation dermatitis both have: 1) hyperkeratotic stratum corneum 2) epidermis is thinned 3) dermis is homogenized -------------- Morphea must also be considered in this DDx |
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How to differentiate Leish from Histo?
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Leish -- organisms are at the periphery of a vacuole. "marquee sign" -- aggregate in masses around the outside
Histo -- similar to kids doing jumping jacks, all evenly spaced Remember to consider Chagas in this DDx |
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How to differentiate from onchocerciasis from dirofilariasis?
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Onchocercoma = mating ball, worms have no muscle tones, females are usually pregnant (paired uteri), these worms are adapted to humans
Dirofilariasis: solitary worm usu b/c humans are incidental host; thick muscle, lateral cord has a chitinous ridge |
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How do cestodes reproduce? Nematodes?
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cestodes - budding
nematodes - more specialized; have mouth, gut & reproductive system |
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What malignancy has been linked to permethrin use?
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Leukemia
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What two diseases can scabies mimick?
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Langerhans Cell Histiocytosis
Pemphigoid (Immunofluorescence can show both IgG and C4) |
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Describe the hair loss pattern (histologically) in LPP
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LP has more inflammation, similar wedge shaped scar, sniper like hair loss
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What three things can show inflammation around the eccrine coils?
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lupus
lymphoma lichen striatus |
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Describe different appearance b/tw septal panniculitis and lobular panniculitis?
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Septal panniculitis - looks like bowl of cheerios
Lobular panniculitis - looks like chicken soup; necrosis of the fat lobules |
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Two drugs that can be assoc with eczematous dermatitis?
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CCB
Piroxicam (feldene) |
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I VACUUM DOG PUS
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Ichthyosis Vulgaris - hyperkeratosis without hypergranulosis
Vitiligo - decreased melanin on Fontana stain, decreased melanocytes on MART1 stain Versicolor - orthokeratosis --> scale (fluffy = furfur) Argyria Candida Urticaria -- PTAH stain for fibrin, PMNs in vessels Urticaria Pigmentosa -- mast cells Macular amyloid Dermatophytosis Onchocerchiasis Gold PXE Ulerythema/KP Seb Derm |
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Describe histo findings in granulation tissue?
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edematous stroma
mixed cell infiltrate capillary proliferation |
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If you only see a small portion of a Verrucous Hemangioma -- it may mimic what other entity?
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Angiokeratoma
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Gene Defect in Muir-Torre?
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MLH1
MSH2 MSH6 ("mismatch repair") There are stains available for these now, and lack of stain is the significant finding |
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Eponym for Clear Cell Acanthoma
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Degos Tumor
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What is the defect in a Clear Cell Acanthoma
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absense of phosphorylase
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Scientific name for oriental rat flea
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Xenopsylla cheopis
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What disease(s) is Xenopsylla cheopis a vector for?
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Yersinia pestis (plaque) & Rickettsia typhi (endemic/murine typhus)
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How do you differentiate xenopsylla cheopis and pulex irritans?
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X cheopis has hairs posterior to the antennae and a rod visible above second pair of legs (Pulex does not); both can transmit yersenia pestis
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What medication should you avoid in a patient with endemic (murine) typhus?
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Sulfa! It can cause multiorgan failure, coma, and stellate purpuric infarcts
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Which two ticks can transmit Rickettsia rickettsii?
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Rhipicephalus sanguineus (Brown Dog Tick), also transmits Mediterranean spotted fever via R. conorii; and Dermacentor andersoni (primary vector for RMSF).
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How does grapefruit juice affect the metabolism of cyclosporine?
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Grapefruit juice inhibits the cytochrome P450 in the intestinal wall, therefore inhibits metabolism of cyclosporine
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Drug interaction between NSAIDs and Cyclosporine?
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NSAIDs can potentiate the nephrotoxicity of cyclosporine
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Drug interaction between TCN and cyclosporine?
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Risk of pseudotumor cerebri
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Metabolism of cyclosporine?
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1) Cyto P450 3A4 and 3A5 in liver and small intestine 2) by the efflux p-glycoprotein pump (PGP) a transmembrane transporter expressed in the GI and liver, encoded for by the multidrug resistance-1 gene, aka ATP binding cassette B1
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