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149 Cards in this Set
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Characterize: macule
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Flat discoloration < 1 cm
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Example: macule
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Tinea versicolor
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Characterize: patch
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Flat discoloration > 1 cm
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Example: patch
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Tinea versicolor
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Characterize: papule
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Elevated skin lesion < 1 cm
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Example: papule
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Acne
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Characterize: plaque
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Elevated skin lesion > 1 cm
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Example: plaque
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Psoriasis
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Characterize: vesicle
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Small, fluid filled blister
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Example: vesicle
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Chickenpox
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Characterize: wheal
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Rounded papule or plaque which goes away (evanescent)
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Example: wheal
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Hives
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Characterize: bulla
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Small, fluid filled blister
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Example: bulla
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Bullous pemphigoid
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Characterize: keloid
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Irregular and raised hypertrophic scar tissue which follows trauma
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Characterize: who gets keloids
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African-Americans
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Example: keloid
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Yaws -- caused by treponema pertenue
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Characterize: pustule
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Pus filled blister
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Example: pustule
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Acne
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Characterize: crust
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Dried exudate from a vasicle or bulla
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Example: crust
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Impetigo
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Characterize: hyperkeratosis
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Increased thickness of stratum corneum
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Example: hyperkeratosis
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psoriasis
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Characterize: parakeratosis
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Increased thickness of stratum corneum, but also with retention of nuclei
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Example: parakeratosis
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Psoriasis
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Characterize: acantholysis
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Seperation of epidermal cells
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Example: acantholysis
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Pemphigus vulgaris
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Characterize: acanthosis
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Epidermal hyperplasia -- increased production of strutum spinosum
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Example: acanthosis
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Acanthosis nigricans
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Characterize: dermatitis
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Inflammation of the skin
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Example: dermatitis
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Contact or atopic dermatitis
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Verrucae: what is the common name
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Warts
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Verrucae: describe
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Soft, tan-colored, cauliflower looking lesions
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Verrucae: mechanism
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Epidermal hyperplasia, hyperkeratosis and koliocytes
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Verrucae: what is it called on the hands and feet
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Verruca vulgaris
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Verrucae: what is it called on the genitalia
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Condyloma aciminatum
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Verrucae: what causes genital warts
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HPV
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Nevocellular nevus: what is it
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common mole (aka benign melanocytic nevus)
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Nevocellular nevus: benign or malignant
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Benign
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Urticaria: what is it
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Hives
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Urticaria: describe
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Intensely pruritic wheals that form after mast cell degranulation
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Ephelis: what is it
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Common freckle
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Ephelis: describe
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It has a normal number of melanocytes which are producing extra pigment
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Atopic dermatitis: what is the common name
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Eczema
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Atopic dermatitis: decribe
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Pruritic eruptions on flexural surfaces
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Atopic dermatitis: where
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Scalp, neck, inside of elbows, behind knees
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Atopic dermatitis: associated with what
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Other atopic disease like asthma and allergic rhinitis
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Allergic contact dermatitis: what is it
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Type IV hypersensitivty reaction that follows exposure to an antigen
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Allergic contact dermatitis: what type of hypersensitivty reaction
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Type IV
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Allergic contact dermatitis: where do lesions occur
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At the site of contact
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Psoriasis: what is it
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Papules and plaques with silvery scale
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Psoriasis: where does it occur
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Especially on the knees and elbows
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Psoriasis: histo process
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Acanthosis and parakeratotic scalins
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Psoriasis: what skin layers are altered
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Acanthosis --> increased strutum spinosum and decreased stratum granulosum
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Psoriasis: what is Auspitz sign
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Punctuate bleeding that occurs after scraping a psoriatic plaque
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Psoriasis: what happens to the nails
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Nail pitting
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Psoriasis: associated with what other conditions
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Psoriatic arthritis
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Seberrheic keratosis: describe
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Flat, greasy pigmented proliferation of squamous epithelium
They are filled with keratin containing cysts called Horn cysts |
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Seberrheic keratosis: how do they appear
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They look as if they have been pasted on the skin
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Seberrheic keratosis: where do they occur
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Head trunk and extremeties
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Seberrheic keratosis: who gets it
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Common neoplasm of older folks
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Seberrheic keratosis: benign or malignant
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Benign
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Seberrheic keratosis: what is the sign of Leser-Trelat?
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Sudden and explosive appearance of many seborrheic keratoses indicates an underlying malignancy (esp GI cancers and lympoid cancers)
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Albinism: what are the causes
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1. Decreased tyrosinase activity leads to normal maloncyte number but with no pigment production (type 1 occulocutaneous albinism)
2. Failure of neural crest migration = no melanocytes |
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Vitiligo: what is it
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Decreased number of melanocytes causes irregular areas of melanin production
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Vitiligo: what is the cause
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Autoimmune mediated attack on melanocytes
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Melasma: what is another name
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Mask of pregnancy
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Melasma: what is it
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Hyperpigmentation that can occur during pregnancy -- appears in well-demarcated hyperpigmented macules or plaques
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Melasma: what else can cause it
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OCP
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Impetigo: what is it
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Superficial skin infection
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Impetigo: what are the orgamisms
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1. S aures
2. S pyogenes |
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Impetigo: contagious
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Hell yes
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Impetigo: what is the classic finding
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Honey-colored crusting
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Cellulitis: what is it
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Acute, painful spreading infection of the dermis and suncutaneous tissues
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Cellulitis: what causes it
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1. S aures
2. S pyogenes |
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Necrotizing fasciitis: what is it
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A deeper tissue infection -- in that fascia
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Necrotizing fasciitis: what causes it
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1. S pyogenes
2. S aureus 3. Anerobes -- C perfringens, V vulnificus, B fragoides |
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Necrotizing fasciitis: what is a finding
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Creptitus -- from methane and CO2 production (esp C perfringens = gas gengrene)
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Necrotizing fasciitis: what is the common name
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Flesh eating bacteria
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SSSS: what does it stand for
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Staphylococcal scalded skin syndrome
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SSSS: what is it
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Staph exotoxin called exfoliatin destroys keratinocyte attachments (desmoglein) in the stratum granulosum
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SSSS: characterize
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Fever + generalized erythematous rash with sloughing of upper layers of the epidermis
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SSSS: who gets it
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Newborns and children
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Pemphigum vulgaris: how serious
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Potentially fatal
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Pemphigum vulgaris: what type of disorder
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Autoimmune
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Pemphigum vulgaris: what antibodies
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IgG antibodies against desmosomes (an anti-epithelial cell antibody) (against desmoglein 1 and 3)
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Pemphigum vulgaris: immunoflourescence
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Antibodies around cells of the epidermic in a reticular (netlike) pattern
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Pemphigum vulgaris: physical findings
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Acantholysis -- intraepidermal bullae involving the skin, gums and oral mucosa
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Pemphigum vulgaris: what is nikosky's sign
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Seperation of the epidermic upon munaul stroking of the skin
It is posiitive in pemphigus vulgaris |
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Bullous pemphigoid: what type of disorder
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Autoimmune
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Bullous pemphigoid: what antibodies
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IgG antibodies against hemidesmosomes in the BM -- the antibodies are against collagen
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Bullous pemphigoid: immunoflourescence
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Linear pattern -- lineal because the BM lights up
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Bullous pemphigoid: histology of blister
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Contains immune cells -- esp eosinophils
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Bullous pemphigoid: how does it compare to pemphigus
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Spares the oral mucosa
It is similar to pemphigus but is less severe |
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Bullous pemphigoid: nikosky's sign
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Negative nikosky's sign
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Dermatitis herpetiformis: what is it?
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Eruption of pruritic papules and vesicles -- not caused by herpes virus
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Dermatitis herpetiformis: what is the dx
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Bx with immunoflourescence look for deposits of IgA along the dermal papillae
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Dermatitis herpetiformis: what other disease is it associated with
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Associated with celiac disease
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Erythema multiforme: associated with what infections
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1. Mycoplasma pneumoniae
2. HSV |
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Erythema multiforme: associated with what drugs
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1. Sulfa drugs
2. Beta-lactams 3. Phenytoin |
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Erythema multiforme: associated with what other conditions
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1. Cancer
2. Autoimmune disease |
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Erythema multiforme: what is the mechanism
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Possibly deposition of IgM immune complexes (type III) in the superficial microvasculature of the skin and oral mucosa
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Erythema multiforme: presentations
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Multiple types of lesions -- macules, papules, vesicles and target lesions
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Erythema multiforme: what is a target lesion
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Red papules with central clearing
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Stevens-Jonshon: what usually causes it
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An adverse drug reaction
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Stevens-Jonshon: what is the typical presentation
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1. Fever
2. Bulla formation 3. Necrosis and sloughing of the skin |
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Stevens-Jonshon: what is a more severe form
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Toxic epidermal necrolysis
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Stevens-Jonshon: what is the outlook
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It has a high mortality rate
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Lichen-planus: what are the 4 P's
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Pruritic, purple, polygonal papules/plaques
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Lichen-planus: histology
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Sawtooth infiltrate of lymphocytes at the dermal-epidermal junction
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Lichen-planus: what disease is it associated with
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Hepatitis C
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Actinic keratosis: what are they
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Premalignant lesions caused by sun exposure
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Actinic keratosis: describe them
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Small, rough, erythematous or brownish papules
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Actinic keratosis: what is a cutaneous horn
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It really is a big ass horn growing out of someone's skin
Most of these are sporadic but some are derived from actinic keratoses |
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Actinic keratosis: what correlates with risk of carcinoma
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Degree of epidermal hyperplasia correlates with risk of carcinoma
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Actinic keratosis: what layer is affectes
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Hyperplasia of the spinosum
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Actinic keratosis: associated with what other conditions
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1. Hyperinsulinemia
2. Visceral malignancy |
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Acanthosis nigricans: what layer is affected
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Hyperplasia of the stratum spinosum
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Acanthosis nigricans: associated with what conditions
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1. Hyperinsulinemia
2. Visceral malignancy |
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Erythema nodosum: what are they
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Inflammatory lesions of the subcutaneous fat
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Erythema nodosum: where does it usually occur
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Usually on the anterior shins
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Erythema nodosum: associated with what conditions
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1. Coccidiomycosis
2. Histoplasmosis 3. TB 4. Leprosy 5. Streptococcal infections 6. Sarcoidosis |
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Pityriasis rosea: describe the lesions
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Mutiple papular eruptions
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Pityriasis rosea: what is it associated with
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Sometimes proceeded by a URI
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Pityriasis rosea: what is the progression
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1. Starts with a single lesion called a "herald patch" -- called this because it foretells what is to come
2. Followed by a full body eruption that characteristiacally follow the rib line -- Christmas tree distribution |
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Pityriasis rosea: tx
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It remits by itself
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Strawberry hemangioma: what is the frequency
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1/200 births
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Strawberry hemangioma: when does it occur
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First few days of life
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Strawberry hemangioma: what happens to it
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It grows rapidly and then spontaneously regresses
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Cherry hemangioma: when do they occur
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First appear between 30-40
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Cherry hemangioma: what happens to them
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They stay put (don't go away)
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Sqaumous cell carncinoma: how common
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Quite
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Sqaumous cell carncinoma: associated with what
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1. Sunlight exposure
2. Arsenic exposure 3. Osteomyelitis?? |
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Sqaumous cell carncinoma: where does it appear
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Hands and face
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Sqaumous cell carncinoma: how aggressive
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Locally invasive but rarely metastasizes
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Sqaumous cell carncinoma: how else can it arise
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Not sure I really understand this but…
Osteomyelitis can cause a chronic draining sinus of the bone which can then lead to SCC |
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Sqaumous cell carncinoma: histo
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Keratin pearls
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Sqaumous cell carncinoma: what is the precursor lesion
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Actinic keratosis
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Sqaumous cell carncinoma: what is a strange variant
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Keratoacanthoma -- is a follicular originated form of SCC which grows rapidly (5 weeks) and regresses spontaneously (5 weeks)
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Basal cell carcinoma: where on the body and associated with what exposure
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Areas of the body which have been the most sum exposed
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Basal cell carcinoma: how aggressive
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Locally invasive but NEVER metastasizes
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Basal cell carcinoma: desribe the lesion
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Rolled edges with central ulceration that sometimes bleeds -- pearly papules with friable telangiectasias
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Basal cell carcinoma: histo
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Nests of cells within dermis with lots of peropheral pallisading
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Melanoma: how aggressive
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Very -- likes to metastasize
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Melanoma: what is the tumor marker
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S-100
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Melanoma: what is the precursor lesion
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Dysplastic nevus
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Melanoma: describe the lesion
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Multi-colored (tan, red, brown) and irregular plaque. Border appears hazy and irregular with pigmentary variation
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Melanoma: what are some risk factors
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1. Sunlight exposure
2. Being fair skinned 3. Family history 4. Having many moles |
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Melanoma: what histo finding correlates with risk of metastasis
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Depth of lesion
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