Sneddon wlkinson Rx
NBUVB
Sneddon wlkinson Association with
IgA monoclonal
gammopathy
Drug-induced DMS implicated drugs include
hydroxyurea, penicillamine, statins, quinidine, and phenylbutazone)
Foregut carcinoid tumor releases
serotonin
what tumor causes itense flushing peptic ulcer lacrimation
Foregut carcinoid tumor
ACD PPD X react with
sulfa drug
neutrophilic dermatoses e.g. PG association with
IgA gammopathy
chronic AD cytokine
IFNy,
anterior subcapsular cataracts keratoconus P alba
AD
K6/k16 expression upregulated in
psoriatic plaque,
low c2/4 occurs in
Sle, acquired c1 estrase deficient-
beefy red tongue folate deficiency associated with?
Celiac desease
lithium pred phenytoin isoniazid cause
acneiform-
primary cutaneous amyloidosis protein
keratin
earlier onset more severe psoriasis
HLA B17
anti centromere assoc w
Crest-
antifodrin 93% specific for
sjogren-
hemorrhagic onycholysis caused by which drug?
taxanes
Psoriatic arthritis HLA link
HLAB 27
Minocycline discoloration shows blue within what cells?
macrophages
sneddon wilkinson configuration
annular serpinginous
Partial lipodystrophy serum shows ?
decreased c3,
most definitive associated HLA type with psoriasis, relative risk 9-15 times normal
HLA cw6
pits-nail, location abn
matrix- ,
pseudoparalysis parrot observed in
congential syphilis
unilateral or ipsilateral pectoralis major aplasia, ipsilateral limb shortening, ipsilateral foot enlargement, spina bifida, scoliosis, pectus carinatum, localized lipoatrophy,congenital adrenal hyperplasia\ polythelia and accessory scrotum,
Becker nevus
Fibrodysplasia ossificans progressiva endochrondral,
Osteoma cutis
What condition avoid aspirin
CIU
dermatomyosisits location muscle biopsy,
triceps
behcets ASSOCIATED hla
hlab 51
GA subcutaneous commoner in which age group
children
krazy glue ACD
ethyl cyanoacrylate
tosylonamide formaldehyde causes
eyelid dermatitis
dermatomyosisits cytokine
TNFa,
anti Mi-2 significance
favorable prognosis
juvenile dermatomyosisits cytokine
↑ thrombospondin
Spindle cell lipoma location
posterior shoulder
A.A transport defect, AR, pellagra like, intermittent ataxia
hartnup disease
phyrnoderma
vitamin A deficiency~
diarrhea dementia photosensitive dermatitis
Pellagra-niacin def
INH, AZA, 5FU,
Pellagra-
• Malignant atrophic papulosis Degos disease
mortality
myocardial ischemia
large vessel –
takayasu arteritis,
Hydralazine HLA DR4, peicillamine cause
drug induced lupus-
14%, with slow acetylators (HLA-DR4)
more prone
Hydralazine induced lupus
What drug induces native SLE disease, with anti-dsDNA Ab’s
Penicillamine
Vitamin D deficiency- hair
alopecia,
Xanthoma disminatum to check gland?
pituitary gland, DI
Reiter- chronic deforming arthritis in %
20 %
schnitzlers syndrome aw
sensorimotor neuropathy
IgG lamda monoclonal gammotpathy dm strep infection
scleremyxedema-
Pulmonary Fibrosis raynauds ssystemic sclerosis - linear morphea,,- ,
bleomycin-
pitted keratolysis organism
Micrococcus sedentaris
Post transplant ctcl-renal stransplant
cyclosporine
ACE - sensitivity 60, specificity 80
Sarcoidosis
sneddon syndrome aw
venous thrombosis
debride cooling, effect dressing
Dhdrogel-
50s subunit
, emycin
inhibit RNA dependent protein synthesis bind 30s ribosomal
azithromycin
Long-term morbidity from kidney disease, which is predicted by the spread of purpura to
the upper trunk
HSP
DH and lymphoma risk
NHL
30% of patients with SLe
anti-U1RNP
Majority of patients with positive U1RNP have
SLE rather than MCTD
atypical beaded papule nasal rim
Lofgren syndrome
partial lipodystrophy mutation LMNA gene
dunnigan variant
shoulder blade rippled hyperpigmented
sipple syndrome
myotonic dystrophy aw
pilomatricomas
MAGIC syndrome
relapsing polychondritis
Erythema gyratum repens underlying
lung cancer
ANA-negative sle → determined often on animal substrates, yet later found to be positive
on human cells, or if patient only makes antibodies to ?
ssdna (not detected by most tests)
DMS hi-risk pulmonary dz,
anti Jo 1
nevus achromicus congenital melanopenic ?extracutaneous assoc
no extracutaneous assoc
safe anestehtic in mastocytosis
propofol
Useful in testing ANA negative patients with clinical manifestations of sle or scle
ro la
Neonatal lupus hematologic abn
thrombocytopenia,
Light based acne therapy targets
Coproporphyrin 111
Which Cytokine marker of psoriasis disease severity
IL22
What cytokine in psoriasis stimulates Th1 cells
IL12
What cytokine in psoriasis stimulates Th17 cells
IL23
Onycholysis splinter hemorrhage and oil spots affects which part of nail
Nail bed
Pitting leukonychia, onychodystrophy affects which part of nail
Nail matrix N.B onychodystrophy- bed and matrix
Calcipotriene inactivated by
Salicylic acid
effect of rifampin on OCP efficacy
reduces
azelaic acid MOA acne
ihibit tyrosinase, PIPA
psorriasis early onset HLA
B17
psorriasis arthritis HLA
HLA B27
PAPA syndrome mutations
AD, PSTPIP1, CD2BP1
defective protein in FMF
pyrin
which biologic CI in CHF, cause drug induced SLE
infliximab
biologics which cause drug induced SLE
infliximab, etanercept
cause of infantile acne
elevated LH levels
Saroidosis lab abormality
Hypercalcemia
Commonest systemic sclerosis systemi finding
Esophageal dysfunction
ACE ihibitors cause angioedea via stimulation of
Bradykinin
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening adverse drug-induced reaction, with an estimated mortality of
10%.
most frequently reported causative agents of DRESS
syndrome
carbamazepine
most frequently affected visceral organ of DRESS
syndrome
liver
AGEP’s 5% mortality rate is most often
related to
secondary infection
patch test-ing shouldbe performed when after DRESS
2 to 6 months after recoveryfrom the symptoms.
recommended to per-form LTT when after the onset of DRESSsyndrome
5 to 8 weeks after the onset of DRESSsyndrome
useful diagnostic imaging techniques
for assessing Cardiac Sarcoidosis
Positron emission tomographic and gadolinium-enhanced cardiac magnetic resonance imaging scans
Eosinophils do reliably distinguish histologic findings of
drug exanthem from acute graft-versus-host disease
not
In CGVHD, when is systemic therapy warranted?
Sclerotic skin involvement, particularly fascial disease, should prompt aggressive treatment before the development of
Skin contractures functional disability
Calcification can be observed in ?panniculitis
Calcification can be observed in pancreatic pannicultis and lupus panniculitis
Painful calcification on the finger has also been effectively treated
with
surgical debridement.
Iodine use and iodine-containing diets (such asshellfish) have been reported to induce flares of
DH
serologic tests that may confirm the diagnosis of dermatitis herpetiformis and be used to monitor disease activity
Tissue and epidermal transglutaminases
DH likelihood of a family member having a similar condition?
18%
? Raynaud phenomenon does not have nail-fold capillary changes, usually has an onset during the teenage years, and does not cause necrosis or gangrene of the digits
Primary
Extracutaneous manifestations in morphea are ? rare
Not
Morphea
The most common extracutanous manifestation is
arthralgia
Morphea Central nervous systemfibrosis is most common in those children with
head and neck involvenent
Children with head and neck morphea
should have regular
ophthalmologic examination monitor
for Asymptomaticinvolvement that may lead to irreversible damage
The outcome
measure best suited for morphea is:
Localized Scleroderma Cutaneous Assessment Tool is a promising recently validated skin scoring tool that allows differentiation between activity and damage, is sensitive to change, and requires no additional equipment.
two therapies for
morphea with the most
clinical data
Methotrexate in combination
with systemic steroids
and ultraviolet A1
light phototherapy
morphea treatment Narrowband ultraviolet B light phototherapy
is as effective as low dose ultraviolet
A1 phototherapy
T
Topical tacrolimus is an effective treatment
for active plaque morphea
t
plaque morphea combination of calcipotriol in combination with betamethasone dipropionate is
supported by level
IIB evidence
type of arthritis Morning stiffness(min)>60, better with activity
PsA, RA
Reactive arthritis (ReA) is distinguished from psoriatic arthritis (PsA) by its
- acute onset arthritis and enthesitis,
- additive involvement of new joints over days
Which of the following imaging findings is unique to psoriatic arthritis
Osteopenia
Osteophyte formation, joint space narrowing,
and the absence of erosions distinguish
OA from PsA on plain radiographic film
CCP Ab Present in ?
RA
Flame figures may be seen in which of thefollowing conditions?
a. Bullous pemphigoid
b. Eczema
c. Arthropod bites
d. Dermatophyte infections
All
average age of onset of drug-induced SCLE is ?than that of idiopathic SCLE.
older (59.5 years)
Associated disease with Pemphigoid gestationis
Graves disease is seen in about 10% of patients with PG
calciphylaxis calcium phosphate product level
elevated calcium phosphate product (Ca 3 P) of[70 mg2/dL2 is associated with calciphylaxis, most patients with calciphylaxis have anormal product.
Which nerve is responsible for sensory inner-vation of the most commonly affected site? In TTS?
b. Maxillary branch of the trigeminal nerve
treatment of choice for EED is
dapsone
Schnitzler syndrome best treatment
Anakinra, an IL-1 re-ceptor antagonist, appears to be a promising agent,
Schnitzler syndrome Cx
Waldenstro¨m macroglobulinemia
Vanco RMS cause
Degranulation of mast cells independently ofimmunoglobulin E or complemen
Type 6 PRP
HIV associated, follicular spines, Hidradenitis suppurativa, acne conglobata
PRP subtype familial cases associated with ichthyosiform scaling, sclerodermatous changes of the hands and feet.
Type V,atypical juvenile PRP,
most common juvenile variant, PRP.
Juvenile focal—or type IV—PRP representsthe most common juvenile variant, and the secondmost common variant overall, accounting for ap-proximately 25% of all cases.
mangos (Mangifera indica) belong to the ?-containing plant family Anacardiaceae, and sensitized patients can develop a contact dermatitis similar to that of ?.
Urushiol—Correct. Like poison ivy, mangos (Mangifera indica) belong to the urushiol-containing plant family Anacardiaceae, and sensitized patients can develop a contact dermatitis similar to that of poison ivy contact dermatitis.The resorcinol in mango cross-reacts in patch tests with the catechols of poison ivy.
Japanese lacquer tree, cashew nut tree, ginkgo fruit pulp, the marking nut tree of India, and the Brazilian pepper tree. Mango, poison ivy
sources of urushiol
valuable therapeutic option for the treatment of refractory cutaneous cGvHD;
ECP
Treatment for cutaneous sarcoidosis first-line therapy for localized scar sarcoidosis.
Topical or intralesional corticosteroid
production of colored sweat that contains water-soluble pigments. The consumption of drugs, such as quinine, has been reported to be causative.
Eccrine chromhidrosis—
What steroid-sparing agent is often used with oral corticosteroids to treat pemphigus vegetans?
Acitretin—Correct. The use of acitretin and steroids has been reported to be effective in the treatment of large verrucous lesions of PV.
treatments is most appropriate for this persistent, pruritic rash?grovers
Pramoxine lotion twice daily and as needed for pruritus
Id reaction cytokine
interleukin-1
is a sudden,generalized eczematous eruption which occurs dis-tant fromthe primary condition. It is commonly seenin stasis dermatitis, contact dermatitis, and infectionsfrom bacteria and dermatophytes, pediculosis, molluscum contagiosum, my-cobacterium infection, and radiation therapy.
Id reaction, or autoeczematization,
Renbok phenomenon, or inverse Koebner phenomenon,
was first described in 1991 by Happle in an individual afflicted with two skin diseases (alopecia areata and psoriasis). It refers to normal hair growth in psoriatic plaques surrounded by hair loss caused by alopecia areata.
exhibit apple jelly color on diascopy,
Lupus vulgaris, sarcoidosis
?xanthomas seen in familial hypercholesterolemia.
familial hypercholesterolemia.
? xanthomas can occur with hypertriglyceridemia.
hypertriglyceridemia.
TC, ET,
? xanthomas can be seen with dysbetalipoproteinemia.
Palmar xanthomas can be seen with dysbetalipoproteinemia.
Terms &Conditions, Extra Terrestrial, Play Bad
?xanthomas, which are protuberant nodules over the knees and elbows, also occur in familial hypercholesterolemia
Tuberous xanthomas, which are protuberant nodules over the knees and elbows, also occur in familial hypercholesterolemia but were not present in this patient.
Mnemonic
145 Extra- Terrestials ( eruptive, hypertriglyceridemia)
Play Bad ( palmar, dysBetalipoproteimemia) so u better agree to
Terms & Conditions i.e. Bad ( tuberous,tendinous hypercholesterolemia, also dysBetaliproteinemia ),
following has (have) been associated withsyringomas
a. Marfan syndrome
b. Down’s syndrome
c. atrophoderma vermiculata
d. EhlerseDanlos syndrome
Secondary cold urticaria has in some patients been associated with
hepatitis B or C infection, lymphoproliferativedisease, or infectious mononucleosis.
PLEVA, vs PLC histo
PLEVA, apoptotic and necrotic keratinocytes, neutrophils, and erythrocytes epidermotropic infiltrate of CD8+ T lymphocytes. Parakeratosis vs PLC CD4+
Antibodies associated with MCTD
U1RNP, hnRNP2
digital skin color changes with Raynaud’sphenomenon naturally progress in which of thefollowing orders?
d. white then blue then red
Raynauds ismost often seen in association with
systemic sclero-sis.
Pellagra caused by
niacin , comes fromsynthesis fromtheamino acid tryptophan. This process requires vita-mins B2 and B6 (riboflavin and pyridoxine
a. malabsorptive disorders
b. chronic alcoholism
d. Hartnup’s disease
e. carcinoid syndrome
Pellagrous
trigeminal trophic syndrome best treatment
The best treatment is use of an occlu-sive dressing or prosthesis, which prevents furthermanipulation.
Axillary parakeratosis defect
in processing of profilaggrin to filaggrin
Sarcoidosis is associated
with
CD4+ Th1 T-helper cells
Sarcoidosis has been associated with the fol-lowing
lymphoproliferative
disorders
chronic myelogenous leukemia
b. hairy cell leukemia
d. Hodgkin’s lymphoma
e. non-Hodgkin’s lymphoma
Sarcoidosis has been associated with the fol-lowing solid tumors
a. testicular cancer
c. melanoma
d. lung cancer
e. carcinoid tumors
Sarcoidosis is associated with HLA-
Sarcoidosis is associated with
a. HLA-1
b. HLA-B8
c. HLA-DR3
Sarcoidosis has been associated the followingautoimmune disorders
a. vitiligo
c. autoimmune thyroiditis
d. Sjogren’s syndrome
e. systemic lupus erythematosus
Id reaction cytokines
interleukins 1 and 6 and tumor necrosis factor a