Norton Part 6 Flashcards

1
Q

atopic dermatitis (eczema) is characterized by what

A

chronic, waxing and waning, extremely pruritic, condition beginning in first year of life

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2
Q

what should one look for in family history when suspecting atopic dermatitis

A

allergies, asthma, eczema

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3
Q

when is eczema the worst and why

A

winter- due to decreased humidity

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4
Q

what lesions are seen in atopic dermatitis

A

papules, vesicles, oozing and crustin

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5
Q

where do babies get atopic dermatitis

A

face, diaper area, extensor surfaces of extremities

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6
Q

where do children and adults get atopic dermatitis

A

neck, face, axillae, antecubital and popliteal fossas

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7
Q

itching, scratching, itching is commonly seen in what

A

atopic dermatitis (eczema)

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8
Q

what is lichenification

A

epidermal thickening, characterized by visible and palpable skin thinking with accentuated skin lines

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9
Q

contact dermatitis can lead to what

A

lichenification

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10
Q

nummular dermatitis is characterized by what

A

“coin shaped” itch red plaques with vesicles and distant borders

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11
Q

nummular dermatitis is commonly seen in what patients

A

children

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12
Q

what is “winter itch”

A

asteatotic dermatitis

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13
Q

asteatotic dermatitis is common when and in what patients

A

elderly during the winter

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14
Q

what is seen in asteatotic dermatitis

A

dry, cracked skin that becomes itchy

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15
Q

what are the histological features of acute eczematous dermatitis (spongiotic dermatitis)

A

spongiosis (intracellualr edema)

exocytosis of lymphocytes

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16
Q

what are the acute eczematous dermatitis (spongiotic dermatitis)

A

contact dermatitis (irritant and allergic)
atopic dermatitis (eczema)
nummular dermatitis
asteatotic dermatitis

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17
Q

what is spongiosis

A

intracellular edema

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18
Q

erythema multiforme is what type of reaction

A

immune-mediated, hypersensitivity reaction resulting in epidermal injury

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19
Q

how does epidermal injury occur in erythema multiforme

A

epidermal cells are attacked by CD8+ cytotoxic T-cells

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20
Q

what are some triggers of erythema multiforme

A

idiopathic, medications, HSV infection, mycoplasma pneumonia

21
Q

what medications act as triggers for erythema multiforme

A

sulfa, penicillin, phenytoin, allopurinol, barbituates

22
Q

what histological features are seen early in erythema multiforme

A

superficial perivascular
lymphocytic infiltrate
dermal edema
accumulation of lymphocytes along dermoepidermal junction associated with degenerating and necrotic keratinocytes

23
Q

what histological features are seen late in erythema multiforme

A

lymphocytes migrate into epidermis, epidermal necrosis occurs with blister formation

24
Q

a target looking lesion is characteristic of what

A

erythema multiforme

25
Q

what does erythema multiforme appear as

A

erythematous macule and papule, vesicles and bullae (multiform) on extremities that are extremely symmetric

26
Q

what is stevens-johnson syndrome

A

more severe form of erythema multiforme

27
Q

steven’s johnson syndrome is common in what patients

A

children

28
Q

steven’s-johnson syndrome involves what sites commonly

A

mucous membranes (mouth and conductive)

29
Q

what systemic manifestations are founding Steven’s-johnson syndrome

A

fever, difficulty eating, renal failure, and sepsis

30
Q

what usually causes steven-johnson syndrome

A

sulfa drugs and anticonvulsants

31
Q

what is toxic epidermal necrolysis (TENs)

A

more severe than steven johnsons syndrome

dermatologic emergency

32
Q

how are steven’s-johnson syndrome and TENs treated

A

stop medication and take to burn unit and treat like burn

33
Q

what histological features are seen in TENs

A

necrotic epidermis is lifting off the dermis to form a subepidermal bulla

34
Q

pityriasis rosea is what

A

subacute spongiotic dermatitis

35
Q

pityriasis rosea is associated with what virus

A

human herpes virus type 7 (HHV7)

36
Q

pityriasis rosea affects what patients and when

A

children and young adults

during winter

37
Q

what is a “herald patch” and when is it seen

A

resembles ringworm and is seen initially in pityriasis rosea

38
Q

“christmas tree” pattern is used to describe what

A

pityriasis rosea

39
Q

what does pityriasis rose look like

A

starts with “herald patch”
progresses to generalized oval, slightly elevated, scaling pauses that resemble the herald patch but are smaller
lesions are pink with scaling near the border

40
Q

where is pityriasis rosea commonly found at what sites

A

trunk, upper arms, thigh

41
Q

what histological features are seen in pityriasis rosea

A

spingiosis with erythrocyte extravasation

42
Q

what does venous incompetence cause

A

increased hydrostatic pressure and capillary damage leading to extravasation of RBCs and serum

43
Q

venous insufficiency is a disease seen in what patients

A

middle age and older adults

44
Q

venous insufficiency starts as what and progresses to what

A

edema and hyperpigmentation

leads to pruritic erythema and stasis dermatitis

45
Q

what occurs in venous insufficiency

A

incompetent vneous vales in lower legs
leads to dependent edema
leads to stasis dermatitis
leads to ulceration above medial malleolus

46
Q

stasis dermatitis is what?

A

subacute spongiotic dermatitis

47
Q

what is seen in stasis dermatitis

A

chronic intracellular epidermal edema

48
Q

what gives the skin a thickened, rough, brown appearance in stasis dermatitis

A

erythrocyte extraversion cases hemosiderin to collect