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Dermatology 2 > The Motherload > Flashcards

The Motherload Flashcards

1
Q

What is the innermost layer of the Epidermis?

A

Stratum basale

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2
Q

What connects the cells together int he stratum spinosum?

A

Desmosomes

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3
Q

What 3 types of connective titsue are within the dermis?

A

Collagen
Elastic tissue
Reticular fibers

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4
Q

What later of the dermis is composed of thin, haphazardly arranged collagen fibers?

A

Papillary layer

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5
Q

What is the arrangement of the collagen in the reticular layer of the dermis?

A

parallel to the surface of the skin

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6
Q

What are the cells in the dermis that are macrophages that accumulate hemosiderin, melanin, and inflammatory debris?

A

Histiocytes

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7
Q

What cells in the dermis are arround blood vessels, anad release histamine and heparin?

A

Mast cells

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8
Q

What types of nerves innvervate the papillary dermis?

A

Unmyelinated nerve endings

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9
Q

What amplitude of stimulation will cause an itch sensation by inflammation?

A

Low intensity

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10
Q

A high intensity of stimulation of nerve endings by inflammation will give what sensation?

A

Pain

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11
Q

This is the type of lesion that most skin diseases begin with, and provides the initial orientation and aloows the formulation of a differnetial diagnosis?

A

Primary lesion

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12
Q

When do secondayr lesions develop?

A

During the evolutionary process of skin disease or are created by scrating or infection

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13
Q

What is the type of lesion characterized by a circumscribed flat discoloration that may be brown, blue, red, or hyperpigmented, and is a primary lesion?

A

Macule

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14
Q

What is the type of lesion characterized by an elevated solid lesion up to 0.5cm, may become confluent?

A

Papule

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15
Q

What is the type of lesion characterized by an circumscribed, elevated, superficial, solid lesion more than 0.5cm is diameter, and formed by the confluence of papules?

A

Plaque

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16
Q

What is the type of lesion characterized by a circumscribed, elevated, solid lesion more than 0.5 cm and resides within the dermis?

A

Nodule

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17
Q

What is the type of lesion characterized by a circumscribed collection of leukocytes and free fluid that varies in size?

A

Pustule

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18
Q

What is the type of lesion characterized by a circumscribed collection of free fluid up to 0.5cm and involves the superficial epidermis?

A

Vesicle

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19
Q

What is the type of lesion characterized by a circumscribed collection of free fluid more than 0.5 cm in diameter?

A

Bullae

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20
Q

What is the type of lesion characterized by a firm, edematous plauqe from infiltration of the dermis with fluid, are tranient and may last only a few hours?

A

Wheal

aka a hive

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21
Q

What is the type of lesion characterized by excess dead epidermial cells that are produced by abnormal keratinization and shedding?

A

Scale

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22
Q

What is the type of lesion characterized by a collection of dried serum and cellular debris, aka a scab?

A

Crust

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23
Q

What is the type of lesion characterized by a focal loss of epidermis, does not penetrate below the dermo-epidermial jxn, and heals without scarring?

A

Erosion

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24
Q

What is the type of lesion characterized by a focal loss of epidermis and dermis, and heals with scarring?

A

Ulcer

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25
Q

What is the type of lesion characterized by a LINEAR loss of epidermis and dermis with a sharply defined, nearly vertical walls?

A

Fissue

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26
Q

What is the type of lesion characterized by a depression in the skin from the thinning of the epidermis or dermis?

A

Atrophy

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27
Q

What is the type of lesion characterized by an abnormal formation of CT implying dermal damage?

A

Scar

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28
Q

What is the type of lesion characterized by a circumscribed lesion with a wall and a lumen, and the lumen may contain solid or fluid matter?

A

Cyst

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29
Q

What are the 2 vehicles for dry disease?

A

Emollient creams

Lotions

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30
Q

This is an exudative inflammatory disease that pours out serum that leaches the complex lipids and proteins from the epidermis?

A

Wet disease

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31
Q

In addition to debridement and antibacterials, what also must you do in the managmenet of a wet disease?

A

Wet compresses to suppress inflammation

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32
Q

You do repeated cycles of wetting and drying for a wet disease because you eventually want a wet lesion to turn into what other kind of lesion?

A

a DRY lesion

DERMATOLOGY. IS. AMAZING.

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33
Q

This is the vehicle that is a mixture of several different organic chemicals, and water, highly versitile, and has a possible drying effect?

A

Creams

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34
Q

This is the vehicle that is a limited # of organic compounds consisting primarily of greases (KY jelly) with little to no water.

A

Ointments

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35
Q

This is the vehicle that is a greaseless mixture of popylene glycol and water and is used for acute exudative inflammation (poison ivy) and on your scalp.

A

Gels

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36
Q

This is the vehicle that may contain water and other chemicals, used for the scalp.

A

Solutions/lotions

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37
Q

This is the vehicle that is used between strands of hair until they reach the scalp and then the foam melts and delivers the active drug.

A

Foams

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38
Q

What does coticosteroids do the small blood vessels in the upper dermis to induce an antiinflammatory response?

A

Vasoconstriction.

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39
Q

Rate the following cotricosteroids from weakest to strongest activity.

Hydrocortisone
Triamcinolone
Fluticasone
Betamethasone diproprionate
Clobestasol
Prednisone
A 
Hydrocortisone (weakest)
Prednisolone
Triamcinolone
Betamethasone diproprionate
Fluticasone
Clobetasol (strongest, group 1)

“Hi Peter, Try Bringing Fucking Cream”

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40
Q

This is the effective method for enhancing absorption of topical steroids by using a plastic dressing or a vinyl body suit.

A

Occlusion

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41
Q

Why do we always crave the moistness of the skin when delivering topical medication?

A

It can penetrate the stratum corneum (10-100x) more effectively than dry

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42
Q

If you use a vinyl body suit for the occlusion method, what inevitably happens?

A

I will laugh at you.

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43
Q

This is the condition where fair-skinned females complain of erythema with or without pustules after the application of topical steroids.

A

Steroid rosacea

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44
Q

If you get steroid rosacea, what inevitably happens?

A

I will discontinue the steroid

What did u think I was gonna say? IM NOT A MONSTER

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45
Q

This is when there is pustules, erythema, and scaling around the nose, mouth, and chin because of the application of topical steroids.

A

Perioral dermatitis

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46
Q

What happens to the dermis and epidermis with long term steroid use?

A

Thinning of the epidermis
Regression of CT in dermis

(Atrophy)

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47
Q

The atrophy of the skin from long term steroid use may reveal what 3 conditions?

A

Telangienctasia
Prominence of underlying veins
Hypopigmentation

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48
Q

What may cortisone creams to do the clinical prsentation of diseases?

A

Alter them and produce unusual atypical eruptions

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49
Q

This is when tinea of the groin spreads to involve a wider area after applying a group II corticosteroid.

A

Tinea incognito

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50
Q

What is the main Sx in the acute stage of eczematous inflammation?

A

SUPER ITCH

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51
Q

What are the lesions seen in acute exzemous inflammation?

A

Vesicles, blisters, intense redness

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52
Q

What causes acute eczematous inflammation?

A

Poison ivy, irridation, ID reaction, other stuff

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53
Q

This is the form of eczema where there is redness, scaling, fissuring, parchednessingableyed, and a scalded appearance.

A

Subacute eczematous inflammation

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54
Q

What are the main Sx to Subacute eczematous inflammation?

A

moderate itching, pain, stinging, burning

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55
Q

What causes Subacute eczematous inflammation?

A

Contact allergy, irritation, atopic dermititis, stasis dermatitis, other crap

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56
Q

What is the Tx for Subacute eczematous inflammation?

A

topical steroids with or without occlusion, lube, antihistamines, antibiotics, tar

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57
Q

Does Subacute eczematous inflammation resolve spontaneousy?

A

Yes, if irritative agent is withdrawn

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58
Q

This is the form of eczema where there is thickened skin, skin lines attenuated, excoriations, and fissuring.

A

Chronic eczematous inflammation

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59
Q

What is the main Sx in Chronic eczematous inflammation?

A

Moderate-intense itch

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60
Q

What are the main etiologies for Chronic eczematous inflammation?

A

Atopic dermatitis, habitual scratiching, lichen simplex chronicus, chapped feet, other eczema stuff.

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61
Q

What is the Tx for Chronic eczematous inflammation?

A

Topical steroids and other stuff

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62
Q

What are the initial changes to cause irritant contact dermatitis?

A

Dryness and chapping

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63
Q

What occurs over the creases in irritant contact dermatitis?

A

Painful cracks and fissues, especially at the fingertips

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64
Q

This is the form of dermatitis on the backs of the hands, where there is erythema, edema, vesiculation, crusting, excoriation, scaling, and lichenification.

A

Atopic hand dermatitis

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65
Q

What main worsen the Sx in Atopic hand dermatitis?

A

Scratching

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66
Q

This is the form of dermatitis where there is an area of inflammaton that corresponds exactly to the area covered by the allergen.

A

Allergic contact dermatitis

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67
Q

This is the form of eczema where there there is red plaques with thin, long, horizontal superficial fissues that appear with excess drying, especially in the winter months.

A

Asteatoic eczema

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68
Q

This is the form of eczema where there is several coin-shaped plaques on the back of the hands

A

Nummular eczema

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69
Q

This is the form of self-inflicted dermatoses where there is focal erosions and scars, being crazy and thinking there are parasites, and being a woman over 50.

A

Psychogenic parasitosis

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70
Q

This is the form of self-inflicted dermatoses where there is random lesions, the pt denies that they did it, from PTSD/depresison/abuse with a “hollow history”

A

Factitial dermatitis

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71
Q

This is the form of self-inflicted dermatoses where there is repetitive self excoiation, pt knows they do it, OCD/depression/stressors.

A

Neurotic excoriations and acne excoriee

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72
Q

This is the form of self-inflicted dermatoses where there is constant scratching, plaques, severe itch, triggered by sress, and lasts forever.

A

Lichen simplex chronicus

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73
Q

This is the form of self-inflicted dermatoses where there is 0.5-1cm itchy noduels on arms or legs, severe pruritis, interferes with sleep, and has a thick epidermis.

A

Prurigo nodularis

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74
Q

This is an eczematous eruption that occurs on the lower legs in some pts with venous insufficiency.

A

Stasis dermatitis

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75
Q

What type of hypersensitivity is contact dermatitis?

A

IV

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76
Q

What cells are the main APCs to cause sensitization to a Ag in contact dermatitis?

A

Langerhans cells

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77
Q

What is the stage of contact dermatitis where there is re-exposure of the Ag, causing dermatitis within 12-48 hours and persistance for 3-4 weeks?

A

Elicitation phase

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78
Q

True or False: the pattern of inflammation usually corresponds exactly to the shape of the offending substance in contact dermatitis.

A

True

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79
Q

This is the form of dermatitis which is an allergic dermatitis caused by poison ivy, poison oak, or poison sumac.

A

Rhus dermatitis

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80
Q

What is the Tx for Rhus dermatitis?

A

Wet compresses, topical steroids, and prednisone

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81
Q

True or False: latex allergies can manifest as a irritant contact dermatitis, type I and type IV HS rreactions.

A

true

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82
Q

What metal causes metal allergies and baboon syndrome?

A

Nickel

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83
Q

What type of HS is metal allergy?

A

IV

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84
Q

This is the method to determine if a specific substance causes allergic inflammation to the skin by production of a local allergic rxn.

A

Patch testing

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85
Q

This is the condition where there is chronic, pruritic, eczematous disease that always begins in childhood and follows a remitting/flaring course that may continue throughout life.

A

Atopic dermatitis

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86
Q

What causes atopic dermatitis?

A

Combo of environmental, immunologic, genetic, and drugs.

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87
Q

What happens to the cheeks in the infant phase of atopic dermatitis?

A

Dry, red, scaling areas to the cheeks

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88
Q

What happens to the lips in the infant phase of atopic dermatitis?

A

habitual licking –> oozing, crusting, and scaling

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89
Q

What area of the body is spared in infant phase of atopic dermatitis?

A

Diaper area

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90
Q

Where are the eczema in the childhood phase of atopic dermatitis?

A

Flexural areas

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91
Q

What is the most common pattern to the inflammation in the adult phase of atopic dermatitis?

A

Localized inflammation with lichenfication

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92
Q

This is the associated feature of atopic dermatitis where there is a disorder of ketatinization characterized by the development of dry, rectangular scales.

A

Ichythyosis vulgaris

“Ichthys” from the ancient greek root meaning “fish” because this has scales.

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93
Q

This is the associated feature of atopic dermatitis where there is small rough follicular papules or pustules that appear at any age and are common in young kids.

A

Keratosis pilaris

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94
Q

This is the associated feature of atopic dermatitis where there is accentuation of the major skin creases of the palms.

A

Hyperlinear palmar creases

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95
Q

This is the associated feature of atopic dermatitis where there is asymptomatic, hypopigmented, slightly elevated, fine scaling plaques with distinct borders.

A

Pityriasis alba

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96
Q

This is the associated feature of atopic dermatitis where there is an extra line on the lower eyelid.

A

Atopic pleats

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97
Q

What eye problem occurs in 10% of atopic dermatitis pts?

A

Cataracts

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98
Q

In 1 word, what sums up the triggers for atopic dermatitis?

A

Irritation

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99
Q

What drugs are used to treat atopic dermatitis by controlling inflammation?

A

Steroids like hydrocotisone, Nonsteroidals like Creams and Tacrolimus

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100
Q

What antibiotics are given for the treatment of atopic dermatitis?

A

Cephalexin and cefadroxil

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101
Q

What class of drugs are Doxepin HCl cream and Zonalon cream, which are used for the treatment of atopic dermatitis?

A

Antihistamines

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102
Q

What type of light therapy can be used for the treatment of atopic dermatitis?

A

UVA and UVB

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103
Q

These are hives or wheals; circumscribed, erythematous or white, nonpitting, edematous, usually pruritic plaque that changes in size and shape by peripheral extension or regression during the few hours or days that the individual lesion exists

A

Urticaria

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104
Q

What is the main mediator for Urticaria, where it causes vascular fluid leaks and tissue edema and wheal formation?

A

Histamine from mast cells

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105
Q

What are the 3 things that histamine produces to cause a Urticaria?

A

Local erythema (vasodilation)
Flare (erythema)
Wheal (fluid)

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106
Q

What R does histamine act on to cause vasodilation, axon reflex, and wheal?

A

H1

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107
Q

What is the effect from histamine binding to H2 to cause Urticaria?

A

Vasodilation

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108
Q

What type of HS rxn causes mose Urticaria?

A

Type I

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109
Q

This is the hivelike swelling caused by increased vascular permeability in the subQ tissue of the skin and mucosa.

A

Angioedema

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110
Q

True or False: angioedema and hives often occur together and have the same etiology.

A

True

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111
Q

What are the 3 main differences between hives and angioedema?

A

Angioedema has more diffuse swelling, no itching, and affects the lips, palms, soles, limbs, trunk, and genitalia.

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112
Q

This is the disease produced by exposure to drugs, monoclonal Ab therapy (rituximab), blood products, or animal-derived vaccines.

A

Serum sickness

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113
Q

What gets trapped in the walls of organs and activates the complement in serum sickness?

A

Ag-Ab complexes

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114
Q

What type of HS reaction is serum sickness?

A

III

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115
Q

In addition to systemic signs, what SKIN signs occur from serum sickness?

A

Morbilliform rash or urticaria limited to the trunk (or generalized)

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116
Q

What type of acne is simple and is divided into open or closed comedones (clogged hait follicles)?

A

Noninflammatory

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117
Q

What are the 2 lesions that are seen in inflammatory acne?

A

Nodules

Papules

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118
Q

What is the MOA for tretinoin and isotretinoin?

A

Normalization of the pattern of follicular keratinization

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119
Q

What is the MOA for benzoyl peroxide, topical antibiotics, oral antibiotics, and isotretinoin (indirectly)?

A

Antibacterial

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120
Q

What is the MOA for esterogens, oral corticosteroids at very low dose, isotretinoin, and anti-androgens?

A

Inhibit sebaceous gland fxn

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121
Q

What is the MOA for intralesional corticosteroids, oral corticosteroids, NSAIDs, and antibiotics?

A

Antiinflammatory effect

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122
Q

What causes the transition from a closed comedo –> open comedo?

A

Pore dilation

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123
Q

What causes the transition from a closed comedo –> papule?

A

follicle wall thins and accumulates P. acnes

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124
Q

What is the main treatment for comedonal acne?

A

Benzoyl peroxide

and retinoids at bedtime

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125
Q

What is the main treatment for mild inflammatory acne?

A

Topical antibiotics

+ BP and a retnoid

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126
Q

What is the main treatment for moderate acne?

A

Systemic antibiotics (tetracycline, doxycycline)

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127
Q

What is the main treatment for severe acne?

A

Accutane (isotretinoin)

I took this stuff and dear jezus it drys the shit outta your skin.

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128
Q

What is the newer retinoid which is more effective than tretinoin, but can only be used for short contact so u gotta wash it off right away?

A

Tazarotene

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129
Q

What is the drug that has tretinoin like activity in terminal differentiation processes of hair follicle, and is for mild-moderate acne?

A

Adapalene

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130
Q

What is the the drug that is antikeratinizing, antibacteria, antiinflammatory, and used for noninflamm and inflamm acne and used with other antibiotics?

A

Azelaoic acid

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131
Q

What is the antibiotics that produces a drying effect and releases radical oxygent hat oxidizes bacterial proteins, and is used for inflammatory acne?

A

Benzoyl Peroxide

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132
Q

This is the condition where there is a Distinctive eruption in young women, resembles acne, erythematous papules and pustules around the mouth but spares the skin immediately around the mouth

A

Perioral dermatitis

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133
Q

What is teh treatment for perioral dermatitis?

A

Tetracycline or erythromycin

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134
Q

This is where there are clusters of papules and pustules on red, swollen, telangiectatic skin of cheeks and forehead.

A

Rosacea

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135
Q

Is rosacea related to alcohol use?

A

Nah

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136
Q

This is where there is Eccrine sweat duct occlusion causes rupture and leakage into surrounding tissue, which induces an inflammatory response in response to heat.

A

Miliaria rubra

Heat rash

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137
Q

What form of miliaria rubra has sweat accumulates under the stratum corneum, looks like a clear dew drop?

A

Crystallina

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138
Q

What form of miliaria rubra is deeper in the intraepidermal section, and causes an erythema from inflammatory response?

A

Rubra

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139
Q

What form of miliaria rubra occurs after several bouts of rubra, occlusion of the dermal section?

A

Profunda

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140
Q

What is the inheritance pattern for psoriasis?

A

AD

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141
Q

What are the lesions like in psoriasis?

A

red scaling plaque, silvery scale, bleeding when removed (auspitz sign)

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142
Q

What is it called when there are psoriasis between ur butt cheeks?

A

Gluteal pinking (no scales)

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143
Q

This is when there is brand new psoriasis after trauma.

A

Koebner phenomenon

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144
Q

What 4 drugs exasterbate psoriasis?

A

Li
Beta blockers
Anti-malarials
Systemic steroids

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145
Q

This is the form of psoriasis where there is a chronic, noninflammatory plaque anywhere on the skin, and they can enlarge,

A

Chronic plaque

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146
Q

This is the form of psoriasis where there is deep pustules on the mid portion of the palms and soles, can be local or spread, dont rupture but are brown in scaly, in smokers.

A

Palm and sole

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147
Q

This is the form of psoriasis where there is crusting of 1 therapy.

A

Acordermatitis continua

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148
Q

This is the form of psoriasis where there is psoriasis in the flexural or intertriginous areas, cracking or fissuring?

A

Inverse

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149
Q

This is the form of psoriasis where there is a scaling plauq on the trunk and extremitis after a viral URT, resolves in months.

A

Guttate

150
Q

This is the form of psoriasis where there is koebner and gluttate lesions, painful, diffusely inflammed plaques in sun-exposed areas.

A

Light

151
Q

What is the favorite sport for psoriasis?

A

Scalp

152
Q

This is the form of psoriasis where there is separation of the nail bed in an irregular pattern, and there is yellowing of the nail.

A

Oncycholysis

153
Q

This is the form of psoriasis where there is retaining of the nail bed but forcing the distal nail to separate, similar to a fungal infeciton.

A

Subungual debris

154
Q

This is the form of psoriasis where there are tiny, punched-out depressions in the nail plate surface, from under the cutucle out of the nail?

A

Pitting

155
Q

This is the form of psoriasis where there is cellular debris and serum accumulation in the nail plate due to separation.

A

Oil spot lesions

156
Q

What join anomality can present in psoriasis pts?

A

Arthritis

157
Q

What class of drugs is psoriasis most responsive to?

A

Steroids

158
Q

What drug for psoriasis is a vitamin D analog, inhibits epidermal cell prolifereation and enahnces cell differentiation?

A

Calcipotriol

159
Q

What is the goal for rotational therapy for psoriasis?

A

Minimize long-term toxicity and allow affective Tx for many years

160
Q

What is the rotational therapy drugs?

A

start with phototherapy (UVB) –> methotrexate –> other form of radiation –> another oral agent –> and so on.

161
Q

What causes seborrheoic dermatitis?

A

Malasseiza ovalis

162
Q

The sudden onset of multiple seborrheic keratosis suggests what visceral anomaly?

A

GI cancer

Leser trelat sign

163
Q

What is the condition where there are common, benign, self-limiting skin eruption, itching, looks like ringworm, looks like dropping pine tree branches.

A

Pityriasis rosea

164
Q

What are the lesions like in Lichen Planus?

A

Papule
Purple
Polygonal
Postinflammatory

165
Q

What disease is Lichen Planus associted with?

A

HCV

166
Q

This is the condition where there is transient acantholytic dermatosis, in men over 60, atopy and dry skin, pruritic papules and vesicles on the chest that are exasterbated by the sun, and is seen in Sesame Street?

A

Grovers disease

167
Q

What is the cause of honey crusted lesions on the face?

A

S. aureus

bullous impetigo

168
Q

What causes non bollous impetigo, where there are lesions around the mouth/nose?

A

S. pyogenes then S. aureus

169
Q

What can Group A strep, S. aureus, Hib cause where there is marked ertyhema, warmth, edema, and pain?

A

Cellulitis

170
Q

This is when there is lymphatic involvement (streaking) on the face, very high fever, tense hot, burning, itching, and pain.

A

Erysipelas

171
Q

What causes Erysipelas?

A

Group A strep

172
Q

This is when there is infection of subcutaneous tissue which results in destruction of fascia and fat

A

Necrotizing fasciitis

173
Q

This si wehn there is inflammation of hair follicle caused by infection, chemical irritation, or physical injury and will present with a painless or tender pustules that will heal.

A

Folliculitis

174
Q

This ia boil/abscess, which is a walled off collection of pus that is painful, firm, or can fluctuate, typically from S. aureus.

A

Furuncles

175
Q

This is an aggregate of infected follicles, forms a broad, lesion that will drain through multiple openings.

A

Carbuncle

176
Q

This is the lesion that caused by the gram positive rod Erysipelothrix rhusiopathiae, and is a potential infection that increased in risk with those that handle meat/animal products, and expands centrifugally over 3-4 days?

A

Erysieploid

177
Q

What are the main skin disorders in HIV?

A

A lot of things.

178
Q

What is the common treatment of verruca vulgaris?

A

Topical salicyclic acid, liquid N2, and light elecrocautery

179
Q

What is the common treatment of recalcitrant warts?

A

Imiquimod and apple cider vinegar

180
Q

What can be added to vaseline to soak the wart, which has no scientific proof of success?

A

Apple cider vinegar

181
Q

What is the DOC for primary herpes?

A

ACV

182
Q

What is thet ransmision for VZV?

A

Respiratory droplets or direct contact

183
Q

What is the lesion characteristics of a VZV?

A

trunk –> face and extremities
Dewdrop on a rose petal
different stages

184
Q

What is teh DOC for children with severe VZV?

A

ACV

185
Q

What is teh DOC for VZV in IC pts if it’s resistnat to ACV?

A

Foscarnet

186
Q

What causes atheletes foot?

A

Tinea pedis

187
Q

What is the manifestation of tinea pedis where there is chronic scaly infection of plantar surfaces.

A

Plantar hyperkeratoic or Moccasin-type

188
Q

What is the DOC for interdigital tinea pedis?

A

Terbinafine 1% cream

189
Q

What is the route of administration for terbinafine for hyperkeratoic tinea?

A

Oral

190
Q

What is the form of heel infection which is actually bacterial, causes circular or longitudinal punched-out lesions with hyperhidrosis, and from D. congolensis, and Micrococcus sedentarius.

A

Pitted keratolysis

191
Q

What is the oral antifungal for foot crap?

A

Fluconazole with irtraconazole

192
Q

This is the syndrome where there is dermatophyte infection of BOTH feet and ONE palm, in men, and from T. rubrum.

A

2 feet-1 hand syndrome

193
Q

What causes jock itch?

A

Tinea cruris

194
Q

What form of T. cruris occurs in moist environemnts, obesity, pain, longitudinal fissues, and sharp borders?

A

Intertrigo

195
Q

What form of T. cruris occurs from a bacterial infection, has halfmoon plaque, noninflammatory, brown and scaly, no advancing border?

A

Erythrasma

196
Q

What 2 classes of meds can be used for the treatment of T. cruris?

A 
Fungicidal allylamines (naftilile and terbinafine)
Fungistatic azoles
197
Q

What pattern of T. capitis causes black dots, where the arthrospores remain inside of the ahir shaft?

A

Endothrix pattern

198
Q

What do the arythrospores do the hair shaft to cause the ectothrix pattern of T. capitis?

A

they dislodge forming a sheath of closely packed spheres

199
Q

This is the form of T. capitis where there is a large spored endothrix, noninflammatory black dot pattern, with well-demarcated areas of hair loss?

A

Trichophyton tonsurans

200
Q

What form of T. capitis has a + skin test to the Trichophyton Ag, has gross looking patches on ur head?

A

Inflammatory tinea capitis (kerion)

201
Q

What is teh topical cream given for T. capitis?

A

Ciclopiroxolamine or terbinafine cream

202
Q

What should you always give in addition to a topical cream for T. capitis?

A

Oral

griseofulvin*, terbinafine, itraconazole, fluconazole

203
Q

What causes Tinea versicolor?

A 
Pityrosporum orbiculare
Pitryosporum ovale (aka M. furfur)
204
Q

What do u see on KOH prep for M. furfur?

A

Spaghetti and Meatballs

205
Q

What are the 2 DOC for M. furfur?

A

Ketoconazole shampoo

Selenium sulfide

206
Q

What is teh class of drugs used to treat fungal infections that butenfine, naftifine, and terbinafine belong to?

A

Allylamine/Benzylamine

207
Q

What can allylamines only treat?

A

Dermatophytes

208
Q

What is teh class of drugs used to treat fungal infections that clotrimazole, econazole, ketoconazole, miconazole, oxiconazole, sulconazole belong to?

A

Imidazole

209
Q

What 2 types of infections does imidazoles treat?

A

Dermatophytes and yeasts

econazole also treats bacteria

210
Q

What is teh class of drugs used to treat fungal infections that ciclopiroxolamine belongs to?

A

Pyridone

211
Q

True or False: pyridone can treat dermatophytes, yeasts, AND bacteria.

A

True

212
Q

What is the only type of infectiosn that nystatin treats?

A

Yeasts

213
Q

Which antifungal binds to tubulin, inhibits mitosis and binds to keratin?

A

Griseofulvin

214
Q

Which drugs inhbiit the enzyme lanosterol 14 a-demethylase, thus inhbiitng the synthesis of ergosterol?

A

Azoles (ketoconazole, fluconazole, itraconazole)

215
Q

Which drugs inhibit squalene epoxidase, thus inhibiting the synthesis of ergosterol?

A

Allylamines (terbinafine)

216
Q

What is the route of administration for miconazole?

A

Vaginal suppository

Cream

217
Q

What is the route of administration for nystatin?

A

Vafinal tablet

218
Q

What is the route of administration for Clotrimazole?

A

Vaginal tablet

219
Q

What is the route of administration for fluconazole and itraconazole?

A

Oral tablet

220
Q

What causes 5th disease/slapped cheeks?

A

Parvivirus B19

221
Q

What is teh appearance of the eryuthema in slapped cheek fever?

A

Fishnet like pattern

222
Q

What is teh syndrome of 5th disease in adults, where ther eis a sudetn onset of systemic polyarthropathy of moderate severity, resembling RA and SLE?

A

Polyarthropathy syndrome

223
Q

What are the most important diagnostic tests for parvovirus B19?

A

Anti-parvovirus B19 IgM and IgG

224
Q

In which cells does HHV6 remain latent in?

A

Monocytes/macrophages

225
Q

What are the Sx to roseola infatum?

A

High fever –> eruptive rash all over the body

226
Q

What happens to WBC levels in roseola?

A

Leukocytosis at the onser of fever, lymphocytosis as the temp increases

227
Q

A skin-sensitizing Ab to ampicillin will cause waht lesions?

A

Urticarial

228
Q

What is the most common type of ampicillin rash, where there is no allergic basis?

A

Exanthematous maculopapular reaction

229
Q

Which populations are at risk for scabies?

A

people subjected to overcrowding, low economic standards, poor hygiene, shcoolkids

230
Q

What is the most effective OTC drug used to treat pediculosis?

A

Permethrin cream

231
Q

What are the 2 possible early cutaneous manifestations of Lyme disease?

A
  1. Erythema migrans

2. Borrelia lymphocytoma

232
Q

What is the possible later cutaneous manifestation of Lyme disease?

A

Acrodermatitis chronica atrophicans

233
Q

What is the DOC for Lyme, except for kids < 8 and preggers?

A

Doxy

234
Q

What is the DOC for kids and preggers for Lyme disease?

A

Amoxicillin

235
Q

What is the DOC for RMSF?

A

Doxy

236
Q

What is the DOC for RMSF in preggers?

A

Chloamphenicol

237
Q

What are the 4 DOC for cat-scratch fever in IC pts?

A

Cipro
Erythromycin
Rifampin
Gentamycin

238
Q

What is the disease where there is superficial vesicles and bullae which rupture easily and leave shallow erosions covered with serum and crust?

A

Pemphigus vulgaris

239
Q

What form of pemphigus presents as superficial vesicles and bullae which rupture easily and leave shallow erosions covered with serum and crust?

A

P. foliaceaus

240
Q

What are the Abs directed ahainst to cause Bullous Pemphigoid?

A

Hemidesmosomes

241
Q

Where in the body are the lesions common for pemphigus vulgaris?

A

Oral mucosa

242
Q

This is the sign in pemphigus vulgaris, where the application of pressure to small intact bullae causes the fluid to dissect laterally into the midepidermal areas altered by bound IgG.

A

Nikolskys sign

243
Q

True or False: the bullae in Bullous Pemphigois rupture easier than the blisters in pemphigus.

A

False

they dont.

244
Q

These are edematous plaques occur in crops on the abdomen and extremities and coalesce into bizarre polycyclic rings covering wide areas of the skin in pregnancy.

A

Herpes gestations

245
Q

What are the HLA’s associated with herpes gestations?

A

DR3 and DR4

246
Q

Where are the Ab’s directed in cicatricial pemphigoid, which cuases chronic subepidermal blisterine and scarring?

A

Lamina lucida

247
Q

This is a rare chronic subepidermal mucocutaneous blistering disease characterized by skin fragility and spontaneous, trauma-induced blisters that heal with scar formation and milia.

A

Epidermolysis bullosa acquisita

248
Q

Approx 50% of Epidermolysis bullosa acquisita pts get this condition, where there is tense blisterns on an erythematous base, pruritis, minimal skin fragility, and healing of some of the lesions without scarring and milia.

A

Bullous pemphigoid-like EBA

249
Q

This is a rare, , autosomal dominant, intraepidermal nonscarring bullous disease characterized by erosions, blisters, and warty papules in areas exposed to UV light and areas of friction and maceration.

A

Benign familial chronic pemphigus

250
Q

What is the lesion morphology in Benign familial chronic pemphigus?

A

Red border with pale center

251
Q

This is a clinically distinct subset of cases of lupus erythematosus that is most often present in white women aged 15 to 40, consisting of skin lesions that are scaly.

A

Subacute cutaneous erythematous

252
Q

Where are the common target lesions in erythema multiforme?

A

Lips and buccal mucosa

253
Q

What is the rare form of erythema muiltiforme where there is flat, atypical target or purpuric maculae, fever, and Nikolskys sign?

A

SJS

254
Q

What is the complication of SJS where there is general detachment of the epidermis through dermoepidermal jxns, resulting in a fullthickness loss of epidermis?

A

TEN

255
Q

What is the most common cause of erythema nodosum in the west?

A

Coccidiomycosis

256
Q

What GI disease is assocaited with erythema nodosum?

A

UC

257
Q

What drugs can cause erythema nodosum?

A

Sulfonamides
Bromides
Oral contraceptives

258
Q

This is the acute febrile neutrophilic dermatosis, where there is fever, leukocytosis, acute tender plaques, and infiltration of neutrophils.

A

Sweet’s syndrome

259
Q

What typically precedes Sweet’s syndrome?

A

URI

260
Q

What happens to the ESR and ALP and neutrophil levels in Sweet’s syndrome?

A

theyre elevated

261
Q

This is the vasculitic syndrome where there is wt loss, myalgias, arthropahy, skin nodules and ulcers, HBV marker, granulocytes in the artery wall, and +p-ANCA?

A

PAN

262
Q

This is the vasculitic syndrome where there is nodules in lungs, hematuria, and ulcers in nasal muscosa, and +c-ANCA?

A

Wegeners

263
Q

This is the vasculitic syndrome where there is asthma, eosinophilia, ↑ IgE, and +p-ANCA?

A

Churg Strauss

264
Q

This is the vasculitic syndrome where there is GI bleeding, purpura, IgA complex deposition.

A

HSP

265
Q

This is the vasculitic syndrome where there is neuropathy, abd pain, arthralgia, palpable purpura, maculopapular rash, elevated ERS, hematuria, and protienuria?

A

Hypersensitivity Vasculitis

266
Q

This is a group of diseases caused by inborn enzymatic defects in heme biosynthesis pathway that results in an excess of a specific porphyrin.

A

Porphyrias

267
Q

Every porphyria is AD except for what 2, which are AR?

A

ADP

CEP

268
Q

What is the more common type of vitligo, where there are symmetric white macules with well-defined borders, especially on the back of the hands, face, and body folds?

A

Type A

269
Q

Which type of vitiligo is nondermatomal, has halo nevi, Koebner phenomenon, and is associated with immunologic diseases?

A

Type A

270
Q

Which exam tecnique accentuates hypopigmented areas and are useful in people with light complexions for vitiligo?

A

Woodlight

271
Q

What is the treatment for generalized vitiligo?

A

UVB therapy

272
Q

What is the treatment for local vitiligo?

A

Topical corticosteroids

273
Q

What is the treatment for facial vitiligo?

A

Excimer laser as an alternative to UVB

274
Q

The following characteristics describe which lesion, seborrheic keratosis or malignant melanoma?

varies in elevation and color, density, and shade.

A

MM

275
Q

Since keratoacanthomas can be hard to distinguish from SCC, how should they be treated?

A

Treat them like they are SCC

276
Q

What are the lesion characteristics for Seborrheic keratosis?

A

Tiny round, embedded pearls or rough, dry + cracked surface

277
Q

What are the lesion characteristics for skin tags?

A

Tiny brown, broad to narrow stalks, can increase and darken

278
Q

This is a hard, conical projection composed of keratin, resembling an animal horn.

A

Curaneous horns

279
Q

True or False: keloids are enlargements of scars that remain within the margins of injury.

A

FALSE

they extend BEYOND the margins of injury

280
Q

What is the main tissue that makes up keloids?

A

Collagen

281
Q

What infection does keratoacantoma lesions look like?

A

Molluscum contagiosum

282
Q

Where on the body are keratoacantomas common?

A

Limbs

283
Q

This is a well-circumscribed growth at birth, round, oval or oblong, elevated, flat topped, yellow-tan to dark brown, and have uniformly wart or velvety surface with sharp borders.

A

Epidermal nevus

284
Q

What are the “lines” that epidermal nevi like to follow?

A

Blaschko lines

285
Q

These round, protruding, smooth surfaced MOVABLE masses, and can originate from a comedone.

A

Epidermal cyst

286
Q

These are sweat duct tumors composed of small, firm, flesh colored dermal papules, typically around the eye?

A

Syringoma

287
Q

What is the msot common malignant cutaneous neoplasm in humans?

A

BCC

288
Q

What is the main risk factor for BCC?

A

UBV radiation

289
Q

Which cells does BCC originate?

A

Basal keratinocytes

290
Q

What is the most common form of BCC, where there is a pink, dome-shaped papule resemblind a molluscum contagiosum or dermal nevus?

A

Nodular BCC

291
Q

What is the cycle of nodular BCC< starting as an oval mass?

A

Oval mass –> ulceration and bleeding –> crusting and scaling –> scaring –> cycle begins again.

292
Q

Which type of BCC contains melanin, making it dark, and has telangiectasias?

A

Pigmented BCCs

293
Q

What is the worst form of BCC, where there is a waxy, FIRM, pale white scar-like lesion?

A

Sclerosing/Morpheaform BCC

294
Q

Why is morpheaform so bad?

A

There is deep extension with subtle outer appearances

295
Q

What is the least aggressive BCC, where there is a circumscribed, red, scaling plaque, thin, raised, and pearly white?

A

Superficial BCC

296
Q

What is the syndrome where there are multiple BCCs at birth, have small pits on palms and soles, jaw cysts, and skeletal problems?

A

Nevoid BCC syndrome

297
Q

What are the histological characteristics of BCCs?

A

resemble basal layer of epidermis, basophilic, large nucleus, palisading.

298
Q

What is the SCC confined to the epidermis?

A

Actinic Keratosis (AK)

299
Q

What is the biggest risk factor for AK?

A

Sun

300
Q

What does UV radiation cause in the skin to causes AK?

A

p53 mutations

301
Q

What is the lesion morphology in AK?

A

Sandpaper texture with yellow scales

302
Q

What form of AK is a hypertrophic AK that accumulates eratin to become a conical hyperkeratoic protuberance?

A

Cutaneous horn

303
Q

What form of AK resembles a scaling lentigo, subrrheic keratosis, or melanoma.

A

Spreading pigmented

304
Q

What form of AK occurs on the lower lips, are rough, scale, red, and fissue?

A

Actinic chelitis

305
Q

What are the histological features of AK?

A

large pleomorphic nuclei and acidophilic cytoplasm, faulty cornification with dyskeratoic cells and parakeratosis, no follicular involvements

306
Q

What is it called when AK invades through the dermoepidermal jxn?

A

SCC lol

307
Q

What is the cream that is a immune response modifier that induces CMI cytokines to treat superficial BCC?

A

Imiquiomod 5% cream (aldara)

308
Q

What type of BCC is 5-FU used to treat?

A

Superifical BCC

309
Q

Generally, what are the 2 treatments for low risk BCC?

A

D&C

Excision

310
Q

Generally, what are the 2 treatments for high risk BCC?

A

Mohs microsurgery

Radiation

311
Q

What is the treatment of choice for most isolated superficial AKs?

A

Cryotherapy

312
Q

What treatmetn for AKs is good for superficial AKs but has a long inflammation period?

A

5-FU

313
Q

What is the premalignant lesion of the oral mucosa, white, and is strongly assocaited with smoking?

A

Leukoplakia

314
Q

If there is leukoplakia at the floor of the mouth, what is the common cause?

A

Smoking

315
Q

What is the aggresive form of leukoplakia where there is hyperkeratosis –> spreads to become multifocal and verruciform –> malignant?

A

Proliferative verrcocuous leukplakia

316
Q

Which leukoplakia is on the lateral congue, cant be scraped off, hair, AIDS pt, EBV and HPV?

A

Hairy leukoplakia

317
Q

What is the cogential multisystem disorder, characterize by skin pigmentation, dystrophic nails, and leukoplakia?

A

Dyskeratosis congenita

318
Q

What is the only predictor for leukoplakia development into oral carcinoma?

A

DNA content (ploidy)

319
Q

Though must leukoplakias regress spontaneously, what drug can be used for the vulva and the lip?

A

5-FU

320
Q

What is the cause of Paget disease of the breast?

A

Ductal carcinoma

321
Q

What is the gross appearance of Paget boob?

A

erythema of nipple + serous drainage –> spreading –> late ulceration

322
Q

What stain differentiates Paget from MM?

A

Alcian blue

also PAS+

323
Q

This is a rare cutaneous adenocarcinoma of the skin, typically on the labia majora.

A

Extramammary Pagets Disease (EMPD)

324
Q

What is the cause of secondary EMPD?

A

Underlying adnexal carcinoma and visceral malignancies

325
Q

What is the gross appearance of EMPD?

A

Unilateral, well-demarcated, eczematous or erythematous plaque

326
Q

What is the main assocaited for EMPD?

A

Lichen sclerosis

327
Q

What are the histological characteristics of EMPD?

A

intraepithelial clusters of large round cells with oval vesicular nuclei and increased pale-staining cytoplasm

328
Q

What is the treatmetn for EMPD?

A

Cut

it

out

329
Q

These are benign tumors of nevus cells that are derived from melanocytes

A

Melanocytic nevi

330
Q

What form of MM is the most common, on the trunk in men and legs in women, irrgular borders, flat, and changes color?

A

Superficial spreading

331
Q

What form of MM is rapdily growing, on trunk and legs, brown/black, ulcerates and bleeds?

A

Nodular

332
Q

What form of MM is located on the head and arms, slow growth, superficial initially, and at in 4-15% of MM?

A

Lentigo maligna melanoma

333
Q

What form of MM is is the lowest prevalence, mainly in blacks/asians/hispanics, on palms and soles, and under nail (Hiutchinsons sign)?

A

Acral lentiginous melanoma

334
Q

What are the clark levels I-V?

A

Level I - tumor limited to epidermis (malignant melanoma in situ)
Level II - tumor invading into but not filling papillary dermis
Level III - tumor invading into and filling papillary dermis
Level IV - tumor invading into reticular dermis
Level V - tumor invading into adipose tissue of subcutis.

335
Q

At what TNM stage determines regional metastases?

A

III

I and II are local

336
Q

Where does stage IV MM’s spread?

A

distant sites

337
Q

This is a big ass red telangiectatic nodule on ur head.

A

Superficial hemangioma

338
Q

Which form of vascular anomaly does not undergo hyperplasia with rapid proliferation?

A

Vascular malformation (nevus flemmeus)

339
Q

Which neurocutaneous syndrome is characterized by arteriovenous malformations in the spinal cord, agnokeratomas of the skin, and has neurologic signs of cord compression?

A

Cobb syndrome

340
Q

Which neurocutaneous syndrome is characterized by IL capillary angioma in branches of V, angiomas of meninges, MR, epilepsy, hemiparesis, and visiual impairment?

A

SWS

341
Q

Which neurocutaneous syndrome is characterized by telangiectasias, angiomas in brain, pulmonary AV anastamoses, and hemorrhages in GI tract?

A

OWR syndrome

342
Q

Which neurocutaneous syndrome is characterized by angiokeratomas, XR, CVAs , stooped psoture, slender limbs, varicose vv, and scant facial fair?

A

Fabry-anderson disease

343
Q

Which neurocutaneous syndrome is characterized by AR telangiectasias in sun exposed areas, ataxia, ocular telangiectasias, MR, sinopulmonary infections, low IgA?

A

Ataxia telangiectasia

344
Q

Which neurocutaneous syndrome is characterized by AD, power wine stains, cafe-au-lait spots, cerebrllar hemangioclastoma and cyst, retinal hemangiomas, pheochromcytomas, and polycythemia?

A

vHL

345
Q

What is the cause of bacillary angiomatosis?

A

B. quintana and B. henselae

346
Q

Waht are the origin of Kaposi sarcoma?

A

Vascular neoplasms from HHV8

347
Q

These are permanently dilated, small blood vessels consisting of venules, capillaries, or arterioles.

A

Telangiectasias

348
Q

This is a scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase.

A

Telogen effluvium

349
Q

True or False: in Telogen effluvium, the follicle is not disease but has had its biological clock reset and undergoes a normal involutional process

A

True

350
Q

True or False: scarring and inflammation are typically absent in Telogen effluvium

A

True

351
Q

This is the abrupt loss of hair from follicles that are in their growing phase

A

Anagen effluvium

352
Q

This is hair loss that occurs due to an underlying susceptibility of hair follicles to androgenic miniaturization

A

Angrogenic alopecia

353
Q

What type of male baldness classification is triangular frontotemporal recession occurs normally in most young men and women after puberty

A

Type II

354
Q

What is the DOC for balding, which increases the duration of anagen, causes follicles at rest to grow, and enlarges miniaturized follicles?

A

Minoxidil (rogaine)

355
Q

Which drug blocks 5a-reductase, inhibing the synthesis of DHT, and treats hair loss?

A

Finasteride

356
Q

What is the most likely diagnosis in a woman with moderate or severe hirsutism and elevated testosterone level?

A

PCOS

357
Q

What drug is an irreversible inhibitor of ornithine decarboxylase, an enzyme that catalyzes the rate-limiting step for follicular polyamine synthesis, which is necessary for hair growth?

A

Eflornithine

358
Q

What is the use of Eflornithine?

A

topical cream used to treat hirsutism of the face in women

359
Q

This is the painless separation of the nail from the nail bed in psoriasis and hyperthyroidism pts.

A

Oncholysis

360
Q

What is it called in lichen planus, where there is adhesion of a depressed proximal nailfold to the scarred matrix?

A

Pterygium

361
Q

What is it called when you constantly biting or picking of a section of the proximal nailfold of the thumb with the index fingernail?

A

Habit tic deformity

362
Q

What is Habit tic deformity related to?

A

OCD or trichotillomania (pull out and eat your hair)

363
Q

These are the trasnverse depressions of all of the nails that appear at the base of the lunula weeks after a stressful event that has temporarily interrupted nail formation.

A

Beau’s lines

364
Q

What are the common associations of Beaus lines?

A

syphilis, uncontrolled diabetes mellitus, myocarditis, peripheral vascular disease, & zinc deficiency

365
Q

What are the 2 main associations for yellow nail syndrome?

A

Lymphedema and/or chronic respiratory manifestions

366
Q

What is the main mediator to cause fingernail clubbing in hypoxic conditions?

A

VEGF

367
Q

These are the white or light pink nails with a distal band, and is assocaited with cirrhosis, chronic congestive heart failure, adult-onset diabetes mellitus, and age.

A

Terrys nails

368
Q

DM or HIV are associations for what skin condition?

A

Granuloma annulare

369
Q

Insulin-resistant states, hyperandrogenic states, obesity, and pituitary disorders are associations for what skin condition?

A

Acanthosis nigricans

370
Q

Hypertriglyceridemia, type I, II, IV, and DM are associations for what skin condition?

A

Eruptive Xanthomas

371
Q

NF1 and NF2 are associations for what skin condition?

A

Neurofibromatosis (cafe au lait spots)

372
Q

Breast CA, follicular thyroid CA, macroencepthaly, and other CAs are associations for what skin condition?

A

Cowden disease

white oral papules

Dermatology 2 (1 decks)

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