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44 Cards in this Set
- Front
- Back
What skin disorder is a chronic disease, characterized by recurrent exacerbations and remissions of scaly papules & plaques? |
Psoriasis |
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What is the most definitive HLA association with psoriasis? |
HLA-Cw6
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What is the term to describe that any area of trauma to the skin can cause a psoriatic plaque? |
Koebner's reaction |
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50% of children get exacerbation of psoriasis after what? |
2-3 weeks of URI |
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Guttate psoriasis is an example that can follow what type of infection? |
Acute streptococcal infection |
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What is a possible medication trigger for psoriasis?
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Lithium or beta-blockers |
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What might be confusing about sunlight with psoriasis? |
Sunlight is reported to be beneficial |
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Persistent TH1 activation is a/w which skin disorder? |
Psoriasis |
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What are the clinical features of psoriasis? |
-sharply demarcated, erythematous plaques, papules and patches |
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What is the most common form of psoriasis?
Where does it commonly occur? |
Psoriasis Vulgaris (erythematous plaques w/ silver)
(SNAKES)- Scalp, nails, anogenital, knees, elbows, sacrum |
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Which form of psoriasis has a sudden appearance of small red/pink scaly papules on skin (almost like small drops of PSA on skin) diffusely over trunk and extremities? |
Guttate Psoriasis |
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Which (more serious) form of psoriasis has an abrupt eruption of numerous sterile pustules on highly erythematous skin? |
Generalized Pustular Psoriasis (of Von Zumbusch) |
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Which form of psoriasis begans as pustules on the distal fingers and is VERY tender? |
Acrodermatitis continua of Hallopeau |
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Which types of nail changes can occur usually after Psoriasis Vulgaris (10-20% pts)? |
Nail matrix: pitting/ crumbling/thickening |
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What are some possible trigger factors for generalized pustular psoriasis (of Von Zumbusch)? |
infections, rapid tapering of corticosteroids, hypocalcemia, pregnancy |
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What are possible treatments for Psoriasis? |
Topical agents (corticosteroids, corticosteroid sparing agents, Vitamin D3 analogues) |
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Which topical agent should be used AFTER UV light therapy?
What is the neg SE of PUVA? |
Vit D3 analogues
risk of developing squamous cell carcinoma |
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What are the clinical features of Pityriasis Rosea? |
-Pink/salmon colored, oval in shape w/ inner central “collarette” of fine scale around lesion.* |
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What disorder is an idiopathic inflammatory disease that affects the skin, hair, nails and mucous membranes (genitals & mouth)? (flat topped papule) |
Lichen Planus |
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What are the clinical features of Lichen Planus? |
-5 P's*: Pruritic**, Planar, Polyangular (irregular angular borders), Purple, Papules -Pterygium= triangular nail scar= angel wing, trachyonychia= distal nail splitting -Koebner Phenomenon may occur (assoc w HCV) |
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Autoimmune Blistering Diseases (AIBDs) result from the production of what? |
autoantibodies that attack a specific adhesion protein in the skin that is responsible for either: |
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Pemphigus causes intraepidermal blisters. Is rupture more common in PV or PF (types)? |
PV
-bc blister above the basal layer of epidermis, easier rupture = more serious |
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What are the clinical features for Pemphigues Vulgaris (PV)? |
-Mainly affects adults, life-threatening
-Characteristic skin lesion: Oral mucosal lesions, FLACCID, thin walled bullae that are easily ruptured
-Healing: brown hyperpigmentation WITHOUT scarring
-Histology: intraepidermal, suprabasilar "tombstoning"
-AutoAbs: desmoglein 1 & 3 |
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What 3 ways can you tell Pemphigous Foliaceous/Superficial Foliaceous (PF) from PV? |
-Blister occurs higher in epidermis |
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What are the clinical features of Bullous Pemphigoid? |
-Elderly pt -Widespread TENSE subepiderimal bullae -AutoAb's: BP Ag 1 (BP230) & BP 2 (BP180) -Eosinophils |
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An 83 year old man (or woman) taking LASIX & SULFA drugs, presents with tense blisters that itch. This is most likely... |
Bullous Pemphigoid |
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What is the treatment for BP?
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Corticosteroids and immunosuppressants
– Oral steroids – Azathioprine – Mycophenolate mofetil – Nicotinamide – Tetracycline |
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Which skin disease is almost ALWAYS a/w gluten sensitivity? |
Dermatitis Herpetiformis
(clinical manifestation of celiacs dz) |
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What are the clinical features of Dermatitis Herpetiformis? |
-SEVERELY PRURITIC grouped subepidermal blisters* w. neutrophils & eosinophils in upper dermis |
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How is DH treated?
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Gluten free diet* |
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Why is it important to consider the location of the lesion in Allergic Contact Dermatitis?
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The ACD reaction is typically LOCALIZED to the area of skin that comes in contact with the allergen
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What are the top 2 allergens for ACD?
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1. Nickel sulfate 16.7% * (nickel ranked as top allergen by NACDG)
2. Neomycin sulfate 11.6%* (found in OTC topical antibiotic Neosporin*) |
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T/F
Latex is a common allergen for ACD. |
True!
This is found in surgical gloves. Alternatives are vinyl or blue nitrile gloves. |
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What type of ACD is caused by Poison Ivy, Poison Oak, or Poison Sumac?
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Rhus Dermatitis
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Describe lesions of Rhus Dermatitis.
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Often pruritic*
Streaky or linear** Also may be marked by hives or blisters* |
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What is the name of a phototoxic reaction that is caused by plant contact with skin that is THEN exposed to light (light activates the photosensitive chemical)?
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Phytophotodermatitis
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Describe the lesions of phytophotodermatitis.
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-Lesions typically appear several hours after exposure followed by burning erythema and development of vesicles/bullae*
-Lesions are asymmetric, of atypical shape and can be streaky -Later, a residual hyperpigmentation occurs |
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The most common areas for skin tags are where?
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the axilla (48%) followed by the neck (35%)
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What is a cutaneous horn?
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A hard, keratin projection
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Describe dermatofibromas.
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Benign, hard nodule
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Name for a painful (can be exquisitely tender), red, inflamed lesion on helix of ear.
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Chondrodermatitis Nodularis Helicis
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What is the best treatment for keratoacanthomas?
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Surgical removal! also helps rule out SCC, since they are difficult to distinguish
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Describe a pyogenic granuloma.
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Fragile and bleed easily
Glistening, moist-to-scaly surface |
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What is the difference between a hypertrophic scar and a keloid?
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Hypertrophic scars are inappropriately large, but they are CONFINED to the wound site and REGRESS with time.
Keloids EXTEND beyond the margins of injury. |