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69 Cards in this Set
- Front
- Back
List the 4 diseases classified under Blistering (Bullous) Diseases
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1. Pemphigus Vulgaris
2. Bullous Pemphigoid 3. Dermatitis Herpetiformis 4. Epidermolysis Bullosa |
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Subcorneal = beneath the Stratum Corneum layer
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What type of blister is this?
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Suprabasal = roof & base of the blister are Keratinocytes
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What type of blister is this?
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Subepidermal = base is connective tissue, roof is basal layer of keratinocytes
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What type of blister is this?
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Define Pemphigus Vulgaris
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Autoimmune bullous disease mediated by cytotoxic antibody (IgG) to Desmoglein (protein in desmosomes) that results in dyshesion
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What type of blister does Pemphigus Vulgaris cause?
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Intra-epidermal blister = Suprabasal
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What does the DIF look like in Pemphigus Vulgaris?
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lace-like pericellular IgG in epidermis
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What does the DIF look like in Pemphigus Vulgaris?
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lace-like pericellular IgG in epidermis
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Pemphigus Vulgaris
-suprabasal acantholytic blister |
What blistering disease is this?
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Pemphigus Vulgaris
-IgG & complement encircling epidermal cells |
What blistering disease is this from?
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Pemphigus Vulgaris:
1. most common age? 2. Where do blisters commonly occur 3. Treatment? |
1. 30-50 years of age
2. scalp, mucous membrane, periumbilical, intertriginous areas 3. Prednisone + Immunosuppressive agents |
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Define Bullous Pemphigoid
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autoimmune bullous disease mediated by antibodies to 2 basement membrane glycoproteins in the Lamina Lucida (IgG ab's to hemidesmosomes)
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What type of blister does Bullous Pemphigoid produce?
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Epidermal-dermal interface blister = SUBEPIDERMAL
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What does the DIF look like in Bullous Pemphigoid?
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Linear deposition of IgG & C3 along the dermal-epidermal jxn
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Bullous Pemphigoid
-subepidermal bullae -perivascular infiltrate of |
What blistering disease is this?
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Bullous Pemphigoid
-linear band of complement & IgG deposition along BM |
What blistering disease is this?
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What are the clinical features of Bullous Pemphigoid?
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MC affects men > 60 years old
Large & tense blisters Blisters on medial thighs & flexor aspect of the forearm |
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A 51-year-old man presents with painful blisters over his entire body. He notes that he currently has several blisters in his mouth as well. A blister appears when you rub his skin with your finger. Skin biopsy demonstrates acantholysis.
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Pemphigus Vulgaris
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What type of hypersensitivity reaction are Bullous Pemphigoid & Pemphigus Vulgaris
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Type II HS = Cytotoxic
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What is the treatment for Bullous Pemphigoid?
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Corticosteroids
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Bullous Pemphigoid
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What disease?
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Bullous Pemphigoid
-subepidermal bullae -perivascular infiltrate of eosinophils & lymphocytes |
What blistering disease?
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Blistering disease strongly associated with Gluten sensitivity (Celiac Disease) in individuals w/ HLA-B8 & HLA-DRw3
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Dermatitis Herpetiformis
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Blistering disease in which IgA to Gliadin cross-react or these immune complexes deposit at the tips of Dermal Papilla
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Dermatitis Herpetiformis
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Dermatitis Herpetiformis
-fibrin & neutrophils accumulate selectively at the tips of dermal papillae forming microabscesses |
What blistering disease is this?
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Dermatitis Herpetiformis
-granular deposits of IgA localized in the tips of Dermal Papillae |
What blistering disease is this?
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Dermatitis Herpetiformis
Celiac disease |
What blistering disease? What is it associated with?
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Dermatitis Herpetiformis
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Intensely pruritic cutaneous eruption
Urticaria-like plaques & small vesicles over the extensor surfaces of the body |
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What is the treatment for Dermatitis Herpetiformis?
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Gluten-free diet
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What is Epidermolytic (simplex) Epidermolysis Bullosa?
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Gene mutations in Keratins 5 & 14 in the basal keratinocytes
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What is Junctional Epidermolysis Bullosa?
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Gene mutation in Laminin in the Basement Membrane (Lamina Lucida)
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What is Dermolytic (Dystrophic) Epidermolysis Bullosa due to?
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Gene mutation in Collagen Type 7 (beneath the lamina densa)
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Epidermolysis Bullosa
1. Where do blisters tend to form? 2. When is this disease usually noted? |
1. at sites of minor trauma
2. at birth or shortly thereafter |
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Epidermolysis Bullosa
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What is this?
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This disorder of epidermal appendages is a result of phsiologic hormonal variations & alterations in hair follicle maturation
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Acne vulgaris
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Describe the pathogenesis of Acne Vulgaris
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Bacterial lipases of Propionibacterium acnes -> liberating highly irritating fatty acids -> expanding mass of lipid & keratin within the mid portion of the hair follicle -> distended follicle = Comedone
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Describe the 2 types of Acne Vulgaris
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1. Noninflammatory
-Obstructive-closed comedos = whiteheads -Open comedos = Blackheads 2. Inflammatory -follicular rupture -> extensive acute & chronic inflammation -> scarring |
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Acne vulgaris
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What is this?
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Acne Vulgaris
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What is this?
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What skin disease is characterized as a Panniculitis (inflammation of subcutaneous fat)?
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Erythema Nodosum
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Erythema Nodosum
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Self-limited, tender and erythematous nodules usually on the anterior portion of the shins
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Inflammation of the fibrous septa of the subcutaneous tissue with Giant cells at the interface between the septa & adipose tissue
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Erythema Nodosum
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What triggers Erythema Nodosum?
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Drugs or Microorganisms = exogenous agents
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Erythema Nodosum
-Inflammation in the fibrous septa of the subcutaneous tissue, and giant cells at the interface between the septa and adipose tissue |
What is this showing?
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What is the cause of Verrucae?
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Human Papilloma Virus (HPV)
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What is the cause of Verruca Vulgaris?
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HPV 1, 2, 3, 4
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Verruca vulgaris caused by HPV 1-4
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What is this?
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Verruca Vulgaris
-papillomatous epidermal hyperplasia -hyperkeratosis -parakeratosis -hypergranulosis -KOILOCYTES |
What is this?
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Verruca vulgaris staining for HPV
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What is seen here?
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Flat wart on the face or dorsal surface of hands, smaller than verruca vulgaris; caused by HPV 3
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Verruca Plana
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Warts on the soles & palms caused by HPV 2
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Verruca Plantaris & Palmaris
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Venereal wart caused by HPV 6, 8, 11, 16, 18
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Condylomata Acuminatum
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Condylomata Acuminatum
HPV 6, 8, 11, 16, 18 |
What is seen here? What is the cause?
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What is Condylomata Acuminatum associated with?
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Dysplasia & In-situ Squamous Cell Carcinoma
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What is the cause of Molluscum Contagiosum?
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Poxvirus
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Firm, pruritic, pink to skin-colored umbilicated papules
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Molluscum Contagiosum
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Molluscum Contagiosum
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What is seen here?
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Molluscum Contagiousum
-large, eosinophilic cytoplasmic inclusion bodies (molluscum bodies) in the cells of the Stratum Granulosum & Corneum |
What is this?
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Impetigo:
1. contagious or not? 2. what are most caused by? |
1. highly contagious, usually in children, face, & hands
2. S. aureus & Strep pyogenes (happy kendall?) |
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What is the pathology of Impetigo?
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Erythematous macule, multiple small pustules, pustules break -> shallow erosions -> covered with drying serum = Honey-colored crust)
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What is the characteristic microscopic feature of Impetigo?
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accumulation of neutrophils beneath the stratum corneum (subcorneal pustule)
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What is blister formation in Impetigo related to?
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a toxin that specifically cleaves the Desmoglein I
-usually due to S. aureus |
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Impetigo
S. pyogenes |
What is seen here? What is the most common cause?
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What skin layer are Superficial Fungal Infections confined to? What are they caused by?
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Stratum Corneum
Dermatophytes |
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Superficial Fungal infections
-mild eczematous dermatitis |
What is shown here?
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Superficial Fungal Infections
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What is seen here?
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Superficial Fungal Infection
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What is seen here?
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Human mite that causes pruritic erythematous streaks
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Scabies
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Scabies
-epidermal tunnels filled with basophilic granular debris and arthropod eggs |
What is seen here?
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