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Derm Flashcards

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1
Q

comparison of epidermis PT, FT, adult and significance

A

PT < FT < adult

increased permeability and water loss

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2
Q

comparison of dermis PT, FT, adult and significance

A

less collagen elastic fibers
PT < FT < adult

greater elasticity and tendency to blister

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3
Q

comparison of melanosomes PT, FT, adult and significance

A

PT < FT < adult
increased photosensitivity

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4
Q

comparison of eccrine glands PT, FT, adult and significance

A

PT = anhidrosis
FT = decreased activity for 1-7 d and neuro control at 3 years

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5
Q

comparison of sebaceous glands PT, FT, adult and significance

A

PT < FT < adult

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6
Q

comparison of hair PT, FT, adult and significance

A

PT = lanugo
FT = decreased terminal hair

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7
Q

comparison of SFA:volume PT, FT, adult and significance

A

PT > FT > adult
water loss
increased transcutaneous penetration

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8
Q

erythema toxicum confirmation

A

eosinophils on Wright staining
some have peripheral eosinophilia

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9
Q

stages of neonatal pustular melanosis

A
  1. small non inflammatory without erythema; birth
  2. ruptures with surrounding hyperpigmented macule
  3. hyperpigmented macule (up to 3 months)
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10
Q

neonatal pustular melanosis confirmation

A

neutrophils by wright staining

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11
Q

miliaria confirmation

A

sparse squamous cells and lymphocytes by wright staining

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12
Q

what causes milia

A

small epidermal inclusion cysts - retension of keratin and sebaceous material

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13
Q

pathogenesis of neonatal acne

A

previously 2/2 androgens
now maybe malassezia

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14
Q

pathogenesis of infantile acne

A

sebaceous gland hyperplasia - androgen stimulation

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15
Q

onset of neonatal and infantile acne

A

2-3 weeks vs 3-4 months

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16
Q

treatment of neonatal and infantile acne

A

neonatal - none

infantile - may require treatment to prevent scarring; may need to evaluate for CAH

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17
Q

epidemiology of neonatal and infantile acne

A

neonatal 20%; M > F

infantile M>F

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18
Q

bullous impetigo

A

first few days
honey crusting
s. aureus
Tx = antibiotics

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19
Q

SSSS

A

exotoxin s.aureus (group 2 phage)
+ nikolsky
+/- conjunctivitis and nasal congestion
fluid is sterile
culture nasopharynx, conjunctiva, skin and blood
antibiotics
NO scarring

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20
Q

histology of bullous impetigo vs SSSS

A

BI =
intradermal bullae with PMNs

SSSS = no inflammatory cells on histology
separation of granular layer

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21
Q

types of epidermolysis bullosa

A

junctional
simplex = epidermolytic
dystrophic = dermolytic

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22
Q

comparison of scarring in EB types

A

J = atrophic
S = without
D = yes

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23
Q

etiology of EB types

A

J = dermal-epidermal junction
S = intra-epidermal blisters
D = intradermal blisters (type 7 collagen decreased; increased collagenase)

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24
Q

genetics of EB types

A

J = AR
S = AD
D = AR or AD

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25
clinical presentation of EB types
J = birth, short life span, BMP abnormal, pyloric stenosis S = brith, heal quickly, mild course D- birth, AR type more severe, cyles of blistering, infection and scarring, hair loss, anemia, dysphasgia
26
incontinentia pigmenti genetics
XL Dominant; lethal for males in utero
27
stages of incontinentia pigmenti
1. linear inflammatory vesicles (eosinophils) birth - 4 mos 2. pigmented warts on red base 3. hyperpigmented streaks and whorls trunk and limbs first year 4. linear hypopigmented streaks - atrophic
28
associated defects in incontinentia pigmenti
cns eye - retinal vascular proliferation dentitia
29
classification of vascular tumors vs vascular malformations
tumors - proliferating endothelium malformation = normal endothelial turnover; error in vasculogenesis (slow or fast flow)
30
infantile hemangioma epi
F > M PT > FT 90% by second month face MC location
31
evolution of infantile hemangioma
increase between 1-5 months stable decrease by 1 year 50% gone by 5 75% by 7
32
PHACES
Posterior fossa brain malformation (Dandy Walker complex or cerebellar hypoplasia) Hemangiomas on face Arterial abnormalities in cerebral artery Cardiac (often aorta) Eye (posterior segment abnormality, persistant fetal vessel, retinal Sternal clefting
33
PHACES epi
F > M
34
nevus flammeus simplex
aka salmon patch (capillary malformation) may darken with crying a/w beckwith wiedenmann
35
port wine stain
similar to nevus flammeus unilateral Sturge Weber, Klippel Trenaunay Weber, Beckwith Weidemann, Cobb (cutaneomeningospinal angiomatosis)
36
blue-rubber bleb nevus syndrome
multiple venous malformations risk of coagulopathy
37
cutis marmorata
a/w tri 18, 21, cornelia de lange, hypothyroid cold stress diffuse reticulated erythematous patter resolve with warming (cutis marmorata telangiectatica congenital does not resolve wiht warming)
38
harlequin color change
dependent side turns red lasting few seconds to 30 minutes temperature imbalance
39
hypopigmented lesions a/w
pku chediak higashi albinism TS hypomelanosis of ito
40
albinism pathophysiology
AR if complete; partial aka piebaldism is AD deficiency of tyrosinase thus limited melanin production
41
hypomelanosis of ito
aka incontinentia pigmenti achromians not genetic like IP
42
waardenburg
AD lateral canthus confluent eyebrows congenital deafness white forelock
43
cafe au lait a/w
NF mccune albright (bone dysplasia, endocrine) LEOPARD TS Silver-Russell
44
congenital dermal melanocytosis a/w
3% remain into adulthood a/w gangliosidosis type 1 and hunter syndrome
45
nevus of ota vs ito
ota - face; trigeminal nerve 1 and 2 distribution ito - shoulder, supraclavicular, neck, arm, scapula, deltoif
46
xeroderma pigmentosa
- AR - low **endonuclease** - decreased ability to repair DNA - risk BCC, SCC, melanoma - cutaneous and ocular **photosensitivity** - DX: **fibroblasts** stressed with UV = chromosomal breakage assessed
47
mastocytosis
infiltration of mast cells mastocytoma : MCC urticaria pigementosa diffuse cutaneous mastocytosis
48
Familial lentiginosis syndromes:
LEOPARD Peutz-Jeghers
49
LEOPARD
Lentigines EKG defects Ocular hypertension Pulmonary stenosis Abnormal GU Restricted growth Deafness
50
Peutz-Jeghers
AD mucocutaneous pigmentation on lips and buccal mucosa risk of polyps in GI tract
51
hypertrichosis a/w
tri 18 cornelia de lange turner mucopolysaccharisosis
52
hypotrichosis
incontinentia pigmentosia ectodermal dysplasia
53
fine light colored hair
tyrosinemia homocystinuria tri 21 pku
54
nail dysplasia
tri 13 or 18 acrodermatitis enteropathica EB turner carbamazepine, hydantoin, warfarin
55
nail hypertrophy
rubinstein taybi
56
aplasia cutis
tri 13 or 4p
57
hamartomas
increased deposition of tissue components to the local organ epidermal nevus nevus sebaceous of Jadassohn
58
epidermal nevus
overgrowth of keratinocytes in epidermis linear wart like lesions a/w: skeletal ocular CNS
59
nevus sebaceous of jadasohn
excessive sebaceous glands solitary well circumscribed yellow/orange/hairless cobblestone waxy plaque
60
ichthyosis and types
abnormal keratinization congenital AR epidermolytic hyperkeratosis AD vulgaris AD x linked XLR lamellar AR
61
which ichthyosis associated with increased stratum corneum
all except epidermolytic
62
which ichthyosis associated with increased granular layer
congenital epidermolytic
63
which ichthyosis associated with sulfatase deficiency
XL
64
which ichthyosis associated with defect in profilaggrin?
vulgaris
65
collodion
shiny tight scale --> thickended corneum desquamate until 2-3 weeks support with humid environment risks: hypernatremia dehydration, infection
66
harlequin ichthyosis
- AR - oral retinoids may help - ectropion secondary to rigid skin around eyes - abnormal ears and nose - PT > FT
67
ectodermal dysplasia
- excessive desquamation MC = XL hypohidrotic ectodermal dysplasia - frontal bossing - depressed nasal bridge - periorbital wrinkling and hyperpigmentation - hypoplastic gum ridges and everted lips - decreased hair and sweat - increased asthma, allergies, eczema normal IQ
68
cutis laxa
generalized elastolysis decreased resiliency, droopy skin AD - mild AR- CDH and emphysema XL - bladder/GI diverticulum, NDI, protuberance of occiput, hip dysplasia
69
ehlers danlos
hyperextensible skin, joint hypermobile intestinal and bladder diverticulum umbilical/inguinal hernias scoliosis aortic aneurysm
70
leiners syndrome aka nethertons
- erythematous - desquamatic dermatitis - ftt - diarrhea - infections - functional complement 5 abnormality - abnormality of hair shaft circumflexa “bamboo hair”
71
histology of subcutaneous fat necrosis
granulomatous reaction in fat with giant cells, fibroblasts, lymphocytes and histiocytes
72
neonatal lupus rash
anti Ro , anti La, anti U1RNP round or elliptical lesions with central clearing worses with phototherapy persists until 6-8 months when maternal Abs disappear
73
causes of pustules
staph listeria gbs
74
causes of vesicles
staph listeria gbs pseudomonas herpes vzv
75
causes of bullae
staph syphillis
76
causes of maculopapules
staph strep fungal measles enterovirus rubella syphillis
77
causes of cellulitis
strep
78
causes of impetigo
strep
79
causes of abcesses
staph strep e coli candida
80
causes of pyoderma grangrenosum
pseudomonas
81
causes of blueberry muffin rash
rubella cmv coxsackie parvo ttts hemolytic disease hereditary spherocytosis neoplastic infiltrative disease leukemia
82
GPC on gram stain
bullous impetigo - staph
83
psudeohyphae or yeast spore on KOH or gram stain
candida
84
eos on wright stain, negative gram stain
erythema toxicum
85
multinucleated giant cells on tzanck smear
herpes
86
squamous cells or lymphocyes in wright stain negative gram stain
miliaria
87
keratinosis debris, pmns on wright stain negative gram stain
neonatal pustular melanosis
88
mites, ova, feces on mineral oil preparation
scabies
89
bullae with no inflammatory cells/sterile
SSSS
90
treponema dark field examination
syphillis
91
biotin deficiency skin findings
alopecia intertriginous and perioral dermatitis scaling seborrhea
92
linoleic acid deficiency skin findings
alopecia scaling intertriginous dermatitis decreased wound healing
93
niacin deficiency skin findings
mucositis, hyperpigmented
94
protein deficiency skin findings
scaling hypopigmentation peripheral edema
95
pyridoxine deficiency skin findings
intertriginous and perioral dermatitis mucositis
96
riboflavin deficiency skin findings
intertriginous and perioral dermatitis mucositis
97
vit A deficiency skin findings
generalized scaling
98
vit c deficiency skin findings
poor wound healing bleeding gums
99
zinc deficiency skin findings
acrodermatitis enteropathica AR FTT alopecia diaper dermatitis ocular rash risk candida and staph
100
infiltration vs extravasation
infiltration = non vesicant extravasation = vesicant
101
pathophysiology of extravasation
1. large fluid volume compressing tissue 2. direct vesicant contact 3. severe vasoconstriction
102
which vesicant extravasation should you not try to treat with hyaluronidase
inotropes
103
medications used for treatment of extravasations
hyaluronidase phentolamine (decreases local vasoconstriction)
104
Aquagenic wrinkling of the palms
CF
105
why should you not give platelets in Kasabach Meritt?
trapped in lesion and further platelet activation
106
PHACE most common CHD
coarctation
107
MC site of neonatal psoriasis
scalp
108
vernix components
stratum corneum (corneocytes) and sebaceous glands (sebum)
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