Dermatology

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Anonymous
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145213
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Dermatology
Updated:
2012-04-02 07:41:14
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oral path tufts
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dermatology
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  1. Heat intolerance
    Hypohidroti E.Dysplas
  2. 2+ ectodermally derived structures fail to develop

    (skin, hair, nails, teeth, sweat glands)
    ectodermal dysplasia
  3. Ectodermal dysplasia demographic
    • x-linked inheritance
    • males
  4. Hypohidroti E. dysplasia signs
    • first= fever of unknown origin
    • sparse blond hair
    • reduced hair density & eyelashes
  5. Oral manifestations of E. Dysplasia
    • 1. xerostomia
    • 2. oligodontia (6+ missing)
    • 3. microdontia
  6. WSNevus inheritance
    • 1. autosomal dominant
    • 2. equal gender
  7. white, thickened, soft plaques on buccal mucosa
    --other sites possible
    W.S.Nevus
  8. W.S.Nevus other sites:
    • 1. nasal
    • 2. esophageal
    • 3. laryngeal
    • 4. anogenital
  9. W.S.N. biopsy
    • 1. hyperkeratosis
    • 2. acanthosis
    • 3. cytoplasmic clearing
  10. Perinuclear eosinophilic condensation
    W.S.Nevus
  11. fried egg appearance
    W.S Nevus
  12. NC triracial "isolate"
    HBID
  13. Native American indian, black and white mixed ancestry
    HBID
  14. Oral & conjunctival lesions
    HBID
  15. HBID ocular
    • 1. conjunctival mucosa w/ gelatinlus plaques
    • 2. spring onset
  16. Dyskeratosis "cell within a cell"
    HBID
  17. Oral txment for HBID
    • none
    • Ocular = refer
  18. hypermobility of joints
    ehlers-danlos
  19. increased contusions
    ehlers-danlos
  20. extreme elasticity
    ehlers-danlos
  21. vascular type of ehlers danlos
    type 3 collagen defect
  22. vascular type ehlers-danlos complications
    aortic aneurysms--> may lead to early death
  23. classic type ehlers - danlos
    • 80% of the time
    • types 1 and 5 collagen
  24. Gorlin's sign: hypermobility of tongue
    ehlers-danlos
  25. bruising
    bleeding
    TMJ subluxation
    ehlers-danlos
  26. pulp stones
    ehlers- danlos
  27. mental retardation /seizures
    tuberous sclerosis
  28. angiofibromas--> skin and nails
    tuberous sclerosis
  29. C.T. hamartomas
    tuberous sclerosis
  30. ash leaf spots
    tuberous sclerosis
  31. shagreeen patches
    tuberous sclerosis
  32. CNS hamartomas
    tuberous sclerosis
  33. cardiac rhabdomyoma
    tuberous sclerosis
  34. renal angio myolipoma
    tuberous sclerosis
  35. enamel pitting--facial, anterior teeth
    tuberous sclerosis
  36. fibrous papules on gingiva
    secondary gingival hyperplasia
    tuberous sclerosis
  37. tuberous sclerosis death
    • 1. CNS
    • 2. kidney
  38. desmososmes
    pemphigus vulagaris
  39. acantholysis
    p. vulgaris
  40. vesicles, bullae, erosions, ulcerations, skin loss, mucosa loss
    p. vulgaris
  41. p. vulgaris age onset
    • 50yr
    • equal gender
  42. + nikolsky sign
    p. vulgaris
  43. oral lesions= first sign
    p. vulgaris
  44. intraepithelial ancantholysis
    p. vulgaris
  45. tzank cells
    p. vulgaris (and herpes)
  46. tzanck cells
    • cels round in shape.
    • not polygonal
  47. acute & chronic inflammation
    p. vulgaris
  48. direct immunofluorence
    p. vulgaris
  49. P. vulgaris==need to rule out:
    • paraneoplastic
    • --malignant neoplasms
    • --lymphoma
    • --leukemia
  50. pemphagoid demographic
    • females
    • 60 yo
  51. p. vulgaris vs. pemphagoid
    • 1. both have + nikolsky
    • 2. pemphagoid: vesicles/bulla last longer
    • --mucosa heals w/o scaring
  52. 25% of pts w/ oral lesions develop conjunctival lesions
    pemphagoid
  53. Desquamative gingivitis seen in:
    • 1. pemphigus
    • 2. benign mucous membrane pemphigoid
    • 3. erosive lichen planus
    • 4. hypersensitivity rxn
    • 5. Linear IgA dx
    • 6. Lupus
    • 7. Epithelial dysplasia
  54. Subepithelial separation
    pemphigoid
  55. direct immunofluoresence
    pemphigoid
  56. 4 categories of epidymolysis bullosa
    • 1. simplex
    • 2. dystrophic
    • 3. jxnal
    • 4. hemidesmosomal
  57. Oral of dystrophic e. bullosa
    • 1. gingival lesions; erythema; recession
    • 2. reduction in vestibular depth
  58. mitten-like deformity
    e. bullosa (dystrophic)
  59. O. manifestations of e. bullosa
    • 1. soft diet
    • 2. microstomia
  60. Perinatal death
    (pitting enamel and oral ulcers)
    e. bullosa
  61. dystrophic e. bullosa txment
    • 1. topical abx
    • 2. plastic sx
    • 3. gastric tube, soft diet
    • 4. topical fluoride
    • 5. close follow-up
  62. pre-disposition to oral and skin cancer
    dystrophic type of e. bullosa
  63. collagen vascular dx
    lupus erythematosus
  64. 3 forms of lupus
    • 1. chronic cutaneous
    • 2. subacute
    • 3. systemic
  65. discoid lupus skin lesions
    • 1. scaly whit patches made worse by sunlight
    • 2. hypopigmentation or hyperpigmentation
  66. 50% butterfly rash seeen in
    systemic SLE
  67. Libman-sacks endocarditis
    lupus: systemic form
  68. renal failure= most serious complication
    lupus
  69. almost indistinguishable from erosive lichen planus
    lupus erythematosus--> striae may be thinner
  70. hyperkeratosis--> thinning of epithelial layer
    lupus erythematosus
  71. direct immunofluorescent
    lupus erythematosus
  72. 95% ANA
    70% Abs vs. dsDNA
    Abs to SM protein
    lupus
  73. Anti-malarial drug txment
    lupus
  74. refer to physicain for (w/ lupus):
    • 1. cardiac
    • 2. renal
  75. anti-malarial drugs cause
    palatal pigmentation
  76. lupus prognosis best for:
    discoid lupus
  77. dense collagen deposition--> females
    scleroderma
  78. raynaud's phenomenon= 1st sign
    scleroderma
  79. raynaud's triggers
    • 1. emo stress
    • 2. cold
  80. mask-like faces
    scleroderma
  81. fibrosis fo vital organs= fatal
    scleroderma
  82. board-like tongue & esophageal inelasticity
    scleroderma
  83. diffuse widening of pdl
    scleroderma
  84. coup de sabre
    scleroderma
  85. D-Penicillamine txment
    • scleroderma
    • --inhibits collagen production
  86. pulmonary death
    scleroderma
  87. types of lichen planus
    1. reticular--> lace-like --> wickham's striae

    2. erosive--> ulcer w/ red border
  88. negative nikolsky sign
    erosive lichen planus
  89. 4 ps of lichen planus
    • 1. purple
    • 2. pruritic
    • 3. polygonal
    • 4. papules
  90. lichen planus oral locations
    1. buccal mucosa
  91. most common lichen planus w/ oral manifestations
    reticular form
  92. hyperplastic lichenplanus --> location
    dorsal tongue
  93. types of l. planus
    • 1. reticular
    • 2. hyperplastic--> papules to plaques
    • 3. erosive---> ulcers
    • 4. bullous--> on skin
  94. Lichen planus Diff Dx:
    • 1. hyperplastic candidiais
    • 2. lichenoid drug rxn
    • 3. factitial injury
    • 4. oral hairy leukoplakia
    • 5. cancer/pre-cancer leukoplakia
  95. hyperkeratosis (no epithelial dysplasia)
    lichen planus
  96. "saw tooth" pattern
    lichen planus
  97. civatte bodies (colloid bodies)
    lichen planus
  98. direct immunofluorescene
    lichen planus
  99. lichen planus= prophylactically tx for:
    candidiasis
  100. E.M minor
    acute--> children and young adults
  101. EM Minor: 50% cases secondary to:
    • 1. herpes simplex
    • 2. mycoplasma pneumona
    • 3. hypersensitivity to drugs
  102. Target or iris lesions
    Erythema multiform
  103. self-limiting (2-6 wks)
    erythema multiform
  104. lip ulcers and crusting
    EMultiform
  105. stevens-johnson syndrome
    • EMajor
    • --toxic epidermal necrolysis (lyell's disease)
  106. geographic tongue predilection
    females
  107. atrophy of filiform papilla with serpentine border
    geographic tongue
  108. erythema migrans
    geographic tongue
  109. psoriasis histology
    geographic tongue
  110. Reiter's triad
    • 1. non-gonoccocal urethritis
    • 2. arthritis
    • 3. conjunctivitis
  111. Penis lesion looks like geographic tongue
    reiter's syndrome
  112. oral lesions 20% of time
    reiters
  113. autosomal dominant multiple hamartomas
    cowden's syndrome
  114. keratosis if palms & soles
    cowden's
  115. hair follicle lesion
    cowden's
  116. hemangioma
    lipoma
    cowden's
  117. papillomatoisis = 80% time
    cowden's
  118. thyroid gland neoplasia
    follicular adenoma
  119. mammary gland: clinical hypertrophy secondary to multiple fibroadenoma @ early age
    cowden's
  120. pendulous breasts
    cowden's
  121. 30-50% transformation to cancer by age 40
    cowden's
  122. fine velvety papillations w/ pigmentation esp w/ skin folds
    acanthosis nigricans
  123. benign form:
    1. diabetes
    2. addison's dix
    3. hypothyroidism
    4. acromegaly
    5. oral contraceptives
    acanthosis nigricans
  124. malignant acanthosis nigracans
    carcinoma of GI tract
  125. papillary lesions in lips, gingiva, tongue
    acanthosis nigricans
  126. acanthosis histology
    • 1. papillomatosis
    • 2. acanthosis
  127. txment for acanthosis nigricans
    • 1. none OR
    • 2. cosmetic rmoval

    ***malignant form= poor survival

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