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  1. type I HS rxn
    • anaphylactic and atopic, antigen cross links igE on pre-sens. mast cells, histamine release
    • drug reactions/wheal/asthma
  2. Type II HS Rxn
    • cytotoxic, igM and IgG bind antigen on enemy cell leading to lysis by complement or phagocytosis
    • AIHA, erythroblastosis fetalis, goodpasture, rheum fever
  3. Type III HS rxn
    • immune complex: antigen ab complexes activate complement, pmns come and release lysosomal enzymes
    • SLE, RA
  4. Serum sickness
    antibodies to foreign proteins are produced in ~5 days, immune complexes form and are deposited in membrane where they fix complement and cause damage, most caused by drugs no serum
  5. Type 4 HS rxn
    • sensitized t lympho encounter antigen and release lymphokinse leading to macrophage activation, delayed, cell mediated not antibody mediated
    • Tb skin test, contact derm, transplant rejection
  6. SJS/TEN
    • dont confuse with SSSS (kids, <6)
    • Drug causes: phenytoin, carbamazepine, quinolones, cephalosporins, allopurinol, cst, nsaids
    • SJS: degen of basal layer of epidermis
    • TEN: full thickness eosinophilic epidermal necrosis
    • SJS <10%, TEN >30%
  7. Bullous pemphigoid vs pemphigus vulgaris
    • B.P: blisters at BM, not in mouth, neg nikolsky, >60 yo, rare mortality, less severe, rx: cst
    • P.V. blisters intraepidermal, anti desmoglein Ab, +nikolsky, in mouth, 40-60, assoc with ace, penicillamine, phenobarb, penicillin
    • prednisone+IvIG, rituximab
  8. Molluscum contagiosum
    • young kids, HIV or dec cellular immunity
    • Waxy papules with central umbil
    • Dx by clinical, confirm by looking for inclusion/molluscum bodies
    • Rx: can do local destruction via freezing etc
    • Resolve spontaneously
  9. Ludwigs angina
    • bilateral cellulitis of submental/submaxillary and sublingual spaces, results from infected tooth
    • sx: dysphagia, fever, drooling, red warm mouth can lead to death from asphyx.
  10. SCC
    • AKs are precursirm crusting and ulceration, arsenic can cause multi SCC in palmoplantar distribution
    • rx: excise
  11. BSC
    • smooth, pearly, rolled edges
    • MC cancer, slow growing ,no met potential
    • excision, etc.
  12. Bacillary angiomatosis
    • baronella hensalae, mimics kaposi, must be excluded in KS patients
    • Rx: erythromycin
  13. Mycosis fungoides
    • cut T cell lymphoma
    • not a fungus, slow progressive neoplastic prolif of T cells
    • psoriatic appearing plaque that is palpable and possibly pruritic, likes butt
    • internal organs can be involved
    • sezary syn: leukemic phase
    • Dx: cerebriform lymphocytes
    • Rx: photothereapy
    • leonine facies
Card Set:
2013-07-13 15:08:22

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