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DisKo
Hypersensitivity Type IV
Delayed-Type Hypersensitivity
T Cell Mediated
Antibody Independant
Macrophages Activated
Examples
Transplant Rejection
PPD Skin Test
Contact Dermatitis
1 min
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
1 min
Hypersensitivity Type II
Cytotoxic
IgM or IgG antibody-mediated
Membrane Attack Complex (MAC)
Mechanism
Opsonization
Complement Activation
NK Cells
Testing
Direct Coombs test
Indirect Coombs Test
1 min
Syphilis
Mechanism
Treponema pallidum
Assessment
Primary Stage
Painless Chancre
Secondary Stage
Rash on Palms and Soles
(Generalized) Lymphadenopathy
Condylomata Lata
Latent Stage
Asymptomatic
Tertiary (Late) Stage
Aortitis
Neurosyphilis
Gummas
Interventions
Penicillin
Jarisch-Herxheimer Rash
3 mins
Atopic Dermatitis / Eczema
Presentation
Pruritic Vesicles
Inflammatory Skin Rash
Cheeks in Children
Skin Flexural Areas
Associated with Asthma and Allergic Rhinitis
Treatment
Tacrolimus
Moisturizers
Corticosteroids
Phototherapy
Avoid Triggers
Antihistamines
2 mins
Vitiligo
Pathophysiology
Autoimmune Destruction of Melanocytes
Presentation
Hypopigmentation
Acral Areas and Around Orifices
Diagnosis
Clinical Presentation + Woods Lamp
Risk Factors
Other Autoimmune Diseases
Treatment
Glucocorticoids
Tacrolimus
Phototherapy
2 mins
Psoriasis
Presentation
Epidermal Hyperproliferation Keratinocytes
Defined Red Salmon Plaques
Silvery Scales
Extensor Surfaces
Bleeding when Removed
Auspitz Sign
Pruritus
Nail Changes
Histological Finding
Munro Microabscesses
Nucleated Cells in Stratum Corneum
Treatment
Retinoids
Topical Corticosteroids
Tar
Immunosuppressants
2 mins
Actinic Keratosis
Sun Exposure
Papules or Plaques
Small, Rough
Erythematous
Precursor to Squamous Cell Carcinoma
53 secs
Lichen Planus
Pathophysiology
Mucocutaneous Disorder
30-60 year olds
Signs & Symptoms
Pruritic
Plaques or Papules
Purple & Polygonal
Often Mucosal or Genital Involvement
Wickham Striae
Diagnosis
Biopsy
Sawtooth Infiltrate of Lymphocytes
Treatment
Topical Corticosteroids
Considerations
Hepatitis C Association
2 mins
Erythema Nodosum
Pathophysiology
Panniculitis
Painful Inflammation
Subcutaneous Fat
Anterior Shins
Risk Factors
Coccidioidomycosis
Pregnancy or OCP Use
Crohn's Disease
Tuberculosis (TB)
Histoplasmosis
Sarcoidosis
Ulcerative Colitis
2 mins
Pityriasis Rosea
Preceded by Upper Respiratory Tract Infection
Single "Herald Patch"
"Christmas Tree" Distribution
Plaques with Collarette Scale
Self-resolving in 6-8 Weeks
2 mins
Stevens-Johnson Syndrome
Etiologies
Drugs
Symptoms
< 10% of Body Surface Area (BSA) Involved
10-30% BSA Overlaps with Toxic Epidermal Necrolysis (TEN)
Fever
Affects Skin and Mucous Membranes
Bullae Formation
Necrosis
Sloughing of Skin
High Mortality Rate
Treatment
Supportive Care
IVIG (Intravenous Immunoglobulin)
3 mins
Acanthosis Nigricans
Associations
Endocrine Disorders
Diabetes Mellitus
Obesity
Malignancy
Presentation
Velvety Plaques
Dark, Thickened Flexural Areas
Diagnosis
Hyperkeratosis with Melanocytes
Treatment
Treat Underlying Disorder
2 mins
Pemphigus Vulgaris
Pathophysiology
Autoantibodies against desmosomes
Symptoms
Flaccid Bullae on Skin
Oral Mucosa Involvement
Intraepidermal Acantholysis
Fluid Loss
Infection
Nikolsky Positive
Diagnosis
Biopsy showing Autoantibodies
Treatment
IVIG and Plasmapheresis
Oral Steroids
Immunosuppressants
2 mins
Anti-desmoglein Antibodies
Pemphigus Vulgaris
Flaccid Blisters
Skin and Oral Mucosa
Positive Nikolsky's Sign
59 secs
Bullous Pemphigoid
Linear Deposits of IgG
Affects Hemidesmosomes
Epidermal Basement Membrane
Tense Blisters on Skin
Nikolsky Negative
Contain Eosinophils
Rarely Affect Oral Mucosa
2 mins
Scabies
Pathophysiology
Sarcoptes Scabiei Mite
Signs & Symptoms
Pruritus
Papules with Burrows
Webs of Fingers and Toes
Axilla and Nipples
Diagnosis
Skin Scraping
Dermoscopy
Mites and Eggs on Magnification
Treatment
Permethrin Cream
Oral Ivermectin
Lindane Cream
Considerations
Wash All Linens In Hot Water
3 mins
Polyarteritis Nodosa
Pathophysiology
Immune Complex-Mediated Transmural Vasculitis
Hepatitis B Association
Fibrinoid Necrosis
Signs and Symptoms
Black Stool (Melena)
Neurologic Dysfunction
Myalgia
Fever
Hypertension
Diagnosis
Vessels / Lesions in Different Stages
Renal Microaneurysms (On Arteriogram)
Spares Pulmonary Arteries (No Pulmonary Involvement)
Treatment
Corticosteroids
Cyclophosphamide
2 mins
Graves' Disease Characteristics
Women 20-40 years old
Pathophysiology
Anti-TSH Receptor Antibodies
Symptoms
Ophthalmopathy
Exophthalmos
Hyperthyroidism
Goiter
Pretibial Myxedema
1 min
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min
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