Ryan Shared "Dermatology" - 38 Picmonics

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Dermatology

Polymyositis / Dermatomyositis Disease
Pathophysiology
Idiopathic Inflammatory Myopathy
More Common in Women
Endomysial Inflammation with CD8+ Cells (Polymyositis)
Perimysial Inflammation with CD4+ Cells (Dermatomyositis)
Signs and Symptoms (Both)
Symmetric Proximal Muscle Weakness
Dysphagia
Lung and Cardiac Involvement
Signs and Symptoms (Dermatomyositis)
Malar Rash
Shawl-like Shoulder Rash
Gottron Papules on Knuckles
Heliotrope Rash
3 mins
Polymyositis / Dermatomyositis Diagnosis and Treatment
Diagnosis
Increased CK (CPK)
Increased Aldolase
Anti-JO-1 Antibody
Anti-SRP Antibody
Antinuclear Antibody
Abnormal EMG
Biopsy
Treatment
Corticosteroids
Methotrexate
Azathioprine
Treatment For Resistant Disease
Intravenous Immunoglobulin (IVIG)
Cyclophosphamide
Rituximab
Calcineurin Inhibitors
2 mins
Melanoma Diagnosis
Signs
ABCDE Mnemonic
Asymmetry
Border irregularity
Color variation
Diameter > 6mm
Evolution over time
Diagnosis
S-100 Tumor Marker
LDH (Lactate Dehydrogenase) Screens for Metastasis
Treatment
Wide Local Excision
Adjuvant Therapy
1 min
Melanoma Mechanism and Characteristics
Mechanism
Associated with Sunlight Exposure
Mutation in B-RAF kinase
Large Number of Moles
Fair-Skinned people at higher risk
Growth Phases
Radial Growth Phase
No Metastasis
Vertical Growth Phase
Depth of tumor correlates with risk of metastasis
1 min
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
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
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
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
Dermatitis Herpetiformis
Autoimmune deposition of IgA
Strong association with celiac disease
Resembles vesicles in herpes
Resolves with gluten free diet
Dapsone treatment
Erythema Multiforme
targetoid rash
Commonly associated with HSV infection
Associated with mycoplasma pneumoniae
Associated with malignancy
Associated with sulfa drugs
Associated with phenytoin
Associated with SLE
Associated with B-lactams
Associated with CD8+T cells
Seborrheic keratosis
Appear during fourth decade
Stuck-on, waxy
Benign
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
Basal Cell Carcinoma of the Skin
Pathophysiology
Most Common Skin Cancer
2/3 of Cases Due to UV Light Exposure
Pink, Pearl-like Lesions
Rolled Borders
Telangiectasias
Commonly Upper Lip
Diagnosis
Shave Biopsy
Pallisading Nuclei
Treatment
Mohs Micrographic Surgery
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
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
1 min
Xeroderma pigmentosum
Extreme sensitivity to sun
Defective endonuclease
Can't repair pyrimidine (usually thymine) dimers
Nucleotide excision repair occurs in G1 phase
UVB radiation
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
4 mins
Albinism
albinism
Normal melanocyte number with decreased melanin production
Due to decreased tyrosinase activity or defective tyrosine transport.
Increased risk of skin cancer
Acquired through locus heterogeneity - Mutations at different loci can produce a similar phenotype.
Autosomal recessive
Ocular albinism is X-linked recessive
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

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