Warning:
JavaScript is turned OFF. None of the links on this page will work until it is reactivated.
If you need help turning JavaScript On, click here.
This Concept Map, created with IHMC CmapTools, has information related to: Skin II, Skin II Terms Elevated Papule- ɝmm Nodule- ɱmm Plaque- flat-topped nodule, ERYTHEMA MULTIFORME -self-limited response to drugs, infx 1. infx (HSV, mycoplasma, histo, coccidio, typhoid, leprosy) 2. Rx: sulfas, PCN, barbs, ASA, hydatoins, antimalarials 3. CA, lymphomas 4. coll vasc dzs-SLE, dermatomyositis, PAN Multiform-macules, papules, vesicles, bullae -symmetric on limbs MORPH-early- dermal edema, infiltrate -CD8 - CTLs later-infiltrate upward to epidermis necrosis->blisters Target lesion-central necrosis Sim to acute GVHD, skin allograft rejection, fixed drug eruptions Variants STEVENS-JOHNSON SYNDROME-w/ fever, in kids -erosion, hemorr crusts on mucosae -infx->sepsis TOXIC EPIDERMAL NECROLYSIS- diffuse nec, sloughing of epith, like burn, Skin II Panniculitis -inflam in SC fat -often lower legs -can be 2ndary in fungus -or lupus extension FACTITIAL PANNICULITIS -self-inflicted or injected -2ndary panniculitis, Skin II Blistering (Bullous) Diseases EPIDERMOLYSIS BULLOSA -noninflammatory -blisters at trauma sites -pressure, rubbing, birth Simplex type-degen of basal cell layer Junctional type-lamina lucida level Dystrophic type-beneath lam densa -COL 7A1 mutations-type VII coll -defective anchoring fibrils ->SCARRING, Skin II Blistering (Bullous) Diseases BULLOUS PEMPHIGOID -ELDERLY, local or gen'ized -don't rupture as easily as PV -heals w/out scarring -inner thigh, axilla, lower abd -1/3 w/ oral lesions AFTER skin -some w/ HIVES, ITCHING! MORPH-SUBEPIDERMAL -NONACANTHOLYTIC -basal cell vacuolization-necrosis -due to degranulating eos-MBP LINEAR BM Ig, complement (granular in lupus) -anti-hemidesmosome ABs -in lamina LUCIDA ->fix comp.t, recruit eos, PMNs, Skin II Terms Microscopic Hyperkeratosis-S. corneum hyperplasia-much keratin Parakeratosis-nuc still in s corneum-NL in muc memb Acanthosis-epid hyperplasia Dyskeratosis-keratinize while below s granulosum Acantholysis-lose cohesion b/w k'cytes Papillomatosis-pap dermis hyperplasia-widen dermal pap Lentiginous-linear mel'cyte prolif in basal layer Spongiosis-intercell edema of epid Exocytosis-inflam or RBCs in epid Erosion-incomplete loss of epid Ulceration-total loss, some dermis Vacuolization-w/in or next to cell -usually basal cell, bsmt memb Hydropic swelling (ballooning) -intracell edema of k'cytes-viral Hypergranulosis-hyperplastic s granulosum-due to rubbing, Skin II Chronic Inflammatory Dermatoses LUPUS ERYTHEMATOSUS SLE-1.3 w/ skin lesions -malar erythema DLE-discoid-no systemic Sx -scaling plaques -can worsen w/ SUN -hypo, hyperpigmentation -keratotic plugs in follic ostia -humoral (MAC) and CMI->destroy basal MORPH-lymphos at DE jcn or dermal-follic epith jcn -LUPUS-BAND TEST-Igs, comp -in DLE (lesional skin), SLE (all over) -also deep, around sweat glands -basal cell layer w/ VACUOLIZATION -thinned epith -PAS (+) thickened bsmt memb LUPUS PROFUNDUS-deep, around fat, Skin II Blistering (Bullous) Diseases DERMATITIS HERPETIFORMIS -urticaria+grouped vesicles -EXTENSOR of elbows, knees, buttocks, upper back -MALES>f - 20s-30s -ass'd w/ CELIAC DZ-gluten MORPH-fibrin+neutrophils at dermal papillae tips->uabscesses -then can have DE separation ->coalesce to blister -basal cell vacuolization -can have EOS in older lesions -GRANULAR IgA deposits in tips IgA, IgG to gliadin, reticulin(anchor) -HLA-B8, HLA-DRw3 -improve w/ gluten-free diet, Skin II Terms Blisters:Fluid-filled, raised Vesicle ɝmm Bulla ɱmm Pustule-raised w/ pus, Skin II Blistering (Bullous) Diseases PORPHYRIA -noninflammatory -urticaria, vesicles->SCARRING -worse w/ SUN -porphyrins in Hgb, myoglobin, cytochromes MORPH-subepid vesicle w/ superficial dermal vessel thickening 5 Types: 1. Congen Erythropoietic Protopor 2. Erythrohepatic protoporphyria 3. Acute intermittent porph 4. Porph cutanea tarda 5. Mixed porphyria, Skin II Acute Inflammatory Dermatoses ERYTHEMA MULTIFORME -self-limited response to drugs, infx 1. infx (HSV, mycoplasma, histo, coccidio, typhoid, leprosy) 2. Rx: sulfas, PCN, barbs, ASA, hydatoins, antimalarials 3. CA, lymphomas 4. coll vasc dzs-SLE, dermatomyositis, PAN Multiform-macules, papules, vesicles, bullae -symmetric on limbs MORPH-early- dermal edema, infiltrate -CD8 - CTLs later-infiltrate upward to epidermis necrosis->blisters Target lesion-central necrosis Sim to acute GVHD, skin allograft rejection, fixed drug eruptions, Skin II Chronic Inflammatory Dermatoses PSORIASIS-1-2% US-T-cell mediated -common in all ages-AUTOIMMUNE -ass'd w/ arthritis, myopathy, AIDS enteropathy, spondylytic hrt dz -can resemble rheum arthritis -ELBOWS, KNEES, SCALP, lumbosac, interglut cleft, glans penis -pink-salmon colored plaque w/ scales -can->erythroderma-full body scaling -nail changes look like oil slick -thickening, crumbling nail -2/3 pts w/ HLA-C*0602 -lots of TNF, CD4 and CD8, IL-12, IFN-g Koebner phenomenon-develop w/ trauma PUSTULAR PSOR-pustules on plaques -neutrophils present -hands, feet - benign -life-threatening- diffuse+fever arthralgias, infx, electrolyte problems MORPH-long rete pegs-thinned epid -thin S granulosum, parakeratosis -spongiform pustules -MUNRO microabscesses in s corneum -Auspitz sign-bleeding when scale lifted, Skin II Acute Inflammatory Dermatoses URTICARIA-hives -local mast cell degranulation via IgE ->hyperperm vasc -pruritic, erythematous plaques -sim to angioedema (deeper) -20-40yo-can fade w/in hrs-mos -presure pts-trunk, distal limbs, ears -coll vasc dzs, Hodgkin-persist MORPH-sparse periven infitrate, monos -widely-spaced coll bundles, dilated lymph IgE-independent-opiates, ABX, curare, rad contrast medium, ASA (PG effect) Hered angioneurotic edema-def C1 activation ->complement-mediated urticaria, Skin II Infection/Infestation SUPERFICIAL FUNGAL INFX Confined to s. corneum-no nuclei -via dermatophytes TINEA CAPITIS- babies, adults +/-Sx -mild erythema, crust, scale TINEA BARBAE-beard area-rare in men TINEA CORPORIS-common all ages -via excessive heat, humidity, infx animals, feet/nail dermatophytoses -expanding, round, erythematous, plaque TINEA CRURIS-inguinal area of fat men in warm weather, heat, friction TINEA PEDIA-athlete's foot-30-40% pop'n -mostly via bac'l superinfx ONYCHOMYCOSIS-spread to nails TINEA VERSICOLOR-Malassezia furfur -many sizes, lighter or darker, fine scale -upper trunk MORPH-PAS(+) fungal cell walls, Skin II Acute Inflammatory Dermatoses ACUTE ECZEMATOUS DERMATITIS -red, papulovesicular, oozing ->scaling -vesicles, bullae 1. Allergic contact dermatitis -langerhans->T cells->endoth activation w/in 24hrs -itching, burning 2. Atopic dermatitis-spongiotic -erythematous in flxural areas 3. Drug-related eczematous derm -will have EOSINOPHILS 4. Photoeczematous derm 5. Primary irritant dermatitis -repeated rubbing ->acanthosis later 6. Eczematous insect bite rxn MORPH-Spongiosis-fluid in epid -prominent intercell bridges -can all develop acanthosis, Skin II Infection/Infestation IMPETIGO-common -HIGHLY CONTAGIOUS 2 types: contagiosa, bullosa -bullosa w/ larger pustules -superficial-exposed skin -face, hands -erythematous macule, then pustules->break->erosions ->HONEY-COLORED CRUST -remove crust or will recur -BULLOUS form in kids -ALL VIA STAPH AUREUS -toxin cleaves desmoglein 1 (pemph folia-autoAB) -same pathogenesis as SSSS -in kids or unhealthy adults MORPH-accum neutrophils beneath strat corneum, Skin II Panniculitis -inflam in SC fat -often lower legs -can be 2ndary in fungus -or lupus extension WEBER-CHRISTIAN DZ -relapsing febrile nodular panniculitis -nonvasculitic -kids, adults -erythematous plaques, nodules in LOWER LIMB -due to deep inflam, Skin II Chronic Inflammatory Dermatoses SEBORRHEIC DERMATITIS -more common than psoriasis -around seb glands-scalp, ear, forehead -NOT DZ OF SEB GLANDS -macs/paps on erthematous-yellow base -extensive scaling, crusting -fissures behind ears INFANTS-CRADLE CAP -or LEINER DZ-all over + FTT, diarrhea HIV-83% pts - severe, hard to treat -w/ apop keratinocytes, plasma cells May be ass'd w/ Malassezia furfur (tinea versicolor) May be due to inc'd sebum production MORPH-mimic spongiotic derm, psoriasis -parakeratosis w/ neutrophils, serum -at follicle OSTIA-"follic lipping" -lymphocytes, neutrophils perivasc Tx: levodopa-improve Sx, Skin II Blistering (Bullous) Diseases PEMPHIGUS-30s to 50s, M=F -from loss of intercell adhesion -rupture easily->heal w/ crust/scar -can be life-threatening w/out Tx 1. P. Vulgaris-80%-scalp, face, axilla -oral ulcers mos before skin -rupture easily -cells just above basal layer 2. P. vegetans-verrucous-groin, axilla -EPIDERMAL HYPERPLASIA -cells just above basal layer 3. P. Foliaceus-S. American epidemic -scalp, face, chest, back, rare muc -VERY SUPERFICIAL 4. P. erythematosus-localized, less severe than (3)-MALAR AREA MORPH-ACANTHOLYSIS-not att'd -cells become rounded -all w/ infiltrates-lymphos, eos,hists CLINICAL-IgG to intercell cement -IF-looks netlike-desmoglein 3 gene, Skin II Terms Wheal-itchy, transient blanching, erythema Scale-via bad cornification Lichenification-via rubbing Excoriation-break epidermis -deep scratch Onycholysis