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First Aid for the USMLE Step 2 CK (8th Ed.)
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2 - Dermatology - Page 49

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First Aid for the USMLE Step 2 CK (8th Ed.) | Medicine (MD/DO) School Study Aid

2 - Dermatology - Page 49
17 Picmonics to Learn | 32 mins
Hypersensitivity Type I
Previous Antigen Exposure
Immediate Reaction
IgE Cross-linking
Presensitized Mast Cells
Histamine Release
Vasodilation
Anaphylaxis
Allergies
Treatment
Epinephrine
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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
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1 min
Hypersensitivity Type III
Immune Complex
Antigen-antibody (IgG) complex activates complement
Neutrophils release lysozomal enzymes
Examples
Arthus Reaction
Serum Sickness
Systemic Lupus Erythematosus (SLE)
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1 min
Hypersensitivity Type IV
Delayed-Type Hypersensitivity
T Cell Mediated
Antibody Independant
Macrophages Activated
Examples
Transplant Rejection
PPD Skin Test
Contact Dermatitis
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1 min
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)
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3 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
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2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
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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
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2 mins
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
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2 mins
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
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4 mins
Pox Virus
Characteristics
Enveloped
Double-Stranded DNA
Linear
Non-Icosahedral
Signs and Symptoms
Smallpox
Cowpox
Molluscum Contagiosum
Umbilicated Flesh-Colored Domed Lesions
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1 min
Pityriasis Versicolor (Tinea versicolor)
Mechanism
Lipid-Dependent Fungus
Fatty Acids Damage Melanocytes
Malassezia Furfur
Hot, Humid Weather
Signs and Symptoms
Hypopigmentation
Hyperpigmented Patches
Diagnosis
Spaghetti and Meatball Appearance on KOH Prep
Fragmented Hyphae with Clusters of Yeast
Treatment
Topical or Oral Antifungals
Selenium Sulfide
Zinc
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4 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
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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
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2 mins
Actinic Keratosis
Sun Exposure
Papules or Plaques
Small, Rough
Erythematous
Precursor to Squamous Cell Carcinoma
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53 secs
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
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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
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1 min

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