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DR - Ta7 - Dermatology Notes

Medicina

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180 views

DR - Ta7 - Dermatology Notes

Medicina

Uploaded by

ritafloresreyes52
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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USMLE STEP 1

DERMATOLOGY
NOTES

Prepared By:
Dr. TA7
First Edition

Combination of:
First aid & U-WORLD extra facts
In an organized, concise & interesting blend

Dr. TA7
Dedication
To my wife and kids (Ellen, Rose, Mazen and
Adam), it's you power that push me to do
more and shine to help everyone.

Name:
E-mail:
Wave:

Remember!
Persistence is the key

I
DERMATOLOGY MADE EASY: First aid + All U WORLD facts integrated (LECTURE 1)
Skin: Histology

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Skin: Basic terms and definitions

 Bleeding lesions:
- Petechiae  superficial bleeding due to capillary rupture < 5 mm diameter
- Purpura  superficial bleeding due to capillary rupture > 5 mm diameter
- Ecchymosis  Deep bleeding due to bone fracture or muscle injury and usually large in size

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Skin: Pathology

 Melanin synthesis pathway:

 Melanocyte development & site:

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 Acne vulgaris also can occur due to tight fitting clothing and sports gear used by sportsmen
 Allergic contact dermatitis is associated with significant spongiosis on skin biopsy
 Histological types of nevi:

- Junctional nevi  Nevus cells in dermoepidermal junction, appear flat with dark center
- Compound nevi  Nevus cells extending to the dermis, appear as raised papules
- Intradermal nevi  Old nevi with epidermal nevi cells lost, appear dome shaped and pedunculated

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 Psoriasis treatment:

 Urticaria is a type 1 hypersensitivity reaction mediated by IgE-induced mast cell degranulation


 Skin allergy e.g., urticarial and pruritus can occur after administration of some drugs which induce an
IgE-independent mast cell degranulation (opioids, Radiocontrast and vancomycin)

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 Light microscopy of cherry hemangioma: Capillary and post-capillary venules proliferation in the
papillary dermis

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Skin infections

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 Tzank smear in herpes will show cowdry bodies (intranuclear inclusions) with multinucleated cells

 Treatment of dermatophytes: Terbinafine (act as squalene peroxidase inhibitor = inh. Cholesterol syn.)

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Bullous pemphigoid with dermo-epidermal acantholysis

 Dermatitis herpitiformis is associated with intestinal intraepithelial lymphocytic accumulation due to


associated celiac disease. These lymphocytes produce IgA antigliadin antibodies which cross react with
the skin epithelium causing these skin lesions

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 Photoaging

 Cortisone induced dermal atrophy:

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Burn

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Wound healing disorders

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Other disorders
 Accessory nipple:
- Most common congenital breast anomaly in men and women
- Cause = Failure of involution of the mammary ridge
- Site = Bilateral (usually), anywhere along the mammary line from axilla to perineum
- Manifestations = Asymptomatic OR swelling +/- tenderness during menses and lactation in females
- Histology = Hyperpigmentation, epidermal thickening, smooth muscle bundles +/- acini and ducts
- Treatment = Not needed except for cosmetical reasons

 Langerhan cell histiocytosis:


- Def = a group of conditions caused by proliferation of dendritic (Langerhans) cells
- Langerhan cells = Immunogenic Stellate cells with intracytoplasmic tennis racquet granules (birbeck granules)
- Epidemiology = rare, males > females, related to smoking
- Pathology = Immature langerhan cell proliferation, BRAF V600E mutation, S100+, CD1a+, and Langerin+
- Manifestations = skin and other organ involvement e.g. bone, viscera, lungs

 Xanthoma:
- Def = Yellow nodules due to lipid laden histiocytes in the dermis
- Types =
# Eruptive  yellow papules appear due to elevated plasma lipids and TGs
# Tuberous and tendinous  on the tendons e.g. Achilles tendons
# Plane  in skin flexures, associated with biliary cirrhosis
# xanthelasma  in eye lids, idiopathic or due to elevated lipids
- Associations = hyperlipidemia and lymphoproliferative malignancies

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 Foreign body giant cell reaction:
- Granulomatous inflammation with giant cells in response to foreign body in the skin e.g. skin suture

Skin ulcers

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ABOUT THE AUTHOR:
Mohammed Abdel-Fattah (Dr. Ta7) who is a USMLE lecturer in TA7
USMLE preparation system for about 15 years of experience in
USMLE step 1 education as a lecturer and he is USMLE step 1 and
step 2 CK certified. He made 2 clinical rotations
in USA:
- Psychiatry: Case western reserve university hospitals.
- Neurology: Institute of neuroscience (JFK medical center).

CONTACT US:

Dr. TA7 Facebook: https://www.facebook.com/dr.ta7.usmle

Dr. TA7 E-Mail: [email protected]

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