Bumps and Scales
I say 'Tree Moss' you say...?
The Guses and the Goids
Ooo Pigment!!
I know everything!
100

This is the only systemic retinoid used to treat psoriasis.

Acitretin.

100

Common triggers of LP. Name one for each: 

Microbe

Drug

Contact allergen

Microbe – HCV

Drug  - HCTZ

Contact allergen – Mercury amalgam

100

picture

answer

100

Common mutation in atypical melanocytic nevus

CDKN2A

100

Common mutations in

1. chronic sun damaged skin, nodular melanomas,

2. non-CSD skin, superficial spreading melanomas


  • NRAS (n = nodular, CSD skin)
  • BRAF (V600E, superficial spreading, non-CSD skin)
200

In psoriasis, keratinocytes secrete these antimicrobial proteins. 

hBD-1,2, Cathelicidin LL37, SLPI


hBD = human β-defensin 1-2
SLPI = Secretory Leukocyte Protease Inhibitor

200

This form of LP can develop into follicular-based SCCs

  • Hypertrophic LP
  • Others susceptible to becoming SCC – Ulcerative oral, vulvovaginal.
200

Which of the two, Dsg1 or 3 antibodies cross placenta?

Dsg3. Transient blistering in infant

200

Is DPN part of blue nevus family?

  • No. Lack GNAQ/GNA11 mutations.
  • DPN has a junctional component (vs CBN)
200

Factors in tumor classification within the TNM system


  • Breslow thickness (<=1.0 mm, 1.01 – 2.0, 2.01 – 4.0, >4.0), ulceration status (generally a = without ulceration; b = with ulceration), mitoses
300

This inherited autoinflammatory disorder can fool us into thinking it is generalized pustular psoriasis.

DIRA (deficiency of IL-1 receptor antagonist), 



DITRA (IL-36 RA), ADAM-17 deletion, CARD-14 mediated pustular psoriasis.

300

I am LP Pemphigoides. Sing my praise, tell my story. Who am I? How do I come to be?

IgG  against BPAG2 (180 kD of Col XVII); post LP; uninvolved skin

300

I am Dsg1. Since you are now experts in blistering conditions, I challenge you to name one other condition that I am involved in.

Dsg1 cleaved in SSSS

300

Nevus of Ota can lead to this in 10% of patients

Glaucoma

300

You are in Dr.Chu’s lecture, you see shades of pink and blue on your screen. With some magic synapses in your brain, you narrow it to subepidermal bullous disease. He zooms in on the blister. There are ants in the blister and on tips of papillary dermis….he is quite, waiting for your answer. And your answer is?

He asks: “Are you sure? Do you want to sign this as a diagnosis?” Then you remember this session, and you say the right answer. And that is?

LABD

No, need DIF to differentiate from DH

400

A type of PRP that has sclerodermoid changes of hands/feet.

Type 5.

400

This syndrome has four names and three significant clinical findings. Classified as a variant of LPP (lichen plano pilaris)

Graham-Little-Piccardi-Lasseur syndrome;

  • non-scarring pubic and axillary hair loss,
  • follicular papules,
  • scarring alopecia on scalp.
400

Biopsy for DIF should be lesional from the center of a bulla.

Result 1: You are a star! You are praised by Dr. Mitre for your acute attention. or

Result 2: You are a learner and strong! You prepare to face the consequences as biopsy comes back non diagnostic because they cannot find the epidermis.

Result 2

You are a learner and strong! You prepare to face the consequences as biopsy comes back non diagnostic because they cannot find the epidermis.

400

Activating mutations in these are seen in 83% of patients with blue nevus

  • GNAQ and GNA11
  • With BAP-1 loss = more aggressive. Also seen in uveal melanoma
400

Parade of antigens!! Next up, LABD

  • LAD-1 (120 kD cleaved portion of BP180 antigen)
  • LABD97 (97 kD cleaved portion of LAD-1)
500

1. This question is a good practice to ask patients coming in with guttate psoriasis.

2. Do this at your own risk of developing erythrodermic psoriasis.

1. Have you had any sore throat and related symptoms in the recent past 3-4 weeks prior? i.e. URI (Strep throat)

2. Abrupt withdrawal of steroids (taper, tapertaper)

500

1. Most patients with LS have circulating antibodies against

2. Protein in the prev question is mutated in this condition

1. ECM-1 (Extra Cellular Matrix protein)

2. Lipoid proteinosis

500

What is IIF? What substrate is used for PV? For PF? For PNP?

  • Indirect immunofluorescence. Detects antibodies in serum.
  • Monkey esophagus - PV.
  • Guinea pig esophagus – PF. (guineapig eating ‘foliage’)
  • Rat bladder – PNP .
  • Note – ELISA more quantitative.
500

Name two differentiating stains for spitz nevus

S100A6, P16

500

Sub types of MMP and corresponding antigens

  • Anti-epiligrin MMP = Laminin 332
  • Ocular MMP = b subunit of a6b4 integrin protein
  • Anti-BP antigen MMP = BP180, C-terminus
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