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MSD Path Skin Disorders - Coggle Diagram
MSD Path Skin Disorders
Eczemas, Papulosquamous and Erythemas
Papulosquamous and Erythemas
Papulosquamous and Erythemas
Psoriasis (Auspitz +) Pinpoint
Drugs
Topical
Acitretin
Tazarotene
Retinoids
Rx
Acitretin
Tazarotene
Isotretinoin
Adverse/Contraindications/MOA
Adverse
Contraindications
MOA
Biologic Agents
TNF-alpha Inhibitors
Adalimumab
Etanerecpt
Infiximab
Certolizumab
IL-17 and IL-17A inhibitors
Brodalumab
Ixekizumab
Secukinumab
IL-12 and IL-23 inhibitors
Ustekinumab
IL-23 Inhibitors
Guselkumab
Risankizumab
Tidrakizumab
Apremilast
Presentations
Location
Visual
Salmon/gray/White Plaques
Histology
Acanthosis with Parakeratosis
Stratum Corneum is thick
Stratum Granulosum is thin
Parakeratosis
Munro's Micro Abscesses (neutrophils in SC)
Pathophys
T-Cell Mediated autoimmune
Pityriasis Rosea
Lichen Planus
Presentations
Location Presentations
Wrist
Elbows
Oral Mucosa
Wicham Striae
Visual Presentations
Associated
HCV
SCC
Histology
Saw Tooth
Hypergranulosis
Lichen Simplex Chonicus
Drugs
Doxepin
Indications
Pruritis
Contraindications
Patients with untreated narrow-angle glaucoma or Urinary retention
Associations
NOT SCC!
Histology
Hypergranulosis
Acanthosis
Orthokeratosis
Presentation
Leukoplakia
Thick leathery skin
Eczematous (HSR)
Contact Dermatitis (HSR-IV Delayed)
Pathophys
Langerhan cells take antigen to lymph node and present to Naive T-Cells) Langerhan is in the Spinosum
Atopic Dermatitis (HSR-I)
Drugs
Tacrolimus or Pipecuroniums (TCIs)
Indication
Mild, and Children over 2y/o
MOA
Dapilumab
Indications
Moderate to severe over 12y/o
Crisaborole
Indications
Mild and children over 3mon
Doxepin
Indications
Pruritis
Contraindications
Patients with untreated narrow-angle glaucoma or Urinary retention
Presntations
Location
Flexor Surfaces
Visual
Pathophys
Reactive Erythemas
Reactive Erythemas
Erythema Multiforme (Nikolsky Sign -)
Presentation
Locaton
Tense Bulla on Palms and Soles (NO Mucosal Lesions) - Minor
Mucosal Lesion - EM Major
Visual
Target Lesions
Drug Eruptions (Nikolsky Sign +)
Causative drugs (SANA)
DRESS Syndrome (Nikolsky Sign -)
Pressentations
Location
Urticaria (HSR-I) Hives
Vesiculobullous Disorders
Viral
HSV
Varicella Zoster
Immunologic
Pemphigus Vulgaris (Nikolsky +) HSR-II (MOUTH)
Pahophys
IgG aginst Desmosomes between Keratinocytes
IgG against Desmoglein 1 and 3
Acantholysis (sep of cells in epidermal)
Presentations
Location (mouth)
Mucosal Bleedin
Mucosa Bulla
Visual
Thin-Walled Bullae that DO rupture easily
Histology
Row of
tombstone (basal layer cells that remain attached
to basement membrane via hemidesmosomes
Fishnet Pattern
Pemphigus Foliaceus (TRUNK)
Pathophys
IgG and C3 on Desmoglein-1
Presentation
Corn-flake ceral leasions on trunk
Bullous Phemphigoid (Nikolsky -) (LEGS, Abdomen, FLEXOR)
Pathophys
IgG against Hemidesmosomes (BP180 and BP230)
Presentations
Locations (Tense Vesicles)
Thighs
Flexor
Abdomen
Alexilla
Visual
Tense Bullae with eosinophils that DON'T rupture easily
Histology
Detachment of the basal cell layer from the basement membrane
Dermatitis Herpetiform
Pathophys
IgA deposition in dermal papillae
Histo
Neutrophilic Papillary Microabcesses
Subepidermal inflammation
Presentation
Pruritic Papules
Vesicles
Bullae
Location
Hands
Knees
Elbows
Buttocks
SLE
Hereditary
Epidermolysis Bollosa (Nikolsky Sign +)
Non-Melanocytic and Malignant Lesions
Linked 1
Actinic Keratosis
Presentation
Thick scaly Red Papule with central brown crust on Face
Squamous cell carcinoma
