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Case Report and Brief Review

The Dermatologist’s Board Review - October 2017

October 2017

The contents of these questions are taken from the Galderma Pre-Board Webinar. The Pre-Board Webinar is now an online course. For details, go to https://www.galdermausa.com/Our-Commitment/PreBoard-Webinar.aspx.

board review 1
What are the characteristics
1. This antinuclear antibody (ANA) is most characteristic of:  

a) Acute cutaneous lupus erythematosus

b) Chronic cutaneous lupus erythematosus

c) Subacute cutaneous lupus erythematosus

d) Neonatal lupus erythematosus

e) Drug-induced lupus erythematosus

 

board review 22. Which of the following is associated with this condition? 

a) Streptococcus pyogenes

b) Rheumatoid arthritis

c) Clostridium perfringens

d) Spider bite

e) Coeliac sprue

{{pagebreak}}

BOARD REVIEW ANSWERS

board review 11. This antinuclear antibody (ANA) is most characteristic of:
 
a) Acute cutaneous lupus erythematosus
 

This slide shows a “rim” pattern ANA which is associated with autoantibodies to double-stranded DNA. These antibodies and the ANA pattern are relatively specific for systemic lupus erythematosus (SLE) and are associated with more severe forms of SLE, such as acute cutaneous lupus erythematosus.

References

Sontheimer RD, Deng JS, Gilliam JN. Antinuclear and anticytoplasmic antibodies. Concepts and misconceptions.  J Am Acad Dermatol. 1983;9(3):335-343.

Keren DF. Antinuclear antibody testing. Clin Lab Med. 2002;22(2):447-474.

Sontheimer RD, McCauliffe DP, Zappi E, Targoff I. Antinuclear antibodies: clinical correlations and biologic significance. Adv Dermatol. 1992;7:3-52.

 

board review 22. Which of the following is associated with this condition?
 
b) Rheumatoid arthritis
 
Pyoderma gangrenosum is associated with a number of other disorders including ulcerative colitis, regional enteritis, rheumatoid arthritis, infectious hepatitis, leukemia, myeloma, benign monoclonal gammopathy, Wegener granulomatosis, and Behçet syndrome. There is an increased incidence of arthritis in pyoderma gangrenosum, which appears to be associated with the pyoderma gangrenosum and not some underlying disease.  

Reference

Ko CB, Walton S, Wyatt EH. Pyoderma gangrenosum: associations revisited. Int J Dermatol. 1992;31(8):574-577.

 

Jo-David Fine, MD, MPH, FRCP, is board certified in internal medicine, dermatology, and diagnostic and laboratory immunodermatology. Dr Fine is currently professor of medicine (dermatology) and pediatrics at Vanderbilt University School of Medicine in Nashville, TN.

Ron J. Feldman, MD, PhD, is assistant professor in the department of dermatology at Emory University School of Medicine in Atlanta, GA.

The contents of these questions are taken from the Galderma Pre-Board Webinar. The Pre-Board Webinar is now an online course. For details, go to https://www.galdermausa.com/Our-Commitment/PreBoard-Webinar.aspx.

board review 1
What are the characteristics
1. This antinuclear antibody (ANA) is most characteristic of:  

a) Acute cutaneous lupus erythematosus

b) Chronic cutaneous lupus erythematosus

c) Subacute cutaneous lupus erythematosus

d) Neonatal lupus erythematosus

e) Drug-induced lupus erythematosus

 

board review 22. Which of the following is associated with this condition? 

a) Streptococcus pyogenes

b) Rheumatoid arthritis

c) Clostridium perfringens

d) Spider bite

e) Coeliac sprue

{{pagebreak}}

BOARD REVIEW ANSWERS

board review 11. This antinuclear antibody (ANA) is most characteristic of:
 
a) Acute cutaneous lupus erythematosus
 

This slide shows a “rim” pattern ANA which is associated with autoantibodies to double-stranded DNA. These antibodies and the ANA pattern are relatively specific for systemic lupus erythematosus (SLE) and are associated with more severe forms of SLE, such as acute cutaneous lupus erythematosus.

References

Sontheimer RD, Deng JS, Gilliam JN. Antinuclear and anticytoplasmic antibodies. Concepts and misconceptions.  J Am Acad Dermatol. 1983;9(3):335-343.

Keren DF. Antinuclear antibody testing. Clin Lab Med. 2002;22(2):447-474.

Sontheimer RD, McCauliffe DP, Zappi E, Targoff I. Antinuclear antibodies: clinical correlations and biologic significance. Adv Dermatol. 1992;7:3-52.

 

board review 22. Which of the following is associated with this condition?
 
b) Rheumatoid arthritis
 
Pyoderma gangrenosum is associated with a number of other disorders including ulcerative colitis, regional enteritis, rheumatoid arthritis, infectious hepatitis, leukemia, myeloma, benign monoclonal gammopathy, Wegener granulomatosis, and Behçet syndrome. There is an increased incidence of arthritis in pyoderma gangrenosum, which appears to be associated with the pyoderma gangrenosum and not some underlying disease.  

Reference

Ko CB, Walton S, Wyatt EH. Pyoderma gangrenosum: associations revisited. Int J Dermatol. 1992;31(8):574-577.

 

Jo-David Fine, MD, MPH, FRCP, is board certified in internal medicine, dermatology, and diagnostic and laboratory immunodermatology. Dr Fine is currently professor of medicine (dermatology) and pediatrics at Vanderbilt University School of Medicine in Nashville, TN.

Ron J. Feldman, MD, PhD, is assistant professor in the department of dermatology at Emory University School of Medicine in Atlanta, GA.

The contents of these questions are taken from the Galderma Pre-Board Webinar. The Pre-Board Webinar is now an online course. For details, go to https://www.galdermausa.com/Our-Commitment/PreBoard-Webinar.aspx.

board review 1
What are the characteristics
1. This antinuclear antibody (ANA) is most characteristic of:  

a) Acute cutaneous lupus erythematosus

b) Chronic cutaneous lupus erythematosus

c) Subacute cutaneous lupus erythematosus

d) Neonatal lupus erythematosus

e) Drug-induced lupus erythematosus

 

board review 22. Which of the following is associated with this condition? 

a) Streptococcus pyogenes

b) Rheumatoid arthritis

c) Clostridium perfringens

d) Spider bite

e) Coeliac sprue

{{pagebreak}}

BOARD REVIEW ANSWERS

board review 11. This antinuclear antibody (ANA) is most characteristic of:
 
a) Acute cutaneous lupus erythematosus
 

This slide shows a “rim” pattern ANA which is associated with autoantibodies to double-stranded DNA. These antibodies and the ANA pattern are relatively specific for systemic lupus erythematosus (SLE) and are associated with more severe forms of SLE, such as acute cutaneous lupus erythematosus.

References

Sontheimer RD, Deng JS, Gilliam JN. Antinuclear and anticytoplasmic antibodies. Concepts and misconceptions.  J Am Acad Dermatol. 1983;9(3):335-343.

Keren DF. Antinuclear antibody testing. Clin Lab Med. 2002;22(2):447-474.

Sontheimer RD, McCauliffe DP, Zappi E, Targoff I. Antinuclear antibodies: clinical correlations and biologic significance. Adv Dermatol. 1992;7:3-52.

 

board review 22. Which of the following is associated with this condition?
 
b) Rheumatoid arthritis
 
Pyoderma gangrenosum is associated with a number of other disorders including ulcerative colitis, regional enteritis, rheumatoid arthritis, infectious hepatitis, leukemia, myeloma, benign monoclonal gammopathy, Wegener granulomatosis, and Behçet syndrome. There is an increased incidence of arthritis in pyoderma gangrenosum, which appears to be associated with the pyoderma gangrenosum and not some underlying disease.  

Reference

Ko CB, Walton S, Wyatt EH. Pyoderma gangrenosum: associations revisited. Int J Dermatol. 1992;31(8):574-577.

 

Jo-David Fine, MD, MPH, FRCP, is board certified in internal medicine, dermatology, and diagnostic and laboratory immunodermatology. Dr Fine is currently professor of medicine (dermatology) and pediatrics at Vanderbilt University School of Medicine in Nashville, TN.

Ron J. Feldman, MD, PhD, is assistant professor in the department of dermatology at Emory University School of Medicine in Atlanta, GA.