01b: Inflammatory Skin Disease

Question 1

Thickening of the epidermis is referred to as:

Answer 1

Acanthosis

Question 2

Loss of cell connections in the epidermis is referred to as:

Answer 2

Acantholysis

Question 3

Fluid pockets forming in epidermis (stretches it out) is a process referred to as:

Answer 3

Spongiosis

Question 4

Describe the histology of psoriasiform epidermal hyperplasia.

Answer 4

Rete of epidermis extend downward to about the same level

Question 5

Interface change in which there’s a thick band of leukocytes that extends from base of epidermis, into dermis.

Answer 5

Lichenoid interface change

Question 6

Parakeratosis refers to:

Answer 6

Abnormality in which nuclei are retained in stratum corneum

Question 7

Seborrheic dermatitis: what’s the histopathologic process/change?

Answer 7

Subacute spongiosis (in epidermis) with characteristic shoulder parakeratosis (distinctive scaling)

Question 8

Lichenoid Dermatitis prototype is (X) inflammatory condition, which is characterized by:

Answer 8

X = Lichen Planus

5 P’s: Purple, Pruritic, Polygonal, Planar Papules

Question 9

Vacuolar Dermatitis, such as in (X) disease, will show which histopathologic changes?

Answer 9

X = lupus

Lymphocytes at interface (of epidermis and dermis) that cause destruction of cells (cleared areas around cells); thickened BM

Question 10

Lupus band test looks for:

Answer 10

Immune deposits (IgG, A, M, and complement C3)

Question 11

Pemphigous vulgaris: classic skin finding is (X).

Answer 11

X = flaccid bullae (easily disrupted due to intraepidermal pathology)

Question 12

Bullous Pemphigoid: classic skin finding is (X).

Answer 12

X = Tense bullae (subepidermal pathology)

Question 13

Elderly man with round/oval well-demarcated skin lesions that vary from brown/black to gray and can be scraped off.

Answer 13

Seborrheic keratoses

Question 14

Multiple seborrheic keratoses that erupt at once are associated with which disease? What is the sign called?

Answer 14

Visceral cancer;

Sign of Leser-Trélat

Question 15

Benign proliferations of epidermis caused by (X) infection. They look like seborrheic keratoses, but on finger.

Answer 15

Verruca Vulgaris

X = HPV (warts)

Question 16

27 yo patient presents with tan growth on index finger. With magnification, you see multiple small black dots, which you suspect are (X). Diagnosis?

Answer 16

X = thrombosed capillaries

Verruca Vulgaris (HPV wart)

Question 17

Epidermal inclusion (sebaceous) cyst: (soft/firm), subcutaneous, (mobile/immobile) growth derived from (X).

Answer 17

Firm, mobile;

X = upper portion of hair follicle epithelium (infundibulum)

Question 18

When suspecting epidermal inclusion cyst, what diagnostic feature should you look for?

Answer 18

Central (blackish) punctum

Question 19

Over 90% of (X) cysts are located on the scalp. They are (Y)-colored and can be distinguished from epidermal inclusion cysts by:

Answer 19

X = pilar
Y = skin

Lack of central punctum

Question 20

Small white papule on eyelid:

Answer 20

Milia (epidermal inclusion cyst contining keratin)

Question 21

17 yo female presents with a brown-colored “mole” on leg that she finds painful. On inspection, it’s smooth, dome-shaped papule. What’s the likely diagnosis?

Answer 21

Dermatofibroma

Question 22

You apply lateral pressure on brown-colored, dome-shaped mole, causing a depression. This is called (X) sign and the skin finding is likely:

Answer 22

X = dimple or Fitzpatrick’s

Dermatofibroma

Question 23

Papules commonly found grouped on the scrotum and may bleed if traumatized.

Answer 23

Angiokeratomas

Question 24

Angiokeratomas may be hallmark of which syndrome?

Answer 24

Fabry (alpha galactosidase deficiency)

Question 25

63 yo man with multiple elevated, multi-lobulated, solid papules on forehead. They are white/yellow in color with central depression. Likely diagnosis is:

Answer 25

Sebaceous Hyperplasia

Question 26

Sebaceous hyperplasia can be mistaken for:

Answer 26

Basal cell carcinoma

Question 27

Bright red/violaceous, dome-shaped papules or tiny macules.

Answer 27

Angiomas (dilated capillaries surrounded by endothelial lining)