1. Clinical and Histological Descriptive Terms

Question 1

Dyskeratosis

Answer 1

Abnormal, premature keratinization of keratinocytes below the granular cell layer; often have brightly eosinophilic cytoplasm

Question 2

Acantholysis

Answer 2

Loss of intercellular connections (desmosomes) between keratinocytes; causes change in cell shape from polygonal to round

Question 3

Spongiosis and vesicles

Answer 3

Intraepidermal edema, causing splaying apart of keratinocytes in stratum spinosum, and vesicles due to shearing of desmosomes

Question 4

Hypergranulosis

Answer 4

Hyperplasia of the stratum granulosum, often due to intense rubbing

Question 5

Acanthosis

Answer 5

thickening of epidermis (squamous layer); rete ridges usually extend deeper into the dermis

Question 6

Parakeratosis

Answer 6

Cells of cornified layer retain their nuclei, often less prominent or absent granular layer; normal for mucous membranes

Question 7

Hyperkeratosis

Answer 7

Thickened cornified layer, often with a prominent granular layer

Question 8

Onycholysis

Answer 8

separation of nail plate

Question 9

Telangiectasia

Answer 9

A visible persistent dilation of small, superficial cutaneous blood vessels, may blanch

Question 10

Erythema

Answer 10

Redness of skin due to increased blood flow, NOT leakage of blood into the skin, may blanch

Question 11

Purpura

Answer 11

Extravasation of red blood cells into the skin or mucous membranes

Question 12

Crust

Answer 12

A hardened layer that results when serum, blood, or purulent exudate dries on the skin surface

Question 13

Scale

Answer 13

Dry, plate like excrescence usually due excess stratum corneum

Question 14

Wheals

Answer 14

Itchy, transient, elevated area with variable blanching and erythema, due to dermal edema

Question 15

Excoriations

Answer 15

Deep linear scratch that is often self-induced

Question 16

Fissure

Answer 16

Canyon-like crack through the epidermis and into the dermis; NO tissue lost

Question 17

Ulceration

Answer 17

Discontinuity of skin causing complete loss of epidermis and possible loss of dermis

Question 18

Erosion

Answer 18

Discontinuity of skin causing partial loss of epidermis

Question 19

Pustule

Answer 19

Intraepidermal or subepidermal vesicle or bullae filled with pus

Question 20

Blister

Answer 20

Vesicle or bullae

Question 21

Cyst

Answer 21

Encapsulated cavity or sac lined by true epithelium

Question 22

Tumor

Answer 22

Solid, palpable, > 20 mm

Question 23

Nodule

Answer 23

Solid, palpable, > 10 mm

Question 24

Plaque

Answer 24

Elevated flat-topped area, usually > 10 mm

Question 25

Papule

Answer 25

Elevated solid area, < 10 mm

Question 26

Patch

Answer 26

Flat discoloration > 1 cm

Question 27

Macule

Answer 27

Circumscribed flat colored area < 1 cm

Question 28

Punch Biopsy

Answer 28

Removal of a "core" of tissue to establish a definitive diagnosis or to remove a small lesion

Question 29

Shave Biopsy

Answer 29

Removal of a "shave" of tissue to a remove superficial lesion and/or to establish a diagnosis

Question 30

What type of lesion should you try to biopsy?

Answer 30

primary

Question 31

What stage should you biopsy?

Answer 31

diagnostic stage, not ruptured bullae, secondarily infected/scratched areas or involuting lesions

Question 32

What does a biopsy do?

Answer 32

Captures histopathology only at one point in time in the evolution of a lesion

Question 33

How should you take a biopsy?

Answer 33

Try to include a margin with both lesion and surrounding normal skin

Question 34

What is integument?

Answer 34

Composed of skin and skin appendages

Question 35

What is the role of integument?

Answer 35

Protects deeper tissues from injury, drying and invasion by foreign organisms

Question 36

What vitamin does integument metabolizes?

Answer 36

Vitamin D

Question 37

Does integument contain peripheral endings of sensory nerves?

Answer 37

yes

Question 38

What are the histological layers of the skin?

Answer 38

Epidermis papillary dermis reticular dermis (hair follicles and sebaceous glands) subcutis

Question 39

What are the layers of the epidermis?

Answer 39

Stratum corneum stratum lucidum stratum granulosum stratum spinosum stratum basale