10.07 Dermatopathology

Question 1

structure of skin

• epidermis
• dermis

Answer 1

epidermis

• stratum corneum: dead layer without nuclei. still have proteins
  
  • karotosis: no nuclei
  • parakarotosis: nuclei
• stratum granulosum
• stratum spinosum: “prickly cell”
• stratum basale: has melanocytes

dermis: connective tissue

Question 2

dyskeratosis

Answer 2

keratosis occurs too early in epidermis development

Question 3

Linchen simplex chronicus

Answer 3

the layers of the epidermis are exaggerated. from surface, looks extra-wrinkly

Question 4

post-inflammation hyperpigmentation

Answer 4

pigments develop in deeper epidermis layer

Question 5

ichthyosis vulgaris

Answer 5

too much stratum corneum (darker color, looks like it’s unwashed)

Question 6

pompholyx (dyshidrotic eczema)

Answer 6

dermatitis of hands

frequently in manual workers whose work involves immersing hands into water and cleaning solvents

Question 7

stasis dermatitis

Answer 7

dermatitis of lower extremities.

involves long stasis of blood there

Question 8

allergic contact dermatitis

Answer 8

type VI hypersensitivity (not type I)

contact with substance leads to combining with protein on the surface.

Question 9

pityriasis rosea

Answer 9

mile, self-limited form of dermatitis that produces a moderate scaly patch, which goes away, followed by widespread smaller patches

goes away by itself in weeks-months

Question 10

Herpes viruses

Answer 10

intranuclear DNA viruses

chickenpox as child, zoster(shingles) as elderly

herpes simplex: lesions around lips or genital area. reoccuring eruptions.

Question 11

poxviruses

Answer 11

intracytoplasmic DNA viruses

• variola: small pox. severe generalized eruptions with pustules
• rubeola: measles or morbilla
• rubella: german measles
• molluscum contagiosum: disease with several small papules on any part of the skin (but mostly genitalia) filled with infected cells. they swell enormously.

Question 12

Bullous diseses

Answer 12

blister diseases

• pemphigus vulgaris: intraepidermal (intact basal layer). usually in younger people
• Bullous pemphigoid: subepidermal blister. usually occur in elderly with ill health

Question 13

multi-layer diseases

Answer 13

• psoriasis vulgaris
• Linchen Sclerous et atrophicans
• acanthosis nigricans
• erythema multiforme

Question 14

Psoriasis vulgaris

Answer 14

exaggeration of everything in epidermis with very fast turn-over rate. leading to parakeratosis

involves defected T-cells and neutrophils on the corneum (top layer)

Question 15

Lichen Sclerous et atrophicans

Answer 15

a flat white scarred lesions in which the epidermis becomes atrophic with time.

mainly elderly women on peritoneum

Question 16

Acanthosis Nigricans

Answer 16

usually occur in obese people on sides of neck, axillae, and elbow.

Dark lines

abnormal hormonal influence, especially insulin

primarily a papillomatosis: skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae

Question 17

Erythema multiforme

Answer 17

kills epidermis then leads to erythema >> more dead >> more erythema >> concentric circles on affected area

can occur because of drug reaction >> immediately stop

Question 18

Neoplasia and cancer

Answer 18

Basaloid cells

• Seborrheic keratosis, basal cell carcinoma

Squamous cells

• actinic keratosis (malignant precursor), arsenical keratosis

melanocyte cells

• Peutz-Jeghers syndrome: melanoma that is malignant and irregular
• histologically prognosed from ulcers and thickness (alhtough thickness preceeds ulcers)