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Human Disease and Therapeutics > 3rd Midterm Study Guide: Dermal Pathology > Flashcards

3rd Midterm Study Guide: Dermal Pathology Flashcards

1
Q

What are the 3 cell types of skin?

A

Squamous cells
Basal cells
melanocytes

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2
Q

Appendages of the skin include…

A

Apocrine = sweat milky with odors near hair follicles
Eccrine = widely distributed water sweat for heat
Sebaceous = secretes oily sebum for lubrication and to
prevent water loss.

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3
Q

What is a Macule?

A

Flat, circumscribed (< 5mm)

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4
Q

What is a Papule?

A

elevated dome or flat topped ( < 5 mm)

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5
Q

What is a Nodule?

A

elevated dome

> 5 mm

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6
Q

What is a plaque?

A

elevated flat topped lesion

> 5 mm

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7
Q

What is Lichenification?

A

Thickened skin due to repeated rubbing

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8
Q

What is a Pustule?

A

discrete, pus filled raised lesion

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9
Q

what is a Scale?

A

Dry, plate-like excrescence, imperfect cornification

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10
Q

What is a Vesicle?

A

Fluid filled raised area

< 5 mm

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11
Q

What is Acantholysis?

A

Loss of intracellular adhesion keratinocytes

epidermis falls apart and sloughs off

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12
Q

What is Excoriation?

A

traumatic breakage of the skin

result of intense scratching

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13
Q

What is a Bulla?

A

Fluid filled raised area

> 5 mm

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14
Q

What is dyskeratosis?

A

abnormal keratinization that is deeper in the epidermis than normal.

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15
Q

What is hyperkeratosis?

A

Hyperplasia of stratum cornum

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16
Q

What is spongiosis?

A

Intracellular edema of the epidermis

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17
Q

What is papillomatosis?

A

Surface elevation caused by hyperplasia

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18
Q

What are examples of acute inflammatory pathologies of the skin?

A
  • Urticaria (hives)
  • Eczematous Dermatitis
  • Allergic Contact Dermatitis
  • Erythema Multiforma
  • Stevens-Johnson Syndrome
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19
Q

What is Urticaria?

A

Hives

  • hypersensitivity mediated by antigens (IgE)
  • treat with antihistamine or steroids
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20
Q

What is eczematous Dermatitis?

A

Contact Dermatitis most common

  • delayed hypersensitivity that can be pruritic, edematous, or oozing plaques/vesicles.
  • can also be caused by drugs, UV or chemicals
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21
Q

What is Allergic Contact Dermatitis?

A

Cellular memory of the reaction so that future contacts cause an increased dermatitis reaction

22
Q

What is Erythema Multiforma?

A

Hypersensitivity to infections and drugs

  • dermal edema that can have blisters or necrosis
  • wide range of expressions and severity
23
Q

What is Stevens-Johnson Syndrome?

A

A Generalized all over the the body reaction to medicines (Sulfonamides and Salicylates)
- Can also be a reaction to infections such as herpes or a fungus.

  • advanced can have epidermal necrosis and blisters
  • T-cells attacking antigen and surrounding cells (basal cells)
24
Q

What are examples of chronic inflammatory pathologies of the skin?

A
  • Psoriasis

- Lichen Planus

25
Q

What is Psoriasis?

A

Either caused by:

  • Inciting antigen
  • auto-rejection
  • environmentally induced
  • Well marked with pink/salmon plaques
  • regular acanthosis in epidermis (increased bleeding)
  • Can be accompanied by increase in heart attacks and arthritis

*tx includes NSAIDS and immunosuppressants.

26
Q

What is Lichen Planus?

A

Lace like white markings referred to as WICKAM STRIAE
on the extremities and oral cavity
-Hyperkeratosis and epidermal hyperplasia
-Resolves after 1-2 years although often stays in mouth
-seen in the middle aged with unknown inciting mechanisms. (Maybe hyperactive T cells?)

27
Q

Infectious Dermatosis can be…

A

Bacterial
Fungal
Viral

28
Q

What is Bacterial Infectious Dermatosis?

A

Impetigo from staph or strep

*tx with topical antibiotics like tetracycline

29
Q

What is Fungal Infectious Dermatosis?

A

Tinea (ring worm) or Candidiasis

  • pruritic, erythematous macules
  • Very common in immunocompromised
30
Q

What is Viral Infectious Dermatosis?

A 
Wart Pathology (HPV and Verrucae)
-Contagious by direct contact
-can auto inoculate and spread
  Epidermal hyperplasia
  Papillo Mitosis
31
Q

What is the prominent feature of Bulbous Blistering?

A

Pemphigus

painful flaccid blister-like deep erosions and crust after rupture - Hypersensitivity Rxn

32
Q

What do you use to treat Dermatitis Herpetiformis?

A

Use Immunosuppressive treatment

33
Q

What are the expressions of Herpes infections?

A

group vesicles
epidermal ancatholysis
Vesicles
Sloughing

34
Q

What are Characteristics of V Zoster virus?

A

Unilateral dermatomal distribution
Expresses as a band of rash that often itches/burns/throb
May persist for weeks to months
Usually tx with anti-inflammatories or opioid analgesics
Not contagious, usually doesn’t repeat but can

35
Q

What are characteristics of pemphigus?

A

Several Variants

  • Acanthosis
  • Blister Formation (Bullous)
  • Autoimmune
  • typically treat with steroids
36
Q

What is acne?

A

Infected hair follicles

37
Q

How is acne expressed?

A

Opened comodomes (blackheads)
Closed comodomes (whiteheads)
Cysts, pustules, accesses, scarring
Worsens with Drugs such as steroids, contraceptives, and testosterone

38
Q

What is characteristic of Acne Vulgaris?

A
  • Hormone changes (increased testosterone)
  • Blocks hair follicle and sebaceous gland
  • Hair follicle have proliferation of lining cells and cellular sloughing which forms a cellular plug and traps bacteria, debris and sebum
  • Gland ruptures and contents spread forming Cysts, accesses, and scarring.
39
Q

What are treatments for Acne Vulgaris?

A
  • Antibiotics (Tetracycline)
  • Keratolytics
  • Drying agents
  • Vitamin A (topical and systemic Accutane)
  • UV exposure
40
Q

What is characteristic of Perioral Dermatitis?

A
  • Seen in Young Women
  • Long-term steroid use of cosmetic use, hormonal change
  • Follicular Papules, Vesicles, and pustules
41
Q

What are 4 skin pathologies that are Neoplastic Benign?

A
  • Seborrhea Keratosis
  • Actinic Keratosis
  • Melanocytic Nevi
  • Dysplastic Nevi
42
Q

What is characteristic of Seborrhea Keratosis?

A
  • Elderly to Middle age
  • Coin-like plaques
  • Stuck-on appearance
  • Tan to dark brown granular surface
  • Can be spread generally
43
Q

What is characteristic of Actinic Keratosis?

A
  • Pre-Malignant, related to UV exposure in fair skinned

- Appears brown to red, rough scaly lesions

44
Q

What is characteristic of Melanocytic Nevi (moles)?

A
  • Benign Neoplasm from melanocytes
  • Variable in appearance
  • Well defined borders and not predisposed to cancer
45
Q

What is characteristic of Dysplastic Nevi?

A
  • Sporadic
  • If greater than 10 lesions, increased risk for melanoma
  • Irregular borders
  • Asymmetric borders
46
Q

Most common skin malignancies…

A
  • Basal cell
  • Squamous cell
  • Melanoma
47
Q

What is characteristic of a Basal cell malignancy?

A
  • Most Common malignancy world wide
  • Least aggressive
  • Slow growing
48
Q

What is characteristic of Squamous cell Malignancy?

A
  • Next most common
  • intermediate aggression, no metastasis
  • Red scaling plaques-locally aggressive
49
Q

What is characteristic of Melanoma?

A
  • Least Common
  • Typically aggressive and metastasizes
  • Caused by UV exposure and genetics
  • High mitotic rate and lack of immune response to slow spread, especially when it hits lymph nodes.
  • Poor prognosis if metastasized (brain, lungs, liver)
50
Q

What are the warning signs for a Melanoma?

A
  • Rapid enlargement of Nevus
  • New Pigmented lesion - not from preexisting nevi
  • irregular borders
  • irregular surface and colors

Human Disease and Therapeutics (24 decks)

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