Blistering Disorders & Tumors

Question 1

What are the three types of blistering disorders talked about in class?

Answer 1

1 Pemphigus
2 Bullous pemphigoid
3 Dermatitis Herpetiformis

Question 2

What is the reason for the painful blister that results from pemphigus?

Answer 2

Loss of cellular attachments

Question 3

What are the two types of pemphigus?

Answer 3

Pemphigus vulgaris and pemphigus foliaceus

Question 4

Which form of pemphigus is more common and more severe?

Answer 4

Pemphigus vulgaris

Question 5

What is the age and gender bias for pemphigus?

Answer 5

Middle-aged/elderly women

Question 6

What type of hypersensitivity is associated with pemphigus?

Answer 6

Type II

Question 7

What family of antibodies is associated with pemphigus?

Answer 7

IgG

Question 8

A “fishnet-like” pattern of IgG antibodies is associated with which blistering disorder?

Answer 8

Pemphigus

Question 9

What are the body locations associated with pemphigus?

Answer 9

Face, scalp, axillae, groin

Question 10

Where are blisters of pemphigus located in the skin?

Answer 10

Bottom of epidermis in stratum basale (suprabasal)

Question 11

Which form of pemphigus is limited to the skin with no influence on the mucosa?

Answer 11

Pemphigus foliaceus

Question 12

Which form of pemphigus involves both the skin and mucosa?

Answer 12

Pemphigus vulgaris

Question 13

What is the location of the blisters associated with pemphigus foliaceus?

Answer 13

Below stratum corneum (subcorneal)

Question 14

What is the age range for bullous pemphigoid?

Answer 14

Older adults

Question 15

What are the body locations for bullous pemphigoid?

Answer 15

Thigh, forearm, axilla, groin

Question 16

What is the location of the blisters associated with bullous pemphigoid?

Answer 16

Subepidermal (below the epidermis)

Question 17

Subcorneal blisters are associated with which blistering disorder?

Answer 17

Pemphigus foliaceus

Question 18

Suprabasal blisters are associated with which blistering disorder?

Answer 18

Pemphigus vulgaris

Question 19

Subepidermal blisters are associated with which blistering disorder?

Answer 19

Bullous pemphigoid

Question 20

Linear IgG antibodies can be seen with which blistering disorder?

Answer 20

Bullus pemphigoid

Question 21

In which blistering disorder does the epidermis separate from the dermis and a blister forms in between?

Answer 21

Bullous pemphigoid

Question 22

Tense bullae are associated with which blistering disorder?

Answer 22

Bullous pemphigoid

Question 23

Why are the bullae associated with bullous pemphigoid strong in appearance?

Answer 23

Epidermis remains intact while blister forms below it

Question 24

Dermatitis herpetiformis is seen in 10% of patients with what chronic disease?

Answer 24

Celiac disease

Question 25

What is the age and gender bias for dermatitis herpetiformis?

Answer 25

Males, ages 20-40 years

Question 26

What are the body locations associated with dermatitis herpetiformis?

Answer 26

Torso, gluteal region, elbows, knees

Question 27

In which blistering disorder are IgA antibodies seen on the dermal papillae?

Answer 27

Dermatitis herpetiformis

Question 28

What three benign and pre-malignant tumors were discussed in class?

Answer 28

1 Seborrheic keratosis 2 Sebaceous adenoma 3 Actinic keratosis

Question 29

What kind of cells make up the tumor of seborrheic keratosis?

Answer 29

Keratinocytes (benign)

Question 30

What age group is primarily affected by seborrheic keratosis?

Answer 30

Middle-aged or elderly

Question 31

What is the appearance of the lesions associated with seborrheic keratosis?

Answer 31

Dark, flat, round, "coin-like", "stuck-on"

Question 32

What condition is important to rule out when observing the dark, flat lesions of seborrheic keratosis?

Answer 32

Malignant melanoma

Question 33

Leser-Trélat sign is associated with what skin condition?

Answer 33

Seborrheic keratosis

Question 34

What is the body location for sebaceous adenomas?

Answer 34

Head and neck

Question 35

Sebaceous adenomas are associated with what larger-scale syndrome?

Answer 35

Muir-Torré Syndrome

Question 36

What type of pre-cancer dysplasia occurs to sun-exposed areas resulting in small, tan/brown, sandpaper-like lesions?

Answer 36

Actinic keratosis

Question 37

What is the treatment for actinic keratosis?

Answer 37

Local eradication

Question 38

What are the three types of malignant epidermal tumors discussed in class?

Answer 38

1 Squamous cell carcinoma 2 Basal cell carcinoma 3 Melanoma

Question 39

When death occurs due to squamous cell or basal cell carcinoma, what was usually the factor involved?

Answer 39

Neglect

Question 40

What is the second most common skin cancer?

Answer 40

Squamous cell carcinoma

Question 41

What genetic mutation is associated with squamous cell carcinoma?

Answer 41

TP53 mutation

Question 42

What age group is mostly affected by squamous cell carcinoma?

Answer 42

Older adults

Question 43

What are risk factors for squamous cell carcinoma?

Answer 43

Total UV exposure, males, burns, ionizing radiation, tar/oil, arsenic, chronic ulcers

Question 44

What is the gender bias for squamous cell carcinoma?

Answer 44

Males more likely to be affected

Question 45

Squamous cell carcinomas are common among those with what preexisting condition involving faulty nucleotide excision repair?

Answer 45

Xeroderma pigmentosum

Question 46

10% of cases of what other skin condition can progress into squamous cell carcinomas?

Answer 46

Actinic keratosis

Question 47

Which is deeper in the skin: squamous cell or basal cell carcinomas?

Answer 47

Basal cell carcinomas (in the stratum basale)

Question 48

What is the most common type of skin cancer?

Answer 48

Basal cell carcinoma

Question 49

What are the risks for basal cell carcinoma?

Answer 49

Total UV exposure, mutated tumor supressor genes

Question 50

What gene mutations are associated with basal cell carcinomas?

Answer 50

TP53 and PTCH (Hedgehog pathway)

Question 51

What is the location of melanocytic proliferations?

Answer 51

Stratum basale

Question 52

What condition involves acquired benign tumors of melanocytes?

Answer 52

Melanocytic nevus

Question 53

What are the two types of melanocytic nevus?

Answer 53

Common nevus and dysplastic nevus

Question 54

What is the lay term for common nevus?

Answer 54

Mole, beauty mark

Question 55

A common nevus grows into what layer of the skin?

Answer 55

Dermis

Question 56

What is the usual onset of a common nevus?

Answer 56

Childhood/adolescence

Question 57

How does a dysplastic nevus differ from a common nevus?

Answer 57

Dysplasia, irregular borders and colors

Question 58

What form of dysplastic nevus has a higher risk of transitioning into melanoma?

Answer 58

Familial dysplastic nevus

Question 59

What are the two forms of dysplastic nevus?

Answer 59

Sporadic or familial

Question 60

What is the third most common skin cancer?

Answer 60

Melanoma

Question 61

What are the risks for melanoma?

Answer 61

Intense UV, fair skin/red hair

Question 62

What is the familial association with melanoma?

Answer 62

10% have family history

Question 63

What is the order of growth direction associated with melanoma?

Answer 63

Horizontal growth followed by vertical growth

Question 64

Which direction of growth of melanoma indicates aggressiveness?

Answer 64

Vertical growth

Question 65

To which organs can melanoma metastasize?

Answer 65

Liver, lung, CNS

Question 66

Do most cases of melanoma present with symptoms?

Answer 66

NO, usually asymptomatic

Question 67

What things can indicated signs of aggressiveness of melanoma?

Answer 67

Increased size Change in color New lesion in adulthood

Question 68

What is the ABCDE acronym for melanoma?

Answer 68

``` Asymmetry Border Color Diameter Elevation* (some say evolving) ```

Question 69

Which form of skin cancer presents as a pearly papule with telangiectasis?

Answer 69

Basal cell carcinoma