Blistering Disorders & Tumors Flashcards
What are the three types of blistering disorders talked about in class?
1 Pemphigus
2 Bullous pemphigoid
3 Dermatitis Herpetiformis
What is the reason for the painful blister that results from pemphigus?
Loss of cellular attachments
What are the two types of pemphigus?
Pemphigus vulgaris and pemphigus foliaceus
Which form of pemphigus is more common and more severe?
Pemphigus vulgaris
What is the age and gender bias for pemphigus?
Middle-aged/elderly women
What type of hypersensitivity is associated with pemphigus?
Type II
What family of antibodies is associated with pemphigus?
IgG
A “fishnet-like” pattern of IgG antibodies is associated with which blistering disorder?
Pemphigus
What are the body locations associated with pemphigus?
Face, scalp, axillae, groin
Where are blisters of pemphigus located in the skin?
Bottom of epidermis in stratum basale (suprabasal)
Which form of pemphigus is limited to the skin with no influence on the mucosa?
Pemphigus foliaceus
Which form of pemphigus involves both the skin and mucosa?
Pemphigus vulgaris
What is the location of the blisters associated with pemphigus foliaceus?
Below stratum corneum (subcorneal)
What is the age range for bullous pemphigoid?
Older adults
What are the body locations for bullous pemphigoid?
Thigh, forearm, axilla, groin
What is the location of the blisters associated with bullous pemphigoid?
Subepidermal (below the epidermis)
Subcorneal blisters are associated with which blistering disorder?
Pemphigus foliaceus
Suprabasal blisters are associated with which blistering disorder?
Pemphigus vulgaris
Subepidermal blisters are associated with which blistering disorder?
Bullous pemphigoid
Linear IgG antibodies can be seen with which blistering disorder?
Bullus pemphigoid
In which blistering disorder does the epidermis separate from the dermis and a blister forms in between?
Bullous pemphigoid
Tense bullae are associated with which blistering disorder?
Bullous pemphigoid
Why are the bullae associated with bullous pemphigoid strong in appearance?
Epidermis remains intact while blister forms below it
Dermatitis herpetiformis is seen in 10% of patients with what chronic disease?
Celiac disease
What is the age and gender bias for dermatitis herpetiformis?
Males, ages 20-40 years
What are the body locations associated with dermatitis herpetiformis?
Torso, gluteal region, elbows, knees
In which blistering disorder are IgA antibodies seen on the dermal papillae?
Dermatitis herpetiformis
What three benign and pre-malignant tumors were discussed in class?
1 Seborrheic keratosis
2 Sebaceous adenoma
3 Actinic keratosis
What kind of cells make up the tumor of seborrheic keratosis?
Keratinocytes (benign)
What age group is primarily affected by seborrheic keratosis?
Middle-aged or elderly
What is the appearance of the lesions associated with seborrheic keratosis?
Dark, flat, round, “coin-like”, “stuck-on”
What condition is important to rule out when observing the dark, flat lesions of seborrheic keratosis?
Malignant melanoma
Leser-Trélat sign is associated with what skin condition?
Seborrheic keratosis
What is the body location for sebaceous adenomas?
Head and neck
Sebaceous adenomas are associated with what larger-scale syndrome?
Muir-Torré Syndrome
What type of pre-cancer dysplasia occurs to sun-exposed areas resulting in small, tan/brown, sandpaper-like lesions?
Actinic keratosis
What is the treatment for actinic keratosis?
Local eradication
What are the three types of malignant epidermal tumors discussed in class?
1 Squamous cell carcinoma
2 Basal cell carcinoma
3 Melanoma
When death occurs due to squamous cell or basal cell carcinoma, what was usually the factor involved?
Neglect
What is the second most common skin cancer?
Squamous cell carcinoma
What genetic mutation is associated with squamous cell carcinoma?
TP53 mutation
What age group is mostly affected by squamous cell carcinoma?
Older adults
What are risk factors for squamous cell carcinoma?
Total UV exposure, males, burns, ionizing radiation, tar/oil, arsenic, chronic ulcers
What is the gender bias for squamous cell carcinoma?
Males more likely to be affected
Squamous cell carcinomas are common among those with what preexisting condition involving faulty nucleotide excision repair?
Xeroderma pigmentosum
10% of cases of what other skin condition can progress into squamous cell carcinomas?
Actinic keratosis
Which is deeper in the skin: squamous cell or basal cell carcinomas?
Basal cell carcinomas (in the stratum basale)
What is the most common type of skin cancer?
Basal cell carcinoma
What are the risks for basal cell carcinoma?
Total UV exposure, mutated tumor supressor genes
What gene mutations are associated with basal cell carcinomas?
TP53 and PTCH (Hedgehog pathway)
What is the location of melanocytic proliferations?
Stratum basale
What condition involves acquired benign tumors of melanocytes?
Melanocytic nevus
What are the two types of melanocytic nevus?
Common nevus and dysplastic nevus
What is the lay term for common nevus?
Mole, beauty mark
A common nevus grows into what layer of the skin?
Dermis
What is the usual onset of a common nevus?
Childhood/adolescence
How does a dysplastic nevus differ from a common nevus?
Dysplasia, irregular borders and colors
What form of dysplastic nevus has a higher risk of transitioning into melanoma?
Familial dysplastic nevus
What are the two forms of dysplastic nevus?
Sporadic or familial
What is the third most common skin cancer?
Melanoma
What are the risks for melanoma?
Intense UV, fair skin/red hair
What is the familial association with melanoma?
10% have family history
What is the order of growth direction associated with melanoma?
Horizontal growth followed by vertical growth
Which direction of growth of melanoma indicates aggressiveness?
Vertical growth
To which organs can melanoma metastasize?
Liver, lung, CNS
Do most cases of melanoma present with symptoms?
NO, usually asymptomatic
What things can indicated signs of aggressiveness of melanoma?
Increased size
Change in color
New lesion in adulthood
What is the ABCDE acronym for melanoma?
Asymmetry Border Color Diameter Elevation* (some say evolving)
Which form of skin cancer presents as a pearly papule with telangiectasis?
Basal cell carcinoma
