Ch. 14 - Metabolic disorders

Question 1

Recall some mucinoses.

Answer 1

Scleredema (of Buschke)

Pretibial myxedma

Scleromyxedema

Timid lupus erythematosus

Focal mucinosis

Question 2

Scleredema (of Buschke)

Answer 2

Thickened dermis, deep dermal mucin with widened spaces between it and normal collagen bundles.

Question 3

Pretibial myxedema

Answer 3

Large amounts of dermal mucin. Collagen bundles separated by mucin and reduced to thin wisps. Concurrent Graves disease

Question 4

Scleromyxedema

(association?)

Answer 4

Increase in dermal fibroblasts, fine collagen, and interstitial mucin.

Associated with IgG paraproteinemia

Question 5

Timid lupus mucinosis

Answer 5

Subtle interface damage, perivascular/periadnexal lymphocytic infiltrate. Abundant mucin in reticular dermis.

Question 6

What are some patterns of amyloidosis?

Answer 6

Nodular (light chains)

Macular (keratin-derived)

Lichen (keratin-derived)

Question 7

Nodular amyloidosis

Answer 7

Large fissued pale pink masses, usually with plasma cells/

Question 8

Focal mucinosis

Answer 8

Dome-shaped papule containing a pool of mucin.

Question 9

Macular amyloid

Answer 9

Sparse pink deposits in the papillary dermis, outlined by melanophages.

Question 10

Lichen amyloid

Answer 10

Hyperkeratosis and acanthosis with pink amorphous deposits in the papillary dermis outlined by melanophages (like macular).

Question 11

Name 3 entities that present with cutaneous calcification.

Answer 11

Calciphylaxis

Subepidermal calcified nodule

Scrotal calcinosis

Question 12

Calciphylaxis

Answer 12

Calcified vessels in subcutaneous fat with necrosis. Usually in diabetic/renal failure patients.

Question 13

Subepidermal calcified nodule

Answer 13

Pseudoepitheliomatous hyperplasia with transepidermal elimination of calcium. Usually an idiopathic process in children.

Question 14

Scrotal calcinosis

Answer 14

Amorphous masses of calcium and smooth muscle throughout the dermis (indicating genital site).

Question 15

Gout

Answer 15

Palisading granuloma surrounding amorphous gray feathery material. Crystals are brown if fixed in ethanol.

Question 16

Erythropoietic protoporphyria (EPP)

(cause?)

Answer 16

Hyaline cuff around post-capillary venules. Absence of elastosis (behavioral)

Associated with deficiency of ferrocheletase

Question 17

Colloid milium

Answer 17

Pale pink, fissured deposits that fill and expand the dermal papillae.

Question 18

Lipoid proteinosis

Answer 18

Eosinophilic hyaline deposits around vessels/adnexae with onion-skinning.

Question 19

Nutritional dermatoses

Answer 19

Pallor of the superficial epidermis and confluent parakeratosis and psoriasiform epidermal hyperplasia.

Question 20

Mucocele

Answer 20

Pseudocystic space containing mucin, surrounded by muciphages and granulation tissue.

Question 21

Oxalosis

Answer 21

Yellow-brown radially arranged needle-shaepd refractile crystals. Vascular involvement & thrombi?

Question 22

Answer 22

Scleredema (of Buschke)

Question 23

Answer 23

Pretibial myxedema

Question 24

Answer 24

Scleromyxedema

Question 25

Answer 25

Timid lupus

Question 26

Answer 26

Focal mucinosis

Question 27

Answer 27

Nodular amyloidosis

Question 28

Answer 28

Macular amyloid

Question 29

Answer 29

Lichen amyloid

Question 30

Answer 30

Calciphylaxis

Question 31

Answer 31

Subepidermal calcified nodule

Question 32

Answer 32

Gout

Question 33

Answer 33

Erythropoietic protoporphyria

Question 34

Answer 34

Colloid milium

Question 35

Answer 35

Lipoid proteinosis

Question 36

Answer 36

Nutritional-deficiency dermatosis

Question 37

Answer 37

Mucocele

Question 38

Answer 38

Oxalosis