Derm 2 Flashcards
Is seborrheic keratoses malignant? sun induced?
Benign
Not sun induced
Describe the histology of a seborrheic keratoses?
flat bottomed bland epidermal proliferation with PSEUDO HORN CYSTS
What is a concentrically laminated collections of surface keratin within the acanthotic epithelium
pseudo horn cyst
What is acanthosis?
epidermal hyperplasia
What is an achrocordon?
skin tag
What are achrocordons associated with?
Obesity in area of friction
Are dermatofibromas malignant? Where are they most often located? What is the key characteristic of pinching them?
- Benign
- Shoulders and legs
3 firm and dimple in when pinched
What is the his to characteristic of dermatofibromas?
fibrohistiocytic proliferation in the DERMIS
Are neurofibromas malignant? Where are they found? what type of tissue proliferation are they?
- Benign
- trunk of middle aged individuals
- neuromesenchymal tissue
Is neurofibromatosis autosomal recessive? What gene is problematic?
- Autosomal Dominant
2. Neurofibromin gene
What are 5 physical signs (marks) of neurofibromatosis?
Neurofibromas Cafe au lait macules Lisch nodules axillary freckling optic glioma
What does a neurofibroma look like under a microscope?
spindled, schwann cells, has a pinkish color that is different than the collagen of dermatofibroma
What is a epidermoid cyst filled with?
keratin- with a stratified squamous wall
What is excessive fibroblast proliferation and collagen production in response to a injury? Does it stay within the original area of injury?
Keloid
no extends beyond
[higher incidence in those with african ancestry]
What is red blanching macules that are present at birth? Do they go away? biopsy shows what?
- nevus flammeus
- many do fade
- capillary dilation (telangiectasia)
Port wine stain is a capillary malformation with a bright red blotchy pattern and has V1 and V2 involvement? What syndrome is it associated with?
- port wine stain
- sturge-weber syndrome
- cns angiomatosis
- mental retardation
- contralateral seizure
- ipsilateral glaucoma
When do strawberry hemangiomas appear? When do they go away?
- appear shortly after birth
2. Grow rapidly for 9 mo to 12 mo and then slowly involute
When do cherry hemangiomas come about? where are they most numerous? how long to the last? what is proliferated?
- middle age
- most numerous on trunk
- persists indefinitely
- capillary proliferation
Kaposi’s sarcoma effects what two groups? what is the virus involved? what is the histology?
- elderly mediterranean males and HIV positive patients
- HHV8
- atypical vascular proliferation
What is the indolent form of cutaneous T-cell lymphoma? how do they progress?
- Mycosis fungoides
2. dermatitis like patch–> plaque–> then tumor
What is sezary’s syndrome?
leukemic form of cutaneous T-cell lymphoma- patients are very pruritic and erythroderma
When does pemphigus vulgaris come about? where are they located? the circulated antibodies are to what proteins? Does it show the Nikolsky sign?
- mid adult life
- oral mucosa and skin
- desmosomal proteins- desmoglein 1 & 3
- Yes- lateral pressure on skin gives blister
What does pemphigus immunofluorescence look like?
chicken wire
Is pemphigus foliaceous deep or superficial? does it effect oral mucosa? Where is it endemic? What are the antibodies against?
- superficial
- spares oral mucosa
- Brasil
- desmoglein 1 (why it spares oral mucosa)
Who is bullous pemphigoid primarily seen? What specific type of blisters are present? Does it have a nikolsky sign? What are the antibodies against?
- in the elderly
- tense, subepidermal
- no nikolsky sign
- hemi-desmosomal proteins
T-F– bullous pemphigoid has an eosinophil-rich upper dermal infiltrate?
True
What does the immunofluorescence look like for bullous pemphigoid?
straight line- think hemidesmosomes
Where are the intensely pruritic vesicles of dermatitis herpetiformis found?
- elbows, knees, scalp, buttocks
What skin disease do we know that is associated with gluten sensitivity enteropathy?
dermatitis herpetiformis
T-F- dermatitis herpetiformis is Nikolsky positive?
False- negative
Where are the micro abscesses of dermatitis herpetiformis found histologically speaking?
in the dermal papillae
What does the direct immunofluorescence of dermatitis herpetiformis logo like?
Granular IgA in dermal papillae
What are the 3 types of epidermolysis bullosa?
Simplex, junctional, dystrophic
Which epidermolysis bullosa is split through upper dermis; defect in type VII collagen?
dystrophic
Which epidermolysis bullosa is split through the basement zone, defective proteins include laminin 5, A6B4 integrin, type XVII collagen?
junctional
Which epidermolysis bullosa is split through the basal layer of the epidermis and the defects are in the K5 or K14?
simplex
T-F- epidermolysis bullosa is an inflammatory bullae?
False- non-inflammatory
Review Porphyria Cutanea Tarda
- defect in heme pathway
- blisters and fragility of sun exposed skin
- defect in uroporphyrin decarboxylase
- associations- can get hirsuitism, alcoholism, estrogens, hemochromatosis and hepatitis C
