Derm Path Flashcards
1
Q
- Symptoms: *Warts. Soft, tan-colored cauliflower-like lesions. Epidermal hyperplasia, hyperkeratosis, koilocytosis. Verruca vulgaris on hands,; condyloma acuminatum on genitals (caused by HPV).
A
Verrucae
2
Q
- Symptoms: *Common mole that has hair growing from it (melanomas don’t have hair growing from it). Pathophysiology: *Benign neoplasm of basal melanocytes. Intradermal (adult) are papular while Junctional (children) are flat macules.
A
Nevocelluar nevus (Melanocytic Nevus)
3
Q
- Symptoms: Hives. Intensity pruritic wheals that form after mas cel degranulations. Lab Values: ** Pathophysiology: ** Treatment: *
A
Utricaria
4
Q
- Symptoms: *Freckle. Hyperpigmentation due to increased number of MELANOSOMES. Normal number of melaoncytes. Darkens with sunlight.
A
Ephelis
5
Q
- Symptoms: Commonly on face and flexor surfaces. Pruritic, erythematous, ooozing rash with vesicles and edema. Lab Values: ** Pathophysiology: *Often associated with other atopic diseases (asthma, allerigc rhinitis). Starts on the face in infancy and then moves to the antecubital fossae.
A
Atopic dermatitis (eczema)
6
Q
- Symptoms: Type IV hypersensitivity that follows epxosure to allergin; lesions occur at site of contact (nickle, poison ivy). Lab Values: ** Pathophysiology: ** Treatment: *
A
Allergic contact dermatitis
7
Q
- Symptoms: Papules and plaques with silvery scaling especially on knees and elbows. Acanthosis (thickening of dermis) with parakeratotic scaling (nuclei still in stratum corneum); increase stratum spinosum and decreased stratum granulosum. Lab Values: Auspitz sign (bleeding spots when scales are scraped off; due to elongated dermal papillae). Munro microabscesses in stratum corneum. Pathophysiology: Associated with nail pitting and psoriatic arthritis. Treatment: *Corticosteroids, UVA light with psoralen.
A
Psoriasis
8
Q
- Symptoms: *Flat, greasy, pigmented squamous epithelial proliferation with keratin-filled cysts (pseudo horn cysts). Looks “pasted on.” Lesions on head, trunk, extremeitis. Pathophysiology: Common benign neoplasm of older persons. Treatment: *
A
Seborrheic keratosis
9
Q
- Symptoms: *Sudden appearance of multipe seborrheic keratosis indicating an underlying malignancy (GI, lymphoid). Due to mutation in TGF alpha.
A
Sign of Leser-Trelat
10
Q
- Symptoms: May involve eye or bot skin and eye. Normal number of melanocytes. Lab Values: ** Pathophysiology: Due to defect in tyrosinase or migratinon of neural crests. Increased risk of skin cancer. Treatment: *
A
Albinism
11
Q
- Symptoms: Irregular areas of complete depigmentation. Lab Values: ** Pathophysiology: Due to local autoimmune destruction of melanocytes. Treatment: *
A
Vitiligo
12
Q
- Symptoms: Hyperpigmentation of cheeks associated with pregnancy (“mask of pregnancy”) or oral contraceptive use. Lab Values: ** Pathophysiology: ** Treatment: *
A
Melasma
13
Q
- Symptoms: Very superficial skin infection usually from S. aureus or S. pyogenes. Highly contagious. Honey color crusting. Lab Values: ** Pathophysiology: ** Treatment: *
A
Impetigo
14
Q
- Symptoms: Acute, painful spreading infection of dermis and subcutaneous tissue. Usually form S. pyogenes or S. aureus. Lab Values: ** Pathophysiology: ** Treatment: *
A
Cellulitis
15
Q
- Symptoms: Deeper tissue injury usually from anaerobic bacteria and S. pyogenes. Results in crepitus from methane and CO2 production. Lab Values: ** Pathophysiology: ** Treatment: *
A
Necrotizing fasciitis
16
Q
- Symptoms: Exotoxin destroys keratinocyte attachments to the stratum granulosum only. Fever, generalized erythematous rash with sloughing of upper layers of epidermis. Seen in young children. Lab Values: ** Pathophysiology: ** Treatment: *
A
Staphyloccal scalded skin syndrome
17
Q
- Symptoms: White, painless plaques on tonguet hat cannot be scraped off. EBV mediated. Occurs in HIV positive patients. Lab Values: ** Pathophysiology: ** Treatment: *
A
Hairy leukoplakia
18
Q
- Symptoms: Acantholysis of skin AND oral mucosa. Positive Nikolsky’s sign (separation of epidermis upon manual stroking of skin). Lab Values: Autoantibody (IgG) to desmoglein (desmosomes). Reticular or netlike pattern on IF. Pathophysiology: Autoimmune disorder (type II hypersensitivity). Treatment: *
A
Pemphigus vulgaris
19
Q
- Symptoms: Similar but less severe than pemphigus vulgaris - affects skin but SPARES ORAL MUCOSA. Negative Nikolsky’s sign. Blisters. Lab Values: Autoantibody (IgG) to hemidesmosomes. Linear pattern on IF. Eosinophiles with tense blisters. Pathophysiology: Autoimmune disorder (type II hypersensitivity). Treatment: *
A
Bullous pemphigoid
20
Q
- Symptoms: Pruritic papules and vesicles in a person with Celiac disease. Lab Values: Deposits of IgA at tips of dermal papillae. Pathophysiology: ** Treatment: *
A
Dermatitis herpetiformis
21
Q
- Symptoms: Presents with multiple types of lesions - macules, papules, vesicles, and target lesions. Lab Values: ** Pathophysiology: Associated with infections (mycoplasma, HSV), drugs (sulfas, penicillins, phenytoin), cancers, and autoimune disease (SLE). Treatment: *
A
Erythema multiforme
22
Q
- Symptoms: Prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital) . Skin lesions progress to epidermal necrosis and sloughing. Lab Values: ** Pathophysiology: ** Treatment: *
A
Stevens-Johnson syndrome
23
Q
- Symptoms: *Pruritic, purple, polygonal papules. Occurs in wrists, elbows, and oral mucosa. * Lab Values: *Sawtooth infiltrate of lymphocytes at dermal-epidermal junction. * Pathophysiology: Associated with chronic hepatitis C infection. Treatment: *
A
Lichen planus
24
Q
- Symptoms: *Premlaignant lesions caused by UVB exposure. Small, rough, erythematous or brownish papules. “Cutaneous horn.” * Lab Values: ** Pathophysiology: Risk of carcinoma is proprotional to epithelial dysplasia. Treatment: *
A
Acitinic keratosis
25
Q
- Symptoms: Hyperplasia of stratum spinosum with darkening of the skin. Lab Values: ** Pathophysiology: * Associated with hyperinsulinemia (Cushing’s, disease, DM2) and VISCERAL MALIGNANCY.* Treatment: *
A
Acanthosis nigricans
26
Q
- Symptoms: Inflammatory lesions of subcutaneous fat, usually on anterior shins. Associated with cocciodiomycosis, histoplasmosis, TB, leprosy, streptococal infections, sarcoidosis. Lab Values: Shows early septal widening and lymphohistiocyte infiltration without vasculitis.
A
Erythema nodosum
27
Q
- Symptoms: Herald patch” followed days later by “Christmas tree” distribution. Multiple papular eruptions that remits spontaneously. Lab Values: ** Pathophysiology: Associated with HHV-7 Treatment: *
A
Pityriasis rosea
28
Q
- Symptoms: Benign capillary hemangioma of infancy. Appears in first few weeks of life, grows rapidly and regresses at 5-8 years of age. Most common tumor of infants. Lab Values: ** Pathophysiology: ** Treatment: *
A
Strawberry hemangioma
29
Q
- Symptoms: Benign capillary hemangioma of the elderly. Does not regress; increase frequency with age. Lab Values: ** Pathophysiology: ** Treatment: *
A
Cherry hemangioma
30
Q
- Symptoms: Common on hands and face. Locally invasive but rarely metastasizes. Ulcerative red lesion. Associated with chronic draining sinuses. Lab Values: Keratin pearls. Pathophysiology: Associated with excessive exposure to UVNB sunlight or arsenic exposure. Acitinic keratosis is a precursor to squamous cell carcinoma. Treatment: *
A
Squamous cell carcinoma of skin
31
Q
- Symptoms: Variant of squamous cell carcinoma that grows rapidly (4-6 weeks) and regresses spontaenously (4-8 weeks). Lab Values: Very well differentiated SCC. Cup-shaped tumor filled with keratin debris. Pathophysiology: ** Treatment: *
A
Keratoacanthoma
32
Q
- Symptoms: Most common in sun-exposed areas of body, especially UPPER LIP. Locally invasive, but almost never metastasizes. Lab Values: Elevated nodule with central ulceration surroudned by telangiectasis. Pearly papules. Tumors have peripheral “palisading” nuclei. Pathophysiology: Due to exposure to UVB sunlight. Treatment: *Cryotherapy.
A
Basal cell carcinoma
33
Q
- Symptoms: Common tumor with significant risk of metastasis. Dysplastic nevus (atypical mole) is a precusor to melanoma. Look for assymetry, border irregularity, color variation, diameter > 6 mm, and a history of change. Lab Values: S-100 tumor marker. Atypical pagetoid (upward spreading). BRAF activating mutation. P16 mutation. Pathophysiology: Fair skinned persons at increased risk. DEPTH of tumor correlates with risk of metastasis. Treatment: BRAF kinase inhibitor (vemurafenib) in pts with metastatic/unresectable melanoma with BRAF V600E mutation.
A
Melanoma
34
Q
- Symptoms: *Flat discoloration < 1 cm (Tinea versicolor).
A
Macule
35
Q
- Symptoms: *Macule > 1 cm
A
Patch
36
Q
- Symptoms: *Elevated skin lesion < 1 cm (acne vulgaris)
A
Papule
37
Q
- Symptoms: *Papule > 1 cm
A
Plaque
38
Q
- Symptoms: *Small fluid containing blister (VZV)
A
Vesicle
39
Q
- Symptoms: *Transient vesicle (hives)
A
Wheal
40
Q
- Symptoms: *Large fluid-contianing blister (bullous pemphigoid)
A
Bulla
41
Q
- Symptoms: *Irregular, raised lesion resulting from scar tissue hypertrophy (trauma to skin; Treponema pertenue)
A
Keloid
42
Q
- Symptoms: *Blister containing pus
A
Pustule
43
Q
- Symptoms: *Dried exudates from a vesicle, bulla, or pustule (impetigo)
A
Crust
44
Q
- Symptoms: *Increased thickness of stratum corneum (psoriasis)
A
Hyperkeratosis
45
Q
- Symptoms: *Hyperkeratosis with retention of nuclei in stratum corneum (psioriasis)
A
Parakeratosis
46
Q
- Symptoms: *Separation of epidermal cells (pemphigus vulgaris)
A
Acantholysis
47
Q
- Symptoms: *Epidermal hyperplasia (increased spinosum)
A
Acanthosis
48
Q
- Symptoms: *Inflammation of the skin
A
Dermatitis
49
Q
- Symptoms: ** Lab Values: ** Pathophysiology: Hormone related increase in sebum and exces kertain block follicles (comedones) followed by inflammation of hair follicles and sebaceous glands by Proprionibacterium acnes infection. Treatment: *Benzoyl peroxide (antimicrobial), isoretinoin (lowers keratin production)
A
Acne vulgaris
50
Q
- Symptoms: *Airses on palms or soles in dark skinned individuals. Pathophysiology: *Not related to UV light exposure.
A
Acral lentiginous melanoma
51
Q
- Chronic excessive keratin accumulation (hyperkeratosis) resembling fish scales.
- Primary deficit is increased cel-cell adhesions resulting in abnormal desquamation.
- Compacted stratum corneum.
A
Ichthyosis
52
Q
- Firm, pink umbilicated papules due to poxvirus.
- Most often in children but also in sexually active adults and immunocompromised.
- Hallmark is molluscum bodies in the affected keratinocytes.
- Cheesy material from central umbilications contain molluscum bodies.
A
Molluscum Contagiosum
53
Q
Four Types:
- Superficial Spreading (radial growth), good prognosis
- Nodular: early vertical phase, poor prognosis
- Lentigo maligna: Remains along the dermal/epidermal junction - good prognosis
- Acrolentiginous: On palms/soles of dark-skinned individuals. Not related to UV Light Exposure
A
Melanoma
