Derm Path Flashcards
1
Q
Squamous epithelial cells (keratinocytes)
A
held together by desmosomes, produce keratin to create a tough and durable barrier
2
Q
Melanocytes
A
produces melanin, brown pigment that absorbs and protects against UV radiation
3
Q
Skin dendritic cells
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Langerhans cells, secrete factors to begin innate immune response
4
Q
Lymphocytes that home to the skin
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T cells with CCR4 and CCR10 receptors
5
Q
Layers of the epidermis
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Stratum corneum, stratum lucidum, stratum granulosum,, stratum spinosum, stratum basale
6
Q
Histological structure of epidermis
A
stratified squamous epithelium
7
Q
Histological structure of dermis
A
connective tissue
8
Q
Skin adnexa
A
structures derived from skin and adjacent to the skin; includes hair follicles, sebaceous and sweat glands
9
Q
Excoriation
A
traumatic lesion breaking epidermis and causing a raw linear area
10
Q
Lechneification
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thickened, rough skin
11
Q
Macule, patch
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circumscribed, flat lesion distinguished from surrounding skin by color
12
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Onycholysis
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separation of nail plate from nail bed
13
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Papule, nodule
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elevated dome-shaped or flat-topped lesion
14
Q
Plaque
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elevated flat-topped lesion
15
Q
Pustule
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Discrete, pus-filled, raised lesion
16
Q
Scale
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Dry, horny, platelike excrescence
17
Q
Vesicle, bulla, blister
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fluid-filled raised lesion
18
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wheal
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itchy, transient, elevated lesion with variable blanching and erythema
19
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Acanthosis
A
diffuse epidermal hyperplasia
20
Q
Dyskeratosis
A
abnormal, permature keratinization within cells below stratum granulosum
21
Q
Erosion
A
discontinuity of skin showing complete loss of epidermis
22
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Exocytosis
A
infiltration of epidermis by inflammatory cells
23
Q
Hydropic swelling
A
intracellular edema of keratinocytes, often seen in viral infections
24
Q
Hypergranulosis
A
hyperplasia of stratum granulosum
25
Hyperkeratosis
thickening of stratum corneum
26
Lentiginous
linear pattern of melanocyte proliferation with epidermal basal cell layer
27
Papillomatosis
surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae
28
Parakeratosis
keratinization with retained nuclei in stratum corneum
29
Spongiosis
intercellular edema of epidermis
30
ulceration
discontinuity of skin showing complete loss of epidermis
31
Vacuolization
formation of vacuoles within or adjacent to cells
32
Most common pigmented lesion of childhood in light pigmented individuals
freckle (ephelis)
33
Ephelis morphology
tan-red macules that appear after sun exposure; increased melanin in basal keratinocytes
34
Lentigo
localized melanocytic hyperplasia
35
Lentigo morphology
oval, tan-brown macules or papules; linear melanocytic hyperplasia restricted to basal cell layer
36
Melanocytic nevi
benign neoplasms caused by activating mutations in Ras pathway
37
Congenital nevus architecture/features
deep dermal, sometimes subcutaneous growth around adnexa, blood vessel walls, and NV bundles
38
Blue nevus architecture/features
non-nested dermal infiltration, often with associated fibrosis; highly dendritic and heavily pigmented nevus cells
39
Spindle and epitheloid cell nevus architecture and features
fascicular growth; large, plump cells with pink-blue cells, fusiform cells
40
Halo nevus architecture and features
lymphocytic infiltration surrounding nevus cells, identical to ordinary acquired nevi
41
Dysplastic nevus architecture and features
coalescent intraepidermal nests, cytologic atypia
42
Junctional nevi morphology
aggregates or nests of round cells that grow along dermoepidermal junction
43
Compound nevi morphology
junctional nevi grow into underlying dermis as nests or cords of cells
44
Dysplastic nevi morphology
involve epidermis and dermis, cytologic atypia, underlying dermis typically shows linear fibrosis
45
Characteristics of a "normal mole"
evenly colored brown, tan, or black spot on the skin; flat or raised; round or oval
46
ABCDE rule
asymmetry, border, color, diameter, evolution
47
Potential warning signs for melanoma
sore that doesn't heal, spread of pigment from border of a spot into surrounding skin, redness or a new swelling beyond the border of the mole, change in sensation, change in surface
48
Radial growth of melanoma
horizontal spread of melanoma within epidermis and superficial dermis
49
Vertical growth phase of melanoma
appearance of nodule and correlates with the emergence of a tumor subclone with metastatic potential
50
Breslow thickness
depth of invasian, distance from superficial epidermal granular cell layer to deepest intradermal tumor cell
51
Seborrheic keratoses affects which populations
middle-aged or older individuals, spontaneously arise on the trunk
52
Seborrheic karatoses morphology
round, flat, coinlike, waxy plaques that vary in diameter; sharply demarcated from the epidermis, exuberant keratin production at the surface
53
Leser-Trélet sign
paraneoplastic syndrome in which a large number of seborrheic keratoses appear at one time, most notably in GI cancers
54
Acanthosis nigricans
dark-thickcened skin in creases or flexural areas that has a velvet-like structure
55
Benign conditions associated with acanthosis nigricans
obesity, DM, pineal or pituitary tumor, AD inheritance
56
Malignant conditions associated with acanthosis nigricans
solid cancers, especially GI carcinoma
57
Morphology of acanthosis nigricans
variable hyperplasia with hyperkeratosis and slight basal cell layer hyperpigmentation
58
fibroepithelial polyp
soft, flesh-colored, bag-like tumors, covered by benign squamous epithelium
59
Epithelial inclusion cyst
lesions formed by invagination and cystic expansion of epidermis; aka sebaceous cyst
60
Typical features of appendage tumors
nondescript, flesh-colored solitary or multiple papules and nodules
61
Eccrine poroma
palms and soles where sweat glands are numerous
62
Cylindroma
appendage tumor with ductal differentiation that typically occurs on the forehead or scalp
63
Syringoma
lesions with eccrine differentiation that occur on the lower eyelids
64
Sebaceous adenomas
typically associated with internal malignancy
65
Pilomatricoma
follicular differentiation
66
Actinic Keratoses
usually occur in sun-damaged skin and exhibits hyperkeratosis
67
Morphology of actinic keratoses
tan-brown, red, or skin-colored and have a rough consistency; hyperplasia of basal cells and atypia in lower most layer of epidermis; elastosis at superficial dermis, parakeratosis at corneum
68
Squamous cell carcinoma morphology
atypical cells at all levels of the epidermis, varying degree of differentiation
69
Basal cell carcinoma pathogenesis
mutations that lead to uncontrolled hedgehog signaling; mutated PTCH receptor causes consistent activation of SMO resulting in excessive gene expression
70
Basal cell carcinoma morphology
pearly papules with telangiectasias, multifocal or nodular growths (epidermis or downward growth, respectively), palisading cells (long axes in parallel alignment)
71
Benign fibrous histiocytoma
heterogenous group of related dermal neoplasms, often seen on adults and typically occur on the legs of young and middle-aged women
72
Dermatofibroma morphology
benign, spindle shaped cells arranged in a well defined, nonencapsulated mass within the mid-dermis
73
Painful skin lesions
GLENDAB; glomus tumor, leiomyoma, eccrine spiradenoma, neurofibroma, dermatofibroma, angiolipoma, blue rubber bleb nevus
74
Dermatofibrosarcoma protuberans
well-differentiated fibrosarcoma of the skin that rarely metastasizes
75
Dermatofibrosarcoma protuberans molecular hallmark
translocation involving collagen 1A1 and PDGFB
76
Mastocytosis
spectum of rare disorders characterized by increased numbers of mast cells in skin and other organs
77
Cutaneous form of mastocytosis that affects children
uritcaria pigmentosa
78
Darier sign
localized area of dermal edema and erythema that occurs when lesional skin is rubbed
79
Dermatographism
area of dermal edema resembling a hive that occurs as a result of localized stroking
80
Signs and sxs of systemic mastocytosis
pruritis and flushing, watery nasal discharge, GI or nasal bleed, bone pain
81
Sezary syndrome
diffuse erythema and scaling of the entire body due to seeding of blood by malignant T cells (Mycosis fungoides
82
Icthyosis
group of inherited disorders apparent at or soon after birth, may be paraneoplastic; chronic, excessive keratin build up
83
Urticaria
localized mast cell degranulation and resultant microvascular hyperpermeability
84
Categories of acute eczematous dermatitis
allergic contact, atopic, drug-related, photoeczematous, primary irritant
85
Appearance of eczematous dermatitis
red, papulovesicular, oozing, crusted lesions, hyperkeratosis and acanthosis
86
Spongiosis
edema seeps into intracellular spaces of epidermis
87
Acantholysis
loss of intracellular connections
88
Erythema multiforme
self-limited hypersensitivity reaction to certain infection and drugs; bulls eye shaped lesion
89
Infections associated with erythema multiforme
herpes, mycoplasmal infections, histoplasmosis, coccidiomycosis, typhoid and leprosy
90
Drugs associated with erythema multiforme
sulfonamides, penicillin, barbiturates, salicylates, hydantoins, antimalarials
91
Collagen vascular diseases associated with erythema multiforme
lupus erythematosus, dermatomyositis, polyarteritis nodosa
92
Psoriasis
chronic inflammatory dermatosis appears to have an autoimmune basis; often associated with arthritis, nail discoloration (onycholysis)
93
Where does psorias most frequently occur?
elbows, knees, scalp, lumbosacral areas, intergluteal cleft, glans penis
94
Auspitz sign
multiple, minute, bleeding points when scale lifted from psoriatic plaque
95
Seborrheic dermatitis
chronic inflammatory dermatosis that involves regions with high density of sebaceous glands; associated with inflammation of epidermis
96
Morphology of seborrheic dermatitis
spongiotic dermatitis and acanthosis with parakeratotic mounts at ostia of hair follicles and mixed inflammatory cell populations
97
Lichen planus
pruritic, purple, polygonal, planar, papules, plaques; typically self limited
98
CA associated with chronic mucosal lesions of lichen planus
squamous cell carcinoma
99
Dermatitis herpetiformis
subepidermal blistering with suprapapillary dermal microabscesses with granular deposits of IgA identified upon testing
100
Pemphigus
blistering disorder caused by autoantibodies that result in dissolution of intracellular attachments within epidermis and mucosal epithelium, caused by IgG autoantibodies against desmogleins
101
Pemphigus vulgaris
typically involves face, axilla, groin, trunk, pressure points, may present as oral ulcers; superficial vesicles and bullae that rupture easily and leave shallow erosions
102
Pemphigus vegetans
rare form that usually presents with large, moist, verrucous plaques studded with pustules
103
Pemphigus foliaceus
endemic form common in brazil, superficial bullae that present as areas of erythema and crusting
104
Pemphigus erythematosus
less sever form that selectively involves the malar area of the face
105
Paraneoplastic pemphigus
association with NHL
106
Bullous pemphigoid
sub epidermal blisters common in elderly individuals, especially inner thighs, flexor surfaces, axillae, groin and lower abdomen; caused by autoantibodies that bind to proteins required for adherence of basal keratinocytes to basement membrane
107
Epidermolysis bullosa
group of disorders caused by inherited defects in structural proteins that lend mechanical stability to skin; proclivity to form blisters at sites of pressure, rubbing or trauma
108
Prophyria
group of inborn disturbances of porphyria; cutaneous manifestations consist of urticaria and vesicles associated with scarring, exacerbated by exposure to sunlight
109
Acne vulgaris
induced or exacerbated by drugs, occupational exposures, conditions that favor occlusion of sebaceous glands
110
Open comedones
small follicular papules containing central black keratin plug, due to oxidation of melanin
111
Closed comedones
follicular papules without visible central plug
112
Bacteria associated with acne vulgaris
Propionibacterium acnes
113
Treatment of acne vulgaris
antibiotics and retinoic acids, vitamin A derivatives
114
Rosacea
associated with chronic inflammation that may be difficult to control; characterized by flushing episodes, persistent erythema, pustules and papules, rhinophyma
115
Levels of what antimicrobial peptide are increased in patients with rosacea?
cathelicidin
116
Panniculitis
inflammatory reaction in subcutaneous adipose tissue that may preferentialy affect fat or connective tissue
117
Erythema nodosum
tender, erythematous plaques and nodules associated with infections, drug administration, sarcoidosis, inflammatory bowel disease, and malignant neoplasms
118
Erythema induratum
typically affects adolescents and menopausal women, primary vasculitis of deep vessel supplying fat lobules, exhibits erythematous nodule that goes on to ulcerate
119
Weber-Christian disease
lobular, nonvasculitic paniculitis, erythematous plaques created by deep-seated foci of inflammation containing aggregates of foamy macrophages
120
Verrucae
squamoproliferative disorders caused by human papillomaviruses
121
Molluscum contagiosum
self-limited viral disease of the skin caused by a poxvirus; multiple lesions on skin and mucous membranes; molluscum body on histo exam
122
Tinea capitis
dermatophytosis of scalp
123
Tinea barbae
dermatophyte infection of beard
124
Tinea corporis
expanding, round, erythematous plaque
125
Tinea cruris
inguinal areas of men
126
Tinea pedis
athlete's foot
127
Tinea versicolor
upper trunk, caused by Malassezia furfur
128
Toxic epidermal necrolysis
drug reaction, mucocutaneous tenderness and hemorrhagic erosions, epidermal detachment that begins on trunk and spreads distally
129
Stevens John Syndrome
drug reaction, mucocutaneous tenderness and surface area of epidermal detachment that occur <10% of the body
130
Indications for punch biopsy
superficial inflammatory diseases, papulosquamous disorders, connective-tissue disorders, benign tumors, nonmelanotic malignant tumors
131
Indications for shave biopsy
raised lesions, lesions that separate easily from deeper skin, dome-shaped nevi
132
Indications for excision biopsy
subcutaneous or deep dermal tumors, deep inflammatory disease, malignant melanoma
