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Psychology- MHD > Derm Path I > Flashcards

Derm Path I Flashcards

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1
Q

What is the role of the stratum basale?

A

Keratinocyte stem cells

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2
Q

What is the role of the stratum spinosum?

A

Production of keratin

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3
Q

What is the role of hte stratum granulosum?

A

Processes keratin to make it soft

Nails don’t have stratum granulosum –> why it’s not soft

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4
Q

What is the role of the stratum lucidem and where in the body is it found?

A

Protective against shear force

Found in thick skin- in the palms and soles of feet

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5
Q

What is the role of the stratum corneum?

A

Adds strength- primarily dead cells- deals with water balance as well

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6
Q

What do Merkel cells look like under a microscope?

A

Nothing - you can’t see them!

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7
Q

What cells are disordered in ichthyosis?

A

Keratinocytes

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8
Q

What is the path of ichthyosis?

A

Defective desquamation leads to build up of compacted scale

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9
Q

Which enzyme is deficient in x-linked ichthyosis?

A

Steroid sulfatase, responsible for “breaking down the concrete between the bricks so the bricks can slough off”

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10
Q

What is orthokeratosis?

A

Fish-like scales - seen in ichthyosis

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11
Q

“barnacles of age” are the dominant feature of what derm condition?

A

Seborrheic keratosis

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12
Q

What is the clinical morphology of seborrheic keratosis?

A

“Stuck on” verrucous waxy appearing brown papules or plaques anywhere on the skin except the palms and soles

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13
Q

What is “papillomatosis”

A

The Bart Simpson sign-

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14
Q

What is the major difference between seborrheic keratosis and melanoma?

A

Lack of atypia in sebhorreic

Flat base “string sign” present in sebhorreic – line in which the hyperplasia does not invade into the dermis

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15
Q

Which disease process is described by poorly defined, hyperpigmented verrucous plaques with a velvety scale commonly found in the creases of the axilla and neck?

A

Acanthosis nigricans

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16
Q

Which layer of the skin undergoes hyperpigmentation in acanthosis nigricans?

A

basal layer

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17
Q

What two histologic findings are found both acanthosis nigricans and seborrheic nigricans?

A

Hyperkeratosis and papillomatosis

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18
Q

Which two histologic findings differentiate seborrheic keratosis from acanthosis nigricans?

A

Shoe-string sign

Pseudo horn cysts

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19
Q

What is the Leser-Trelat sign?

A

Eruption of MANY many seborrheic keratosis spots

Indicative of a paraneoplastic syndrome (predominantly GI)

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20
Q

Differentiate the age of onset of benign type vs malignant type of acanthosis nigricans

A

Benign: childhood (usually caused by obesity/endocrine or hereditary)

Malignant: middle age and up

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21
Q

What is an acrochordon?

A

Fibroepithelial polyp/skin tag

22
Q

How would you describe a skin tag?

A

Flesh colored pedunculated papule

23
Q

What is the core of a acrochordon?

A

Fibrovascular core

24
Q

What is the name for a common scaly erythematous patch/macule located on sun-damaged skin?

A

Actinic Keratosis

25
Q

Actinic keratosis is a precursor of which neoplasm?

A

Squamous cell carcinoma

26
Q

What is the treatment for actinic keratosis?

A

cryotherapy or topical chemotherapeutics to prevent progression to squamous cell carcinoma

They are all treated, although not all will become SCC

27
Q

What is the flag sign?

A

Parakeratosis alternating with orthoparakeratosis

Parakeratosis = retention of nuclei

28
Q

What is Bowen’s disease?

A

Squamous cell carcinoma in situ

Histo: atypia at all levels of the epidermis
Clinical: irregular scaly erythematous plaque like lesion

29
Q

What is bowenoid papulosis?

A

Squamous cell carcinoma in situ

Histo: similar to Bowen’s- atypia at all levels of the epidermis

Clinically: HPV induced, located on the genitals, frequently multiple papules, may spontaneously regress or progress

30
Q

Why do you not see the flag sign in bowen’s disease?

A

Because the atypia involves the hair follicle

31
Q

What is the second most common skin tumor?

A

Squamous Cell Carcinoma

32
Q

Who is at risk for developing squamous cell carcinoma?

A

People with lots of sun exposure, older individuals and males

33
Q

What mutations are commonly associated with squamous cell carcinoma?

A

TP53

34
Q

What is the risk of metastasis with squamous cell carcinoma?

A

Less than 5% metastasize

35
Q

What is the invasion pattern of squamous cell carcinoma?

A

They follow nerves- but they don’t enter blood vessels and metastasize

36
Q

Where is the keratinocyte atypia in actinic keratosis?

A

Basal cell layer

37
Q

Where is the keratinocyte atypia in SSC in situ?

A

full thickness

38
Q

Does actinic keratosis involve the hair follicle?

A

No - this is why you get the flag sign

39
Q

Does SSC in situ involve the hair follicle?

A

yes- this is why you don’t see the flag sign

40
Q

Is basal cell carcinoma invasive?

A

Yes- it is the most common invasive cancer in humans

41
Q

What is a gene mutation associated with 30% of basal cell carcinomas?

A

PTCH

42
Q

Describe Nevoid Basal Cell Carcinoma Syndrome/Gorlin syndrome

A

AD

Multiple BCC before age 20
Accompanied by medulloblastomas, ovarian fibromas, odantogenic keratocysts

43
Q

What is the gene mutated in Nevoid Basal Cell carcinoma/Gorlin syndrome?

A

PTCH on chromosome 9q22.3

Two hit hypothesis

44
Q

What is the clinical morphology of basal cell carcinoma?

A

Pearly pink papule with underlying telangectasia

45
Q

“Peripheral palisading” architecture is typical of what type of neoplasm?

A

Basal cell carcinoma

46
Q

“Clefting” between the tumor and the stroma is indicative of what cancer?

A

basal cell carcinoma

47
Q

What is the cause of vitiligo

A

Autoimmune destruction of MELANOCYTES

48
Q

What do we see on histology for vitiligo?

A

Loss of melanocytes

49
Q

What is the cause of albinism?

A

Decreased tyrosinase activity, or defective transport of melanin

50
Q

What is melasma?

A

HYPERpigmentation of the skin seen in pregnancy or OBC use

51
Q

Where does melanin deposit in melasma?

A

Melanin deposits in the dermis

Psychology- MHD (14 decks)

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