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Psychology- MHD > Derm Path III > Flashcards

Derm Path III Flashcards

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1
Q

What are the two types of subcutaneous neoplasms?

A

Panniculitis- inflammation of fat or vessles

Tumors- Lipomas or leiomyomas

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2
Q

Polyarteritis nodosum is what type of subcutaneous neoplasm?

A

Panniculitis

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3
Q

What is polyarteritis nodosum?

A

Inflammatory disease of small/medium sized muscular arteries

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4
Q

How does polyarteritis nodosum present?

A

Palpable purpura in the skin +/- ulceration, often in the lower limbs

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5
Q

What do we see on histology of polyarteritis nodosum?

A

Inflammation of the arteries in the subcortis with fibrin deposition

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6
Q

Where on the body is erythema nodosum found?

A

Most commonly on the front of the legs

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7
Q

What conditions are thought to cause erythema nodosum

A

May be associated with drugs- sulfa, NSAIDs or OCP, infections, or idiopathic

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8
Q

Inflammatory dermatosis is a fancy name for what?

A

Rash

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9
Q

What is lichenoid dermatitis?

A

Band-like infiltrate of inflammatory cells attacking the dermal/epidermal junction

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10
Q

List the 6 P’s of lichen planus?

A

Pruritic, purple, polygonal, papule, plaques

all of lichen Planus

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11
Q

What changes occur in the rete ridges in lichen planus?

A

Sawtoothing

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12
Q

Apoptotic cells stay where in lichen planus? Why is this important?

A

The basal layer- it differentiates lichen planus from erythema multiforme

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13
Q

Where are colloid bodies seen in lichen planus?

A

In the basal layer- they are the apoptotic keratinocytes

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14
Q

What causes erythema multiforme and what is the disease course?

A

EM is cause by infections, most commonly HSV

It is self-resolving

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15
Q

At what % surface involvement is TENS designated?

A

SJS –> TENS at 30% surface involvement

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16
Q

What is the characteristic appearance of erythema multiforme?

A

Targetoid- looks like little bullseyes

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17
Q

In contrast to lichen planus, apoptotic bodies (Civatte bodies) of erythema multiforme are found where?

A

Throughout the entire thickness of the epidermis

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18
Q

What are the corneal changes seen in erythema multiforme?

A

None- this is a very acute process

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19
Q

What is the major difference between erythema multiforme and SJS/TENS?

A

By SJS/TENS, all of the keratinocytes have been killed off

Once the entire epidermis is necrosed, it’s going to fall off –> skin sloughing

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20
Q

Lupus is what type of dermatitis?

A

Lichenoid dermatitis

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21
Q

Dermal mucin is a buzzword for which dermatitis?

A

Lupus erythematosis

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22
Q

On direct immunofluorescence of lupus, which proteins are positive?

A

Positive lupus band test = IgG, IgA, IgM and C3 all along the basement membrane

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23
Q

How does dermatomyositis appear histologically?

A

Similar to lupus but with less mucin and epidermal atrophy….requires clinical picture to differentiate

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24
Q

What is lichen sclerosis et atrophicus?

A

Seen with chronic itching/irritation –> seen in the genital area

Hyalinization of the collagen

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25
Q

Atypical lymphocytes along the dermal/epidermal junction are suggestive of what disease?

A

Cutaneous T-cell lymphoma

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26
Q

What is a Pautrier’s microabscess?

A

Group of atypical lymphocyte seen in cutaneous t-cell lymphoma

27
Q

What makes an atypical lymphocyte from T-cell lymphoma “atypical”?

A

Cerebriform nuclei

“lump of coal on a pillow”

28
Q

What is the “Lichenoid pattern” seen in Lichen planus, erythema multiform, SJS/TENS, Lupus, Lichen sclorosis and CTCL?

A

Lymphocytes coming up and attacking the dermal/epidermal junction

29
Q

List the 3 histologic features that differentiate lichen planus from the other lichenoid dermatoses

A

wedge shaped hypergranulosis, hyperkeratosis, and apoptotic stay on the basal layer.

30
Q

What is the major histologic distinguishing feature of erythema multiform?

A

Full thickness apoptotic bodies

31
Q

What is the major histologic distinguishing feature of SJS/TENS?

A

Full thickness epidermal necrosis-> sloughing

32
Q

What is the major histologic distinguishing feature of lupus?

A

follicular plugging, mucin deposition, increased basement membrane

33
Q

What is the major histologic distinguishing feature of lichen sclerosis?

A

Sclerotic collagen

34
Q

What is the major histologic distinguishing feature of cutaneous t cell lymphoma?

A

Atypical lymphocytes + Pautrier microabscesses

35
Q

What defines psoriasiform dermatitis?

A

Regular elongation of the rete ridges

36
Q

What is the clinical appearance of psoriasis?

A

Well demarcated plaques with adherent silver/white scale

37
Q

What is important about the thinning of the suprapapillary plates?

A

Thinning –> auspitz sign. When you peel off the scale, it bleeds because the dilated blood vessels in the –> pinpoint bleeding

38
Q

What causes spongiotic dermatitis?

A

Edema within the epidermis caused by inflammatory factors –> vesicle formation in the epidermis

39
Q

What is a common example of spongiotic dermatitis?

A

allergic contact dermatitis

40
Q

What causes a bullous dermatitis?

A

Split in the epidermis

41
Q

Give three examples of a bullous dermatitis

A

Bullous pemphigoid
Pemphigus vulgaris
Dermatitis herpetiformis

42
Q

Are the bullae of bullous pemphigoid tense or flaccid?

A

Tense

43
Q

WHere does the “split” occur in a bullous pemphigoid?

A

Subepidermal

Associated with eosinophils

44
Q

What causes blistering in bullous pemphigoid?

A

IgG antibodies against hemidesmosomes (BPAG1 and BPAG2)

45
Q

Which is the most common type of pemphigus?

A

Pemphigus vulgaris

46
Q

How does pemphigus vulgaris appear clinically?

A

Superficial vesicles and bullae that rupture easily leaving shallow, crusted erosions

47
Q

IgG against which protein structure are attacked in pemphigus vulgaris?

A

Desmosomes –> intraepidermal bullae that are flaccid and more easily rupture

IgG is against desmoglein, most specifically

48
Q

Dermatitis herpetiformis is associated with which disease?

A

Celiac disease

Both the herpetiformis and enteropathy respond to a gluten-free disease (due to antibodies

49
Q

What is the poster child disease for granulomatous dermatitis?

A

sarcoidosis

50
Q

Name a leukocytoclastic vasculitis

A

Henoch schonlein purpura

51
Q

Verrucas are driven by what infection?

A

HPV

52
Q

What are the histologic features of verrucas?

A

Hyperkeratosis, hypergranulosis and papillomatosis (bart simpson sign)

+ Koilocytes- (vacuolated keratinocytes with raisin like nuclei)

53
Q

Who gets molluscom contagiousum?

A

Kids

54
Q

What causes molluscom contagiosum?

A

viral infection–> mollsucum bodies (HENDERSON PATTERSON BODIES) : intracytoplasmic virus pushes cellular structures to the outside –> glassy cellular appearance of cells

55
Q

What are the 3 M’s of HSV1 and HSV2?

A

Molding (“spooning”), multinucleated and marginated chromatin

56
Q

HSV: What is hutchinson’s sign? Why is it important?

A

HZV involvement of the nose: important because it could result in vision impairment if there is ocular involvement

57
Q

Where do we see the fungus on KOH prep of a cutaneous fungal infection?

A

In the corneum

Can also see fungi with PAS stain

58
Q

Which fungal infection looks like “spaghetti and meatballs” on H and E?

A

Tinea versicolor

59
Q

What does a tinea versicolor infection look like?

A

Macules and patches of hypo/hyperpigmentation on the trunk

60
Q

How does the size of blasto compare to surrounding inflammatory cells?

A

Slightly larger- basically the same size, and consistent in size

61
Q

How does the size of coccidiomycosis compare to surrounding lymphocytes?

A

WAY BIGGER

62
Q

How does the size of histo compare to surrounding lymphocytes?

A

Histo is intracellular- much smaller

63
Q

How does the size of cryptococcus compare to surrounding inflammatory cells?

A

About the same size, although the sizes varies a little bit (differentiate from blastomycosis)

Psychology- MHD (14 decks)

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