Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MHD > Derm Pathology > Flashcards

Derm Pathology Flashcards

1
Q

What are the 5 layers of the epidermis (superficial –> deep)?

A 
Corneum
Lucindum (thick skin only)
Graulosum
Spinosum
Basale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Acanthosis

A

Thickening of the epidermis, often due to thickening of stratum spinosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is desquamatization? How long does it take?

A

Maturation of keratinocytes from undiff basal cells to diff cornified cells

Takes about 25 days normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ichthyosis

What is seen grossly?

A

Fish-like scales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ichthyosis

Cause

A

Defective desquamatization leads to a buildup of a compacted scale

Mostly hereditary that appear at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ichthyosis Vulgaris

Histology

A

Hyperkeratosis

Fish-like scales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is hyperkeratosis?

A

Thickening of the cornified layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Seborrheic Keratosis

Gross appearance

A

Generally well circumscribed with a “stuck on” appearance

Mostly in ppl above age 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Seborrheic Keratosis

What is it? Describe the histology

A

Benign epithelial neoplasm

Hyperkeratosis
Undulations = papillomatosis
Horn cysts- small cysts filled with keratin

String sign – flat bases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acanthosis Nigricans

Gross appearance

A

Velvety appearance on neck or axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acanthosis Nigricans

Histology

A 
Lots of papillomatosis
Increased pigmentation (increased melanin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acanthosis Nigricans

Benign or Malignant?

A

Benign type in childhood (may be related to obesity or endocrine disorder)

May be a sign of malignancy in adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Seborrheic Keratosis

Lesar Trelat Sign

A

Paraneoplastic Syndrome

Many seborrheic keratoses coming up at once – may be a sign of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Fibroepithelial Polyp?

A

Skin tag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Actinic Keratosis

Gross appearance and Cause

A

Scaly erythematous patch on sun-damaged skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Actinic Keratosis

Histology

A

Atypia of the lower levels of epidermis

Solar elastosis in dermis – grey-blue color

Flag sign (alternating pink/blue)

Inflammation with lots of T lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Actinic Keratosis

Precursor to…

A

SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SCC

What mutations are most common?

A

P53

Could also have mutations in HRAS or Notch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SCC

Risk of Metastasis

A

Low (Less than 5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SCC

Risk factors

A 
Sun-exposed sites
Older age
M > F
Immunosuppression (HPV 5 and 8)
Industrial exposures
Chronic wounds
Arsenic
Burn scars
Ionizing radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SCC

Gross appearance

A

Hyperkeratotic
Ulcerated

Papules and nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

SCC

Histology

A

Invasion of malignant cells into sun-damaged dermis

Keratin pearls

Atypia in squamous keratinocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

SCC In Situ (Bowen’s Disease)

Describe the histology

A

Full thickness atypia of the epithelium (dark cells, mitotic figures, apoptosis)
Often see acanthosis

Basal layer is unaffected/uninvaded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SCC In Situ (Bowen’s Disease)

Gross Appearance and Treatment

A

Plaque-like lesion that needs to be cut out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Bowenoid Papulosis | Cause, Location, Appearance, Prognosis
HPV induced, often on genitals Multiple papules May spontaneously regress or progress
26
Basal Cell Carcinoma | Gross appearance
Pearly pink papule with overlying telangiectasia
27
Basal Cell Carcinoma | Histology
Blue tumor Peripheral pallisading of nuclei Islands of basaloid cells in the dermis (nodular type)
28
Basal Cell Carcinoma | Mutations in...
PTCH (regulates Hedgehog pathway signaling) P53
29
Basal Cell Carcinoma | Two genetic diseases associated with this disease....
Xeroderma Pigmentosum (aut recessive, DNA mismatch repair syndrome) Nevoid Basal Cell Caricnoma Syndrome = Gorlin Syndrome (Aut dom, mutation in PTCH)
30
Melanocytes | Where are they located? What is their appearance and function?
Located on basal layer in epidermis Dark and small nuclei Release melanin and pass the pigment off to neighbors Also have a small "cap" of pigment to protect themselves from DNA damage
31
What is a freckle?
Small, tan-red macules on sun exposed areas Increased melanin pigment with basal keratinocytes
32
What is a Melanocytic Nevi?
Tan-brown macules and papules May be common or dysplastic
33
Difference between Common and Dysplastic Melanocytic Nevi
Common: Junctional, compound and intradermal: nests of melanocytes Dysplastic: single and cytologically atypical melanocytes; nests with architectural atypia
34
What are Dysplastic Nevi?
Architecturally atypical with melanocytic nests that may be alrger and fused Single melanocytes along DEJ Cytologic atypia
35
Dysplastic Nevi | Prognosis
Vast majority are clinically stable, but some consider it to be a risk factor for melanoma
36
Dysplastic Nevus Syndrome | What is it? What is the common mutation?
Tendency to develop many dysplastic nevi and melanomas Mutation in CDKN2A and CDK4 mutations
37
Melanoma | What are the ABCDEs?
``` Asymmetry Borders (irregular) Color Diameter Elevation/Evolving ```
38
Melanoma | Prognostic Factors
Depth of tumor Ulceration of tumor of mitotic figures
39
What is the major mutation in sporadic melanomas?
BRAF mutations (60% of melanomas)
40
How are melanomas with BRAF mutations treated?
Vemurfenib (a monoclonal Ab against BRAF)
41
What are the two major predisposing factors to melanoma?
Sun exposure and family history
42
When do melanomas acquire metastatic potential?
When they develop a vertical growth phase, so it is important to cut them out before that
43
Describe the 4 Stages of Melanoma
0: Melanoma in situ I/II: Confined to skin (any depth) III: nodal involvement IV: distant skin or viscera
44
Trichelemmoma - Mutation - Syndrome - Risks
PTEN mutations Cowden's syndrome Increased risk for breast, endometrial, thyroid cancer
45
What is a dermatofibroma and how is it identified?
Pink/brown papule or nodule most common on lower extremities Dimpling sign
46
Dermatofibrosarcoma Protuberans | What is it? What does nit look like?
Large nodule with several protuberances Dense proliferation of spindle cells within the dermis
47
Cylindroma - Location - Appearance on histology
Common on scalp (turban tumor) basaloid islands in puzzle pieces
48
What is a sebaceous adenoma? How is it addressed?
Papule or small nodule that looks like BCC Work them up for Lynch Syndrome (HNPCC) -- look for MLH1, MSH2, MSH6 mutations
49
Leiomyoma What is it? Appearance on Histology?
Tumor of the smooth muscle of dermis Histology: Bubbles and cigar shaped cells
50
Polyarteritis Nodosum/Erythema Induratum | What is it? What is the rash appearance?
Vasculitis of small and medium sized arteries Purpura on skin, often with ulceration and on lower limbs
51
Erythema Nodosum - Location - Appearance - Workup
Front of legs Macular appearance Work them up for TB
52
P's of Lichen Planus
``` Purple Papules Plaques Pruritic Polygonal ```
53
Lichen Planus | Common location and appearance
Oral mucosa is common Wickham striae -- white lines across the lesion
54
Erythema multiforme - Appearance - Prognosis - Cause
Annular lesion (often targetoid) Often resolves spontaneously and is associated with viruses
55
TEN and SJS | Describe the histology
Civatte bodies (necrotic keratinocytes) TEN = necrotic keratinocytes at all levels of epidermis
56
DLE - Appearance on Histology - Stains to use
Mostly cutaneous Lichenoid infiltrate and interface change Mucin Get thickened basement membrane seen on PAS stain
57
LS&A (Lichen Sclerosis et Atrophicus) | Appearance (histology and gross)
Lichenoid infiltrate gets pushed down, leaving behind pink hyaline Often appears as a thinning white patch on vulva
58
Psoriasis | Associated with...
HLA-C haplotype ``` Arthritis Myopathy Enteropathy Spondylitis joint Acquired immunodeficiency ```
59
Psoriasis | Gross Appearance
Well demarcated plaques with silver/white scales May also have yellow/brown nail discoloration with pitting "Peeling off sign" -- peel off scale, see pinpoint hemorrhage due to elongated Rete pegs
60
Psoriasis | Histology
Elongated Rete pegs Acanthosis is even Wafer like scale of PMNs
61
Allergic Dermatitis | Histology
Spongiotic dermatitis with EOSINOPHILS
62
Bullous Pemphigoid - Gross appearance - Histology - DIF
Tense bullae Subepidermal blister with eosinophils DFA reveals IgG antibodies to HEMIDESMOSOMES (lines up along the DEJ in a linear fashion)
63
Pemphigus Vulgaris - Gross appearance - Histology - DIF
Loose flaccid blister May rupture easily Suprabasalar clefting = tombstoning Net-like IgG and C3 on DIF (Antibodies formed against DESMOSOMES)
64
Dermatitis Herpetiformis - Associated with... - Treated with... - DIF
Assoc with celiac disease and treated with a gluten free diet Granular IgA deposits on direct immunofluorescense
65
Sarcoidosis | -Histology
Chronic granulomatous inflammation with few lymphocytes (naked granulomas)
66
Henoch Schonlein Purpura What it is? -DIF
Leukocytoclastic vasculitis with arhtritis, abd pain, or hematuria IgA seen around vessel walls
67
Mycosis Fungoides | Gross appearance and Histology
Cutaneous T Cell Lymphoma -Dark or erythematous patches and plaques, often on trunk Histo: Lymphocytes with dark nuclei line up at the DEJ
68
Verruca Vulgaris - Cause - Histology
Wart caused by HPV Hyperkeratosis and hypergranulosis seen above papillomatosis See Koilocytes: vacuolated keratinocytes with raisin like nuclei
69
Molluscum Contagiosum - Appearance - Histology
Small papuls that often look umbilicated Seen in kids Histology: crater with epidermis reaching down; may see molluscum bodies
70
3 Ms of HSV infection
Molding (nuclei) Multinucleation Marginalization
71
Primary VZV infection is.... - Appearance - Transmission
Chicken Pox Vesicles on red base/papules/crusted erosions Transmitted by resp secretions
72
Reactivation of latent VZV infection is...
Shingles Painful vesicles in a dermatomal distirbution
73
HZV Infection | Hutchinson's sign
Involvement of the nose Should make you think of potential ocular involvement, which needs immediate attention
74
Impetigo - Causes - Appearance - Histology
Staph aureus or Strep pyogenes Loose blisters with honey colored crusts, often on face Histo: Subcorneal blister filled with PMNs and debris
75
Tinia infections - Where may they be located? - Appearance
Pedis- foot Corporis- body Cruris- genitals Capitus- head Annular (ring-like) lesion
76
What is onchomycosis?
Fungi seen in the nail
77
How to identify Tinia infections
Do a biopsy (scrape) in the office and look at it under a KOH prep or PAS stain
78
Tinea versicolor - Appearance - Histology
Macules or patches of hypopigmentation/hyperpigmentation on the trunk Hyphae and yeasts form in the CORNEUM (spaghetti and meatballs pattern)
79
Scabies - What is it? - Histology
Mite infection that is highly contagious Forms a blister in the corneum
80
Blastomycosis | -Histology
Epidermal acanthosis Broad based budding yeast Can mimic SCC
81
Coccidiomycosis | Appearance
Mariner's wheel = single larger form filled with tinier yeasts
82
Cryptococcus | Appearance
Encapsulated yeast seen with mucicarmine
83
Histoplasma | Appearance
Small intracytoplasmic organisms with surrounding clear halo PAS and GAS +

MHD (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions