Derm Pathology Flashcards
Steven Johnson Syndrome is a more severe form of
Erythema Multiforme
Steven Johnson Syndrome includes
Oral mucosa and lips
Psoriasis
Pink to Salmon colored plaque
Abnormal T cell release of cytokines causing speedy growth of skin cells and increased bloodflow
Auspitz sign
Bleeding when peeling back the silvery salmon plaques.
Parakeratosis with Monroe microabscesses
aggregates of neutrophils within parakeratotic scale
Lichen Planus lesions
Papules
Pruritic
Purple
Papules can form Plaques
Wickham Striae
white dots or lines on the papules
Colloid or Civatte bodies
Anucleate necrotic keratinocytes in the papillary dermis
Bullous pemohigoid
Blisters that are very tense and do not rupture easily. Blisters are typically filled with clear fluid on an erythematous base.
Subepidermal nonacantholytic blister
Bullous pemphigoid
Linear deposition of immunoglobulin and complement at the dermal-epidermal junction
Bullous pemphigoid immunofluorescence
Pemphigus vulgaris
vesicles and bullae that rupture easily.
Acantholytic suprabasalar blister
Pemphigus vulgaris
Netlike pattern of intercellular IgG
Pemphigus vulgaris
Antibodies against desemogelin 3
Pemphigus vulgaris
Basal cell layer remains attached to the roof of the dermis in
Pemphigus vulgaris
Shallow erosions and scarring after blister rupture associated with?
Pemphigus vulgaris
Dermatitis Herpatiformis
Associated with celiac disease.
Gluten free diet may help reduce the symptoms.
Fibrin and neutrophils accumulate at the tips of the dermal papillae forming dermal - epidermal separations.
Antibodies to gliadin cross react with skin
Dermatitis herpatiformis.
Granular deposits of IgA at the tips of dermal papillae is found in ?
Dermatitis herpatiformis
Seborrheic Keratosis
Flat, waxy,
What type of malignancy may be associated with paraneoplastic emergence of seborrheic keratosis?
GI malignancies most often.
Actinic keratosis is premalignant lesion for?
Squamous cell carcinoma.
Actinic keratosis is related to ?
Chronic sun exposure - higher incidence in lighter skinned individuals
Parakeratosis, cytologic atypia at the lowe most epidermal layer, and elastosis characterizes?
Actinic Keratosis
Squamous cell carcinoma of the skin is typically caused by?
Sunlight.
Chronic ulcers, tars, oils, carcinogens, HPV has been attributed to squamous cell carcinoma too.
What areas are MC to see squamous cell carcinoma?
Lip, scalp, ear, face.
Basal cell carcinoma
MC Skin malignancy. MC seen in lighter skinned individuals.
Pink pearly papular appearance. Often have
Most common skin malignancy?
Basal cell carcinoma.
Tumor islands in the dermis show palisading peripherally in
Basal cell carcinoma.
Rodent ulcers
Invasive basal cell carcinoma subtype
Central ulcerations with rolled margins
Commonly seen in basal cell carcinoma.
Benign melanocytic nevi
most of the superficial cells are immature, large, and melanin producing.
Maturation refers to
Ways to determine melanoma or melanocytic nevi based on the cell age.
Notched borders, different colorations, asymmetry
Dysplastic nevus with risk for progression toward melanoma.
In patients who are darker pigmented melanomas typically develop melanomas in their
Acral skin regions–> palms, soles, nailbeds more often than other locations.
ABCDE of Melanomas
Assymetry
Borders
Color
Evolving - changing with time.
Melanomas can also be found in
esophagus, oral mucosa.
Dyskeratosis
abnormal keratinizaton occurring prematurely in cells below the stratum granulosum
malignancies may be associated with dyskeratosis
Acantholysis
Loss of connections between keratinocytes within epidermis.
Spongiosis
Fluid accumulation in the epidermis- epidermal intercellular edema.
Acanthosis
Diffuse Hyperplasia of the epidermis
Ulceration vs. Errosion
Ulceration is a complete loss of the epidermis
Hyperkeratosis
Thickening of the stratum corneum by abnormal keratin
Scaling appearance to the skin
Parakeratosis
Nuclei retention within the stratum corneum
Lentiginous
Continuous linear pattern of melanocytes along the basal cell layer of the epidermis.
Urticaria
Hives
Pruritic edematous plaques and papules- wheals
Angioedema- edema deeper in the dermis and subcutaneous tissues and fat.
Usually rapid onset and termination to the presence of lesions in urticaria.
What causes urticaria ?
Type I Hypersensitivity Reaction
IgE antibodies are produced in response to exposure to an antigen. IgE antibodies bind to and induce degranulation of mast cells. Mast cells degranulate and cytokines and other mediators cause vasodilation and edema to develop.
Is urticaria always IgE dependent reaction?
No.
Eczema
Red papulovesicular lesions that eventually rupture into scaling raised plaques.
Acute eczematous dermatitis may result from what common environmental exposure?
Poison ivy
What is the underlying morphological change that results in eczematous dermatitis?
Spongiosis is the predominant underlying cause of eczematous dermatitis leading to intraepidermal edemal and formation of blisters- vessicles and bullae.
What is the primary pathogenesis of acute eczematous dermatitis?
Langerhans cells- dendritic cells- pick up an antigen they encounter and bring them via lymphatics to lymph node for presentation to naive T cells CD4+–> lead to activation and generation of memory CD4 T lymphocytes as well as effector cells. In future exposure - cytokines released.
Erythema multiforme
Acute dermatosis
Hypersensitivity reaction related to exposure to drugs or infections by different pathogens.
Multiformed lesions - vessicles, papules, bullae usually symmetrical and on the extremities
Target lesions are characteristic of
Erythema multiforme. Center of the target lesion often ruptures and leaves behind an errosion on the skin.
Pathology of erythema multiforme
Accumulation of lymphocytes along the dermal epidermal junction where they are associated with necrotic keratinocytes.
Vacuolated DE junction and necrotic keratinocytes ***
Superficial perivascular lymphocytic infiltrate with dermal edema indicates
Erythema multiforme
Koebner phenomenon
lesions develop where skin trauma occurs.
Erythroderma
Red edematous appearance of the skin associated with psoriasis.
Psoriasis on histology appears as
Acanthosis (epidermal thickening) with downward elongations of the rete ridges/pegs.
Parakeratosis scaling
Munro bodies
Microabscesses with neutrophil infiltrate seen in psoriasis.
