Dermal Pathology Flashcards
What cell types do you see in the skin?
- Squamous cells
- Basal cells
- Melanocytes
What type of gland is a sweat gland, that is milky with odors and located near hair follicles?
-Apocrine gland
What type of gland is a sweat gland and is water for thermo control and is widely distrubuted?
-Eccrine gland
What type of gland secretes oily sebum for lubrication and also helps prevent water loss?
-Sebaceous
what is Flat and circumscribed less than 5 mm?
macule
Elevated dome or flat topped Less than 5 mm
papule
Elevated dome greater than 5 mm
nodule
Elevated flat-topped lesion greater than 5 mm
plaque
Thickened skin due to repeated rubbing
lichenification
Discrete, pus filled raised lesion
pustule
Dry plate like excrescence with imperfect cornification
scale
Fluid filled raised area less than 5 mm
vesicle
Loss of intercellular adhesion keratinocytes
acantholysis
T/F in Acantholysis the epidermis falls apart and sloughs off
True
Traumatic breakage of the skin
excoriation
Fluid filled raised area greater than 5 mm
bulla
what is characterized by abnormal keratization that is deeper in epidermis than normal?
dyskeratosis
Hyperplasia of stratum corneum
hyperkeratosis
Intercellular edema of epidermis
spongiosis
Surface elevation caused by hyperplasia
papillomatosis
Fluid filled sac lined with true epithelium
cyst
Chronic inflammatory lesion consisting of granulation tissue
granuloma
Acute inflammatory lesion with pus, surrounded by a fibrous wall
abscess
Acute diffuse swelling along fascial planes separating muscle bundles
cellulitis
Define Calor?
-Warm
Define Tumor?
-Swelling
Define Rubor?
-Reddening
Define Dolor?
-Painful
Define Funcio laesa?
-Lost function
Define Uticaria (hives)?
-associated with mast cell degranulation and resulting swelling, redness and itching
What is Uticaria?
-Hypersensitivity mediated by antigens
What are some antigens that can cause urticria?
- Pollen
- Food
- Drugs
- Mediated by IgE
How do you treat Urticaria?
- Antihistamine
- Steroids
T/F Urticaria is a chronic inflammatory response
False
-Acute inflammatory
What is the most common eczematous dermatitis?
-Contact dermatitis
T/F Eczematous dermatitis is a delayed hypersensitivity reaction
True
What do you see with eczematous dermatitis?
- Pruritic
- Edematous or oozing plaques/vesicles
What can cause eczematous dermatitis besides contact dermatitis?
- Drugs
- Reaction to UV
- Irritation chemicals
- Can also be associated with asthma or allergic rhinitis
What is allergic contact dermatitis?
-Cellular memory of the reaction so that future contacts cause an increased dermatitis reactions
What is erythema multiforma?
- Hypersensitivity to infections and drugs
- Dermal edema
- Can have blisters and necrosis
What is a severe life threatening reactions of erythema multiforma known as?
-Stevens Johnson syndrome
What can cause Stevens johnson syndrome?
- Reaction to medicines such as sulfonamides or salicylates
- Can be a reaction to infections such as herpes virus or fungal infections
T/F Psoriasis is an acute conditon
False
-It is chronic
What can Psoriasis be accompanied by?
-Increased heart attacks and arthritis
What is the treatment for Psoriasis?
- NSAIDS
- immunosuppressant drugs
What are some signs/symptoms of psoriasis?
- Pink to salmon colored plaques
- Regular acanthosis in epidermis with increased bleeding
What is Wickham Striae associated with?
-Lichen planus lace like white markings
What does systemic lupus erythematosus on the skin look like?
-Butterfly rash on the face
How do you manage systemic lupus erythematosus?
- Manage with NSAIDS
- Steroid
- Autoimmune drugs
What are some long term effects that can occur from Systemic lupus erythematosus?
- Blood clots
- Seizures
- Heart attacks
What are some environmental factors that can cause systemic lupus erythematosus?
- Drugs
- UV radiation
- Viruses
- Stress
Impetigo is an example of infectious dermatosis what do you use to treat it?
-Topical antibiotics such as Tetracycline
What is a type of fungal infectious dermatosis?
- Tinea (ring worm)
- Candida
What are some types of viral infectious dermatosis?
- Wart pathology -HPV
- Verrucae
HSV1?
-Oral herpes (cold sores)
HSV2?
-Genital herpes
If you get trigeminal nerve involvement with Herpes zoster what is a major concern?
-Spread to surrounding tissue such as eye or brain
T/F Shingles is contagious
False
-Not contagious
What type of cells do you see with Pemphigus vulgaris?
-Tzanck cells
What do you see with pemphigus vulgaris?
- Acanthosis
- Blister formation
T/F Pemphigus vulgaris is autoimmune
True
What are opened comodones?
-Blackheads
What are closed comodones?
-White heads
What drugs can worsen acne?
- steroids
- testosterone
- contraceptives
What can cause acne vulgaris?
-Hormone changes that increases testosterone influences
In acne vulgaris what do you see with the hair follicle?
- Blocks hair follicle and sebaceous gland
- Proliferation of lining cells and cellular sloughing that forma cellular plug and traps bacteria, celllular debris and sebum
If the gland ruptures in acne vulgaris the contents spread to form what?
- Cysts
- Abscesses
- Scaring
What is the treatment for acne vulgaris?
- Antibiotics (TTC)
- Keratolytics
- Drying agents
- Vitamin A (Accutane)
- UV exposure
What gender and age do you see perioral dermatitis in?
-Young women
What can cause perioroal dermatitis?
- Long term steroid use
- Cosmetic use
- Hormonal changes
What are four Benign neoplastic skin conditions?
- Seborrhea keratosis
- Actinic keratosis
- Melanocytic nevi
- Dyplastic nevi
What does Seborrhea keratosis appear like?
-Coin like plaques that appear stuck on with a tan to dark brown granular surface
Can seborrhea keratosis spread?
-Yes
What is a pre-malignant skin lesions that is related to UV exposure and appears brown to red with rough scaly texture lesions?
-Actinic keratosis
What is a benign neoplasm from melanocytes?
-Melanocytic nevi
If you have greater than 10 dyplastic nevi what do you have an increased risk for?
-Melanoma
What type of borders do you see with Dyplastic nevi?
- Irregular
- Assymetric
What is the most common type of skin malignancy?
-Basal cell carcinoma
What is the second most common type of skin malignancy?
-Squamous cell carcinoma
What are the warnings of melanoma?
- Rapid enlargement of nevus
- New pigmented lesion not from pre-existing nevi
- Irregular borders
- Irregular surface and colors
What are common sites of metastatic spread for melanoma?
- Lungs
- Liver
- Brain
Diffuse epidermal hyperplasia (thicker than normal)
acanthosis
what is the presentation with advanced stevens-johnson syndrome?
- can have epidermal necrosis with blisters
- T cells attack antigen and surrounding cells (basal cells)
what is the prevalence of psoriasis in the US?
1-2%
what is the cause of psoriasis?
inciting antigen, auto-rejection or environmentally induced
what age patient is commonly affected by lichen planus? what location on the body are typically affected?
- middle aged
- extremities and oral cavity
does lichen planus resolve on its own?
yes, on the extremities, but it often persists in the oral cavity
lichen planus is characterized by what two things?
hyperkaratosis and epidermal hyperplasia
what is the cause of lichen planus?
unknown inciting mechanisms, but hyperreactive T cells may be involved
how is pemphigus treated?
steroids
what is the presentation of perioral dermatitis?
follicular papules, vesicles, and pustules in the perioral area
what is the least aggressive/most common malignancy worldwide?
basal cell carcinoma
what can happen if basal cell carcinomas are not removed?
they don’t metastasize, but they can be disfiguring and can ulcerate and bleed
what is the treatment of basal cell carcinomas?
local excision
what is the second most common malignancy worldwide?
squamous cell carcinoma
do squamous cell carcinomas metastasize?
no
how does squamous cell carcinoma present?
- often as a red scaling ulcerative nodule
- locally aggressive
- can have “keratin pearls” (islands of neoplastic skin cells)
what is the least likely malignancy worldwide?
melanoma
what is melanoma caused by?
UV exposure and genetics
does melanoma metastasize?
yes
what is the prognosis of melanoma?
- poor if metastasized
- good if they are superficial lesions
melanoma has a high ___ rate and a lack of immune response to slow spread, especially once it reaches ___
- mitotic
- lymph nodes
