Dermal Pathology Flashcards
1
Q
skin cell types
A
- squamous cells
- basal cells
- melanocytes
2
Q
T/F The skin is a major immunologic organ
A
true
3
Q
types of skin appendages
A
- apocrine glands (milky sweat with odors; located near hair follicles)
- eccrine glands (widely distributed; watery sweat for thermoregulation)
- sebaceous glands (located near hair follicles; secretes oily sebum for lubrication and to prevent water loss)
4
Q
macule
A
- flat, circumscribed
- < 5mm
5
Q
papule
A
- elevated dome or flat topped
- < 5mm
6
Q
nodule
A
- elevated dome
- > 5mm
7
Q
plaque
A
- elevated flat-topped lesion
- > 5mm
8
Q
lichenification
A
- thickened skin due to repeated rubbin
9
Q
pustule
A
- discrete, pus-filled raised lesion
10
Q
scale
A
- dry, plate-like excresence
- imperfect cornification
11
Q
vesicle
A
- fluid-filled, raised area
- < 5mm
12
Q
acantholysis
A
- loss of intercellular adhesion of keratinocytes
- epidermis falls apart and sloughs off
13
Q
acanthosis
A
- diffuse epidermal hyperplasia (thicker than normal)
14
Q
excoriation
A
- traumatic breakage of the skin
- ex. intense scratching
15
Q
bulla
A
- fluid-filled raised area
- > 5mm
16
Q
dyskeratosis
A
- hyperplasia of stratum cornum
17
Q
sponigosis
A
- intercellular edema of epidermis
18
Q
papillomatosis
A
- surface elevation cause by hyperplasia
19
Q
cyst
A
- fluid-filled sac lined with true epithelium
20
Q
granuloma
A
- chronic inflammatory lesion consisting of granulation tissue
21
Q
abscess
A
- acute inflammatory lesion with pus, surrounded by a fibrous wall
22
Q
cellulitis
A
- acute diffuse swelling along fascial planes separating muscle bundles
23
Q
descriptive terms: calor, tumor, rubor, dolor, funcio laesa, urticaria
A
- calor: warmth
- tumor: swelling
- rubor: reddening
- dolor: pain
- funcio laesa: loss of function
- urticaria: hives (associated with mast cell degranulation, results in swelling, redness and itching)
24
Q
urticaria
A
- type of acute inflammatory skin pathology
- hypersensitivity mediated by antigens (IgE)
- pollen, food, drugs
- treat with antihistamine or steroids
25
Q
eczematous dermatitis
A
- type of acute inflammatory skin pathology
- contact dermatitis is the most common
- delayed hypersensitivity reaction
- can be pruritic (itching), edematous, or oozing plaques/vesicles
- can be caused by drugs, UV, or irritating chemicals
- can be associated with asthma or allergic rhinitis
26
Q
allergic contact dermatitis
A
- cellular memory of the reaction so that future contacts cause an increased dermatitis reaction
27
Q
erythema multiforma
A
- hypersensitivity to infections and drugs
- dermal edema (blister and necrosis)
- wide rand of expression and severity
- can be severe and life-threatening (Stevens-Johnson Syndrome)
28
Q
Stevens-Johnson syndrome
A
- severe form of erythema mutltiforma
- generalized all over the body
- reaction to medication (sulfonamides, salicylates)
- can also be a reaction to infections such as herpes virus or fungal infections
- can have epidermal necrosis with blisters
- T-cells attacking antigen and surrounding cells (basal cells)
29
Q
psoriasis
A
- type of chronic inflammatory skin pathology
- inciting antigen; auto-rejection or environmentally induced
- 1-2% in US
- can be accompanied by increase in heart attacks and arthritis
- treatment: NSAIDs and immunosuppressant drugs
- symptoms: well-marked by pink to salmon colored plaques; regular acanthosis in epidermis –> thinning of epidermis with increased bleeding
30
Q
lichen planus
A
- type of chronic inflammatory skin pathology
- middle aged patients
- affects extremities and the oral cavity
- symptoms: lace-like white markings referred to as “Wickham Striae”; resolves in 1-2 years but usually persists in the oral cavity; hyperkeratosis; epidermal hyperplasia
- cause: unknown mechanism; hyper-reactive T-cells may be involved
31
Q
Systemic Lupus Erythematosus (SLE)
A
- can result in a type of chronic inflammatory skin pathology
- chronic auto-immune response
- environmental triggers: drugs, UV , viruses, stress
- affects the skin: butterfly rash on face
- manage with NSAIDs, steroids, immunosuppressant drugs
- can cause long-term effects such as blood clots, seizures, and heart attacks
32
Q
bacterial infectious dermatosis
A
- ex. impetigo
- usually superficial staph or strep infections on face and extremities
- contagious through contact; primarily seen in kids
- symptoms: honey color crusts, pustules
- treatment: topical abx such as tetracycline
33
Q
fungal infectious dermatosis
A
- tinea (ring worm) or candida
- often infections in immunocompromised patients (very common)
- erythematous macules; often pruritic (itching)
34
Q
viral infectious dermatosis
A
- ex. warts/verrucae (HPV)
- contagious by direct contact
- can auto-inoculate and spread
- epidermal hyperplasia; papillo mitosis
35
Q
bulbous blistering
A
- pemphigus: painful flaccid blister-like deep erosions and crusts after rupture; due to hypersensitivity reaction
- dermatitis herpetiformis
- use immunosuppressive treatment
- tend to be auto-immune responses
36
Q
pemphigus
A
- several variants
- has acanthosis
- blister formation (bullous)
- auto-immune
- typically treat with steroids
- pemphigus vulgaris has “Tzanck cells”
37
Q
Herpes simplex
A
- oral expression = HSV 1 (cold sores)
- genital expression = HSV 2
- group vesicles, epidermal acantholysis, vesicles, sloughing
38
Q
Herpes Zoster
A
- dermatomal distribution (possible to have trigeminal nerve involvement and can be dangerous if spreads to surrounding tissue such as the eye or brain)
- Varicella Zoster Virus can cause shingles usually later in life in those who have had chicken pox)
- symptoms: unilateral, dermatomal distribution; band of rash that often itches, burns, or throbs; persists for weeks to months; relief via anti-inflammatories and opioids; in some cases can be like an intense neuralgia
- not contagious
39
Q
expressions of acne
A
- opened comodones (black heads)
- closed comodones (white heads)
- cysts, pustules, abscesses, and scarring
- worsened by drugs such as steroids, testosterone, and possibly contraceptives
40
Q
characteristics of acne vulgaris
A
- hormone changes (esp. sex hormones; increases testosterone influences)
- blocks hair follicle and sebaceous gland
hair follicle has proliferation of lining cells and cellular sloughing –> forms a cellular plug and traps bacteria, cellular debris and sebum - gland ruptures and contents spread to form cysts, abscesses, and scarring (area is inflamed and swollen)
41
Q
treatments for acne vulgaris
A
- antibiotics (tetracycline)
- keratolytics
- drying agents
- vitamin A (topical and systems - Accutane)
- UV exposure
42
Q
perioral dermatitis
A
- young women
- causes: long-term steroid use or cosmetic use, hormonal changes
- follicular papules, vesicles and pustules
43
Q
seborrheic keratosis
A
- benign dermal neoplastic
- elderly, middle-aged
- coin-like plaques, stuck-on appearance
- tan to dark brown, granular surface
- can be generally spread
44
Q
actinic keratosis
A
- pre-malignant
- related to UV exposure in fair-skinned people
- brown to red lesions
- rough, scaly texture
45
Q
melanocytic nevi
A
- moles
- benign neoplasm of melanocytes
- well-defined borders and not predisposed to cancer
- pigmented nevus
46
Q
dysplastic nevi
A
- sporadic
- if more than 10 lesions, have increased risk of melanoma
- irregular borders
- asymmetric borders
47
Q
Basal cell carcinoma
A
- most common malignant skin neoplasm
- least aggressive, most common malignancy worldwide
- slow growing, but can be disfiguring if not removed early and can ulcerate and bleed
- remove with local incision (does not metastasize)
48
Q
squamous cell carcinoma
A
- 2nd most common (behind basal cell)
- intermediate aggression, no metastasis
- red, scaling plaques - locally aggressive, remove with surgery
- often presents as a scaling, ulcerative nodule
- can have “keratin pearls” which are islands of neoplastic skin cells
49
Q
melanoma
A
- least common, typically aggressive and metastasizes
- warning signs: rapid enlargement of a nevus, new pigmented lesions not from a pre-existing nevus, irregular borders, irregular surface, and irregular colors
- usually superficial and spreads
- caused by UV exposure and genetics
- prognosis: poor if metastasized (common sites are lungs, liver, and brain)
50
Q
characteristics of malignant skin neoplasms in general
A
- high mitotic rate
- lack of immune response to slow the spread (especially when it has traveled to the lymph nodes)
- prognosis is good for superficial lesions and poor for metastatic disease, high mitotic rate and poor immune response
51
Q
chronic inflammation can lead to…
A
- cancers
- pulmonary diseases
- cardiovascular diseases
- diabetes
- alzheimer’s disease
- oral diseases (periodontal disease)
- neurological diseases
- arthritis
