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Human Disease and Therapeutics > Dermal Pathology > Flashcards

Dermal Pathology Flashcards

1
Q

skin cell types

A
  • squamous cells
  • basal cells
  • melanocytes
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2
Q

T/F The skin is a major immunologic organ

A

true

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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)
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4
Q

macule

A
  • flat, circumscribed

- < 5mm

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5
Q

papule

A
  • elevated dome or flat topped

- < 5mm

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6
Q

nodule

A
  • elevated dome

- > 5mm

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7
Q

plaque

A
  • elevated flat-topped lesion

- > 5mm

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8
Q

lichenification

A
  • thickened skin due to repeated rubbin
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9
Q

pustule

A
  • discrete, pus-filled raised lesion
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10
Q

scale

A
  • dry, plate-like excresence

- imperfect cornification

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11
Q

vesicle

A
  • fluid-filled, raised area

- < 5mm

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12
Q

acantholysis

A
  • loss of intercellular adhesion of keratinocytes

- epidermis falls apart and sloughs off

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13
Q

acanthosis

A
  • diffuse epidermal hyperplasia (thicker than normal)
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14
Q

excoriation

A
  • traumatic breakage of the skin

- ex. intense scratching

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15
Q

bulla

A
  • fluid-filled raised area

- > 5mm

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16
Q

dyskeratosis

A
  • hyperplasia of stratum cornum
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17
Q

sponigosis

A
  • intercellular edema of epidermis
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18
Q

papillomatosis

A
  • surface elevation cause by hyperplasia
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19
Q

cyst

A
  • fluid-filled sac lined with true epithelium
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20
Q

granuloma

A
  • chronic inflammatory lesion consisting of granulation tissue
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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

Human Disease and Therapeutics (11 decks)

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