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Week 9 - Dermatology > Dermatopathology > Flashcards

Dermatopathology Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the reasons to take a skin biopsy?

A
  • Possible skin cancer
  • Inflammatory skin condition
  • Possible drug reaction
  • Dermatological emergency
  • Infection or infestation
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2
Q

In histology what do grey structures in the dermis represent?

A

Sun damage

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3
Q

What are the layers of the epidermis?

A
  • Stratum corneum
  • Stratum granulosum
  • Stratum spinosum
  • Stratum basalis
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4
Q

Describe the appearance of keratinocytes

A

Squamous epithelial cells

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5
Q

Describe the appearance of melanocytes

A

Clearer cells along the basal epidermis

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6
Q

Why is skin pathology important?

A
  • For accurate Diagnosis of the skin condition
  • For treatment of a suspicious lesion
  • Prognosis and staging of tumours
  • Further patient management
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7
Q

What are the malignant epithelial tumours?

A
  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Merkel cell carcinoma
  • Extramammary pagets disease
  • Carcinosarcoma
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8
Q

What are the 4 malignant skin cancer types?

A
  • Malignant epithelial tumours
  • Malignant melanoma
  • Cutaneous lymphoma
  • Sarcoma
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9
Q

What are the risk factors for developing a basal carcinoma?

A
  • UV exposure/ sun damage
  • Age
  • Immune compromise and specific genodermatoses
  • Arsenic exposure
  • Coal tar derivatives
  • Irradiation
  • Scars
  • Sinuses
  • Ulcers
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10
Q

Where do the majority of basal cell carcinomas occur?

A

On the head and neck in unexposed areas

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11
Q

Explain the histopathology of a basal cell carcinoma

A
  • Originate from follicular bulge stem cells and basaloid epithelia of follicular projections of anagen hair buds
  • Dual population of fibrous stroma and islands of basaloid cells
  • Peripheral palisading and haphazard arrangement of cells in centre of islands
  • Numerous mitoses and apoptotic bodies
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12
Q

Which of the basal cell carcinomas has the least risk of recurrence?

A

Nodular

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13
Q

Which basal cell carcinoma has a higher risk of recurrence?

A

Infiltrative

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14
Q

What is the definition of a squamous cell carcinoma?

A
  • Malignant neoplasm of the epidermal keratinocytes

* Component cells show various squamous differentiation

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15
Q

Describe the histology of squamous cell carcinoma

A
  • Nests or islands of squamous cells arising from the epidermis and extending into the dermis or beyond
  • Variable keratinisation depending upon differentiation of the tumour (more differentiation= more keratin)
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16
Q

TX

A

Tumour cannot be assessed

17
Q

T0

A

No evidence of primary tumour

18
Q

Tis

A

Carcinoma in situ

19
Q

T1

A

Tumour

20
Q

T4a

A

Tumour with gross cortical/marrow invasion

21
Q

T4b

A

Tumour with axial skeleton/skull base/foraminal invasion

22
Q

What is breslow thickness?

A

Measured from the most superficial aspect of granular cell layer (or from the base of ulcer) to deepest point of invasion

23
Q

What are the tumour related prognostic factors of a malignant melanoma

A
  • Tumour thickness
  • Mitotic rate
  • Ulceration
  • Extent of metastatic disease
24
Q

What are the non tumour related prognostic factors of malignant melanoma

A
  • Lymphatic invasion
  • Perineural invasion
  • Family history
  • Sun exposure, tanning beds
  • molecular mutational gene expression, immunogenetics
25
Q

What molecular testing can you carry out for melanoma?

A

•BRAF V600E

26
Q

What are the major tissue reaction patterns?

A
  • Psoriasiform e.g. psoriasis
  • Spongiotic e.g. eczema
  • Lichenoid e.g. lichen planus, lupus
  • Vesiculobullous e.g. pemphigus
  • Granulomatous e.g. tuberculosis, sarcoidosis
  • Vasculopathic e.g. leukocytoclastic vasculitis
27
Q

What are the histological characteristics of psoriasis?

A
  • Hyperkeratosis - thickened keratin layer
  • Parakeratosis - nuclei in the keratin layer
  • Acanthosis - thickened epidermis
28
Q

What are the histological characteristics of eczema?

A
  • Increased fluid between cells
  • Eosinophils
  • Space between keratinocytes
29
Q

What are the histological characteristics of granulomatous reaction?

A
  • Epithelioid cells
  • giant cells
  • Lymphocytes
  • Plasma cells
  • Fibroblasts
  • non-epithelioid macrophages
30
Q

What is acute generalised exanthematous pustulosis?

A
  • Rapidly evolving pustules on erythematous background
  • Starts on face or in armpits and groin
  • Following ingestion of certain drugs, resolves on cessation

Week 9 - Dermatology (8 decks)

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