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D & T exam 2 > Dermatopathology 2 > Flashcards

Dermatopathology 2 Flashcards

1
Q

Dermatofibroma is also known as

A

benign fibrous histiocytoma

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2
Q

Dermatofibroma usually occurs where on the body

A

lower legs

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3
Q

how fast does Dermatofibroma grow

A

slow

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4
Q

clinical signs for Dermatofibroma

A

Flesh-colored to pigmented papule

- “dimple-sign” depresses when squeezed

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5
Q

what proliferates in Dermatofirbroma

A

fibroblasts with collagen

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6
Q

histo pic for dermatofibroma

A

whirling (pinwheel or storiform) fibroblasts with collagen bundles

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7
Q

Does Dermatofibroma metastasize

A

no

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8
Q

what happens to overlying epidermis in Dermatofibroma

A

thins

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9
Q

Dermatofibroma extends where in the skin and how

A

dermis to subcutaneous fat

“honeycomb” pattern

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10
Q

What happens in Mycosis Fungoides

A

T cell lymphoma presents in skin and may evolve into generalized lymphoma

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11
Q

where does Mycosis Fungiodes occur

A

trunk

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12
Q

what are the 3 stages of Mycosis Fungoides

A

Patch: scaly, red, brown
plaque: raised
nodule ( tumor)

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13
Q

the three stages of Mycosis Fungoides is similar to what other disease

A

Kaposi Sarcoma

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14
Q

Explain histo process of Mycosis Fungoides

A
  • T-helper cells form bands in superficial dermis

- single cells or small clusters invade epidermis

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15
Q

what are two types of Mastocytosis

A

Urticaria pigmentosa

Systemic mastocytosis

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16
Q

Urticaria pigmentosa usually presents in who

A

children

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17
Q

Systemic Mastocytosis usually occurs in who

A

adults

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18
Q

what are two signs and symptoms for Mastocytosis

A

Darier sign

Dermatographism

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19
Q

Darier sign

A

Wheal ( dermal edema and erythema) when skin lesion is rubbed

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20
Q

Dermatographism

A

hive occurs when normal skin is stroked with pointed instrument

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21
Q

Why do these signs and symptoms occur in mastocytosis

A

release of histamines, heparin, and other mast cell content

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22
Q

In systemic disease of Mastocytosis, foods, drugs, alcohol can trigger what

A

Pruritus and flushing

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23
Q

what do the dendritic mast cells look like in mastocytoma

A

metachromatic granules within dendritic mast cells

- Fried egg cells : central nuclei with rigid rim of peripheral cytoplasm

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24
Q

what stain is good for Mastocytoma

A

Giemsa

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25
Q

define Ichthyosis

A

disorders which impair epidermal maturation

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26
Q

what are two types of Ichthyosis

A

congenital

acquired

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27
Q

histo for Ichthyosis: stratum corneum

A

build up of compacted stratum corneum with loss of basket-weave pattern

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28
Q

which types of Ichthyoses has stratum granulosum normal to slightly thickened

A
  • lammellar
  • X-linked
  • congenital ichthyosiform erythroderma
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29
Q

which types of Ichthyosiss has stratum granulosum thin or absent

A

ichthyosis vulgaris

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30
Q

what is a common name for urticaria

A

hives

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31
Q

how does urticaria form

A

from mast cell degranulation through sensitization with specific IgE
and microvascular hyper-permeability

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32
Q

histo for Urticaria

A

pervenular infiltrate
dermal edema
no epidermal changes

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33
Q

another name for Acute Eczematous Dermatitis

A

Spongiotic Dermatitis

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34
Q

what are 2 forms of contact dermatitis

A

irritant and allergic

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35
Q

Allergic contact dermatitis creates what type of reaction

A

cell-mediated, delayed-type hypersensitivity reaction type 4

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36
Q

Allergic contact dermatitis, explain process form skin contact

A
  • Antigen on skin taken up by langerhans cell
  • dermal lymphatics to lymph nodes
  • CD 4 helper T cells
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37
Q

what are common allergic contact dermatitis

A

Nickel, poison ivy/oak

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38
Q

for allergic contact dermatitis characterize the vescicles

A

fluid in vesicles do not contain allergen and cannot induce disease in others.

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39
Q

for allergic contact dermitis when does sensitization occur for first time exposure? reexposure?

A

1st: 1-2 weeks
2nd: hours to days

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40
Q

Mechanism of actin for irritant and allergic

A

irritant: direct effect
allergic: type IV

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41
Q

onset for irritant and allergic

A

Irritant: few hours
allergic: 12-72 hours

42
Q

incidence for irritant and allergic

A

I: anyone
A: only sensitized person

43
Q

lesionfor irritant and allergic

A

I: erythema, vesicles, crust
A: erythema, papules, vesicles, scale

44
Q

common name for atopic dermatitis

A

eczema

45
Q

clinical feature for atopic dermatits? when does it start?

A

chronic waxing and waning
dry skin
extremely pruritic, papules, vesicles, oozing, crusting
beginning first yr of life

46
Q

where do babies usually get atopic dermatitis

A

face, diaper area

47
Q

where do children and adults get atopic dermatitis

A

neck, face, axillae

48
Q

chronic atopic dermatitis can lead to what

A

Lichenification: epidermal thickening, visible and palpable skin thickening with accentuated skin lines

49
Q

Nummular dermatits is what shape? clinical presentation

A

coin-shaped

- itchy red plaques with vesicles and distinct borders

50
Q

asteatotic dermatitis is known as what? clinical presentation

A

winter itch

- dry cracked skin

51
Q

histo what does acute eczyematous dermatitis ( spongiotic dermatitis) look like

A

Spongiosis: intracellular edema
exocytosis: infiltration of epidermis by inflammatory cells

52
Q

what happens in erythema multiforme

A

CD8 T cells, hypersensitivity reaction resulting in epidermal cell injury

53
Q

what is a clinical diagnostic factor for erythema multiforme? other clinical features

A
  • target lesions

- macules, papules, vesicles, bullae, puritic

54
Q

what can trigger Erythema multiforme

A

HSV

mycoplasma pneumonia

55
Q

histo for Erythema multiforme

A

early: dermal edema
degenerating and necrotic keratinocytes

later: lymphocytes migrate into epidermis

56
Q

which is more severe Stevens-Johnson syndrome or erythema multiforme

A

Steves-Johnson syndrome

57
Q

who usually gets Stevens-Johnson Syndrome

A

children

58
Q

what involves Stevens-Johnson Syndrome

A 
mucous membranes ( mouth and conjuctivae) 
fever, difficulty eating, renal failure
59
Q

how is a Stevens-Johnsone syndrome patient treated

A

burn patient

60
Q

what my cause Steven-Johnson syndrome

A

sulfa drugs and anticonvulsants

61
Q

toxic Epidermal Necrolysis what happens

A

detachment of large areas of epidermis

62
Q

body surface involvement for EM, Steven johnson, TEN

A

EM: less than 30%
SJ: 10-30%
TEN: more than 30

63
Q

Pityriasis Rosea is possibly related to what virus

A

herpes virus 7

64
Q

What time of year does Pityriasis occur

A

winter

65
Q

Clinically what does PItyriasis Roasea look like

A
  • Initial “herald patch” resembles ringworm
  • pink, scaling near border
  • “Christmas tree pattern”
66
Q

what does the histo for pityriasis rosea

A

spongiosis with erthrocyte extravasation

67
Q

where is Pityriasis Rosea commonlyfound

A

trunk, upper arms, thighs

not face

68
Q

what is venous insufficiency

A

venous incompetence causes increased hydrostatic pressure and capillary damage
- extravasation of RBCs and serum

69
Q

clinically what does venous insufficiency look like

A

edema and hyperpigmentation

  • pruritic erthema and stasis dermatitis
  • ulceration above medial malleoulus
70
Q

what is the histo features for stasis dermatitis of venous incompetence

A

subacute spongiotic dermatitis

- intracellular epidermal edema

71
Q

how is venous insufficiency treated

A

compression stocking

72
Q

what is Psoriasis

A

accelerated proliferation of skin cells resulting in scaling

73
Q

clinically what does Psoriasis look like

A

well-demarcated, erythematous plaques and plaques with SILVER SCALING
- symmetrical

74
Q

what is Auspitz’ sign

A

pinpoint bleeding on removal

- Psoriasis

75
Q

what is the koebner phenomenon

A

trauma to the skin and stress can cause exacerbations

- Psoriasis

76
Q

histo for Psoriasis

A
  • Downward elongation of rete ridges
  • thining on stratum granulosum
  • parakertosis above granulosum layer
    capillaries in dermal papillae brought close to the surface
77
Q

Erythrodermic psoriasis

A

entire skin, very serious

78
Q

Guttate psoriaisis

A

scattered, drop-like, pink, scaly plaques

may follow Strep

79
Q

Pustular psoriasis

A

pustules on erythematous skin,

80
Q

Psoriasis effects on nails

A

oil spotting: focal brown discoloration of nail plate
onycholysis: distal separation of plate from bed
subungural hyperkeratosis
pitting

81
Q

Psoriasis can cause what other health problem? what does it look like

A

arthritis

“pencil-in-cup”

82
Q

what should you not give a psoriasis patient

A

oral steroids

83
Q

what are common names for Seborrheic dermatitis

A

“cradle cap”

dandruff

84
Q

what causes seborrheic dermatitis

A

Malassezia furfur

85
Q

what areas on the skin does seborrheic dermatitis impact

A

sebaceous gland rich areas

86
Q

Seborrheic dermatitis is usually found in patients who have what conditions

A

Parkinson and HIV

87
Q

what does Seborrheic dermatitis look like

A

yellow, greasy, scaly patches with surrounding erythema

88
Q

what is the histo for Seborrheic dermatitis

A

features of both spongiotic dermatitis and psoriasis

  • mounds of parakeratosis with neutrophils
  • serum at ostia of hair follicle
89
Q

what is Lichen Planus

A

idiopathic Inflammatory disorder

90
Q

what are the 5 P’s for Lichen Panus

A 
Pruritic
Purple
Polygonal
Planar
Papules
Plaques
91
Q

where is Lichen Panus common

A

wrists and ankle

92
Q

clinical presentation of Lichen Panus

A

Wickham’s striae: fine, reticulated, white lines
mucous involvement
Koebner phenomenon
severe ithcing

93
Q

Lichen Planus can be associated with what disease

A

Hep. C

94
Q

Histo for Lichen Planus

A
  • many lymphocytes along dermo-epidermal junction
  • Civatte bodies
  • saw-tooth pattern
95
Q

Civatte bodies

A

incorporation of necrotic basal keratinocytes into inflammaed papillary dermis

96
Q

Systemic Lupus Erythematosus involves what organs

A

autoimmune disease involving connective tissue and blood vessel

97
Q

Who is more likely to have Systemic Lupus Erythematosus

A

African Americans

98
Q

Which gender is more likely to get Systemic Lupus Erythematosus

A

females

99
Q

what are some clinical symptoms of Systemic Lupus Erythematosus

A 
skin lesions
fatigue 
fever
weight loss
CNS symptoms
100
Q

what are classic symptoms of Systemic Lupus Erythematosus

A

Malar rash- butterfly rash ( spares nasolabial folds)

101
Q

histo for lupus

A

epidermal atrophy

thickening of basal membrane

D & T exam 2 (27 decks)

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