Dermatopathology 2 Flashcards
1
Q
Dermatofibroma is also known as
A
benign fibrous histiocytoma
2
Q
Dermatofibroma usually occurs where on the body
A
lower legs
3
Q
how fast does Dermatofibroma grow
A
slow
4
Q
clinical signs for Dermatofibroma
A
Flesh-colored to pigmented papule
- “dimple-sign” depresses when squeezed
5
Q
what proliferates in Dermatofirbroma
A
fibroblasts with collagen
6
Q
histo pic for dermatofibroma
A
whirling (pinwheel or storiform) fibroblasts with collagen bundles
7
Q
Does Dermatofibroma metastasize
A
no
8
Q
what happens to overlying epidermis in Dermatofibroma
A
thins
9
Q
Dermatofibroma extends where in the skin and how
A
dermis to subcutaneous fat
“honeycomb” pattern
10
Q
What happens in Mycosis Fungoides
A
T cell lymphoma presents in skin and may evolve into generalized lymphoma
11
Q
where does Mycosis Fungiodes occur
A
trunk
12
Q
what are the 3 stages of Mycosis Fungoides
A
Patch: scaly, red, brown
plaque: raised
nodule ( tumor)
13
Q
the three stages of Mycosis Fungoides is similar to what other disease
A
Kaposi Sarcoma
14
Q
Explain histo process of Mycosis Fungoides
A
- T-helper cells form bands in superficial dermis
- single cells or small clusters invade epidermis
15
Q
what are two types of Mastocytosis
A
Urticaria pigmentosa
Systemic mastocytosis
16
Q
Urticaria pigmentosa usually presents in who
A
children
17
Q
Systemic Mastocytosis usually occurs in who
A
adults
18
Q
what are two signs and symptoms for Mastocytosis
A
Darier sign
Dermatographism
19
Q
Darier sign
A
Wheal ( dermal edema and erythema) when skin lesion is rubbed
20
Q
Dermatographism
A
hive occurs when normal skin is stroked with pointed instrument
21
Q
Why do these signs and symptoms occur in mastocytosis
A
release of histamines, heparin, and other mast cell content
22
Q
In systemic disease of Mastocytosis, foods, drugs, alcohol can trigger what
A
Pruritus and flushing
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
24
Q
what stain is good for Mastocytoma
A
Giemsa
25
define Ichthyosis
disorders which impair epidermal maturation
26
what are two types of Ichthyosis
congenital
| acquired
27
histo for Ichthyosis: stratum corneum
build up of compacted stratum corneum with loss of basket-weave pattern
28
which types of Ichthyoses has stratum granulosum normal to slightly thickened
- lammellar
- X-linked
- congenital ichthyosiform erythroderma
29
which types of Ichthyosiss has stratum granulosum thin or absent
ichthyosis vulgaris
30
what is a common name for urticaria
hives
31
how does urticaria form
from mast cell degranulation through sensitization with specific IgE
and microvascular hyper-permeability
32
histo for Urticaria
pervenular infiltrate
dermal edema
no epidermal changes
33
another name for Acute Eczematous Dermatitis
Spongiotic Dermatitis
34
what are 2 forms of contact dermatitis
irritant and allergic
35
Allergic contact dermatitis creates what type of reaction
cell-mediated, delayed-type hypersensitivity reaction type 4
36
Allergic contact dermatitis, explain process form skin contact
- Antigen on skin taken up by langerhans cell
- dermal lymphatics to lymph nodes
- CD 4 helper T cells
37
what are common allergic contact dermatitis
Nickel, poison ivy/oak
38
for allergic contact dermatitis characterize the vescicles
fluid in vesicles do not contain allergen and cannot induce disease in others.
39
for allergic contact dermitis when does sensitization occur for first time exposure? reexposure?
1st: 1-2 weeks
2nd: hours to days
40
Mechanism of actin for irritant and allergic
irritant: direct effect
allergic: type IV
41
onset for irritant and allergic
Irritant: few hours
allergic: 12-72 hours
42
incidence for irritant and allergic
I: anyone
A: only sensitized person
43
lesionfor irritant and allergic
I: erythema, vesicles, crust
A: erythema, papules, vesicles, scale
44
common name for atopic dermatitis
eczema
45
clinical feature for atopic dermatits? when does it start?
chronic waxing and waning
dry skin
extremely pruritic, papules, vesicles, oozing, crusting
beginning first yr of life
46
where do babies usually get atopic dermatitis
face, diaper area
47
where do children and adults get atopic dermatitis
neck, face, axillae
48
chronic atopic dermatitis can lead to what
Lichenification: epidermal thickening, visible and palpable skin thickening with accentuated skin lines
49
Nummular dermatits is what shape? clinical presentation
coin-shaped
| - itchy red plaques with vesicles and distinct borders
50
asteatotic dermatitis is known as what? clinical presentation
winter itch
| - dry cracked skin
51
histo what does acute eczyematous dermatitis ( spongiotic dermatitis) look like
Spongiosis: intracellular edema
exocytosis: infiltration of epidermis by inflammatory cells
52
what happens in erythema multiforme
CD8 T cells, hypersensitivity reaction resulting in epidermal cell injury
53
what is a clinical diagnostic factor for erythema multiforme? other clinical features
- target lesions
| - macules, papules, vesicles, bullae, puritic
54
what can trigger Erythema multiforme
HSV
| mycoplasma pneumonia
55
histo for Erythema multiforme
early: dermal edema
degenerating and necrotic keratinocytes
later: lymphocytes migrate into epidermis
56
which is more severe Stevens-Johnson syndrome or erythema multiforme
Steves-Johnson syndrome
57
who usually gets Stevens-Johnson Syndrome
children
58
what involves Stevens-Johnson Syndrome
```
mucous membranes ( mouth and conjuctivae)
fever, difficulty eating, renal failure
```
59
how is a Stevens-Johnsone syndrome patient treated
burn patient
60
what my cause Steven-Johnson syndrome
sulfa drugs and anticonvulsants
61
toxic Epidermal Necrolysis what happens
detachment of large areas of epidermis
62
body surface involvement for EM, Steven johnson, TEN
EM: less than 30%
SJ: 10-30%
TEN: more than 30
63
Pityriasis Rosea is possibly related to what virus
herpes virus 7
64
What time of year does Pityriasis occur
winter
65
Clinically what does PItyriasis Roasea look like
- Initial "herald patch" resembles ringworm
- pink, scaling near border
- "Christmas tree pattern"
66
what does the histo for pityriasis rosea
spongiosis with erthrocyte extravasation
67
where is Pityriasis Rosea commonlyfound
trunk, upper arms, thighs
| not face
68
what is venous insufficiency
venous incompetence causes increased hydrostatic pressure and capillary damage
- extravasation of RBCs and serum
69
clinically what does venous insufficiency look like
edema and hyperpigmentation
- pruritic erthema and stasis dermatitis
- ulceration above medial malleoulus
70
what is the histo features for stasis dermatitis of venous incompetence
subacute spongiotic dermatitis
| - intracellular epidermal edema
71
how is venous insufficiency treated
compression stocking
72
what is Psoriasis
accelerated proliferation of skin cells resulting in scaling
73
clinically what does Psoriasis look like
well-demarcated, erythematous plaques and plaques with SILVER SCALING
- symmetrical
74
what is Auspitz' sign
pinpoint bleeding on removal
| - Psoriasis
75
what is the koebner phenomenon
trauma to the skin and stress can cause exacerbations
| - Psoriasis
76
histo for Psoriasis
- Downward elongation of rete ridges
- thining on stratum granulosum
- parakertosis above granulosum layer
capillaries in dermal papillae brought close to the surface
77
Erythrodermic psoriasis
entire skin, very serious
78
Guttate psoriaisis
scattered, drop-like, pink, scaly plaques
| may follow Strep
79
Pustular psoriasis
pustules on erythematous skin,
80
Psoriasis effects on nails
oil spotting: focal brown discoloration of nail plate
onycholysis: distal separation of plate from bed
subungural hyperkeratosis
pitting
81
Psoriasis can cause what other health problem? what does it look like
arthritis
| "pencil-in-cup"
82
what should you not give a psoriasis patient
oral steroids
83
what are common names for Seborrheic dermatitis
"cradle cap"
| dandruff
84
what causes seborrheic dermatitis
Malassezia furfur
85
what areas on the skin does seborrheic dermatitis impact
sebaceous gland rich areas
86
Seborrheic dermatitis is usually found in patients who have what conditions
Parkinson and HIV
87
what does Seborrheic dermatitis look like
yellow, greasy, scaly patches with surrounding erythema
88
what is the histo for Seborrheic dermatitis
features of both spongiotic dermatitis and psoriasis
- mounds of parakeratosis with neutrophils
- serum at ostia of hair follicle
89
what is Lichen Planus
idiopathic Inflammatory disorder
90
what are the 5 P's for Lichen Panus
```
Pruritic
Purple
Polygonal
Planar
Papules
Plaques
```
91
where is Lichen Panus common
wrists and ankle
92
clinical presentation of Lichen Panus
Wickham's striae: fine, reticulated, white lines
mucous involvement
Koebner phenomenon
severe ithcing
93
Lichen Planus can be associated with what disease
Hep. C
94
Histo for Lichen Planus
- many lymphocytes along dermo-epidermal junction
- Civatte bodies
- saw-tooth pattern
95
Civatte bodies
incorporation of necrotic basal keratinocytes into inflammaed papillary dermis
96
Systemic Lupus Erythematosus involves what organs
autoimmune disease involving connective tissue and blood vessel
97
Who is more likely to have Systemic Lupus Erythematosus
African Americans
98
Which gender is more likely to get Systemic Lupus Erythematosus
females
99
what are some clinical symptoms of Systemic Lupus Erythematosus
```
skin lesions
fatigue
fever
weight loss
CNS symptoms
```
100
what are classic symptoms of Systemic Lupus Erythematosus
Malar rash- butterfly rash ( spares nasolabial folds)
101
histo for lupus
epidermal atrophy
| thickening of basal membrane
