Dermatopathology 3 Flashcards by Bina Malapur

Pemphigus vulagris what happens

IgG autoantibodies against desmogleins 1 and 3 in desomosomes in suprabasal deep epidermis and mucosal epithelium

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what is Nikolsky sign and what are Pemphigus vulgaris tests results

pressure on blister causes lateral spread of lesion

- positive

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where do 80-90% of pemphigus vulgaris begin

oral lesions

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what forms the roof of the blister for pemphigus vulagris

stratum corneum

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what happens in pemphigus foliaceus

autoantibodies against Dsg1 alone

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histo for pemphigus

row of tombstomes
acantholysis
net like pattern of intracellular IgG deposists

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what does pemphigus vegetans look like

large, moist, verrucous, plaques rather than blisters

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common lesion site for pemphigus vegetans

oral lesions

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what other disorder is pemphigus vegetans related to

ulcerative colitis

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what country is pemphigus foliaceus found

Brazil

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what happens in bullous Pemphigoid

autoantibodies bind BPAg1 and BPAg2 ( only one causing blister) in hemidesosome

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At what layer of the skin does bullous Pemphigoid form a blister

lamina lucida of the basement membrane

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age groups of pemphigus and Bullous Pemphigoid

P: 30-50
BP: elderly

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target antigen for pemphigus and Bullous Pemphigoid

P: demoglein 1 and 3
BP: BPAg1 and BPAg2 in hemidesmosomes

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Blister ( bulla) pemphigus and Bullous Pemphigoid

P: suprabasal, ancantholytic, positive Nikosky sign
BP: subepidermal, nonacantholytic, sturdy

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oral mucosa for pemphigus and Bullous Pemphigoid

P: many early lesions
BP: few after cutaneous lesions

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what happens in Dermatitis Herpetiformis

IgA autoantibodies to transglutaminases bind to TG in gut and cross-react with reticulin in fibrils in skin

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what is the onset and gender of Dermatitis Herpetiformis

20-60

males

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clinical presentation of Dermatitis Herpetifromis

symmetrically grouped lesions

-papules and plaques progressing to vesicles and bullae

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For Dermatitis Herpetiformis what other disease is present and what is used to show this

Gluten senstive

small bowel biopsy

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Histo feature for Dermatitis Herpetiformis

subepidermal blister

microabscesses at dermal papillae

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what is epidermolysis bullosa

group of disorders caused by inherited defects ( 10 genes) in proteins that lend stability to skin

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when do symptoms of Epidermolysis bullosa occur

at or soon after birth

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Name 4 types of Epidermolysis Bullosa

simplex
junctional
dystrophic
non-Herlitz junctional

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Simplex type

mutations in gene encoding keratin 14 or 5 ( form keratin fiber) - basal cell layer defect

Junctional type

blisters formed from separation lamina lucida

Dystrophic types

blisters below lamina densa, from defect in collagen VII

Non-Herlitz Junctional

defect in laminin Vbeta3

histo for Epidermolysis Bullosa? similiar to what?

fibrin deposition in floor of blister cavity | - bullous pehphigoid

what happens in prophyria cutanea tarda

``` uroporphyrinogen decarboxylase (UROD) deficiency - excessive accumulation of porphyrins ```

who is prone for Prophyria cutanea tarda

30-50 yrs - females on OCP - alcohol - hep C

what are the types of Porphyria cutanea tarda

Type I: acquired | type II: autosomal dominant, deficient in RBC and fibroblasts

what does Porphyria cutanea tarda do to skin

make it photosenstivie

what does Porphyria cutanea tarda do to face

hypertrichosis ( hairy face)

how does one diagnose Porphyria cutanea tarda

uroprophryin in urine

what 3 things must be avoided for porphyria cutanea tarda

alcohol estrogens fungicides

histo for porphyria cutanea tarda

subepidermal vesiculation - protuberance of rigid dermal papillae into blister cavity( festooning - thickening of walls of superficial dermal vessels

what happens in acne vulgaris

obstruction of sebaceous follicles by sebum | -promotes proliferation of propionibacterium acnes ( anaerobe)

what do obstructive acne look like

closed whiteheads flesh colored dome

what do inflammatory acne look like

papules/pustules to nodules to cysts

Risk factors for Acne vulgaris

``` male puberty Cushing oily complexion androgen excess ```

what are 4 components of acne vulgaris

1. keratinization of lower portion of follicular infundibulum - development of keratin plug, block outflow of sebum 2. hypertrophy of sebaceous gland 3. lipase-synthesizing bacteria ( propionibacterium acnes_ colonizing upper hair follicle 4. inflammation of follicle - release of cytoxic and chemotactic factors

Acne Rosacea what is it

chornic inflammatory disorder that affects blood vessels and pilosebaceous units

4 stages of acne rosacea

1. flushing 2. persistent erthyema and telangiectasias 3. pustules and papules 4. Rhinophyma

what is rhinophyma

skin on nose becomes thick and greasy, hyperplasia of sebaceous glands, connective tissue and vasculature

what areas of the face are impacted with acne rosaceae

nose and cheeks including nasolabial folds

histo for rosacea

perfollicular infiltrate of lymphocytes

Panniculitis

inflammation of lobules or connective tissue septa separating fat lobules

what is Erythema nodosum

inflammatory reaction of connective tissue septa separating fat lubules

gender of who gets it more for Erythema nodosum

females

clinical for Erythema nodosum

red, painful, elevated nodules, poorly circumscribed

where is erythema nodosum usually ocur

anterior aspect of tibial

what are some crazy things that cause Erythema nodosum

``` strep pregnancy OCP syphilis TB ```

histo erythema nodosum

widening of septa from fibrin, edema, and neutrophilic infiltrate

what is warts

infection of epidermal cells with human papilloma virus

who usuallly gets warts

children and young adults

who are warts transmitted

skin to skin

in warts, intralesional borwn-black dots are pathognomonic and represesent what

thrombosed vessels

scientific name for common wart

Verruca vulgaris

scientific name for flat wart? | location

verruca plana | -chin, dorsum of hand, legs

scientific name for war on foot? what can cause this

Verruca platnaris | HPV1

Condyloma acuminatum

anogenital wart

what causes Condyloma acuminatum

most common STD, HPV6 and 11

hist for warts

Church spire

who usually gets Molluscum contagiosum

viral infection in kids and sexually active adults

what causes Molluscum contagiosum

poxvirus

how is Molluscum contagiosum transmitted

skin to skin

clinical representation of Molluscum contagiosum

asymptomatic smooth, dome-shaped papules with central umbilication

hist for Mollluscum contagiosum

Molluscum bodies in stratum corneum and granulosum

what is impetigo

superficial bacterial infection of skin

what are the two forms of impetigo

nonbullous and bullous

what is the most common form of impetigo

nonbullous

what is the most common cause of impetigo

Staph aureus

histo for impetigo

neutrophils beneath stratum corneum

Sacabies how long in incubation

1 month

scabies is infection with

Sarcoptes scabiei

where does scabies usually occur

finger webs, wrists, and penis

the egg and feces causes what reaction to the body

type IV hypersensitivity | - extremem itching at night

how does one confirm scabies

scraping burrow with scalpel | look under microscope

what is Xanthelasma ( Xanthoma)

collection of macrophages containing lipid droplets

Mongolian spots clinical picture

single-gray-blue lesion over lumbosacral area

who usually gets Mongolian spots

Asian and Native Americans

what goes wrong in Mongolain spots

melanocytes located in dermis instead of epidermis

what is cherry angioma

bright red, domed, vascualar lesions on trunk | - increase with age

what is the most common tumor of infancy

Hemangioma of infancy

what is Hemangioma of infancy? what does it look like

benign hyperplastic blood vessels, | - blanchable bright red to deep purple lesions

over time what happens to hemangioma of infancy

regressses

when do you treat hemangioma of infancy

do not treat until ulcerates or blocks ears, eyes, larynx

what are the 3 phases of hair devleopment

anagen catagen telogen

what is alopecia

common cause of hair loss in adults

Xeroderma pigmentosum how is it inherited?

Autosomal recessive

Xerdomera pigmentosum

decrease ability to repair DNA following UV damage

timeline of Xeroderma pigmentusm

1st year of life: scaling later: atrophy 5-6 yeras: squamous and basal cell cancer

Chediak-Higashi syndrome

immunodiciency due to defect in neutrophil phagosome lysosome fusions -abonormal giant lysosomal inclusions visible on peripheral blood smear

Wiskott-Aldrich Syndrome

``` X-linked immunodeficiency Exzema thrombocytopenia B and T lymphocyte disorder ```

albinsim

melanocytes normal in number and location - production of melanin defective - due to complete absence of tyrosinase