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Dermatopathology > Dermatopathology > Flashcards

Dermatopathology Flashcards

1
Q

A: Identify

B: What are the 2 types of Biopsy

A

B: Punch (shown in image) vs. Shave

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2
Q

A: Identify

B: What is the Epidermis composed of (4)

C: Define Hyperkeratosis

D: Define Parakeratosis

E: What connects [Basal Layer] to Dermis (2)

A

Cancel Lab, Get Some Beer

B: MLK belongs in the Epidermis - [Melanocytes & Merkels Disc] / Langerhan / Keratinocytes]

C: When [Stratum Corneum] becomes thick

D: When [Straum Corneum] retains Nuclei

E: Hemidesmosomes & [Undulated Projections from Rete Ridge]

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3
Q

A: How long does [Epidermal maturation] from basal cell to [cornified cell] take

B: What’s the result of [Disordered maturation]

C: What condition shortens this maturation

A

A: 25 Days = [Desquamatization Vertical Maturation]

B: Skin thickening due to No Desquamation

C: Inflammation

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4
Q

A: Define Ichythosis

B: What’s the most common subtype and its [Mode of Inheritance]

C: Name the other 3 subtypes

A

A: Hereditary DO that appears at birth = Defective Desquamatization –> build up of compacted scales

B: Ichthyosis Vulgaris (AD vs. acquired)

C:

  • [Congenital Ichthyosiform Erythroderma (AR)]
  • [Lamellar Ichthyosis (AR)]
  • [X-linked Ichthyosis–> Defective steroid sulfatase]
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5
Q

A: Describe the Histology (2)

B: Dz

A

Ichthyosis Vulgaris

Orthokeratosis = Thickening of Stratum Corneum = Hyperkeratosis without Parakerotosis

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6
Q

A: Describe Histology

B: Dz

A

Ichthyosis Vulgaris

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7
Q

A: Describe Histology

B: Dz

C: Location

D: Demographic

A

A: Stuck-on,” waxy appearing brown papules or plaques

B: Seborrheic Keratosis

C: Anywhere on Skin [except palms/soles]

D: Pt > 30 y/o

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8
Q

A: Describe Histology (5)

B: Dz

C: Location

D: Demographic

A

A:

  • [Hyperkeratosis (light purple in top L)]
  • Epidermal Acanthosis made of uniform small keratinocytes
  • Horn Cyst
  • [Flat Base String Sign] = no infiltration into dermis
  • [Papillated Undulated Epithelium] (Papillomatosis)

B: Seborrheic Keratosis

C: Anywhere on Skin [except palms/soles]

D: Pt > 30 y/o

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9
Q

A: Describe Histology (3)

B: Dz

C: Location (2)

D: What’s this Dz caveat

A

A: image

B: Acanthosis Nigricans

C: Axilla and Neck Creases

D: THERE IS NO ACANTHOSIS ON HISTOLOGY

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10
Q

A: Describe Histology (3)

B: Dz

C: Location (2)

D: What’s this Dz caveat

A

A: image

B: Acanthosis Nigricans

C: Axilla and Neck Creases

D: THERE IS NO ACANTHOSIS ON HISTOLOGY

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11
Q

A: Describe the sign associated with [Seborrheic Keratosis​]

B: Demographic

A

Leser Trelat Sign

A: Paraneoplastic Syndrome accompanied with acute onset of multiple SK

B: Pts with metastatic CA

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12
Q

What are the 2 Types of [Acanthosis Nigricans]

A
  • Benign type = childhood (Obesity/Endocrine vs. Hereditary)
  • Malignant = middle age and up pts who have other internal malignancies
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13
Q

A: Describe Histology (2)

B: Dz

C: Composition

A

A: image

B: [STAFP: Skin Tag Achrochordon Fibroepithelial Polyp]

C: [Outgrowth of (Fibroblast/Collagen/Vessels) covered in acanthotic epidermis]

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14
Q

Name 2 common [Epithelial Neoplasms]

A

[Seborrheic Keratosis] & [Acanthosis Nigricans]

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15
Q

A: [Actinic Keratosis] is a precursor to ______

B: Tx (2)

A

A: [Actinic Keratosis] is a precursor to [Squamous Cell Carcinoma]

B:

  1. Cryotherapy
  2. Topical tx
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16
Q

A: Describe Histology (3)

B: Dz

C: What’s the primary leukocyte in the skin

A

A: image

-Solar Elastosis=Grayish-bluish color of the Dermis from sun damage

B: [Actinic Keratosis-PreMalignant]

C: Lymphocyte

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17
Q

A: Describe Histology (3)

B: Dz

C: What’s the primary leukocyte in the skin

A

A: image

-Solar Elastosis=Grayish-bluish color of the Dermis from sun damage

B: [Actinic Keratosis-PreMalignant]

C: Lymphocyte

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18
Q

A: Name the 2nd most common Skin Tumor

B: Risk Factors (11)

C: What’s the BIGGEST Risk Factor and why

A

A: Squamous Cell Carcinoma

B: HAIR IN WOMBS

  1. [HRAS activating mutation]
  2. Arsenic
  3. Immunosuppresion (HPV)
  4. Radiation-ionizing
  5. Industrial
  6. [Notch receptor LOSS OF FUNCTION mutation]
  7. Wounds-chronic
  8. Older
  9. Males
  10. Burn Scars
  11. SUN!!!!! = BIGGEST RISK FACTOR!

C: Sun–>[TP53 mutation at pyrimidine dimers] (INC potential in Xeroderma Pigmentosum pts)

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19
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: [Squamous Cell Carcinoma]

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20
Q

A: Describe Histology in each image

B: Dz

A

A: image

B: [Squamous Cell Carcinoma]

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21
Q

A: Describe Histology (3)

B: Dz

C: How would this appear Clinically

D: Tx

A

A: image

B: [SQC IN SITU] = BOWEN’S DZ

C: Plaque

D: Excision (will not regress on its own-but won’t metastasize once excised)

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22
Q

What is [Bowenoid Papulosis] (3)

A

Same Histology as [SQC IN SITU Bowen’s Dz] but is

  • HPV induced
  • Genital location
  • Frequent multiple papules
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23
Q

Basal Cell Carcinoma

A: Statistic

B: Risk factors (3)

C: Pathogenesis (2)

A

A: Most common invasive CA in humans

B:

  1. [Sun exposed sites of Older pts]
  2. Immunosuppressed
  3. [Xeroderma Pigmentosa (DNA mismatch repair syndromes)

C: [PTCH Hedgehog signaling mutation] vs. [P53 mutation]

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24
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Basal Cell Carcinoma

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25
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Basal Cell Carcinoma

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26
Q

[Nevoid Gorlin Basal Cell Carcinoma Syndrome]

A: Pathogenesis

B: Mode of Inheritance

C: What is this often accompanied with (3)

A

A: [2 Hit Hypothesis] involving [PTCH Chromo 9 Hedgehog signaling mutation]

B: Auto Dom

C: Medulloblastoma/Ovarian Fibroma/ [Odontogenic Keratocyst]

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27
Q

Name the most common [Melanocytic Neoplasms] (3)

A
  1. Lentigos
  2. Melanocytic Nevi
  3. Melanoma
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28
Q

A: Name these cells

B: Where are they found

C: What’s their ratio to other cells

D: Function

A

B: [Basal Layer of Epidermis] (along with Merkel Disk)

C: [1:10 ratio = (1 melanocyte):(10 Basal Keratinocytes)]

D: [Uses Tyrosinase to Produce Melanin]–>worn by [Basal Keratinocytes] to block out UV

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29
Q

A: Function of these cells

B: Pathogenesis of Albinism

A

A: [Uses Tyrosinase to Produce Melanin]–>worn by [Basal Keratinocytes] to block out UV

B: They Lack Tyrosinase

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30
Q

A: Most common Skin lesion of Childhood

B: Description (2) and Pathogenesis

C: Location

A

A: [Freckle Ephelis]

B: [Small & (Red - Brown macules)] from INC melanin pigment within basal keratinocytes. Comes from [Enlarged but normal density Melanocytes]

C: Sun exposed areas

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31
Q

Lentigo

A: Clinical Description (2)

B: Location & Demographic

C: Histology

A

A: Small & [Tan-Brown]

B: Mucus membranes / any age

C: Melanocyte Hyperplasia along basal layer

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32
Q

A: Describe Histology

B: Dz

C: Locations (3)

D: Clinical Description

A

A: image

B: [IntraDermal Melanocytic Nevus]

C: Common Type = [IntraDermal vs. Junctional vs. Compound]

D: [Tan - brown] Macules vs. Papules

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33
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Dysplastic Nevi

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34
Q

A: Clinical Description of [Dysplastic Nevi] (2)

B: Locations (2)

C: Pgn

A

A:

  1. [Tan - brown] slightly raised Macules
  2. [>5 mm]

B: Sun exposed AND Protected Areas
C: Are Clinically stable, which –> Melanoma Risk from DEC early detection

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35
Q

A: Describe [Dysplastic Nevus Syndrome]

B: Genetic Causes (2)

C: Mode of Inheritance

D: Pgn

A

A: Tendency to develop [Multiple Dysplastic Nevi AND MELANOMA]

B: [CDK-N2A Chromo 9 mutation] vs. [CDK4 Chromo 12 mutation]

C: Auto Dom

D: 50% develop Melanoma by 60!

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36
Q

A: Describe Histology (5)

B: Dz

C: List the Prognostic Factors (4)

A

A: image

B: Melanoma

C: “Use MUDS to assess Melanoma PGN!”

  1. [Depth *Breslow* - good indicator especially whenGRTR** than 1 MM thickness]
  2. [# of Mitotic Figures - only can be used with <1 MM thickness] = always poor pgn if positive
  3. Ulceration
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37
Q

A: What test is used if [Melanoma is > 0.8 MM]

B: Pgn for Melanoma in general

A

A: [Sentinel Lymph Node Biopsy]: if positive = Stage 3 = POOR PGN

B: FATAL (early recognition and surgical excision is IMP)

“Use MUDS to assess Melanoma PGN!”

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38
Q

A: Describe Histology

B: Dz

A

A: image

B: Melanoma

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39
Q

A: Describe Histology

B: Dz

A

A: image

B: [Melanoma In Situ] (No dermal infiltration)

Melanophages are seen in dermal level and have pigment covering their nucleus

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40
Q

A: Melanoma Risk Factors (4)

B: Which Risk Factor has a tx and what is the tx

A

“Blacks Circumvent Sun CA”

  1. Sun Exposure (not straight forward)
  2. [CDK-N2A Chromo 9 mutations]
  3. BRAF mutations –> [Tx = Vemurfenib]
  4. [CKIT mutation in non-sun exposed]
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41
Q

Describe the 2 Growth Phases of the Dz showin in the Image

A

1st: [Radial Growth Phase] = Lentigo Maligna (lentigenous) superficial spreading
2nd: [Vertical Growth Phase] = Nodular or [Progression of Radial Growth phase]–> Metastatic potential into Dermis with lil epidermal involvement

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42
Q

Describe the 4 Stages of Melanoma

A

Stage 0 = [Melanoma In Situ]

Stage 1/2 = Confined to Skin = 5 year Survivial

Stage 3 = [Sentinal Lymph node] = 5 year Survival

Stage 4 = [Distant Skin vs. Visceral Metastasis] = 5 year Survival

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43
Q

A: Identify Histology (2)

B: Dz (2)

C: Composition

D: Which Dz makes keratin –> appears as [keratin filled cyst structure]

A

A: image

B:

L arrow = [Fibroepithelial Polyp]

R arrow = [EpiDermalInclusion Cyst Wen] - [DERMAL BASEDnodule made of [Infundibular hair follicle tht hasloss its rete pegs]. Also makes Keratin–> Appears as [Keratin filled cyst structure] lined with epidermis. Does NOT communicate with epidermis

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44
Q

A: Describe Histology (2)

B: Dz

C: Composition

A

A: image

B: [EpiDermal Inclusion Cyst Wen]

C: [DERMAL BASED nodule made of [Infundibular hair follicle but tht has loss its rete pegs]. Also makes Keratin–> Appears as [Keratin filled cyst structure] lined with epidermis. Does NOT communicate with epidermis

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45
Q

A: Describe Histology

B: Dz and composition

C: Explain the Precipitating Dz of this, its [mode of inheritance], and pathogenesis

A

A: image

B: Trichilemmoma - [outer root sheath proliferation] with epidermal vertical growth

C: Cowden’s Dz (Auto DOM): [PTEN mutation] –> [Multiple Trichilemmoma] / [Breast-Endometrial-Thyroid CA] / Fibromas

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46
Q

A: Describe Histology

B: Dz

C: Location

A

A: image

B: DermatoFibroma

C: LE

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47
Q

A: Describe Histology (2)

B: Dz

C: Location

A

A: image

B: DermatoFibroma

C: LE

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48
Q

A: Describe Histology (2)

B: Dz

C: Location

D: Pgn

A

A: image

B: [DFSP - DermatofibroSarcoma Protuberans]

C: image

D: Aggressive local invasiveness –> morbidity

  • CD34 Positive*
  • [Dense Dermal Proliferation] / [Fayo/Morbidity from local invasiveness] / [Storiform Cartwheel] / [Protuberans on a large nodule]*
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49
Q

A: Describe Histology (2)

B: Dz

C: Location

D: Pgn

A

A: image

B: [DFSP - DermatofibroSarcoma Protuberans]

C: image

D: Aggressive local invasiveness –> morbidity

  • CD34 Positive*
  • [Dense Dermal Proliferation] / [Fayo/Morbidity from local invasiveness] / [Storiform Cartwheel] / [Protuberans on a large nodule]*
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50
Q

A: Describe Histology

B: Dz

C: Cause

A

A: image

B: Keloid

C: Hyperrxn after Trauma

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51
Q

A: Identify Dz

B: What syndrome is this associated with? Describe the Syndrome (Mode of Inheritance,Pathogenesis)

A

A: Sebaceous Adenoma

B: [Auto DOM- Muir Torre Syndrome] = [MLH1 vs. MSH2 DNA mismatch repair gene mutation]–> microsatellite instability –>

  • Sebaceous Adenoma
  • GI CA
  • GU CA
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52
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Leiomyoma

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53
Q

A: Describe Image (Clinical vs. Histo)

B: Dz

C: Which vessels are affected (2)

A

A:

  • Clinical: [Palpable Purpura +/- LE Ulceration]
  • Histo: Inflammation of arteries in subcutis with fibrin deposition

B: [PNEI - Polyarteritis Nodosum Erythema Induratum]

C: Small and [Medium Muscular] arteries

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54
Q

A: Describe Image (Clinical vs. Histo)

B: Dz

C: Location

D: Causes (3)

A

“[Erythema NoDosum GIFTS]”

A: image

B: Erythema Nodosum

C: Front Of Legs

D:

  1. Drugs (Sulfa vs. NSAID vs. BCP)
  2. TB Infection
  3. Idiopathic

“No Dosum GIFTS​”

[Needs space = Macule more spread out Papules] / [Drug-induced] / [Giant cells + Histiocytes]/[Idiopathic]/[Front Legs]/[TB]/[Septal fibrosis & Inflammation]

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55
Q

A: Describe image (5)

B: Dz

C: How does this manifest in the mouth

A

“The Lichens had sawteeth and always had a plan”

A: image

B: Lichen Planus (subtype of Lichenoid Dermatitis)

C: image

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56
Q

A: Describe Histology (3)

B: Dz

C: How does this manifest in the mouth

A

“The Lichens had sawteeth and always had a plan”

A: image

B: Lichen Planus (subtype of Lichenoid Dermatitis)

C: image

57
Q

A: Describe Histology (2)

B: Dz

A

A: image

B: Lichenoid Dermatitis

58
Q

A: Identify Dz (2)

B: Describe its corresponding Histology (3)

C: Cause and onset

A

A: [Steven Johnsons Syndrome] vs. [Toxic Epidermal Necrolysis (will cover >30% body surface)]

B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with

  • [Civatte necrotic keratinocytes] in epidermis and/or
  • [confluent full thickness necrosis]

C: [Drug (Allopurinol) induced ( <8 weeks post exposure)]

59
Q

A: Dz

B: Describe its corresponding Histology (3)

C: Cause (2)

A

A: [Erythema Multiforme (minor vs. Major)]

B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with

  • [Civatte necrotic keratinocytes] in epidermis and/or
  • [confluent full thickness necrosis]

D: HSV vs. [Mycoplasma or HSV if Major] - self resolving

60
Q

A: Identify Dz (3)

B: Describe the Histology (3)

A

A: [Steven Johnsons Syndrome] vs. [Toxic Epidermal Necrolysis (will cover >30% body surface)] vs. [Erythema Multiforme(minor vs. Major)]

B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with

  • [Civatte necrotic keratinocytes] in epidermis and/or
  • [confluent full thickness necrosis]
61
Q

A: Describe Histology (3)

B: Dz

A

A: Epidermal atrophy w/[superficial / interface / deep] perivascular & periadnexal infiltrate of lymphocytes w/plasma cells

  • Dermal mucin (highlight w/Alcian blue or colloidal FE)
  • Basal Layer thickening

B: Discoid Lupus Erythematosus

DLE: [Dermal Mucin]/[Lower level (BL) thickening]/[Epidermal Atrophy w/Lymphocytic infiltrate]

62
Q

A: Describe Histology (3)

B: Dz

A

A: Epidermal atrophy w/[superficial / interface / deep] perivascular & periadnexal infiltrate of lymphocytes w/plasma cells

  • Dermal mucin (highlight w/Alcian blue or colloidal FE)
  • Basal Layer thickening

B: Discoid Lupus Erythematosus

DLE: [Dermal Mucin]/[Lower level (BL) thickening]/[Epidermal Atrophy w/Lymphocytic infiltrate]

63
Q

A: Describe Histology (3)

B: Dz

A

A: [Similar to SLE] but MORE epidermal atrophy and [no deep or periadnexal infiltrates]. Will have lab markers.

B: Dermatomyositis

64
Q

A: Describe Histology (3)

B: Dz

A

A: LSA: [Loss of Rete Pegs]/[Sclerosis of Dermis with Follicular Plugging]/[Above lichen infiltrate is pink hyalinized material]

B: [Lichen Sclerosus & Atrophicus]

65
Q

A: Describe Image (4)

B: Dz

C: What is this Dz associated with? (5)

D: Genetic Cause

A

A: image

B: Psoriasis

C: [SAAME: Arthritis / Myopathy / Enteropathy / Spondylitic Joint Dz / Acquired Immuno]

D: [2/3 have HLA-C but only 10% of those people actually have Psoriasis]

PSORIASIS: Plaque/Silver scales/Onycholysis/[Rigid border=Well Demarcated]/[Inappropriate Nail Discoloration]/[Auspich sign]/[Scales tht are WAFTER like]/[Dilated blood vessel]/[Skinny Suprapapillary plates]

66
Q

A: Describe Histology (5)

B: Dz

C: Genetic Cause

A

A: image

B: Psoriasis

C: [2/3 have HLA-C but only 10% of those people actually have Psoriasis]

Psoriasis will also be accompanied with Auspich sign = peeling off scab –>bleeding since suprapapillary plates are now so thin

PSORIASIS: Plaque/Silver scales/Onycholysis/[Rigid border=Well Demarcated]/[Inappropriate Nail Discoloration]/[Auspich sign]/[Scales tht are WAFTER like]/[Dilated papillary blood vessel]/[Skinny Suprapapillary plates]

67
Q

A: Describe Histology ( 1 per slide)

B: Dz

A

A: image

B: Spongiotic Dermatitis

68
Q

A: Dz

B: Describe Image ( 3)

C: When does this typically onset

A

A: [Allergic Contact Dermatitis] (Suptype of Spongiotic Dermatitis)

B: “[Allergic Contact Dermatitis] is a PES!”

  1. [Erythematous papules]
  2. [Small vesicles vs. weeping plaques]
  3. Pruritic

C: 12-48 Hrs post exposure = Delayed Hypersensitivity rxn

69
Q

A: Dz and description

B: What’s used for Dx? How is PGN assessed (3)?

A

A: Bullous Dermatitis (3 Types) = [Bullae vs. vesicle] anywhere in Epidermis

B: Direct Immunofluorescence (since Ab are the ones attacking Hemidesmosomes –> Subepidermal Blisters)

  1. WHAT: What’s Causing/Underlying MOD for the split
  2. WHERE: Epidermal Anatomic level of split (Where’s the Split located within the Epidermis?)
  3. HOW: Nature of inflammatory infiltrate
70
Q

A: Describe Image (1 for each)

B: Dz

C: Which Ab causes this

D: Location (5)

A

A: image

B: Bullous Pemphigoid (subtype of Bullous Dermatitis)

C: IgG Ab attaching hemidesmosomes

D: image = FAGAT = [Forearm / Axillae / Groin / Abd / Thigh-inner]

71
Q

A: Describe Image (1 for each)

B: Dz

C: Which Ab causes this

A

“[Easily ruptured bullae are Vulgar] / [Tombstones are Vulgar] / [Nets are Vulgar]”

A:

  • Gross: Superficial bullae that ruptured easily
  • Micro: Acantholysis –> [Tombstoning Suprabasalar Clefting]

B: Pemphigus Vulgaris (MOST COMMON subtype of Bullous Dermatitis)

C: [IgG Ab & C3] attacking Desmogleins

72
Q

A: Describe Image (Gross vs. IF)

B: Dz

C: What Other Dz is this associated with

A

A:

  • Gross: EXTREMELY PRURITIC Papules vs. Vesicles on erythematous base (usually forearm)
  • IF: [IgA despoits against gliadin]

B: Dermatitis Herpetiformis (subtype of Bullous Dermatitis)

C: Celiac Dz

73
Q

A: Describe Histology

B: Dz

A

A: image

B: Sarcoidosis

Naked = No lymphocytes on surrounding outside layer (rules out infection)

74
Q

A: Describe Image

B: Dz

C: Describe Histology

A

A: small purpura on LE

B: [Vasculopathic Neutrophilic Dermatitis]

C: image

75
Q

A: Clinical Course for Henoch Schonlein Purpura

B: Histology

C: What is this accompanied with? (4)

A

A:[URI vs. ingestion of certain things] –> [Leukocytoclastic vasculitits] from [Anticardiolipin IgA] and [Neutrophil cytoplasmic IgA]

B: IgA Deposition in vessel wall

C: HSP

  • Hinge pain (Arthritis)
  • Stomach pain
  • [Pee with blood! (Hematuria)] & [Palpable Purpura]
76
Q

Dz

A

“My Pa was a DEJ Soldier” = [Mycosis Fungoides/Pautrier’s microabscess/lymphocytes along DEJ like Soldiers]

Mycosis Fungoides

[MOST COMMON Subtype of Cutaneous T Cell Lymphoma]

77
Q

A: Describe Histology

B: Dz

A

“My Pa was a DEJ Soldier” = [Mycosis Fungoides/Pautrier’s microabscess/lymphocytes along DEJ like Soldiers]

A: image

B: Mycosis Fungoides [MOST COMMON Subtype of Cutaneous T Cell Lymphoma]

78
Q

A: Describe Histology

B: Dz

A

“My Pa was a DEJ Soldier” = [Mycosis Fungoides/Pautrier’s microabscess/lymphocytes along DEJ like Soldiers]

A: image

B: Mycosis Fungoides [MOST COMMON Subtype of Cutaneous T Cell Lymphoma]

79
Q

A: Describe Histology

B: Dz

C: What is different about these cells

A

“My Pa was a DEJ Soldier” = [Mycosis Fungoides/Pautrier’s microabscess/lymphocytes along DEJ like Soldiers]

A: image

B: Mycosis Fungoides [MOST COMMON Subtype of Cutaneous T Cell Lymphoma]

C: NO Expression of CD7 (like normal lymphocytes)

80
Q

A: Describe Histology (4)

B: Dz

C: Cause

A

A: image

B: Verruca Vulgaris (Other Types: [plana = face/hands] vs. plantaris vs. palmaris vs. Condyloma Acuminatum)

C: HPV

81
Q

A: Describe Histology Image Only

B: Dz

C: Mode of Transmission

A

A: image

B: Molluscum Contagiosum (skin infection)

C: Sexually transmitted (especially to breast & genitalia of immunocompromised)

82
Q

A: Describe Histology (3)

B: Dz (2)

A

A: image

B: [Oral HSV1] vs. [Genital HSV2]

83
Q

A: Describe Image (3)

B: Dz

C: Mode of Transmission (2)

A

A: image

B: [1° Varicella Zoster Chicken POX]

[Papules/ (Ocrusty Erosions) /Xesicles]

C: image

84
Q

A: Dz

B: Location and Demographic

A

A: [Varicella Zoster SHINGLES]

B: image

85
Q

A: What sign is this?

B: Dz

C: Why does this sign warrant hasty evaluation?

A

A: image

B: [Herpes Zoster]

C: could indicate potential ocular involvement as well –> Blindness

86
Q

A: Describe Histology (1 for each)

B: Dz

C: Causes (2)

D: Tx

E: Demographic

A

A: image

B: Bullous Impetigo

C: [Staph vs. (Group A Strep Pyogenes)]

D: Mupirocin Topical

E: Kids

87
Q

A: Identify (4)

B1: Dz

B2: Most common Genera (3)

C: Dx (2)

A

A: image

B1: [Dermatophytes (fungus living on keratin)]

B2: [Microsporum vs. Trichophyton vs. Epidermophyton]

C: Hyphae seen on [KOH prep] or [Corneal layer using tissue PAS stain]

88
Q

What is [Dermatophyte Infection of the Nail] called?

A

Onychomycosis

89
Q

A: Describe Histology

B: Dz

A

A: image

B: Tinea Versicolor

90
Q

A: Describe Image

B: Dz

A

A: image

B: Tinea Versicolor

91
Q

A: Describe Histology

B: Dz

C: Clinical manifestation (2)

A

A: image

B: Scabies

C:

  • [Papulovesicular Persistent Nodules]
  • [Norwegian Crusted Forms]
92
Q

A: Describe Histology (4)

B: Dz

C: What can this Dz mimic and why?

A

“BLAST: [Broad Base Budding yeast forms]/[Lakes (Great Lakes) & Mississippi River]/[Acanthosis in Epidermis]/[SQC mimicking]/[Tissue Death in Dermis]

A: image

B: Blastomycosis

C: [Squamous Cell Carcinoma] (since it’s so acanthotic as well)

93
Q

Dz

A

Coccidiomycosis

94
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Cryptococcus Neoformans (capsule looks like halo)

95
Q

A: Describe Histology (4)

B: Dz

C: What type of cells are these found inside

A

A: image

B: Histoplasma Capsulatum

C: Giant Cells

96
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Pyogenic Granuloma (type of Capillary Hemangioma)

97
Q

A: Dermatomyositis and Acute Lupus have similar cutaneous histology other than what?

B: Which ab is most indicated in Dermatomyositis

C: What 3 things are associated with Dermatomyositis

D: Etiology

A

A: [Dermatomyositis has More Epidermal Atrophy]

B: [p155/p140 Ab] positive = INC risk of malignancy

C: [Pulm Dz] / [Elevated Creatine Kinase] / [Underlying CA in Adult form]

D: Autoimmune

98
Q

A: Dz

B: Location (4)

C: What will these pts serology show

A

A: [Discoid Lupus Erythematosus] (Disincludes Systemic involvement!)

B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia]

C: NEGATIVE SEROLOGY (since this Disincludes Systemic involvement)

99
Q

Dz

A

Dermatomyositis

100
Q

A: Dz

B: What distinguishes this from Dermatomyositis

C: What is this Dz associated with? (2)

A

A: [Acute Cutaneous Lupus]

B: Spares Nasolabial Folds!

C: [Kidney Dz] & [Systemic Lupus Erythematosus]

101
Q

A: Dz

B: What distinguishes this from Dermatomyositis

C: What is this Dz associated with? (2)

A

A: [Acute Cutaneous Lupus]

B: Spares Nasolabial Folds!

C: [Kidney Dz] & [Systemic Lupus Erythematosus]

102
Q

Dz

A

Dermatomyositis

Rash is OVER the knucles (not in between)

103
Q

A: Dz

B: Location (4)

C: What will these pts serology show

A

A: [Discoid Lupus Erythematosus] (Disincludes Systemic involvement!)

B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia]

C: NEGATIVE SEROLOGY (since this Disincludes Systemic involvement)

104
Q

A: Identify each image. What Dz

B: Location (4)

C: What will these pts serology show

A

A: Image. [Discoid Lupus Erythematosus] (Disincludes Systemic involvement!)

B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia]

C: NEGATIVE SEROLOGY (since this Disincludes Systemic involvement)

105
Q

Dz

A

Lupus

106
Q

A: Dz

B: Demographic

A

A: Sclerodactyly seen in [Systemic/Limited Sclerosis]

B: Female

107
Q

A: Clinical Presentation for [Limited Scleroderma] (5)

B: Cause

C: Pgn compared to [Systemic Scleroderma]

A

A: CREST

[Calcinosis cutis & Cuticular Hypertrophy]

Raynaud’s Phenomenon (Connective tissue Dz​)

Esophageal Dysmotility

Sclerodactyly

Telangiectasia

B: [Anti-Centromere Ab]

C: Better Pgn than Systemic

108
Q

Dz

A

Limited Sclerosis

CREST

[Calcinosis cutis & Cuticular Hypertrophy]

Raynaud’s Phenomenon (Connective tissue Dz)

Esophageal Dysmotility

Sclerodactyly

Telangiectasia

109
Q

A: Describe image

B: What is this associated with? (5)

C: Tx (2)

D: What is this worsened by (3)

E: Demographic

A

A: Raynaud’s Phenomenon

B: “Raynaud worked for the NDC S&S”

  • Scleroderma
  • SLE
  • Connective Tissue Dz
  • [Drugs (clonidine / bleomycin)]
  • Neuro Disorders (Carpal Tunnel)

C: [Ca+ channel blockers] / [Warm up Body]

D: [Caffeine] / Smoking / [Beta Blockers]

E: Female

110
Q

Dz

A

Calcinosis Cutis in Limited Sclerosis

CREST

[Calcinosis cutis & Cuticular Hypertrophy]

Raynaud’s Phenomenon (Connective tissue Dz)

Esophageal Dysmotility

Sclerodactyly

Telangiectasia

111
Q

A: Dz

B: Demographic

C: What is this often associated with

A

[Lichen Sclerosus Dermatitis]

B: Women

C: Localized Scleroderma

112
Q

A: Dz

B: Location

C: Lab

A

A: Sarcoidosis

B: Scar vs. [trauma sites] (tattoos)

C: INC ACE levels

113
Q

A: Dz

B: Location

C: Lab

A

A: Sarcoidosis

B: Scar vs. [trauma sites] (tattoos)

C: INC ACE levels

114
Q

A: Dz

B: What is this associated with

C: Location

A

A: [Necrobiosis Lipoidica]

B: DM

C: Pretibia

115
Q

A: Dz

B: What is this associated with? (3)

A

A: Pyoderma Gangrenosum

B: IBD / [Inflammatory Arthritis] / Hematologic DO

116
Q

A: Describe image (2)

B: Dz

C: Associated with?

D: Tx

A

A:

  • [Retiform Stellate Purpura w/Ca+] on fatty areas
  • Central Black Eschar

B: Calciphylaxis

C: ESRD (PGN = HIGH MORTALITY)

D: Na+ Thiosulfate

117
Q

A: Dz

B: Type of Hypersensitivity

C: Causes (4)

A

A: Leukocytoclastic Vasculitis (Palpable Purpura)

B: Type 3 Hypersensitivity!!!

C:

  1. MOSTLY IDIOPATHIC
  2. Drugs (DAN - Diuretics / Abx / NSAIDs)
  3. Infections
  4. Foods
118
Q

Dz

A

[Venous Stasis Dermatitis]

Will be Bilateral

119
Q

Dz

A

[Acute Stasis Dermatitis]

120
Q

Dz

A

Varicose Veins

121
Q

Dz

A

[Stasis Dermatitis + Lymphedema]

122
Q

A: Dz

B: Location

A

Atrophie Blanche

White areas = ischemic areas from atrophy

B: Medial Ankle

123
Q

A: Dz

B: Location

A

A: Venous Ulcer

B: Medial LE

124
Q

A: Dz

B: Course of Dz

A

A: [CCM- Capillary Congenital Malformation]

B: Grows in proportion to the child

125
Q

A: Dz

B: Onset

C: Dx

A

A: [ACM- ArterioVenous Congenital Malformation] (many are apparent at birth)

B: Puberty

C: US

126
Q

A: Dz

B: What seasons is this seen in (2)

C: Pgn

A

A: [Viral Exanthem]

B: Summer & Fall

C: Self-Resolving

127
Q

A: Dz

B: What type of skin lesions are seen

C: Pgn

A

A: [Coxsackie Hand Foot Mouth Dz]

B: Vesicles

C: Benign

128
Q

A: Dz

B: Accompanied sx

C: Seasons this occurs in (2)

D: Pgn

A

A: Parvovirus B19 (LOOKS LIKE SLAPPED CHEEKS)

B: Arthralgia (Mimics RA in Adults)

C: Winter & Spring

D: Fetal infection may –> [FAAD- Anemia / Fetal Hydrops / (Acral Purpura) / Death]

129
Q

A: Name Skin condition

B: What type of Hypersensitivity

C: Describe the Skin condition

D: How do you differentiate this from Angioedema

A

A: Urticaria

B: Type 1 Hypersensitivity

C: image

D: Angioedema has swelling deeper in Dermis + More Painful (vs. Urticaria is fluid collection in Epidermis)

130
Q

A: Dz

B: What type of cells will Histology show

B: How long do the lesions last

A

A: Urticaria Pigmentosa

B: Mast Cells

C: LONGER (NOT Transient)

131
Q

A: Dz

B: What type of cells will Histology show

B: How long do the lesions last

A

A: Urticaria Pigmentosa

B: Mast Cells

C: LONGER (NOT Transient)

132
Q

A: Dz

B: Causes (4)

C: What should you look for in these pts

A

A: [Allergic Contact Dermatitis]

B: “Never Touch or Carry PoisonIvy”

  1. [Topical Abx vs. Cleansers]
  2. Chlorhexadine
  3. Nickel
  4. Poison Ivy

C: “Outside In” Pattern

133
Q

A: Dz

B: Causes (2)

C: Risk Factors (3)

A

A: [MEDE- Morbilliform Exanthematous Drug Eruption] (looks like viral exanthem)

B: Bug vs. [Drug rxn (7-10 days post intake)]

C:

  • HIV
  • Connective tissue Dz
  • Hepatitis
134
Q

A: Dz

B: Location (2)

A

A: [MEDE- Morbilliform Exanthematous Drug Eruption] (looks like viral exanthem)

B: Intertriginous & Dependent Areas

No Blister or Mucus Membrane involvement

135
Q

A: Dz

B: Describe the Syndrome (5)

A

A: DRESS Syndrome

B:

[Drug-induced and Delayed onset (2-6 wks post intake)]

Rash: (Morbiliform vs. Infiltrated vs. Exfoliative Dermatitis)

Eosinophilia

[Systemic and Severe] = [Liver–>Failure–>Death] / Heart / Kidney / Lung

Symptoms = Facial Swelling & LAD

136
Q

A: Dz

B: Causes (5)

A

A: DRESS Syndrome

B: DRESS SAAAM

  1. [Aromatic AntiConvulsants]
  2. Minocylcine Abx
  3. Sulfasalazine
  4. Allopurinol
  5. [Abacavir antiretroviral]
137
Q

A: Dz

B: Explain the unique onset

C: Cause (4)

A

A: Fixed Drug Rxn

B: [1-2 weeks post exposure] but with subsequent exposure will reappear within 24 hours in same “fixed’ location

C: [Sulfa vs. NSAIDS vs. Barbiturates vs. Tetracyclines]

138
Q

A: Dz

B: What can this Dz progress to?

C: Accompanying Sx (2)

A

A: [Severe Mucus membrane involvement] in [Steven Johnson Syndrome]

B: TENS

C: [Stinging Eyes] + Dysphagia

139
Q

A: SPF (Sunburn Protection Factor) measures what?

B: Recommended Dose

C: How long does [Water Resistant vs. VERY Water Resistant] last?

A

A: UVB protection

B: [SPF 30+ q 2 Hours]

C: [Water Resistant=40 min.] vs. [VERY Water Resistant=80 min.]

Dermatopathology (1 decks)

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