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Derm, infectious disease, topical drugs, RBC disorders > Dermatopathology I > Flashcards

Dermatopathology I Flashcards

1
Q

Layers of Skin

A

Stratum corneum
Stratum granulosum
Stratum spinosulm
Stratum Basale

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2
Q

Macule

A

Circumscribed, flat lesion <5mm distinguished from surrounding skin by color

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3
Q

Patch

A

Circumscribed, flat lesion >5mm distinguished from surrounding skin by color

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4
Q

Papule

A

Elevated dome-shaped or flat-topped lesion <5mm

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5
Q

Nodule

A

Elevated dome-shaped or flat-topped lesion >5mm

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6
Q

Plaque

A

Elevated flat-topped lesion >5mm

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7
Q

Pustule

A

Discrete, pus-filled, raised lesion

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8
Q

Scale

A

Dry, horny, platelike excrescence; usually the result of imperfect cornification

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9
Q

Vesicle

A

Fluid-filled raised lesion <5mm; also called a blister

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10
Q

Bulla

A

Fluid-filled raised lesion >5mm; also called a blister

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11
Q

Excoriation

A

Traumatic lesion breaking the epidermis and causing a raw linear area (deep scratch)

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12
Q

Wheal

A

Itchy, transient, elevated lesion with variable blanching and erythema formed as the result of dermal edema

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13
Q

Lichenification

A

Thickened, rough skin; usually the result of repeated rubbing

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14
Q

Acanthosis

A

Diffuse epidermal hyperplasia

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15
Q

Dyskeratosis

A

Abnormal, premature keratinization within cells below the stratum granulosum

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16
Q

Hypergranulosis

A

Hyperplasia of the stratum granulosum

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17
Q

Hyperkeratosis

A

Thickening of the stratum corneum

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18
Q

Lentiginous

A

A linear pattern of melanocyte proliferation within the epidermal basal cell layer

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19
Q

Papillomatosis

A

Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae

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20
Q

Parakeratosis

A

Keratinization with retained nuclei in the stratum corneum

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21
Q

Spongiosis

A

Intercellular edema of the epidermis

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22
Q

Acute Inflammatory Dermatoses

A

Last from days to weeks

Characterized by lymphocytic and macrophage inflammatory infiltrate and edema

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23
Q

Chronic Inflammatory Dermatoses

A

Persist for months to years

Associated with changes in epidermal growth (atrophy or hyperplasia) or dermal fibrosis

The skin is roughened due to excess or abnormal scale formation and shedding

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24
Q

Urticaria (Hives)

A

Common disorder characterized by localized mast cell degranulation and dermal microvascular hyperpermeability

Patients present with pruritic edematous plaques (wheals)

Angioedema is a related condition with edema of the deeper dermis and subcutaneous fat

Can be acute (less than 6 weeks) or chronic

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25
Causes of Urticaria
``` Immunologic mechanisms Non-immunologic mechanisms Physical stimuli Skin contact Small vessel vasculitis ```
26
Treatment of Urticaria
Avoidance of specific allergens Oral H1 antagonists Epinephrine
27
Acute Eczematous Dermatitis
One of the most common skin disorders Can be subdivided into 5 categories 1. Allergic contact dermatitis 2. Atopic dermatitis 3. Drug-related eczematous dermatitis 4. Photoeczematous dermatitis 5. Primary irritant dermatitis Results from T-cell mediated inflammatory reactions (TYPE IV HYPERSENSITIVITY)
28
Causes and treatment of acute eczematous dermatitis
Causes can be broadly categorized as INSIDE: reaction to an internal circulating antigen OUTSIDE: reaction from external application of an antigen TREATMENT Removal of the offending substance Topical steroids
29
Erythema Multiforme
``` Self-limited hypersensitivity reaction Associated with infections from: VIRUS: Herpes simplex BACTERIA: Mycoplasma, leprosy, typhoid FUNGUS: Histoplasma, Coccidioides Exposure to drugs: sulfonamides, penicillin, barbiturates, salicylates, antimalarials ``` Cancer Collagen vascular disease
30
Stevens Johnson Syndrome
A febrile form of erythema multiforme with extensive skin involvement Also involves oral mucosa, conjunctiva, urethra, genital and perianal areas May lead to sepsis Often seen in children
31
Toxic Epidermal Necrolysis
Type of erythema multiforme characterized by diffuse necrosis and sloughing of cutaneous and mucosal epithelial surfaces Clinical picture similar to that of burn patients
32
Treatment of Acute Erythema Multiforme
``` Observation Oral antihistamines Topical steroids Acyclovir Prednisone ```
33
Treatment of Chronic Erythema Multiforme
Antivirals (acyclovir) Dapsone Azathioprine Cyclosporine
34
Psoriasis
Common disorder affecting 1-2% of the US population Chronic inflammatory dermatosis that results from interactions of genetic and environmental factors Associated with HLA-C Results from activated T cells in the skin stimulating the secretion of cytokines and growth factors that induce keratinocyte proliferation 15% of patients have associated arthritis
35
Psoriasis is associated with what gene and what condition?
HLA-C | Arthritis
36
Treatment of psoriasis
``` Topical steroids Intralesional steroid injection UVB and tar Methotrexate Cyclosporine Soriatane ```
37
Seborrheic Dermatitis
Common chronic inflammatory dermatosis that affects up to 5% of the general population ``` Involves regions with high density of sebaceous glands: Scalp Forehead External auditory canal Retroauricular area Nasolabial folds Presternal area ```
38
Causes of Seborrheic Dermatitis
Increased sebum production Colonization of the skin by Malassezia Severe form seen in HIV+ patients with low CD4 counts
39
Treatment of Seborrheic Dermatitis
Frequent washing of the affected area with antisebhorreic soaps Topical steroids Anti-yeast medications Oral antifungals
40
Lichen Planus
Self-limited condition most commonly resolving spontaneously 1-2 years after onset “Six Ps”: Pruritic, purple, polygonal, planar, papules and plaques Resolution of lesions may leave postinflammatory hyperpigmentation Squamous cell carcinoma may develop in oral lesions
41
6 P's of Lichen Planus
``` Pruritic Purple Polygonal Planar Papules Plaques ```
42
Treatment of Lichen Planus
``` Topical steroids Intralesional steroids Systemic steroids Azathioprine Cyclosporine Light therapy (PUVA & UVB) ```
43
Acute Inflammatory Dermatoses
Urticaria Acute Eczematous Dermatitis Erythema Multiforme
44
Chronic Inflammatory Dermatoses
Psoriasis Seborrheic Dermatitis Lichen Planus
45
Blistering Disorders
Pemphigus Bullous Pemphigoid Dermatitis Herpetiformis Epidermolysis Bullosa
46
Pemphigus
In inflammatory blistering disorder caused by autoantibodies that result in the dissolution of intercellular attachments within the epidermis and mucosal epithelium IgG autoantibodies to desmoglein 1 and 3 disrupt intercellular adhesions of desmosomes
47
In Pemphigus, _______ to ________ disrupt intercellular adhesions of desmosomes
IgG autoantibodies, Desmoglein 1 and 3
48
Pemphigus Variants
``` Pemphigus vulgaris Pemphigus vegetans Pemphigus foliaceus Pemphigus erythematosus Paraneoplastic pemphigus ```
49
Pemphigus treatment
Immunosuppressive agents to decrease the titers of the pathogenic antibodies
50
Bullous Pemphigoid
A blistering disorder caused by autoantibodies directed to the proteins that bind basal keratinocytes to the basement membrane Antibody deposition occurs in a linear pattern at the dermoepidermal junction The proteins BPAGs are part of the hemidesmosomes that link basal keratinocytes to the basement membrane
51
In bullous pemphigoid, the protein _______ are part of the hemidesmosomes that link _______ to ______
BPAGs keratinocytes basement membrane
52
Treatment of Bullous Pemphigoid
Topical steroids Systemic steroids Methotrexate Azathioprine
53
Dermatitis Herpetiformis
Rare disorder characterized by urticaria and grouped vesicles Strong association with HLA-B8, HLA-DR3 and HLA-DQw2 Genetically predisposed individuals develop IgA antibodies to dietary gluten These antibodies cross-react with reticulin which is a component of the anchoring fibrils that attaches the epidermal basement membrane to the superficial papillary dermis The injury results in subepidermal blisters
54
Which genes are strongly associated with dermatitis herpetiformis
HLA-B8 HLA-DR3 HLA-DQw2
55
With dermatitis herpetiformis, genetically predisposed individuals develop ______ to _____
IgA antibodies to dietary gluten
56
The IgA antibodies created in Dermatitis herpetiformis cross react with which protein and what is the role of this protein
Reticulin, a component of the anchoring fibrils that attaches to the epidermal basement membrae to the superficial papillary dermis
57
Treamtment of Dermatitis Herpetiformis
Dapsone | Sulfapyridine
58
Epidermolysis Bullosa
Inherited defect in structural proteins that cause mechanical instability to the skin Clinical manifestations soon after birth with blister formation at sites of pressure, rubbing or trauma 4 types: - Simplex - Junctional - Dystrophic - Mixed
59
Epidermolysis Bullosa Simplex Type
Autosomal dominant inheritance of defects in keratin 14 or keratin 5 resulting in defects in the basal cell layer of the epidermis
60
Epidermolysis Bullosa Junctional Type
Autosomal recessive inheritance of defects in laminin, a protein at the lamina lucida The lamina lucida binds to both hemidesmosomes and anchoring filaments Blisters are seen at the level of the lamina lucida
61
Epidermolysis bullosa Dystrophic Type
Autosomal dominant or recessive inheritance of defects in type VII collagen (a major component of the basement membrane anchoring fibrils) Defects causes blisters at the level of the lamina densa This is a scarring disorder
62
What is the defect in epidermolysis bullosa simplex type
Keratin 14 or 5
63
What is the defect in epidermolysis bullosa junctional type
laminin
64
What is the defect in epidermolysis bullosa dystrophic type
type VII collagen

Derm, infectious disease, topical drugs, RBC disorders (8 decks)

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