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D&T1 Exam II > Dermatopathology I > Flashcards

Dermatopathology I Flashcards

1
Q

Vitiligo:

A

Chronic depigmenting condition from complete loss of epidermal melanocytes.

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2
Q

Vitiligo cause:

A

Autoantibody against melanin-concentrating hormone receptor 1 in serum.

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3
Q

Vitiligo repigmentation:

A

Begins around hair follicles that look like freckles and become confluent.

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4
Q

Ephelis (4):

A

Freckle

  • Basal layer hyperpigmentation
  • Appear after sun exposure in lightly pigmented kids
  • Darken with sun exposure
  • No risk of malignancy
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5
Q

Lentigo (3):

A
  • Small circumscribed brown macular lesions
  • Hyperpigmentation of cells just above the basement membrane
  • Do not darken with sun exposure
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6
Q

Melanocytic nevi gross features (5):

A
  • Tan to brown
  • Uniformly pigmented
  • Small
  • Flat to elevated
  • Well-defined, rounded borders
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7
Q

Melanocytic nevi histological features (5):

A
  • Sharply defined
  • Well nested at the dermal-epidermal junction
  • Melanocytes mature as they descend in dermis
  • No deep mitoses
  • No deep pigment in melanocytic nests
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8
Q

Location of melanocytic nests in junctional melanocytic nevus:

A

Tips and sides of rete.

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9
Q

Compound melanocytic nevus histologic features:

A

Histologic features of junctional nevus + nests and cords of nevus cells in underlying dermis.

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10
Q

Dermal melanocytic nevus histologic feature:

A

Epidermal nests are lost completely

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11
Q

Spitz Nevus (6):

A
  • Composed of spindle and/or epithelioid cells
  • Dyskeratotic melanocytes
  • Sharply defined laterally
  • Line symmetry from left to right
  • Clefts separating nests from keratinocytes
  • Deep red color
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12
Q

Kamino bodies:

A

Dyskeratotic melanocytes

- Eosinophilic bodies along dermal-epidermal junction

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13
Q

Dysplastic (atypical) melanocytic nevus (3):

A
  • Commonly large, oval and multiple
  • Irregular pigment common
  • Fading border/fried egg appearance
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14
Q

Dysplastic melanocytic nevus histologic features (3):

A
  • Horizontally oriented nests with bridging of adjacent rete
  • Nests are at the tips and sides of rete
  • Cytologic atypia: hyperchromatic, enlarged nuclei
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15
Q

Number 1 cause of skin cancer deaths worldwide:

A

Melanoma

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16
Q

Melanoma:

A

Malignancy of pigment-producing cells (melanocytes)

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17
Q

Melanoma stage determination:

A

Vertical phase depth.

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18
Q

ABCDE of melanoma:

A 
A: Asymmetry
B: Border irregularity
C: Color variation
D: Diameter > 6mm
E: Evolving
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19
Q

Radial growth phase (2):

A

Melanoma-in-situ

  • Horizontal spread of melanoma cells within the epidermis and superficial dermis
  • Tumor cell slack the ability to metastasize
20
Q

Vertical growth phase (4):

A
  • Tumor cells invade downward into deeper dermal layers as a mass
  • Cells with metastatic potential emerge
  • Invading cells do not mature
  • Grossly, a nodule appears
21
Q

Most common melanoma subtype:

A

Superficial spreading

22
Q

Superficial spreading melanoma is usually found on:

A

Sun-exposed skin, typically on backs of men and lower legs of women, but any age, any place.

23
Q

Superficial spreading malignant melanoma histologic features (5):

A
  • Buckshot scatter of atypical melanocytes within the epidermis
  • Typically not symmetrical
  • Typically fails to mature from top to bottom
  • Deep mitoses may be present
  • Cytologic atypia
24
Q

Lentigo maligna melanoma (4):

A
  • Indolent, slow growing lesion
  • Typically on the face of old men
  • Long radial growth phase, 10-50 years
  • Starts as a tan-brown macule and gradually enlarges developing a darker, asymmetric foci
25
Q

Lentigo maligna histologic features (3):

A

Melanoma-in-situ

  • Poorly nested and confluent melanocytes at the dermal epidermal junction
  • Adnexal extension
  • Heavily sun damaged skin
26
Q

Acral lentiginous melanoma (2):

A
  • Most common melanoma in African Americans and Asians

- Palms, soles, beneath nail plate

27
Q

Nodular melanoma histologic features (4):

A
  • Vertical growth phase melanoma
  • No apparent radial growth phase
  • Dermal growth occurs in isolation or in association with an epidermal component
  • Mitoses are frequent and often atypical
28
Q

Melanoma prognostic factors (5):

A
  • Tumor thickness
  • Mitotic rate
  • Ulceration
  • Lymph node involvement
  • Distant metastases
29
Q

Most common benign tumor in older individuals:

A

Seborrheic keratosis

30
Q

Seborrheic keratosis (4):

A
  • Begin as light brown flat macules
  • Develop velvety or waxy to finely verrucous surface
  • Color may vary from pink to dark brown or black
  • Appear stuck on and crumble with scraping
31
Q

Dermatosis papulosa nigra (3):

A
  • Brown to black, smooth, dome-shaped papules
  • Most often seen in African Americans
  • Sub-type of seborrheic keratosis
32
Q

Acanthosis nigrans (5):

A
  • Hyperpigmentation is first sign
  • Hyperplasia of stratum spinosum makes skin thick and velvety
  • Usually found in folds of the neck, axilla and groin
  • Associated with endocrine abnormalites
  • Associated with visceral malignancy in middle-aged and older
33
Q

Epidermal (inclusion) cyst histologic features:

A

Cyst wall resembles normal epidermis, filled with strands of keratin

34
Q

Earliest identifiable lesion that can develop into squamous cell carcinoma (SCC):

A

Actinic keratosis

35
Q

Actinic keratosis risk factors (3):

A
  • Years of sun exposure
  • Fair skin
  • Immunosuppression
36
Q

Actinic keratosis appearance (3):

A
  • Initially may be hard to see but will have areas of rough or “gritty” skin
  • Discrete, scaly, feels like “broken glass” surface lesion
  • Develop into poorly-demarcated, slightly erythematous papule or plaque with scale
37
Q

Most common cancer in the US:

A

Nonmelanoma Skin Cancer (NMSC)

38
Q

Majority of NMSC:

A

Basal cell carcinomas (BCC)

39
Q

Bowen disease:

A

Subtype of SCC-in-situ characterized by a sharply demarcated pink plaque and can arise on non-sun-exposed skin.

40
Q

Erythroplasia of Queyrat:

A

Bowen disease of the glans penis, which manifests as one or more velvety red plaques

41
Q

Invasive SCC (2):

A
  • Raised, firm, pink-to-flesh colored keratotic papule or plaque arising on sun-exposed skin
  • Surface changes: scaling, ulceration, crusting, or cutaneous horn
42
Q

Keratoacanthoma (5):

A
  • Benign epithelial tumor that may progress to SCC
  • Appear suddenly on actinically-damaged skin
  • Spontaneously regress after a few months
  • Red to flesh colored dome-shaped papule with a central crater filled with keratinous plug
  • Treat the same as SCC
43
Q

Basal cell carcinoma (BCC) (3):

A
  • Pluripotential cells in the basal layer of the epidermis or follicular structures
  • Can cause local destruction and disfigurement
  • Slow grown and rarely metastasizes
44
Q

Nodular BCC (7):

A
  • Face most common site
  • Waxy papules with central depression
  • Pearly appearance
  • Erosion, ulceration or crusting
  • Bleeding with minor trauma
  • Rolled border
  • Telangiectasias over the surface
45
Q

Superficial BCC (4):

A
  • Trunk is most common site
  • Slight scaly papule or plaque
  • Light red color
  • Atrophic center with fine translucent micropapules on rim

D&T1 Exam II (18 decks)

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