Dermatoscopic-histologic correlation Flashcards
1-What colours correlate to the nature of the pigment / substance and, in the case of melanin, the depth of the pigment observed histopathologically?
See image
1-What are the 5 elements in dermoscopy and what is their importance?
Dermatoscopic patterns are formed by the repetition of, or absence of one of the five basic elements. The absence of a dominant repetitive pattern of one of these elements typifies the structureless pattern.
1-What are the 5 dermatoscopic patterns of lines as discussed in kittler et al?
see image
1-Describe epidermal rete ridges and dermal papillae as seen in normal skin histology
2-What are some lesions that can cause thickening/deepening of the rete ridges?
1-Epidermal rete ridges are the normal interdigitations (downgrowths) and Dermal papillae are the upward indentations.
2- Keratinocytic proliferations (e.g. seborrhoeic keratosis); or broadened network due to melanocytic proliferation expanding epidermal rete ridges.
1-What skin manifestation is occurring to make radial lines?
2-What feature of radial lines makes them difficult to view on a histology slide?
3-What do radial lines look similar to when viewing on histology slide?
1-Dermatoscopic manifestations of peripheral extensions of pigmented lesional cells such as pigmented BCC or elongated nests of pigmented melanocytes in melanocytic proliferations.
2-As radial lines are viewed perpendicular to the epidermal surface for histolological examination, precluding specific correlation.Therefore cannot be viewed on histology.
3-Comprise elongated nests of melanocytes similar to pseudopods on histology.
1-What are reticular and branched lines and what lesions can they be seen in?
1-Reticular lines are straight and intersect at regular intervals at right angles. Branched lines are also straight but intersect at irregular intervals and not at right angles. Seen in lesions in which there is basal epidermal hyperpigmentation/proliferation of pigmented melanocytes preferentially involving the epidermal rete ridges with preservation of the epidermal architecture.
1-Where are curved lines most likely to be seen on the body and in what lesions?
2-Describe the curved lines seen in this picture and in the one in the answer box?
1-Curved lines are seen in pigmented keratinocytic proliferations that are either acanthotic, such as seborrhoeic keratosis. Locations are as close to mucocutaneous junctions, as with some labial and genital melanotic macules.
2-Thin curved lines in the Q box and thick curved lines in the A box.
1-What lesions are characterised by either reticular, branched or curved lines (4)?
1-Melanotic macules (e.g. ink spot lentigo), Solar lentigos, Seborrhoeic Keratosis, and Dysplastic (Clark) naevus.
1-Describe the type of line (reticular/branched/curved) in both the Q and A images.
Q pic-Dermatoscopy of ink spot lentigo. Reticular dark brown lines that end abruptly at the margin of the lesion.
A pic-Dermatoscopy of ink spot lentigo. Branched dark brown lines that end abruptly at the margin of the lesion.
1-Describe the types of lines that can be seen in mucosal melanotic macules (reticular/branched/curved)
2-Describe the basic histology in the answer box picture that fits with melanotic macules in the answer box
These lesions can show 3 different patterns on dermatoscopy: curved parallel lines, circles or structureless. The first two likely represent the unique configuration of the dermoepidermal junction in mucocutaneous transition zones, whereas the latter reflects the presence of flattened rete in some lesions.
2-Slide shows epidermal acanthosis (thinkening of the epidermis and elongation of the rete ridges) with pigmentation of the basal layer at the tips of the rete ridges and often underlying superficial dermal melanophages. i.e Basal epidermal hyperpigmentation confined to the tips of the rete.
1-Describe the types of lines in this solar Lentigo on the trunk (reticular/branched/curved).
2-Why are lines typically more inconspicuous on sun-damaged surfaces e.g. the face and arms?
1-These lesions typically show a pattern of reticular or curved lines, sometimes with superimposed circles.
2-Solar lentigo from the face/arms typically show a structureless pattern with hypopigmented follicular openings, or regularly spaced circles. Lines are usually inconspicious due to the flattened dermoepidermal junction in sun damaged facial skin. Solar lentigo on the forearm is seen in the picture.
1-Describe the basic histopathology of this solar lentigo on the trunk
1-Bulbous pigmented epidermal rete ridges are present. These are manifest as a pattern of lines dermatoscopically.
NB: Lines are not often seen in other Solar Lentigos due to the pattern of chronic sun damage.
1-What is the lesion and what types of lines (reticular/branched/curved) can be seen in these Q and A pictures?
Dermatoscopy of seborrhoeic keratosis.
Pattern of thin curved lines. Q pic
Dermatoscopy of seborrhoeic keratosis. Pattern of thick curved lines. A pic
histology of seborrhoic keratosis
