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SBL Exam 2 > DermPath- Dr. Martin > Flashcards

DermPath- Dr. Martin Flashcards

1
Q

excoriation

A

Traumatic lesion breaking the epidermis and causing a raw linear area (i.e., deep scratch); often self-induced

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2
Q

Name the 5 Disorders of Pigmentation & Melanocyteses

A
  1. Freckles
  2. Lentigo
  3. Melanocytic nevus
  4. Dysplastic nevi
  5. Melanoma
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3
Q

A child presents with a 1mm, tan-red macule. The macule changes shade with season changes and is caused by hyperpigmentation (Inc melanin). What is the dx?

A

Freckle (ephelis)

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4
Q

What is a type of freckle that arises independently of sun exposure? Has a neurological source (neurofibromatosis)

A

Café au lait

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5
Q

What do café au lait spots contain?

A

Macromelanosomes (aggregated melanosomes in the cytoplasm of melanocytes)

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6
Q

Plaque

A

Elevated flat-topped lesion, usually greater than 5mm across (may be caused by coalescent papules)

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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, Bulla, Blister

A

Fluid-filled raised lesion 5mm or less across (vesicle) or greater than 5mm across (bulla). Blister is the common term for either.

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10
Q

Wheal

A

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

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11
Q

Name the 5 Disorders of Pigmentation & Melanocytes

A
  1. Freckles
  2. Lentigo
  3. Melanocytic nevus
  4. Dysplastic nevi
  5. Melanoma
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12
Q

Acanthosis

A

Diffuse epidermal hyperplasia

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13
Q

Dyskeratosis

A

Abnormal, premature keratinization within cells below the stratum granulosum

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14
Q

Erosion

A

Discontinuity of the skin showing incomplete loss of the epidermis

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15
Q

Exocytosis

A

Infiltration of the epidermis by inflammatory cells

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16
Q

Hydropic swelling (ballooning)

A

Intracellular edema of keratinocytes, often seen in viral infections

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17
Q

Hypergranulosis

A

Hyperplasia of the stratum granulosum, often due to intense rubbing

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18
Q

Hyperkeratosis

A

Thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin

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19
Q

Lentiginous

A

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

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20
Q

Papillomatosis

A

Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae

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21
Q

Parakeratosis

A

Keratinization with retained nuclei in the stratum corneum. On mucous membranes, parakeratosis is normal.

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22
Q

Spongiosis

A

Intercellular edema of the epidermis seen in eczema

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23
Q

Ulceration

A

Discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutis

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24
Q

Vacuolization

A

Formation of vacuoles within or adjacent to cells; often refers to basal cell-basement membrane zone area

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25
Q

A child presents with a 1mm, tan-red macule. The macule changes shade with season changes, and is caused by hyperpigmentation (Inc melanin). What is the dx?

A

Freckle (ephelis)

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26
Q

What is a type of freckle that arises independently of sun exposure? Has a neurological source (neurofibromatosis)

A

Café au lait

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27
Q

What do café au lait spots contain?

A

Macromelanosomes (aggregated melanosomes in cytoplasm of melanocytes)

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28
Q

What is a disorder of pigmentation that is initiated in childhood/infancy that has to do with benign localized hyperplasia of melanocytes?

A

Lentigo

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29
Q

What skin lesion has…?

  • uniform pigmentation
  • well-defined rounded borders
  • 3 forms (junctional, compound, intradermal)
  • benign histology
  • can be flat macules or elevated papule
A

Melanocytic nevus (mole)

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30
Q

Histology of lentigo

A

restricted to basal cell layer

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31
Q

Where do compound nevi nest?

A

in epidermis and dermis

junction + derm

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32
Q

Histology of lentigo

A

restricted to basal cell layer

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33
Q

Describe melanocytic nevi in the superficial, deeper, and deepest layers.

A

▪Superficial = nests, large-round cells, ↑ melanin

▪ Deeper = cords or single cells, smaller cells, ↓pigment

▪ Deepest: fusiform, fascicles resembling neural tissue (MELANOMA)

▪ Helpful in differentiating benign nevi from melanoma

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34
Q

dysplastic nevus syndrome has what genes that are mutated?

A

CDKN2A or CDK4

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35
Q

What cancer occurs at all ages, in skin and uvea of the eye, is cured surgically, and requires biopsy*?

(Biopsy of the center of cell as well as the periphery because the cells in the center are dead- not useful in diagnosing this cancer.)

A

Melanoma

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36
Q

Melanoma has a high incidence. What therapy has contributed to the downward trend in death rates?

A

Reflects the effectiveness of immune checkpoint inhibitor therapy.

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37
Q

Describe melanocytic nevi in the superficial, deeper, and deepest layers.

A

▪Superficial = nests, large-round cells, ↑ melanin

▪ Deeper = cords or single cells, smaller cells, ↓pigment

▪ Deepest: fusiform, fascicles resembling neural tissue

▪ Helpful in differentiating benign nevi from melanoma

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38
Q

How do the nuclei in dysplastic nevi change in size as they go deeper

A

Some of the nuclei of the melanocytes get larger as they go deeper; which is why it’s “dysplastic growth”

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39
Q

What is the most deadly skin cancer that is acquired through UV radiation from sunlight (DNA damage)?

A

Melanoma

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40
Q

can radial growth of melanoma metastasize?

A

nope

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41
Q

Melanoma has a high incidence. What therapy has contributed to the downward trend in death rates?

A

Reflects the effectiveness of immune checkpoint inhibitor therapy.

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42
Q

Do males or females have melanomas in their upper backs?

A

Males

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43
Q

What driver mutation in melanoma activates telomerase?

A

TERT (most common)

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44
Q

What kinase do growth factors activate the signaling circuits of? Melanoma

A

Tyrosine Kinase (KIT)

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45
Q

What is the stain for melanoma cells in lymph nodes?

A

HMB-45+

FYI: it is a monoclonal antibody that stands for Human Melanoma Black

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46
Q

Dysplastic nevi often require activating mutations in

A

NRAS and BRAF genes

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47
Q

dysplastic nevi are larger than

A

5 mm

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48
Q

Histo characteristics of dysplastic nevi

A

Variegated pigmentation
irregular borders of lesions
Enlarged epidermal nests that may coalesce with other nests
Lentiginous hyperplasia: single nevus cells replace basal cells along E-D junction
Atypia: lg nuclei, irreg angulated nuclear contour, hyperchromasia
Lymphocytic infilt of superf dermis, melanin incontinence (loose melanin)
Linear fibrosis surrounds epidermal rete ridges

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49
Q

How do the nuclei in dysplastic nevi change in size as they go deeper

A

Some of the nuclei of the melanocytes get larger

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50
Q

What driver mutation in melanoma disrupts cell cycle control genes?

A

Mutation in CDKN2

(fyi: encodes p15, p16, ARF) –> tumor suppressor genes

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51
Q

What driver mutation in melanoma activates pro-growth signaling pathways? And is the target of drug treats!

A

Increased RAS & P13K/AKT signaling

mutation in BRAF

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52
Q

What driver mutation in melanoma activates telomerase?

A

TERT (most common)

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53
Q

What kinase do growth factors activate the signaling circuits of? Melanoma

A

Tyrosine Kinase (KIT)

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54
Q

What is the stain for melanoma cells in lymph nodes?

A

HMB-45+

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55
Q

What does radial growth of melanoma mean?

A

horizontal spread of melanoma within epidermis

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56
Q

can radial growth of melanoma metastasize?

A

nope

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57
Q

What are large nuclei with red nucleoli characteristic of?

A

Melanoma

abnormal mitotic figures - more proliferation
chromatin is clumped at the periphery of the nuclear membrane

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58
Q

vertical growth of melanoma is when tumor cells travel…

A

downwards

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59
Q

What is the thickening of the epidermis caused by an increased number of squamous cells?

A

Acanthosis nigricans

a cutaneous sign of several underlying benign & malignant conditions

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60
Q

A child going through puberty presents with thickened, hyperpigmented, velvet-like, skin with velvet-like texture in flexural areas & intertriginous areas.
1. What is this benign epithelial tumor?

  1. What are the 2 most common causes?

(intertriginous areas - skin rubs together)

A
  1. Acanthosis nigrican

2. Obesity & Diabetes

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61
Q

favorable prognosis: melanoma

A 
thinner tumor depth 
NO (<1 per mm²)mitosis 
brisk tumor infiltrating lymphocyte response
NO regression 
lack of ulceration
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62
Q

What is the gene related to increased growth factor receptor signaling in the skin in acanthos nigricans and seborrheic keratosis?

A

FGFR3

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63
Q

What gene in pts with DM contributes to acanthos nigricans?

A

IGFR1

DM2, hyperinsulinemia believed → ↑ stimulation of insulin-like growth factor receptor-1 (IGFR1)

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64
Q

A child going through puberty presents with thickened, hyperpigmented, velvet-like, skin with velvet-like texture in flexural areas & intertriginous areas.
1. What is this benign epithelial tumor?

  1. What are the 2 most common causes?

(intertriginous areas - skin rubs together)

A
  1. Acanthosis nigrican

2. Obesity & Diabetes

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65
Q

a type of benign epithelial tumor that arises spontaneously primarily in the trunk, extremities, head, and neck

A

Seborrheic Keratosis (Seb K)

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66
Q

People of color mainly have this type of benign epithelial tumor and it appears as multiple small lesions on the face

A

Dermatosis papulosa nigra (a type of Seb K)

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67
Q

where is the carcinoma usually that’s associated with Leser-Trelat

A

carcinomas of GI tract

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68
Q

what is the type of benign epithelial tumor associated with the presence of a skin tag

A

Fibroepithelial polyp aka acrochordon

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69
Q

name of the paraneoplastic syndrome associated with Seb K

A

Leser-Trelat

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70
Q

where is the carcinoma usually that’s associated with Leser-Trelat

A

carcinomas of GI tract

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71
Q

Follicular Inclusion Cyst (Wen) spills ______ into the dermis

A

keratin

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72
Q

what is the type of benign epithelial tumor associated with the presence of a skin tag

A

Fibroepithelial polyp

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73
Q

fibroepithelial polyp associated with what diseases

A

diabetes, obesity, intestinal polyposis

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74
Q

what is the type of benign epithelial tumor associated with a painful granulomatous inflammatory response

A

Epithelial or Follicular Inclusion Cyst (Wen)

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75
Q

Follicular Inclusion Cyst (Wen) spills ______ into the dermis

A

keratin

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76
Q

What gene in pts with DM contributes to acanthos nigricans?

A

IGFR1

DM2, hyperinsulinemia believed → ↑ stimulation of insulin-like growth factor receptor-1 (IGFR1)

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77
Q

Does acanthosis nigricans have melanocytic hyperplasia?

A

No

FYI: Histo: epidermis & underlying enlarged dermal papillae undulate sharply →numerous repeating peaks and valleys. Variable hyperplasia may be seen, along with hyperkeratosis & slight basal cell layer hyperpigmentation (but no melanocytic hyperplasia).

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78
Q

Compare removal of fibroepithelial polyp and Follicular Inclusion Cyst

A

the polyp is easily removed at the stalk whereas the follicular inclusion cyst (wen) has to be removed by the whole sac or else keratin will still be getting filled inside the cyst

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79
Q

typical location of follicular inclusion cyst (wen)

A

mainly on scalp

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80
Q

fibroepithelial polyp typically located at

A

head, neck, trunk, face and intertriginous areas

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81
Q

name of adnexal (appendage tumor) that has an increased risk for breast cancer

A

Cowden syndrome

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82
Q

Cowden syndrome has loss of function in

A

PTEN

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83
Q

name of adnexal tumor that looks like a “jigsaw” puzzle or is also called “turban tumor”

A

Cylindroma

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84
Q

Adnexal tumor that is associated with Muir Torre syndrome

A

Sebaceous adenoma

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85
Q

Familial Cancer Syndromes with Cutaneous Manifestations

Chromosomal Location: 9q22 and others

Gene/Protein: XPA /XPA and others

Normal Function/Manifestation of Loss: Nucleotide excision repair/melanoma and nonmelanoma skin cancers

A

Xeroderma pigmentosum

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86
Q

What are the 3 Premalignant & Malignant Epidermal Tumors

A

▪Actinic Keratosis
▪Squamous Cell Carcinoma
▪Basal Cell Carcinoma

87
Q

Proliferation of basaloid cells that forms primitive structures resembling hair follicles

Histology: Buds of basaloid cells

A

Trichoepithelioma

88
Q

Ghost cells: no nucleus

A

Pilomatrixoma

89
Q

Apocrine decapitation

A

Apocrine carcinoma

90
Q

Key characteristics of Actinic Keratosis are?

A

Cutaneous horn: excessive keratin production

Dyskeratosis: pink cytoplasm, intracellular bridges, elastosis (due to sun damage), parakeratosis

91
Q

Familial Cancer Syndromes with Cutaneous Manifestations

Chromosomal Location: 9q22

Gene/Protein: PTCH /PTCH

Normal Function/Manifestation of Loss: Developmental patterning gene/multiple basal cell carcinomas; medulloblastoma, jaw cysts

A

Nevoid basal cell carcinoma syndrome

92
Q

What carcinoma in younger people (<20 y/o) is related to medulloblastoma, ovarian fibromas, odontogenic keratocysts, pits of palms & soles?

A

Nevoid basal cell carcinoma syndrome (NBCCS) aka Gorlin syndrome

93
Q

What carcinomas have these properties?

Pearly papules, telangiectasia (vessels), rodent ulcers, & peripheral palisading (arranged radially with their long axes in parallel alignment) with cleft separating nest from adjacent stroma

A

Basal Cell Carcinoma (BCC)

94
Q

What are the 2 Tumors of the Dermis?

A

Benign Fibrous Histiocytoma (Dermatofibroma)

Dermatofibrosarcoma Protuberans

95
Q

A young-middle age women presents with a dimple sign on her legs with hx of antecedent trauma.

Histology:

  • Benign spindle-shaped cells, well-defined, non-encapsulated mass in mid dermis.
  • Pseudoepitheliomatous hyperplasia (epidermal hyperplasia)
A

Benign Fibrous Histiocytoma (Dermatofibroma)

  • Dimple sign: lateral pressure on the skin produces a depression
  • Indv collagen bundles & fibroblast are also present.
96
Q

What is the second most common tumor arising in sun exposed skin?

A

SCC

97
Q

cowden syndrome is?

A

trichilemmomas (benign tumor of skin involving hair follicle)

98
Q

Histology

  • Storiform (fibroblasts arranged radially)
  • Rare mitoses, overlying epidermis is thinned (opposite of dermatofibroma
  • Honeycomb pattern = deep extension from the dermis into the subQ fat
A

Dermatofibrosarcoma Protuberans (DFSP)

99
Q

What are the 3 Premalignant & Malignant Epidermal Tumors

A

▪Actinic Keratosis
▪Squamous Cell Carcinoma
▪Basal Cell Carcinoma

100
Q

Does SCC metastasize?

A

yes, less than 5% metastasize to regional lymph nodes

101
Q

Ghost cells: no nucleus

A

Pilomatrixoma

102
Q

Apocrine decapitation

A

Apocrine carcinoma

103
Q

What are the acquired mutations in SCC

A

p53
RAS signaling
decrease in Notch signaling

104
Q

What carcinoma is associated with Hedgehog signaling, PTCH gene?

A

Basal Cell Carcinoma (BCC)

105
Q

Characteristics of invasive SCC

A

lesions are nodular
keratin producing (hyperkeratotic)
may ulcerate

106
Q

Xeroderma pigmentosum increases the risk for SCC

A

mutation in nucleotide excision repair pathway

107
Q

What are the 2 Tumors of the Dermis?

A

Benign Fibrous Histiocytoma (Dermatofibroma)

Dermatofibrosarcoma Protuberans

108
Q

Does SCC metastasize?

A

yes, less than 5% metastasize to regional lymph nodes

109
Q

A young-middle age women presents with a dimple sign on her legs with hx of antecedent trauma.

Histology:

  • Benign spindle-shaped cells, well defined, non-encapsulated mass in mid dermis.
  • Pseudoepitheliomatous hyperplasia (Overlying epidermal hyperplasia, downward elongation of hyperpigmented rete ridges)
A

Benign Fibrous Histiocytoma (Dermatofibroma)

110
Q

SCC causes immunosuppression and causes risk of infection by which oncogenic virus?

A

HPV 5 & 8

111
Q

Name of syndrome that causes an increase in cutaneous SCC and is also HPV implicated

A

Epidermodysplasia verruciformis

112
Q

What are the acquired mutations in SCC

A

p53
RAS signaling
decrease in Notch signaling

113
Q

Characteristics of in situ SCC

A

sharply defined
red
scaling plaques
enlarged and hyperchromatic nuclei involving all levels of epidermis

114
Q

Characteristics of invasive SCC

A

lesions are nodular
keratin producing (hyperkeratotic)
may ulcerate

115
Q

What is a well-differentiated primary fibrosarcoma of the skin, locally aggressive, with a protuberant” nodule?

Induration: Localized hardening of soft tissue of the body.

A

Dermatofibrosarcoma Protuberans (DFSP)

116
Q

Translocation collagen 1A1 (COL1A1) & PDGFB, promoting tumor cell growth

A

Dermatofibrosarcoma Protuberans (DFSP)

117
Q

Histology

  • Storiform (fibroblasts arranged radially)
  • Rare mitoses, overlying epidermis is thinned (opposite of dermatofibroma
  • Honeycomb pattern = deep extension from the dermis into the subQ fat
A

Dermatofibrosarcoma Protuberans (DFSP)

118
Q

Xeroderma pigmentosum increases the risk for SCC

A

mutation in nucleotide excision repair pathway

119
Q

What describes a spectrum of rare disorders characterized by increased numbers of mast cells in the skin and, in some instances, in other organs as well?

A

Mastocytosis

120
Q

What describes multiple, widely distributed lesions, round-oval, red-brown, nonscaling papule & sm plaques?

cutaneous form, children, >50% of mastocytosis cases

A

Urticaria pigmentosa (Mastocytosis)

121
Q

Sezary syndrome characterized by

A

erythroderma
cerebriform contour to CD4 cells
there are band-like aggregates in superficial dermis
small clusters of cells in the epidermis: Pautrier microabscesses

122
Q

What 2 things are released when mast cells degranulate?

A

Histamine & heparin

123
Q

What sign describes localized area of dermal edema & erythema (wheal) when skin is rubbed?

A

Darier Sign (Mastocytosis)

124
Q

What is this called?

area of dermal edema resembling a hive, result of local stroking skin with pointed instrument

A

Dermatographism (Mastocytosis)

125
Q

What are systemic signs of Mastocytosis?

A
  1. pruritus & flushing
  2. rhinorrhea
  3. rarely GI or nasal bleeding (anticoagulant effect of heparin)
  4. bone pain (mast cell infiltration or osteoporosis)
126
Q

In what population besides men face osteoporosis due to excessive histamine release in the BM?

A

premenopausal women

127
Q

What gene mutation is associated with Mastocytosis?

A

Point mutations in KIT receptor tyrosine kinase,→ mast cell growth & survival

128
Q

What are the 2 Tumors of Cellular Migrants to the Skin?

A

▪Mycosis Fungoides (Cutaneous T-Cell Lymphoma)

▪ Mastocytosis

129
Q

What are the three Chronic Inflammatory Dermatoses?

A

▪ Psoriasis
▪Seborrheic Dermatitis
▪Lichen Planus

130
Q

Pt presents with AIDS &

  1. Pink to Salmon colored plaque covered by loosely adherent silver scale
  2. Nail changes: Pitting, yellow-brown discoloration, & oncolysis (separation of the nail plate from the underlying bed)
  3. Histology: elongation of rete ridges “test tubes in a rack” & parakeratotic scale
A

Psoriasis

131
Q

What is the name of the phenomenon that induces psoriatic lesions in susceptible pts by local trauma, starts a self-perpetuating local inflammatory response?

A

Koebner phenomenon

132
Q

What is a feature of psoriasis where small PMN aggregates in parakeratotic stratum corneum?

A

Munro microabscesses

Neutrophils, eosinophils, and basophils are PMN

133
Q

Three types of acute inflammatory dermatoses

A

Urticaria
Acute Eczematous Dermatitis
Erythema Multiforme

134
Q

What is a cause of erythroderma (total body erythema and scaling)?

A

Psoriasis

135
Q

What condition is treated excellently by TNF & IL-17 inhibitors?

A

Psoriasis

136
Q

What is a disease of the product of sebaceous gland and not the glands themselves?

It is more common than psoriasis and involves an inflammation of the epidermis.

A

Seborrheic dermatitis

137
Q

What are 2 causes of increased sebum production, associated with Seborrheic dermatitis?

A
  1. in response to androgens

2. Dopamine deficiency, seen in Parkinson’s Disease

138
Q

A severe form of seborrheic dermatitis that is difficult to treat was once common in many HIV individuals with low CD4 counts, but its incidence has fallen with what therapy?

A

Antiviral therapy

139
Q

What condition is associated with follicular lipping?

A

Seborrheic dermatitis

(Mounds of parakeratosis containing neutrophils and serum are present at the ostia of hair follicles = follicular lipping)

140
Q

What condition is associated with macules and papules on an erythematous-yellow, often greasy base & dandruff?

A

Seborrheic dermatitis

141
Q

What are inflammatory & non-inflammatory blistering DOs?

A

Inflammatory Blistering DOs
▪ Pemphigus
▪Bullous Pemphigoid
▪Dermatitis Herpetiformis

Noninflammatory Blistering DOs
▪Epidermolysis Bullosa & Porphyria

142
Q

What disease produces dramatic lesions which can be fatal if untreated?

A

Bullous dzs

Blisters occur at different levels of the skin; histology needed for accurate diagnosis

143
Q

What Inflammatory Blistering DOs involves IgG autoantibodies disrupt intracellular adhesions (within the epidermis & mucosal epithelium) → blisters; may be fatal without TX?

A

Pemphigus

Net-like pattern of intercellular IgG deposits; vulgaris = all levels, foliaceus = superficial

144
Q

Which type of Pemphigus is suprabasal?

A

Pemphigus Vulgaris: most common
▪ Mucosa & points of pressure
▪ Superficial vesicles rupture easily → shallow erosions with dried serum & crust
▪ Histology: Fishnet-like pattern in fluorescence stains, tombstones (stand up in oral cavity)

145
Q

Which type of Pemphigus is more benign form that is endemic in Brazil & at stratum granulosum level?

A

Pemphigus foliaceus

delicate superficial (subcorneal) blisters are much less erosive than those seen in pemphigus vulgaris

146
Q

What kind of Noninflammatory Blistering DOs has blisters at sites of pressure, rubbing, or trauma?

inherited defects in structural proteins

Occurs at flexural creases. Subepidermal blister, no inflammation

A

Epidermolysis Bullosa

in newborns

147
Q

What kind of Noninflammatory Blistering DOs has scarring, exacerbated by sunlight?

Inborn or acquired disturbances in porphyrin metabolism

A

Porphyria

Porphyrins: pigments normally present in Hgb, myoglobin, & cytochrome

148
Q

What is a noninflammatory blister at the dermoepidermal junction; with seemingly rigid dermal papillae at the base that contain abnormal superficial vessels?

A

Porphyria

149
Q

What are two forms are Panniculitis: inflammatory rxn in subQ adipose tissue?

A 
Erythema Nodosum (most common form)
& Erythema Induratum
150
Q

What inflammatory rxn preferentially affects (1) the lobules of fat or (2) the connective tissue that separates fat into lobules?

A

Panniculitis

151
Q

What condition is treated excellently by TNF & IL-17 inhibitors?

A

Psoriasis

152
Q

A self-limited hypersensitivity rxn to certain infections and drugs

A

Erythema Multiforme

153
Q

erythema multiforme is mediated by

A

CD8 cytotoxic T lymphocytes

154
Q

erythema multiforme is characterized by

A 
targetoid lesions
interface dermatitis (dermal edema, lymphocyte infiltration, degenerating keratinocytes)
155
Q

Stevens Johnson syndrome is associated with

A

erythema multiforme in children in oral mucosa, conjunctiva, urethra, genial, and perianal areas

156
Q

what is toxic epidermal necrolysis

A

it’s associated with erythema multiforme and is characterized my diffuse necrosis and sloughing of cutaneous and mucosal epithelia

157
Q

infections that cause erythema multiforme

A

herpes simplex, mycoplasma, histoplasmosis

158
Q

What is a disease of the product of sebaceous gland and not the glands themselves?

It is more common than psoriasis and involves an inflammation of the epidermis.

A

Seborrheic dermatitis

159
Q

What are 2 causes of increased sebum production, associated with Seborrheic dermatitis?

A
  1. in response to androgens

2. Dopamine deficiency, seen in Parkinson’s Disease

160
Q

A severe form of seborrheic dermatitis that is difficult to treat was once common in many HIV individuals with low CD4 counts, but its incidence has fallen with what therapy?

A

Antiviral therapy

161
Q

What condition is associated with follicular lipping?

A

Seborrheic dermatitis

(Mounds of parakeratosis containing neutrophils and serum are present at the ostia of hair
follicles = follicular lipping)

162
Q

What condition is associated with macules and papules on an erythematous-yellow, often greasy base & dandruff?

A

Seborrheic dermatitis

163
Q

Other characteristics of lichen planus

A

sawtoothing–> zigzag of dermoepidermal juct

civatte bodies–> anucleate, necrotic basal cells

164
Q

What disease produces dramatic lesions which can be fatal if untreated?

A

Bullous dzs

Blisters occur at different levels of the skin; histology needed for accurate diagnosis

165
Q 
Pt presents with:
pruritic
purple
polygonal
planar
papules
plaques
A

Lichen Planus

166
Q

self-limited condition that MAY resolve spontaneously in 1-2 years

A

Lichen Planus

167
Q

If lichen planus occurs in chronic mucosal and paramucosal lesions can become

A

SCC

168
Q

Koebner phenomenon occurs in both

A

lichen planus

psoriasis

169
Q

Wickham striae is associated with

A

lichen planus, they are papules highlighted with white dots, created by areas of hypergranulosis

170
Q

Other characteristics of lichen planus

A

sawtoothing–> zigzag of dermoepidermal juct

civatte bodies–> anucleate, necrotic basal cells

171
Q

What Inflammatory Blistering DOs involves IgG autoantibodies disrupt intracellular adhesions (within the epidermis & mucosal epithelium) → blisters; may be fatal without TX?

A

Pemphigus

Net-like pattern of intercellular IgG deposits; vulgaris = all levels, foliaceus = superficial

172
Q

Which type of Pemphigus is suprabasal?

A

Pemphigus Vulgaris: most common
▪ Mucosa & points of pressure
▪ Superficial vesicles rupture easily → shallow erosions with dried serum & crust

173
Q

Which type of Pemphigus is more benign form that is endemic in Brazil & at stratum granulosum level?

A

Pemphigus foliaceus

174
Q

What kind of Noninflammatory Blistering DOs has blisters at sites of pressure, rubbing, or trauma?

A

Epidermolysis Bullosa

175
Q

inflammatory blistering DO that is common in the elderly, is at the inner aspect of the thighs, and is usually on the flexor surfaces of forearms

A

bullous pemphigoid

176
Q

where do antibodies deposit in bullous pemphigoid

A

at the dermoepidermal junction

177
Q

name of the antigen associated with bullous pemphigoid

A

BPAG= bullous pemphigoid antigens

178
Q

inflammatory blistering DO that is usually seen as grouped vesicles on extensor surfaces (elbows, knees)

A

Dermatitis herpetiformis

179
Q

condition associated with celiac disease, IgA antibodies to gluten, and Abs that cross react with reticulin–> subepidermal blister

A

Dermatitis herpetiformis

180
Q

What kind of Noninflammatory Blistering DOs has scarring, exacerbated by sunlight?

Inborn or acquired disturbances in porphyrin metabolism

(Porphyrins: pigments normally present in Hgb, myoglobin, & cytochrome)

A

Porphyria

181
Q

What is a noninflammatory blister at the dermoepidermal junction; with seemingly rigid dermal papillae at the base that contain abnormal superficial vessels?

A

Porphyria

182
Q

What are two forms are Panniculitis: inflammatory rxn in subQ adipose tissue?

A 
Erythema Nodosum (most common form)
& Erythema Induratum
183
Q

What inflammatory rxn preferentially affects (1) the lobules of fat or (2) the connective tissue that separates fat into lobules?

A

Panniculitis

184
Q

2 disorders of Epidermal Appendages

A

Acne Vulgaris

Rosacea

185
Q 
Pt presents with:
flushing
persistent erythema and telangectasia
pustules and papules
Rhinophyma: permanent thickening of nasal skin
A

Rosacea

186
Q

Rosacea is associated with high cutaneous levels of the…..

A

antimicrobial peptide cathelicidin

187
Q

skin condition that is virtually universal in middle-late teens, present in all races

A

acne vulgaris

188
Q

antibiotic treatment for propionibacterium acnes

A

13-cis-retinoic acid (isoretinoin)= antisebaceous action

189
Q

acne vulgaris: closed comedones

A

keratin plug trapped beneath epidermal surface, potential for follicular rupture and inflammation

190
Q

acne vulgaris: multifactorial

A

1) keratin block blocks outflow of sebum
2) hypertrophy of sebaceous glands (puberty), 3)Propionibacterium acnes colonizing hair follicles, 4)secondary inflammation of follicles

191
Q

severe variant of acne vulgaris–> causes dermal scarring and causes sinus tract formation

A

acne conglobate

192
Q

antibiotic treatment for propionibacterium acnes

A

13-cis-retinoic acid (isoretinoin)= antisebaceous action

193
Q

uncommon type of panniculitis

A

erythema induratum

194
Q

pt will usually be an adolescent or menopausal females, will present with primary vasculitis of deep vessels supplying fat lobules of the subQ–> fat necrosis and inflammation

A

erythema induratum

195
Q

Other types of panniculitis

A

Weber-Christian disease (relapsing febrile nodular panniculitis):
rare form of lobular, nonvasculitic panniculitis, children and adults.
crops of erythematous plaques or nodules, predominantly on lower extremities
created by deep-seated foci of inflammation containing aggregates of foamy macrophages with lymphocytes, neutrophils, &giant cells
Factitial panniculitis:form of secondary panniculitis caused by self-inflicted trauma or injection of foreign or toxic substances
T-cell lymphoma: home to fat lobules, producing fat necrosis &superimposed inflammation that mimics panniculitis
Systemic Lupus erythematosus: may occasionally cause inflammation of the subcutis &an associated panniculitis

196
Q

Which panniculitis has a subacute presentation & poorly defined, exquisitely tender erythematous plaques & nodules, more readily palpated (ropy) than seen?

A

Erythema nodosum

197
Q

Which panniculitis is associated with infectious β-hemolytic streptococcal infection, tuberculosis?

A

Erythema nodosum

198
Q

a squamoproliferative DOs caused by HPV 6 & 11

A

verrucae (warts)

199
Q

What skin condition is associated with staphylococcus aureus → toxin causing epidermal injury?

What does the toxin cleaves?

A

Impetigo

desmoglein 1

200
Q

HPV 5 & 8 related to

A

SCC esp in individuals with epidermodysplasia verruciformis

201
Q

molluscum contagiosum giemsa or H&E stain will show

A

molluscum bodies= ellipsoid, homogenous, cytoplasmic inclusions

202
Q

pt presents with pruritic, pink-skin colored umbilicated papules, curd-like material can be expressed from umbilication

A

molluscum contagiosum

203
Q

molluscum contagiosum giemsa or H&E stain will show

A

molluscum bodies= ellipsoid, homogenous, cytoplasmic inclusions

204
Q

What is a common superficial bacterial infection of the skin?
Highly contagious; otherwise healthy kids, occasionally adult in poor health

A

Impetigo

205
Q

What skin condition is associated with staphylococcus aureus → toxin causing epidermal injury?

What does the toxin cleaves?

A

Impetigo

desmoglein 1

206
Q

Describe the crust in Impetigo.

A

Honey-colored crust: drying serum, if crust not removed, new lesions form around periphery & extensive epidermal damage may occur

▪Eliminate bacteria, lesion heals

207
Q

superficial fungal infections are confined to

A

stratum corneum

208
Q

tinea capitis

A

dermatophytosis of the scalp

209
Q

tinus barbae

A

dermatophyte infection of the beard

210
Q

tinea corporis

A

superficial fungal infection of the body surface

211
Q

tinea cruris

A

inguinal areas of obese men during warm weather

212
Q

tinea pedis (athlete’s foot)

A

most of the reaction due to bacterial superinfection and is not directly related to the primary dermatophytosis

spread to nail is referred to as onychomycosis

213
Q

tinea versicolor

A

upper trunk

usually due to the yeast Maassezia furfur

SBL Exam 2 (1 decks)

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