DermPath rounds Flashcards

1
Q

Hairs are most likely to be pigmented (in pigmented coats) in which hair follicles, primary, secondary or both?

A

You are more likely to see pigmented hair in primary hair follicles.

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2
Q

Which structure of the hair is more likely to be visible in the primary hair follicle compared to a secondary hair follicle?

A

The medulla

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3
Q

What marks the transition of the infundibulum to the isthmus?

A

A ring of tricholemmal keratin

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4
Q

Which cornifies first, Henle’s or Huxley’s layer?

A

Henle’s layer (outermost layer of IRS)

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5
Q

Which cells in the follicle wall are indicative of a regressing hair follicle?

A

Apoptotic keratinocytes

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6
Q

If a hair follicle shows apoptotic keratinocytes and trichilemmal keratin, what stage is it in?

A

Catagen

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7
Q

Which unusual features can be seen in normal bovine skin?

A

Dilated sweat glands

Parakeratotic inner root sheath

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8
Q

What is a flame follicle?

A

Excessive trichilemmal keratin (produced by the ORS) that protrudes between keratinocytes
+/- hair shaft

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9
Q

What % of hairs in skin biopsies are in catagen?

A

1-2%

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10
Q

What is abnormal about the keratohyaline granules in hairless cats?

A

They are irregularly sized

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11
Q

When describing a pustule histopathologically, what are the key features?

A
  1. Size, width and location (e.g. interfollicular)
  2. Is it multilayered (pustules with overlying crust)
  3. Location in the epidermis (e.g. intracorneal, subcorneal)
  4. Content of pustule (not crust! e.g. degenerate or non-degenerate neutrophils)
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12
Q

Which species has lots of large sweat glands and low numbers of single hair follicles with bulbs that reach deep into the subcutis?

A

Pigs

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13
Q

What does a tuberculoid granuloma look like?

A

A central zone of neutrophils and necrosis surrounded by histiocytes, epithelioid macrophages, and giant cells, in turn surrounded by lymphocytes and an outer layer of fibroblasts

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14
Q

What does a sarcoidal granuloma look like?

A

It consists of epithelioid macrophages

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15
Q

Tuberculoid granulomas can be seen in which diseases?

A

Tuberculosis, feline leprosy, atypical mycobacterial infection, and Corynebacterium pseudotuberculosis infections.

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16
Q

Sarcoidal granulomas can be seen in which diseases?

A

Sterile sarcoidal granulomas and foreign-body reactions.

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17
Q

What is a palisading granuloma?

A

They are characterised by the alignment of histiocytes, such as staves around a central focus of collagen degeneration (feline, canine, and equine eosinophilic granuloma; equine mastocytoma); parasite or fungus (habronemiasis, pythiosis, conidiobolomycosis, basidiobolomycosis, demodicosis); lipids (xanthoma); or other foreign material (e.g., calcium as in dystrophic calcinosis cutis and calcinosis circumscripta).

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18
Q

What does an epithelioid macrophage look like?

A

Elongated or oval vesicular nuclei and abundant finely granular, eosinophilic cytoplasm with ill-defined cell borders.

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19
Q

What do Langhans MNGCs look like?

A

The nuclei form a circle or semicircle at the periphery of the cell

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20
Q

What do foreign body MNGCs look like?

A

The nuclei are scattered throughout the cytoplasm

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21
Q

What do Touton MNGCs look like?

A

The nuclei form a wreath that surrounds a central, homogeneous, amphophilic core of cytoplasm that is, in turn, surrounded by abundant foamy cytoplasm

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22
Q

Which type of MNGCs:

a) is strongly indicative of xanthomas
b) suggests the need for an acid-fast stain

A

a) Touton

b) Langhans

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23
Q

Which group of diseases has diffuse, compact orthokeratotic hyperkeratosis on histopathology?

A

Cornification disorders e.g. ichthyosis

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24
Q

A ‘wind-blown’ appearance of epidermal keratinocytes is typical of which disease?

A

Bowenoid in situ carcinoma

It can also affect the hair follicles

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25
How big are erythrocytes, mast cells and keratinocytes?
Erythrocytes ~5-6um diameter Mast cell ~15um diameter Keratinocyte ~15-20um diameter
26
In which species is a lamellar appearance of the stratum corneum a normal finding?
Horses and cattle
27
Which granules within keratinocytes cannot be seen on H&E stained slides?
Lamellar granules Can see keratohyalin granules only with H&E
28
Bacteria can produce which enzyme leading to dryness of the skin and impaired barrier function?
Ceramidase
29
Which structure is missing from the stratum corneum in JRTs with TGM-1 deficiency?
Cornified envelope is missing
30
What are the extracellular proteins of the desmosome?
Desmoglein and desmocollin
31
What are the intracellular proteins of the desmosome?
Plakophilin, plakoglobin and desmoplakin which are linked to keratin filaments
32
Where is desmocollin 1 expressed?
Stratum cornuem Stratum granulosum Haired skin and foot pads only, not found in the buccal mucosa
33
Where is desmocollin 3 expressed?
All layers of the epidermis in haired skin and foot pad and more strongly in basal layer of buccal mucosa than the superficial layers
34
Epidermolysis bullosa simplex is associated with mutations in which genes in cats and cattle?
KRT14 cats | KRT5 cattle
35
Palmoplantar keratoderma in the Dogue de Bordeaux is associated with which gene mutation?
KRT16
36
What are the two layers of the dermis called?
Papillary dermis and reticular dermis. Papillary dermis is not easily seen in dogs and cats; easier to see in people, pigs and large animals. It has finer collagen fibres than the reticular dermis.
37
Which species have dilated sweat glands as a normal histopathological finding?
Cows and pigs
38
Which species have simple hair follicles?
``` Equine Bovine Porcine Murine Ovine Human ```
39
Which species have compound hair follicles?
``` Canine Feline Rabbits Caprine Ovine ```
40
What features define the transition of the infundibulum to the isthmus?
Sebaceous gland duct and rim of trichilemmal keratin
41
What feature marks the transition from isthmus to inferior portion of the hair follicle?
The isthmus starts where the last cell of the inner root sheath is fully cornified (can no longer see pink keratohyalin granules)
42
How does cornification differ in anagen and telogen hair follicles?
Anagen show inner root sheath cornification | Telogen show trichilemmal cornification of the outer root sheath
43
What is iSALT and where is it found?
Inducible skin associated lymphoid tissue | Found at the post-capillary venules
44
Which species has the most brightly eosinophilic eosinophils?
Horse
45
What should you describe in the first sentence of a histopath report for a tumour?
``` Location Densely or sparsely cellular Well or poorly demarcated Shape (nodular, verrucous etc) Expansile or infiltrative Encapsulated or unencapsulated ```
46
How do you describe cell patterns in tumours?
Carcinoma: nests, packets, lobules, cords Adenocarcinoma: tubules, acini Sarcoma: bundles fasicles, streams Round cells: sheets Densely packed or loosely arranged Stroma: fine, coarse, fibro vascular, pre-existing
47
How do you describe neoplastic cells?
Shape: round, spindle, oval, cuboidal, colnat, polygonal, pleomorphic Size: small or large Cell borders: distinct or indistinct Cytoplasm: amount, colour, character Nucleus: shape, location, chromatin distribution Nucleolus: number, colour
48
Porphyria has been reported in which species?
Cattle, pigs and cats | It is caused by defective uroporphyrinogen III cosynthetase, an enzyme of hemoglobin synthesis
49
Secondary photosensitisation is caused by what?
Secondary photosensitisation is caused by defective liver function with subsequent accumulation of photodynamic phylloerythrin a chlorophyll metabolite
50
Primary photosensitisation is caused by what?
Primary photosensitisation is caused directly by chromophores from plants, drugs, or abnormal metabolites
51
What are the subcategories of mural folliculitis?
Interface Infiltrative (lymphyocytes, eosinophils, granulomatous, destructive, necrotizing, mucinotic) Pustular Bulbitis
52
Name the superficial pustular diseases of the epidermis
``` Impetigo Superficial spreading pyoderma Mucocutaneous candidiasis Superficial spreading dermatophytosis PF PE Subcorneal pustular dermatosis Sterile superficial erythroderma of miniature Schnauzers Superficial drug reaction Idiopathic linear pustular acantholytic dermatosis Dermatophilosis (equine) Bovine papular stomatitis Greasy pig disease (Staphylococcus hyicus) ```
53
Name the bullous and vesicular diseases of the epidermis and dermal-epidermal junction
``` Bullous pemphigoid MMP PV PNP Hereditary epidermolysis bullosa Epidermolysis bullosa acquisita Canine Darier's disease Linear IgA disease Mixed AISBD Vesicular stomatitis Swine vesicular disease FMD (apthovirus) Vesicular erythema of swine Swine parvovirus vesicular disease ```
54
Name the interface diseases of the dermal-epidermal junction
``` DLE SLE PE ECLE VCLE MCLE Erythema ab igne EM Feline exfoliative dermatitis (+/- thymoma) SLO Juvenile onset ischaemic dermatopathy Post rabies panniculitis Generalised idiopathic ischaemic dermatopathy Bovine viral diarrhoea ```
55
Name the necrotizing diseases of the epidermis
``` EM Feline exfoliative dermatitis (+/- thymoma) PNOE TEN Toxic shock syndrome SND Generic dog food dermatosis Split pad disease Burns Irritant contact dermatitis ```
56
Name the spongiotic and vesicular diseases of the epidermis
``` Allergic contact Feline eosinophilic plaque Psoriasiform dermatitis of pads Facial dermatitis of Persian / Himalayan cats Sarcoptes, psoroptes, chorioptes Contact dermatitis Viral vesicular dermatitis FMD Orf (parapoxvirus) Photosensitisation ```
57
Name the ulcerative and crusting diseases of the epidermis
``` Pyotraumatic dermatitis Miliary dermatitis Mosquito bite hypersensitivity Herpesvirus ulcerative dermatitis Feline cowpox Indolent ulcer Feline idiopathic ulcerative dermatosis Canine pyoderma gangrenosum Molluscum (equine - poxvirus) Candidiasis Dermatophilosis (bovine, equine) Linear keratosis (equine) ```
58
Name the hyperplastic diseases of the epidermis
``` Chronic hyperplastic dermatitis Fibropruritic nodules Acral lick Malassezia dermatitis Actinic dermatitis / solar keratosis Acanthosis nigricans (dachshunds) Psoriasiform-lichenoid dermatosis (Springers) Lichenoid keratosis Inflamed linear epidermal nevus Giant cell dermatosis in FeLV Linear keratosis (equine) ```
59
Name the diseases with abnormal cornification
``` Primary seborrhea Vitamin A responsive dermatosis Canine ear margin seborrhea Nasodigital hyperkeratosis Nasal parakeratosis of Labradors Congenital follicular parakeratosis Ichthyosis Familiar pawpad hyperkeratosis Schnauzer comedo syndrome Actinic comedones Callus Sebaceous adenitis Zinc-responsive dermatosis SND Inflamed linear epidermal nevus Acrodermatitis of bull terriers Ulcerative nasal dermatitis in Bengals ```
60
Name the perivascular disease of the dermis
``` Superficial spreading pyoderma Atopic dermatitis Food allergy FAD Urticaria (allergic) Allergic contact dermatitis Sarcoptes / Notoedres Cheyletiellosis Feline superficial demodicosis Cutaneous microfilariasis Hookworm dermatitis Cutaneous anatrichosomiasis Vitiligo Onchocerca (equine) Habronema (equine) Stephanofiliaria (bovine) ```
61
Name the Vascular diseases of the dermis
Septic vasculitis Urticaria and angioedema Telangiectasia, phlebectasia and cutaneous flushing Cyroglobulinaemia and cryofibrinogenaemia Neutrophilic immunologic vasculitis Cell poor vasculitis Familial cutaneous vasculopathy of GSDs CRGV Proliferative thrombovascular necrosis of the pinnae Proliferative arteritis of the nasal planum Solar vasculopathy
62
Name the lichenoid (Band- like) diseases of the dermis
``` Mucocutaneous pyoderma DLE PF VKH / uveodermatological syndrome Psoriasiform-lichenoid dermatosis Lichenoid keratosis ```
63
Name the infectious nodular and diffuse granulomatous and pyogranulomatous diseases of the dermis
Actinomyces and nocardiosis Bacterial pseudomycetoma Feline leprosy Canine leproid granuloma Opportunistic mycobacterial infection (rapidly growing / atypical / nontuberculous) Opportunistic mycobacterial infection (M. avium) Dermatophytic (pseudo)mycetoma Cutaneous blastomycosis, histoplasmosis and coccidiomycosis Cutaneous cryptococcosis Sporotrichosis Opportunistic fungal infection Cutaneous pythiosis, lagendiosis, entomophoromycosis Leishmaniosis
64
Name the noninfectious nodular and diffuse granulomatous and pyogranulomatous diseases of the dermis
Sterile granuloma and pyogranuloma syndrome Reactive histiocytosis Juvenile sterile granulomatous dermatitis and lymphadenitis (juvenile cellulitis, puppy strangles) Adult sterile granulomatous dermatitis Cutaneous xanthoma Canine sarcoidosis Foreign body reaction (foreign body granuloma) Palisading granuloma Localised and generalised granulomatous dermatitis (Eq. sarcoidosis)
65
Name the nodular and diffuse diseases of the dermis with prominent eosinophils, neutrophils, or plasma cells
Arthropod reaction Feline mosquito bite hypersensitivity Spider bites Fire ant bite Feline herpes virus ulcerative dermatitis Feline eosinophilic plaque Feline indolent ulcer Feline eosinophilc granuloma (feline collagenolytic granuloma, feline linear granuloma) Canine eosinophilic granuloma Canine eosinophilic dermatitis Feline hypereosinophilic syndrome Plasma cell pododermatitis Familial cutaneous vasculopathy of german shepherd dogs Canine sterile neutrophilic dermatosis (Sweet’s syndrome) Sterile pustular erythroderma of miniature schnauzers Well’s syndrome Cutaneous mastocytosis
66
Name the degenerative, dysplastic and depositional diseases of dermal connective tissue
``` Calcinosis cutis Calcinosis circumscripta Cutaneous mucinosis Cutaneous amyloidosis Ehlers-danlos syndrome Feline acquired skin fragility syndrome Topical steroid reaction Perforating dermatitis Morphea Cicatricial alopecia Solar elastosis (solar dermatitis) Erythema Ab Igne ```
67
Name the pustular and nodular diseases without adnexal destruction
``` Superficial bacterial folliculitis Feline dermatophytosis Canine dermatophytosis PF Sterile eosinophilic pustulosis Stralensia cynotis ```
68
Name the pustular and nodular diseases with adnexal destruction
Deep bacterial folliculitis and furunculosis German shepherd dog pyoderma Post-grooming furunculosis Acral lick dermatitis Actinic furunculosis Interdigital furunculosis (pedal folliculitis and furunculosis, interdigital pyoderma) Callus pyoderma (pressure point pyoderma) Canine acne (muzzle folliculitis and furunculosis) Feline acne Kerion Canine demodicosis Feline follicular demodicosis (d. mange, demodectic acariasis) Pelodera dermatitis Eosinophilic furunculosis of the face Sebaceous adenitis Stralensia cynotis
69
Name the mural diseases of the hair follicle
Alopecia areata Mural folliculitis due to demodicosis and dermatophytosis Pseudopelade Eosinophilic mural folliculitis in dogs Degenerative mucinotic mural folliculitis in cats Granulomatous mural folliculitis in dogs Follicular mucinosis (alopecia mucinosa) ILPAD (Idiopathic linear pustular acantholytic dermatosis) Mural mucinotic isthmic folliculitis of Lundehunds Proliferative, lymphocytic, infundibular, mural folliculitis and dermatitis with follicular apoptosis and parakeratosis (PLIMF) Malignant catarrhal fever (ovine)
70
Name the atrophic diseases of the adnexa
Hypothyroidism Canine hyperglucocorticidism (canine hyperadrenocorticism, canine cushing) Feline hyperglucocorticoidism (feline hyperadrenocorticism, feline cushing) Canine sertoli cell tumour-associated skin disease (male feminizing syndrome) Canine female hyperestrogenism (ovarian imbalance typeI) Alopecia X Post-clipping alopecia Feline paraneoplastic alopecia Acquired pattern alopecia (canine pinnal alopecia, pattern baldness, dachshund pattern baldness) Ischemic dermatopathy/canine dermatomyositis Post-traumatic alopecia Traction alopecia (mechanical alopecia) Telogen effluvium Doxorubicin-induced alopecia Excessive physiological shedding Feline psychogenic alopecia
71
Name the dysplastic diseases of the adnexa
Color dilution alopecia and black hair follicular dysplasia Canine follicular dysplasia Cyclical flank alopecia (seasonal flank alopecia, recurrent FA) Congenital hypotrichosis Follicular lipidosis Sebaceous gland hyperplasia Sebaceous gland dysplasia
72
Name the diseases of the panniculus
``` Post-rabies vaccination panniculitis Post-injection panniculitis Sterile abscess of repositol injection Traumatic panniculitis Vasculitic panniculitis of thermal burns Idiopathic sterile nodular panniculitis Vasculitic septal panniculitis (subcutaneous leukocytoklastic vasculitis) Feline pansteatitis Metatarsal fistulation of the german shepherd dog (sterile pedal panniculitis of the GSD, Deep metatarsal/metacarpal toritis in GSD) Pancreatic panniculitis ```
73
What four things should you first describe when looking at tumour?
1. Demarcation 2. Cellularity 3. Infiltrative or expansive 4. Capsule or not
74
Name the types of round cell tumour in the skin
``` MCT Histiocytoma Lymphoma Plasmacytoma Transmissible venereal tumour ```
75
Which features can help to differentiate a histiocytoma from a lymphoma (both can be epitheliotropic)?
1. Histiocytomas have a 'bell' shaped dome 2. Histiocytomas have rete ridges associated with epidermal hyperplasia 3. Histiocytomas have parallel sheets of round cells that 'fall' from the epidermis 4. Histiocytes have more cytoplasm and bean shaped nuclei
76
Where do you see lymphocytes appear in a regressing histiocytoma?
At the edges/base of the tumour - they infiltrate as the mass regresses
77
Other than tumours, what other space occupying masses can be seen in the skin?
Cysts, hyperplasia, hamartoma
78
Are benign or malignant tumours are more likely to have a capsule?
Benign
79
Cells with nest/packet/lobule formation in tumours are most likely of what origin?
Epithelial
80
Which round cell tumour is often associated with dilated sweat glands?
MCTs
81
What can be seen within the abnormal vessels formed with haemangiosarcomas?
Thrombi
82
What do you call an epitheliotropic lymphoma that only affects the epidermis?
Pagetoid reticulosis
83
What are the neutrophils surrounding in this crust?
Bacterial colonies
84
What is the arrow pointing at?
Acid fast bacillus within an epitheliod macrophage
85
Histopath of crusted lesions from a goat; what is the arrow pointing at?
Paired cocci arranged in parallel rows with branching filaments Dermatophilus congolensis
86
What are pallisading granulomas?
Palisading granulomas are generally circumscribed infiltrates of histiocytes perpendicularly oriented to collagen fibers or foci of necrosis - inflammatory lesions. Localized trauma/damage to collagen bundles may be the primary inciting cause.
87
Match the IHC markers with the cells: CD3, CD79b, Mum1 T cells, B cells and plasma cells
``` CD3 = T cells CD79b = B cells Mum1 = plasma cells ```
88
How do dermal dendritic and Langerhans cells differ in their IHC staining? Both are IBA1-positive.
Interstitial dendritic cells are E-cadherin-negative with variable CD204 labelling. Langerhans cells are expected to be E-cadherin positive and CD204-negative
89
When taking biopsies from alopecia, where should you sample?
Center/worst part of the lesion AND partially affected areas
90
With loss of hair follicles, eg dysplasia, what happens to the epidermis?
It becomes hyperplastic and the stratum corneum is more compact (more like glaborous skin)
91
What do you see on histopathology with trichotylomania?
Abnormally oriented fragments of hair shafts within the follicles - pulling on hair shafts leads to breakage and broken hairs within the follicle snap back
92
A pale outer root sheath (contains glycogen) and trichohyaline granules are seen in which stage of the hair cycle?
Anagen
93
Which changes, other than follicular arrest, can be seen on histopathology of HAC?
Epidermal and dermal atrophy Comedone formation Sebaceous gland atrophy Calcinosis cutis (then see epidermal hyperplasia!)
94
What is kenogen?
Hairless telogen with no evidence of a new anagen follicle developing (consequence of prolonged telogen)
95
Which changes, other than follicular arrest, can be seen on histopathology of hypothyroidism?
Mucin deposition Dermal thickening Vavuolar changes in erector pili muscles (not very reliable change)
96
What histopathological changes do you see with ischaemic dermatopathy?
- Fading follicles - Pronounced follicular fibrous sheath - Deposition of fine fibrillar (wispy) collagen - Vascular walls are hyalinised/mummified with a lack of endothelial cells +/- leukocytoclasia
97
Ear margin seborrhoea can be seen with which endocrinopathy?
Hypothyroidism
98
What do you see on histopathology with feline paraneoplastic alopecia?
Epidermal hyperplasia | Miniaturised hair follicles (makes SG looks big!)
99
Biopsy from a horse with scaling and alopecia on the face; what is the diagnosis?
Onchocerca (purple larvae on H&E)
100
Can you see a clonal T cell population in inflammatory lesions?
Yes, rarely (e.g. drug reactions, ehrlichiosis)
101
What histopathological changes do you see with alopecia X?
Prominent trichilemmal cornification of primary hairs (flame follicle) Nordic breeds normally have increased trichilemmal keratin in telogen!
102
Which non-inflammatory alopecia has these characteristic follicles?
Canine recurrent flank alopecia (witches feet)
103
What mechanisms of keratinocyte necrosis are involved in confluent necrosis in SJS/TEN?
1. Lymphocytes: Soluble cytotoxic proteins such as FasL and granulysin 2. Macrophages/dendritic cells: TNF-alpha - TNF related apoptosis induced ligand (TRAIL) interacting with Apo2 - TNF weak inducer of apoptosis (TWEAK) interacting with Apo3
104
With viral triggers of EM, should you see viral inclusions at the site of EM lesions?
No - if you see viral inclusions then the pathology is due to antiviral cytotoxicity rather than EM
105
PNOE in cats affects the pinna, ear canal and more rarely, which other sites?
Periocular, perioral and generalised
106
What do you see on histopathology of Erythema ab igne?
- Basal cell vacuolation - Apoptosis throughout epidermis - Dysplastic keratinocytes with karyomegaly - Wavy elastin fibres (red spaghetti) - Fibrosis
107
Why do you not see many hair follicles in catagen?
It is the shortest phase of the hair cycle
108
How many substages of catagen are there?
8
109
How many substages of anagen are there?
6
110
What is the most important feature for recognising the hair cycle phase?
The dermal papilla It's size (most prominent in anagen and within hair bulb) and position in the hair follicle and location in the dermis or subcutis
111
What is the only mesenchymal component of the hair follicle?
Dermal papilla
112
Trichohyaline granules are present in the outer root sheath in which portion of the hair follicle?
Inferior
113
What is Adamson Fringe?
Where both layers of the outer root sheath are cornified (where the isthmus starts!)
114
Which granules are visible in the infundibulum?
Keratohyalin granules There are no granules in the isthmus! Trichohyalin granules are present in the inferior portion
115
Which part of the hair follicle contains glycogenated cells in the outer root sheath?
Lower isthmus and suprabulbar portion of inferior
116
Why do you see comedones in HAC?
Thinned collagen is unable to support the hair follicle and it dilates
117
What is a typical epidermal feature of histiocytomas?
Rete ridges
118
Do plasma cell tumours or histiocytomas form cords?
Histiocytomas form cords, particularly noticeable at the superficial dermis Plasma cell tumours often form dense sheets
119
What shape can nuclei be in histiocytomas?
Round to oval and often indented (like a potato!)
120
Some plasma cell tumours contain accumulations of which eosinophilic substance? Which special stain can be used to help identify the substance?
Amyloid Congo red
121
Which type of furunculosis most often contains haemorhage?
Post grooming furunculosis
122
Biopsy of a cat pinna; what is the most likely diagnosis?
Cystadenomatosis
123
Why do lesions of atypical mycobacterial infection in cats feel firm?
Fibroplasia
124
From a cutaneous nodule in a ferret, what is the diagnosis?
Fungal pyogranuloma (dermatophytic pseudomycetoma)
125
What is Dunstan’s blue line?
Gram-positive cocci within superficial layers of keratin accompanied by granular basophilic cellular debris
126
How do you differentiate candidiasis from superficial pustular dermatophytosis?
Culture
127
What is the 'usable artifact of Stannard'?
Artifactual dermal–epidermal separation at the margin of the specimen. Only tissue weakened through the dermal–epidermal junction will separate in this manner during processing, and consequently this ‘usable artifact of Stannard’ is valid evidence of interface damage
128
What is ‘red spaghetti of Walder’?
Eosinophilic, wavy elastin fibrils in the superficial dermis seen in erythema ab igne
129
How many nuclei can be present in an epidermal syncytial giant cell in FeLV giant cell dermatosis?
Up to 30!