Dermpath scaling

Question 1

Scaling Skin Disease - clinical terms and derm path term

Answer 1

Clinical terms
◼ Scale
◼ Seborrhea
◼ Plaque
◼ Lichenification
◼ Cornification disorder
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Derm Path term
◼ HYPERKERATOSIS and PARAKERATOSIS

Question 2

The Language of Dermatology: Scale, flakes
- histological term?

Answer 2

Scale - is a cornification defect > excessive production, or failure of removal
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- Scale is an accumulation of loose fragments of keratin (stratum corneum)
- Flakes (dandruff in effect) may be white, red, brown, yellow, dry, greasy, adherent, flaky, powdery or bran-like.
- Histological term: THICKENED STRATUM CORNEUM HYPERKERATOSIS, PARAKERATOSIS

Question 3

Scaling indicates a disorder of cornification - possible types:

Answer 3

◼ Reduced loss of corneocytes (failure to separate)
◼ Excess production of corneocytes

Question 4

Primary cornification disorder - what this?
- 3 main examples

Answer 4

Primary cornification disorder (failure to release corneocytes)
◼ Nasodigital hyperkeratosis
◼ Nasal hyperkeratosis of Labrador retrievers
◼ Ichthyosis – ‘primary seborrhea’

Question 5

Secondary cornification disorders - what is this? examples / causes?

Answer 5

Secondary cornification (reactive hyperplasia)
◼ Basic response of epidermis to injury is epidermal hyperplasia
◼ Trauma - Scratching
◼ Infection
◼ Altered barrier function

Question 6

HYPERKERATOSIS
- definition
- causes
- other names
- clinical correlate

Answer 6

increase in the thickness of a NORMALLY differentiated stratum corneum
* Primary disorder
* Reactive hyperplasia
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* Also called: orthokeratotic hyperkeratosis
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- Clinical correlate – Scaling
- Ichthyosis in a Golden Retriever

Question 7

PARAKERATOSIS
- what is this?
- causes?
- clinical correlate?

Answer 7

• retention of nuclei in the stratum corneum
• Indicates abnormal cornification
• Diffuse parakeratosis is a powerful pattern
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  Causes:
• Zn responsive dermatosis
• Vitamin A responsive dermatosis
• Superficial necrolytic dermatitis (Hepatocutaneous syndrome)
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  Clinical correlate – Scaling

Question 8

Stratum granulosum hyperplasia - name, clinical correlate?
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Stratum spinosum hyperplasia - name, clinical correlate?

Answer 8

Stratum granulosum hyperplasia
◼ HYPERGRANULOSIS
◼ No clinical correlate
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Stratum spinosum hyperplasia
◼ ACANTHOSIS
◼ No clinical correlate

Question 9

The Language of Skin: plaque - definition, histo term

Answer 9

• A Plaque is a larger (>1cm) , flat topped elevation
• Histological term: PLAQUE

Question 10

Infundibulum of hair follicle
- structure
- what is it called when excessive keratin forms? clinical terms?

Answer 10

◼ Identical to epidermis
◼ Excessive keratin forms
◼ Histological term – follicular keratosis and follicular parakeratosis
◼ Clinical terms
> Follicular casts
> Comedones

Question 11

The Language of Skin: Comedones definition, histo term

Answer 11

• Follicles plugged with keratin
• Histological term: FOLLICULAR DILATATION AND KERATOSIS