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VET 411: Skin > Epidermal & Dermal Response to Injury > Flashcards

Epidermal & Dermal Response to Injury Flashcards

1
Q

why should a gross description of a lesion be submitted with a biopsy

A

skin biopsies are small (usually 6 mm punch biopsies)

requires adequate description of the gross appearance to achieve a final diagnosis

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2
Q

what are the two main steps of describing dermatologic lesions

A
  1. patterns - cell arrangement
  2. subcategories
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3
Q

what are the subcategories to describe patterns

A
  • character of cell infiltrate
  • superficial vs deep
  • primary spongiosis
  • necrotizing
  • ulcerative
  • hyperplastic
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4
Q

perivascular dermatitis

A

inflammation surrounding the vessels of the dermis

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5
Q

how common and how diagnostic is perivascular dermatitis

A

very common - ALL dermatitis starts as perivascular because cells extravasate from vessels

LEAST diagnostic pattern

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6
Q

what epidermal changes are seen in perivascular dermatitis

A
  • pruritus
  • inflammation
  • scratching/licking
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7
Q

acute histologic lesions of perivascular dermatitis

A
  • spongiosis
  • parakeratosis
  • hypogranulosis
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8
Q

chronic histologic lesions of perivascular dermatitis

A
  • compact hyperkeratosis
  • hypergranulosis
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9
Q

what does the depth of perivascular dermatitis tell you

A

superficial only: indicates an outside –> in process

superficial + deep: indicates an inside –> out process

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10
Q

what does type of cell infiltrate tell you about perivascular dermatitis

A

chronicity

cell type changes over time

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11
Q

what are specific features associated with perivascular dermatitis

A
  • keratinocyte swelling (intracellular edema)
  • diffuse superficial epidermal lysis
  • diffuse parakeratosis
  • keratinocyte apoptosis
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12
Q

what disease process is most consistent with keratinocyte swelling

A

viral infection

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13
Q

what disease process is most consistent with parakeratosis

A

metabolic process

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14
Q

cytotoxic interface dermatitis

A

single cell necrosis or apoptosis of keratinocytes

causes keratinocytes to become VACUOLATED

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15
Q

what are etiologies for cytotoxic interface dermatitis

A
  • autoimmune
  • immune-mediated
  • viral
  • ischemic
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16
Q

cell-rich interface

A

lichenoid inflammation associated with single cell necrosis
- subepidermal band of inflammatory cells

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17
Q

cell-poor interface

A

minimal to mild perivascular inflammation

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18
Q

pigmentary incontinence

A

damage to keratinocytes leading to “drop out” of melanin that gets phagocytized by dermal macrophages

causes leukoderma and leukotrichia

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19
Q

subepidermal clefting

A

basal cell damage leading to BMZ failure and dermal-epidermal separation

causes ulceration

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20
Q

vasculitis

A

inflammation of the blood vessels (arteries, veins, small vessels)

21
Q

what causes vasculitis

A

infectious
immune mediated

22
Q

signs of acute vasculitis

A

erythema
ecchymosis
hemorrhagic macules
palpable purpura
superficial ulcers
necrosis
no blanching on diascopy

23
Q

diascopy

A

pressing a glass slide against redness to determine if true color change or vasodilation

24
Q

histology of vasculitis

A

inflammatory cells migrating through vessel wall with NECROSIS of the wall

target of cell attack is the vascular wall

25
Q

cell rich vasculitis

A

intact and degenerate inflammatory cells within wall

various degrees of degenerative change

26
Q

cell poor vasculitis

A

degenerative changes of the vascular walls

lack of inflammation

27
Q

intraepidermal vesicular/pustular dermatitis

A

accumulation of fluid (vesicles) or fluid + inflammatory cells (pustules) within the epidermal layer

28
Q

what do vesicles and pustules turn into

A

rupture to form erosions and crusting

29
Q

erosions

A

loss of the epidermis with intact basal cell layer

30
Q

crusts

A

degenerated cells + serum + WBCs, RBCs

31
Q

what lesions would you want to sample the edge for biopsy

A

vesicles/pustules
erosions/ulcers

32
Q

subepidermal vesicular/pustular dermatitis

A

accumulation of fluid or fluid + inflammatory cells below the epidermis (in BMZ)

33
Q

what lesion occurs from sub epidermal dermatitis

A

ulceration due to splitting at the BMZ

34
Q

what can lead to subepidermal dermatitis as a secondary lesion

A
  1. cytotoxic interface dermatitis
  2. neutrophilic inflammation
  3. hypoxia
  4. steroid drugs
35
Q

folliculitis

A

inflammation of the hair follicle

36
Q

perifolliculitis

A

perifollicular perivascular/nodular dermatitis

37
Q

furunculosis

A

ruptured hair follicle leading to free keratin and hair shaft in the dermis

elicits an immune response to foreign body in dermis

38
Q

perforating folliculitis

A

superficial rupture of hair follicles

39
Q

luminal folliculitis

A

inflammatory cells that cross the follicular epithelium and accumulate in the lumen of the follicle

40
Q

what causes luminal folliculitis

A

infectious (bacterial, fungi, demodex, pelodera)

41
Q

mural folliculitis

A

inflammatory cells migrate into the follicular epithelium (NOT the lumen)

42
Q

what causes mural folliculitis

A

infectious
auto-immune
immune-mediated

43
Q

bulbitis

A

inflammation of the hair bulb and deep hair follicle

leads to alopecia with no other superficial lesions due to no hair follicle

44
Q

what causes bulbitis

A

autoimmune

45
Q

nodular to diffuse dermatitis

A

inflammation of the dermis in nodular aggregates or generalized/diffuse distribution

46
Q

what causes nodular/diffuse dermatitis

A

neoplasia vs inflammatory (infectious vs noninfectious)

47
Q

panniculitis

A

inflammation of the subcutis that occurs as an extension of dermatitis (dermal inflammation)

48
Q

what causes panniculitis

A

infectious
metabolic
immune mediated
idiopathic

VET 411: Skin (16 decks)

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