Epithelial Flashcards
Traumatic lesion breaking the epidermis and causing a red linear mark (ie a deep scratch); often self-inflected
excoriation
flat, circumscribed area, 5mm or less in diameter, distinguished from surrounding skin by coloration. if greater than 5 mm, referred to as a nodule
macule
elevated dome-shaped lesion 5mm or less in diameter. if greater than 5mm in diameter, referred to as a nodule
papule
elevated flat-topped lesion, usually greater than 5mm in diameter
plaque
pedunculated or polypoid elevated lesion, base often smaller than body of lesion
polp
dry, horny, plate-like excrescence; usually the result of imperfect cornification
scale
fluid filled raised area 5mm or less in diameter. if greater than 5mm in diameter, referred to as a bulla
vesicle
loss of intercellular adhesion of keratinocytes
acantholysis
diffuse epidermal hyperplasia
acanthosis
abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum
dyskeratosis
hyperplasia of stratum corneum, often associated with a qualitative abnormality of keratin
hyperkeratosis
surface elevation caused by hyperplasia and enlargement of dermal papillae
papillomatosis
keratinization characterized by retention of the nuclei in the stratum corneum. on squamous mucosal membranes, such as buccal mucosa, is normal
parakeratosis
intercellular edema of the epidermis
spongiosis
common chronic imflammatory skin condition affecting 2-3% of the population; immunologic process; CD4+ and CD8+ T-cell mediated disease characterized by an increase in the proliferative activity of keratinocytes; often induced by local trauma (Koebner phenomenon) or inflammatory process that goes awry
psoriasis
can affect all ages; lesions often waxing and waning during the summer; skin of the elbow, knees, scalp, lumbosacral areas, intergluteal cleft commonly involved; well-dermarcated, pink to salmon-colored plaque covered by loosely adherent scale that is characteristically silver white in color; when scale is removed it gives rise to multiple punctate bleeding points (Auspitz sign)
psoriasis
can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration; nails may become loose and separate from the nail bed (onycholysis). severe cases may cause the nail to crumble; oral lesions are uncommon (benign migratory glossitis)
psoriasis
munro abscesses (in the stratum corneum of the epidermis due to the infiltration of neutrophils from papillary dermis into the epidermal stratum corneum
psoriasis
etiologically related to HPV (usually 6 and 11); occur at any site but tongue and soft palate commonly affected; soft, painless, typically pedunculated and has a papillary or verrucoid (cauliflower) surface; light pink, white, or same color as adjacent mucosa; typically solitary
squamous papilloma
papillary, “cauliflower-like” hyperparakeratotic proliferation of epithelium; individual finger-like fronds are supported by a fibrovascular core; viral cytopathic effect evident in the epithelium-koilocytes
squamous papilloma
benign lesions associated with HPV, most often affecting children and adolescents; typically a benign skin lesion induced by HPV (subtypes 2,4); contagious; generally self-limited
verruca vulgaris (common wart)
dysregulated epidermal cell growth with increased survival; different kinds are identified on the basis of their gross appearance and location and generally are caused by distinct HPV subtypes; variable in color but typically white
verruca vulgaris
papillary, hyperkeratotic proliferation of epithelium; course keratohyaline granules and koilocytes; rete ridges appear to converge toweard the center of the lesion
verruca vulgaris
“venereal warts”; caused by several types of HPV (2,6,11,16,18); typically genital; oral lesions: multiple, sessile, cauliflower surface, often greater than 1 cm in size; associated with squamous cell carcinoma of the uterine cervix
condyloma acuminatum
a “self healing” variant of squamous cell carcinoma; self-limiting hyperplasia of epithelium with a papillary/verrucous clinical appearance, bland cytomorphology, “pushing” border, and a good prognosis; males more affected; average age is >45; associated with sun damage
keratoacanthoma
significantly more common on skin that intraorally; oral usually confined to vermilion of lip; rapid enlargement is typical; Ferguson Smith type (multiple lesions seen early in life); Grzybowski type (hundreds of papules on skin and upper digestive tract, associated with internal malignancy)
keratoacanthoma
exo-endophytic lesion w/ central keratin plug filled crater; overall symmetrical appearance due to “buttressing” at edges of lesion
keratoacanthoma
common pigmented epidermal tumors occurring most frequently in middle-age or older persons; spontaneous and numerous on the trunk, although the extremities, head and neck also may be sites of involvement; unknown etiology (correlated with sun); may be hereditary; hundreds of lesions may appear suddenly as a paraneoplastic syndrome (sign of Lesser-Trelat)
seborrheic keratosis
exclusively a skin lesion (face, trunk, extremities); round, exophytic tan to brown, roughened plaques; “stuck on” appearance; except for cosmetic concerns, they are usually of little clinical importance
seborrheic keratosis
exophytic, papillary proliferation of monotonous sheets of basaloid cells; horn cysts (keratin-filled inclusions) and pseudo-horn cysts; variable amounts of melanin pigmentation is present
seborrheic keratosis
common premalignant lesion of skin or lip; secondary to cumulative sun exposure; >40years, particularly fair-skinned individuals; face, dorsum of hands, scalp; irregular scaly plaques of variable color, develop slowly; rough “sandpaper” feel
actinic keratosis
most common cancer in humans; extremely low grade cutaneous malignancy secondary to chronic sun exposure or genetic mutation; tumor cells arise from the basal cell layer of skin and appendages; fair complexioned individuals, generally >40 years of age; most common location is middle third of face
basal cell carcinoma
basaloid cells in islands, strands and nests that arise from the basal layer of the epithelium and penetrate the underlying connective tissue; distinct peripheral palisading and stromal retraction
basal cell carcinoma
benign acquired pigmentation of the oral mucosa characterized by dendritic melanocytes dispersed throughout the thickness of the epithelium; oral lesion seen almost exclusively in blacks with female predilection; most common in third and fourth decades; buccal mucosa most common site of involvement with lesions presenting as a well demarcated, smooth macule or slightly elevated plaque with a relatively uniform dark-brown to black color
melanoacanthoma
a relatively rapid increase in size over a period of a few weeks; may develop a synchronous _ on the contralateral buccal mucosa
melanoacanthoma
benign proliferation of melanocytes; acquired or congenital; majority appear during first 2 decades of life; females more than males; majority have an activating mutation in the BRAF gene
acquired melanocytic nevus
tan-to-brown, uniformly pigmented, small papules with well-defined, rounded borders; intraoral are uncommon; proliferation of nevus cells that vary in morphology depending upon their depth, superficially arranged in theques
acquired melanocytic nevus
Proliferation of nevus cell confined to the basal layer of epithelium
junctional nevus
Proliferation of nevus cell seen in both the basal layer of epithelium and in the underlying dermis
compound nevus
proliferation of nevus cell confined to the underlying dermis
intradermal nevus
benign hyperpigmentation of the mucous membranes; increase in focal melanin deposition w/o increase in number of melanocytes; most commonly on the vermilion border; can be found on the gingiva or palate; if multiple consider Peutz-Jeghers syndrome
oral melanotic macule
lesions are brown to tan in color and smaller than 1 cm, well-demarcated border; women more than men; average age is 40 years
oral melanotic macule
Proliferation of benign melanocytes within the deep subepithelial connective tissue; slate blue to blue black lesion; Tyndall effect; 2nd most common intraoral pigmented lesion with palate being a common location; buccal 2nd most common locale; more in females
blue nevus
highly aggressive malignant neoplasm; less common but more deadly than basal or squamous cell carcinoma; may arise from preexisting benign melanocytic lesions or from skin subject to a history of acute solar damage; white adults; aged 50-55 most common
melanoma
rapid enlargement or change in color of a preexisting nevus; itching or pain in a lesion; ABCDE’s; 3rd most common skin cancer; oral is rare in US; atypical melanocytes along the basal epithelial layer (lateral growth phase); vertical growth begins as these cells invade the connective tissue
melanoma
