Gen Path Exam 4 - Dermatologic Disease Flashcards
What are the 4 layers of the epidermis?
Stratum corneum
Stratum granulosom
Stratum spinosum
Straum germinativum
Which layer of the epidermis?
Composed of orthokeratin (w/o nuclei)
Stratum corneum
Which layer of the epidermis?
Thin layer that acquires large basophilic granules called keratohyalin
Stratum granulosum
Which layer of the epidermis?
Layer of keratinocytes that mature and acquire keratin as they are pushed toward the surface
Stratum spinosum
Which layer of the epidermis?
Single layer of dividing cells that give rise to all epithelial cells
Stratum germinativum
Which layer of the epidermis?
Granular layer
Stratum granulosum
Which layer of the epidermis?
Squamous layer
Stratum spinosum
Which layer of the epidermis?
Basal layer
Stratum germinativum
Epithelial projections that anchor epithelium to underlying CT
Rete ridges
Which part of the dermis?
Reticulin fibers that act as a scaffold for epidermis
BM
Which part of the dermis?
Loose collagen and elastin directly below rete ridges
Papillary dermis
Which part of the dermis?
Dense structural collagen
Reticular dermis
Found in all locations except palms and soles
Hair follicles
Oil glands accompanying each hair follicle and in other locations w/o hair (mucosa)
Sebaceous glands
Lubricates hair and is antibacterial
Sebaceous glands
Smooth muscle that attaches to hair follicle
Arrector pili muscles
Found at all locations; thermoregulators
Eccrine sweat glands
Found under arms
Apocrine sweat glands
Clear cells living in the basal layer
Epidermal melanocytes
Spindly cells living in papillary dermis
Dermal melanocytes
Dendritic histiocytic antigen processing cells living in stratum spinosum
Langerhans cells
Receptors for light touch; live in the basal layer
Merkel cells
2 words to describe flat lesions
Macule
Patch
A flat, non-palpable change in shape or color that is ≤ 1.0 cm
Macule
A flat, non-palpable change in shape or color that is > 1.0 cm
Patch
Slightly elevated lesion with large area
Plaque
Solid, ≤ 0.5 cm
Papule
Solid, >0.5 cm (sessile vs. pedunculated)
Nodule
Non-specific for any large, solid lesion
Tumor/mass
Fluid-filled elevation ≤ 0.5 cm
Vesicle
Fluid-filled elevation > 0.5 cm
Bulla
Pus-filled elevation of any size (yellow fluid)
Pustule
Arising on a broad base
Sessile
Arising on a stalk or pedicle that is narrower than the lesion
Pedunculated
Lesion composed of multiple fronds or projections (may be sessile or pedunculated)
Papillary
Exophytic lesion means?
Raised lesion
Linear cleavage of mucosa
Fissure
Thinning of the mucosa (red)
Atrophy
Depressed lesion, incomplete loss of mucosa (red)
Erosion
Complete loss of mucosa (dark yellowish)
Ulcer
Result of injury causing mucosal atrophy or hypertrophy with increased underlying collagen
Scar
Thickened parakeratin
Hyperparakeratosis
Thickened orthokeratin
Hyperorthokeratosis
Thickened granular cell layer (accompanies
hyperorthokeratosis, never parakeratosis)
Hypergranulosis
Thickening or hyperplasia of stratum spinosum
Acanthosis
Loss of intercellular bridges and cohesion of cells of stratum spinosum
Acantholysis
Edema of stratum spinosum, widened intercellular bridges
Spongiosis
Hyperplasia of papillary dermis, resulting in multiple surface elevations
Papillomatosis
Abnormal formation of keratin below surface
Dyskeratosis
Infiltration of epidermis by inflammatory cells
Exocytosis
What are the 2 acute inflammatory dermatoses?
Urticaria (hives)
Eczema
What category of diseases?
Duration: several days to weeks
Acute inflammatory dermatoses
What category of diseases?
Histology: inflammation, edema often marked by mononuclear infiltrate instead of neutrophils
Acute inflammatory dermatoses
What category of diseases?
Course: may be self-limited or become chronic
Acute inflammatory dermatoses
Which disease?
Type I hypersensitivity reaction; localized mast cell degranulation
Urticaria (hives)
Which disease?
Dermal microvascular hyperpermeability resulting in erythematous, edematous, and pruritic plaques are termed wheals
Urticaria (hives)
Which disease?
Localized or generalized, small, pruritic papules to large erythematous plaques
Urticaria (hives)
Which disease?
Usually develop and fade within hours, but can persist for days to months
Urticaria (hives)
Which disease?
Tx: antihistamines, leukotriene antagonists (block IgE), or steroids
Urticaria (hives)
Which disease?
Group of conditions showing pruritic, erythematous papules, and possible vesicles which ooze and crust and later coalesce into raised scaly plaques
Eczema
Which disease?
Caused by allergen (delayed hypersensitivity), defect in keratinocyte barrier, drug hypersensitivity, UV light, physical/chemical irritant
Eczema
Which disease?
Example: allergic contact dermatitis (e.g. poison ivy)
Eczema
Which disease?
Environmental agent that reacts with self-
proteins creating neoantigens that sensitizes T cells
Eczema
Which disease?
On re-exposure, memory CD4+ T cells are
activated and release cytokines that recruit inflammatory cells and cause epidermal damage
Eczema
What category of diseases?
Features become most apparent over many months to years
Chronic inflammatory dermatoses
What category of diseases?
Skin can appear rough due to thick scale and shedding (desquamation)
Chronic inflammatory dermatoses
What is the 1 chronic inflammatory dermatoses?
Psoriasis
Which disease?
1-2% of US population is affected (common)
Psoriasis
Which disease?
Increased risk for heart attack and stroke and affects 10% of arthritis pts
Psoriasis
Which disease?
Autoimmune, T cell-mediated inflammatory disease; self and environmental antigens involved
Psoriasis
Which disease?
T cells secrete cytokines (TNF is a major mediator) and growth factors inducing keratinocyte hyperproliferation
Psoriasis
Which disease?
Well-demarcated, pink to salmon–colored plaque covered by loosely adherent silver-white scale
Psoriasis
Which disease?
Psoriatic arthritis is a severe complication of this disease
Psoriasis
Which disease?
Affects skin of the elbows, knees, scalp etc. (oral
lesions extremely rare)
Psoriasis
Which disease?
Diagnosed by Auspitz sign – pinpoint bleeding upon scratching scale off lesions
Psoriasis
Which disease?
Diagnosed by Koebnerization – creation of lesions by scratching
Psoriasis
Which disease?
Tx: coal tar derivatives, sunlight, TNF antagonists, Vitamin A and D derivatives, methotrexate for severe cases
Psoriasis