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Pathology > Hi - Skin > Flashcards

Hi - Skin Flashcards

1
Q

what stain is used in skin histopath

A

haemotoxin

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2
Q

what colour do the epidermis and dermis stain

A

epi = purple
dermis = pink

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3
Q

name a key component of the epidermis

A

keratinoytes

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4
Q

name a key component of the dermis

A

collagen

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5
Q

how long does it take cells to mature from the base to the surface of the epidermis

A

28 to 40 days

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6
Q

name the layers of epidermis from outer to inner

A

desquamated cells
stratum corenum
stratum granulosum
stratum spinosum
BM

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7
Q

what cell is present in the stratum spinosum

A

desmosomes

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8
Q

in what layer do cells lose their nuclei & what is the benefit

A

straum corneum
- water tight layer

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9
Q

where are melanocytes in epidermis

A

stratum spinosum

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10
Q

what is present in the dermis

A

hair follicles
sweat glands

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11
Q

name the 6 key types of inflammatory skin reactions

A

spongiotic
lichenoid
psoriasiform
vesiculobullous
graanulomatous
vasculitis

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12
Q

give an example condition of spongiotic reaction

A

eczema

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13
Q

what is the hallmark feature of spongiotic reaction

A

intraepidermal intercellular oedema

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14
Q

what is the hallmark feature of lichenoid reaction

A

band of lymphocytes at epidermal/dermal junction causing keratinocyte death –> interface dermatitis
basal cell damage

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15
Q

what is the hallmark feature of psoriasiform reaction

A

regular epidermal cells but hyperplasia –> thickened due to increased turnover of keratinocytes

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16
Q

what is the hallmark feature of vesiculobullous reaction

A

blistering in and beneath epidermis

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17
Q

why do you get oedema in spongiotic

A

lymphocyte infiltration brings in fluid in perivascular soace

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18
Q

what does spongiotic look like

A

red, weepy rash with vesicles

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19
Q

give an example condition for lichenoid

A

lichen planus

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20
Q

describe lichenoid rash

A

shiny, purple, flat topped, scaly plaques and papules

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21
Q

what line is characteristic of lichenoid

A

wickham striae - white lines

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22
Q

describe histology of lichenoid

A

epidermal keratinocytes lose nuclei and apoptose
thickened epidermis
liquefaction degeneration of basal epidermis
melanin beneath epidermis
band of lymphocytes at epidermal/dermal junction causing keratinocyte death

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23
Q

name a subset of lichenoid

A

erythema multiforme

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24
Q

describe erythema multiforme rash

A

target lesion

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25
Q

what is erythema multiforme similar to

A

TEN
Sjorgrens

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26
Q

give an example condition of psoriasiform

A

psoriasis

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27
Q

describe psoriasiform rash inc location

A

erythematous plaques, with silver white scales
on extensor surfaces - backs of elbows/knees

28
Q

describe Ix for psoriasiform rash

A

clinically usually
biopsy

29
Q

what causes scales in psoriasiform rash

A

nuclei still present in keratinocytes in stratum corneum + neutrophils

30
Q

name 2 types of vesiculobullous

A

pemphigoid
pemphigus

31
Q

describe rash of vesiculobullous

A

large tense bullae, intrinsicly pruritic

32
Q

pathophysiology of bullous pemphigoid

A

epidermal BM attacked by IgG AB
eosinophils
fluid filled space between epi/dermis = bullae

33
Q

where are bullae in pemphigoid

A

below epidermis

34
Q

Ix for pemphigoid and finding

A

direct immunoflurescence
–> IgG attacking BM - linear IgG deposit at BM

35
Q

name 2 types of pemphigus and their distinction

A

folliaeceous - superficial
vulgaris - deep

36
Q

pathophysiology of pemphigus

A

epidermal cells fall apart as intercellular junction (desmoglien 3) is attacked

37
Q

rash of pemphigus

A

blisters / crusts all over skin and mucous membranes

38
Q

Ix of pempigus and finding

A

immunoflurescence –> CHICKEN WIRE pattern of intercellular IgG deposits

39
Q

should pemphigus be Tx?

A

YES - fatal without tx

40
Q

what colour is skin tumour in PM

A

grey

41
Q

what RF are skin tumours related to & how

A

sun exposure - superifical solar ilastiosis (reduced collagen / elastic)

42
Q

name 2 benign skin cancers

A

seborrhoeic keratosis
sebaceous cyst

43
Q

3 types of malignant skin cancer

A

basal cell carcinoma
squamous cell carcinoma
melanoma

44
Q

clinical features of basal CC

A

pearly, telangiectasia, rolled edges

45
Q

prognosis of basal CC inc mets / recurrence

A

virtually never mets but locally aggressive
can recur

46
Q

what mutation is associated with basal CC

A

PTCH mutation for a TS gene

47
Q

histology of basal CC

A

blue tumour due to stain
cleft artefact
peripheral palisading - stand in line in nests

48
Q

histology of SCC

A

keratin pearls - form pink tumours due to keratin
breaks through BM
increased mitoses

49
Q

prognosis of SCC inc mets / recurrence

A

invasive - mets to distal sites by BVs
more aggressive than BCC

50
Q

what preceeds SCC

A

acitinic keratosis

51
Q

describe histopath features of acitinic keratosis

A

rapid prolfieration
atypia of epidermis

52
Q

how does acitinic keratosis invasiveness compare to SCC

A

AK = dysplasia - not broken through BM
SCC = breaks BM

53
Q

clinical features of acitinic keratosis

A

rough, scaly

54
Q

what is bowens disease

A

full thickness atypia with BM intact

55
Q

3 types of benign naevi with location

A

junctional - epidermis
compound - dermis / epidermis
intradermal - dermis

56
Q

what causes benign naevi and how is it different to cancer

A

nesting of melanocytes
–> its organised

57
Q

histology of benign naevi

A

nice, small nests
well spaced
smaller in depths of dermis

58
Q

clinical features of melanoma

A

ABCDE
asymmetry
border - irregular
colour - irregular colouring / pink/red
diameter - >6mm
evolving - changing in size/shape/colour

59
Q

histology of melanoma

A

cellular atypia
large melanocytes
asymmetry
pagetoid spread

60
Q

what is pagetoid spread of melanoma

A

melanocytes high in epidermis

61
Q

melanoma stains

A

melan A stain, S100, HMB45

62
Q

2 key prognostic indicators of melanoma

A

breslow thickness
ulceration

63
Q

other prognostic indicators of melanoma

A

lymphovascular invasion
perineural invasion
clark level
microsatellites
TILs
regression
mitotic levels

64
Q

what is breslow thickness

A

granular layer to deepest keratinocytes

65
Q

name a common mutation seen in melanoma

A

BRAF V600E
20-30% of melanoma has this

Pathology (87 decks)

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