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Path Memory Test > Histo path - Skin > Flashcards

Histo path - Skin Flashcards

1
Q

Itchy Rash

Inflammatory infiltrate
Dilated dermal capillaries
Spongiosis (intracellular)

A

Acute eczema

Think inflam = dilated cap = fluid

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2
Q

Itchy Rash

Acanthosis (epidermal hyperplasia due to ↑ in stratum spinosum)
Crusting/Scaling

A

Chronic Eczema

Think thickening of skin = lichenification.
Think grey, leathery, crusty

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3
Q

Itchy Rash

Child, atopy, face scalp
Flexures if older

A

Atopic Dermatitis

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4
Q

Erythema, swelling, itchy rash

on wrist, ear lobes, neck

A

Contact Dermatitis

Think urticaria, think watch, ear rings and necklace. Commonly to metal and rubber.

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5
Q

Child, yellow scale on scalp, non itchy

A

Seborrheic Dermatitis

Remember it is not itchy or mildly itchy. Will be in sebaceous areas

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6
Q

red plaque, Silver scale, when scraped left pin point bleeding. On extensor surfaces.

Microabscesses in epidermis, neutrophil infiltration (not eosinophilic)

plaques formed at injury site

pitting, thickening, irregular contour nails

A

Psoriasis

pin point bleeding is called Auspitz’ sign

plaques forming at injury site is called Koebner phenomenon

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7
Q

Scaly rash

Histo: 
Nuclei in Stratum Corneum
Loss of granular layer
Rete ridges have test tube appearance
Neutrophil infiltration in s. corneum
A

Psoriasis

Nuclei in s. corneum is called parakeratosis. This process happens in high turn over cells and is a way of keratinising cells. Inflammation or neoplasm.

With parakeratosis, granular layer is lost

Neutrophil infiltration in S. corneum aka Munro’s Microabscesses happens only in psoriasis

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8
Q

Red itchy rash with silver scale in ‘body folds’ - groin and sub mammary areas. 30 years old.

A

Flexure psoriasis

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9
Q

Raindrop plaques in child, 2 weeks after throat infection

A

Guttate psoriasis

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10
Q

Itchy, purple, polygonal, plaque, pimple with fine white network, lymphocytic infiltrate

Inner wrists or inside mouth

Histo: Saw tooth rete ridges

A

Lichen Planus

White network is called Wickam’s Striae

Thought to be an autoimmune disorder, assoc with Hep C

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11
Q

Scattered, red and round plaque-like in appearance

Affects flexural surfaces 
Increased fluid between keratinocytes in the epidermis, stretching them apart.  

Generally see eosinophils in the inflammatory infiltrate. (not neutrophilic)
A

Discoid Eczema

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12
Q

Pt has coeliac - itchy vesicle on elbows and buttocks.

Histo shows IgA bound to basement membrane

Microabscesses which coalesce to form subepidermal bullae. Neutrophil & IgA deposits at tips of dermal papillae

A

Dermatitis herpetiformis

Subepidermal, BM membrane

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13
Q

Elderly man with large tense blistering of skin on erythmateous base.

Subepidermal bulla with eosinophils and linear deposition of IgG along basement membrane

A

Bullous Pemphigoid

IgG binds to hemidesmosome of BM (type 2 hy)

Often on forearms, groin and axillae.
PemphigoiD - Deep

Nikolski sign negative

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14
Q

Fragile small blisters on skin and mucosal surfaces

Intraepidermal bulla
Netlike pattern of intercellular IgG deposits
Acantholysis

A

Pemphigus vulgaris

IgG binds to desmosomal proteins

PemphiguS - superficial

Nikolski sign positve - rubbing causes exfoliation

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15
Q

Desmoglein antibodies

A

Pemphigus follaceous

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16
Q

Elderly lady with sharply demarcated pigmented lesion that protrudes above surface of skin

Appears to be stuck to skin
Is soft, tan-black, “greasy” surface

Thick epidermis

A

Seborrhoeic Keratosis

Leser-Trélat sign:

Sudden appearance or increase in number and size of seborrheic keratoses, associated with internal malignancy

A paraneoplastic phenomenon typically associated with GI malignancy
17
Q

Man who is well tanned has Tan-brown, red or skin colored, circumscribed scaly lesions with sandpaper texture

Solar elastosis
Parakeratosis
Atypia/dysplasia
Inflammation
Not full thickness
A

Actinic keratosis

18
Q

Male, sun exposed, on face

Flesh colored, dome shaped lesion with central, keratin-filled crater

Grew for 3 weeks then subsided

A

Keratoacanthoma

19
Q

Flat/Slightly raised, large scaly erythematous plaque with irregular border on skin exposed to sunlight OR on the trunk

Atypia throughout the epidermis
Includes nuclear hyperchromasia and multinucleation, individual cell dyskeratosis, increased mitotic figures, atypical mitotic figures
Does not invade through the basement membrane

A

Bowen’s Disease

20
Q

Flat/Slightly raised, large scaly erythematous plaque with irregular border on skin exposed to sunlight OR on the trunk

Atypia throughout the epidermis
Includes nuclear hyperchromasia and multinucleation, individual cell dyskeratosis, increased mitotic figures, atypical mitotic figures
Very invasive through the dermis

A

Squamous Cell Carcinoma

2nd most common

21
Q

Slow growing, telangectasic ulcerated nodule on a 65 year old man’s nose. Has a pearly look with a rolled edge.

Cells with scant cytoplasm and elongated hyperchromatic nuclei and peripheral palisading of surrounding stroma

A

Basal Cell Carcinoma

‘baslow blue’? often don’t spread but will be ugly

22
Q

A mole that has changed. Irregular colour, borders, itchy and bleeding

Upward migration of melanocytes through epidermis (pagetoid spread)

Size of melanocytes at the top are the same as the bottom

Hyperpigmented and with mitotic figures

A

Melanoma

ABCDE: 

    Asymmetrical 

    Borders irregular 

    Colour multipigmented 

    Diameter >5mm 

    Evolving (growing)
23
Q

Malignant melanoma measures 2.3cm in thickness. What is it’s breslow thickness

A

T2

Breslow thickness is the main measure 

    >2mm thickness epithelial cancer is called T2 

    <2mm called T1  Best prognostic indicator
24
Q

Melanoma - elderly person, flat slowly growing black lesion

A

Lentigo maligna melanoma

25
Q

Melanoma - Irregular borders with variation in colour

A

Superficial spreading maligna melanoma

Think ‘superficial’ and ‘variation’

26
Q

Melanoma - Younger

A

Nodular maligna melanoma

27
Q

Melanoma - palms, soles and subungual

areas

A

Acral Lentiginous melanoma

‘Acro’ and ‘Hands’

28
Q

Sheets of skin detachment - 8% body surface area

SJS or TEN?

A

SJS

<10% body surface area in SJS and > 30% in TEN

Nikolsky sign positive

29
Q

Salmon pink rash appears first (=herald patch) followed by oval macules in Christmas
tree distribution.
Appears after viral illness.
Remits spontaneously

A

Pityriasis Rosea

Path Memory Test (40 decks)

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