Histopathology 11 - Dermatopathology

Question 1

Give an example of vesiculobullous inflammation?

Answer 1

Bullous pemphigoid

Question 2

What are the aetiological agents of pemphigoid

Answer 2

IgG and C3

They attack the basement membrane and destroy the adhesion molecules

Question 3

How can you confirm the diagnosis of pemphigoid?

Answer 3

Immunofluorescence of fresh samples to show IgG and C3

Question 4

What causes pemphigus vulgaris?

Answer 4

Pemphigus antibody attacks proteins that holds cells together in the stratum spinosum, causing “akantholysis”, which leads to formation of suprabasilar bulla/intraepithelial bulla- bullous pemphigoid has subepidermal bulla

IgG antibodies against desmoglein 1 & 3

Question 5

On which surfaces does psoriasis tend to present?

Answer 5

Extensor

Question 6

On which surfaces does eczema tend to present?

Answer 6

Flexor

Question 7

What is the appearance of basal cell carcinomas?

Answer 7

Pearly white border

Central area of ulceration

Question 8

What do pre-cancerous skin cells (Bowen’s disease) look like histologically?

Answer 8

Pleomorphic
Atypical mitotic figures
All within the epidermis

Sometimes can see “glomerular vessels”

Question 9

What is the upward spread of melanocytes known as?

Answer 9

Pagetoid spread

Question 10

When would mitotic figues in the skin not be alarming?

Answer 10

Pregnancy

Question 11

The Breslow thickness is used to stage which skin cancer?

Answer 11

Malignant melanoma

Question 12

Which common skin cancer does not metastasise?

Answer 12

Basal cell carcinoma

Question 13

Is diameter or thickness more important for malignant melanoma?

Answer 13

Thickness

Question 14

Which patient group is most at risk of pemphigus foliaceus?

Answer 14

The elderly - but it’s rare

Question 15

Which cells of the immune system are most involved in eczema?

Answer 15

T-cell mediated pathology

Eosinophils recruited to sites of inflammation

Question 16

Where does fluid build in eczema?

Answer 16

Between keratinocytes

Question 17

Which skin pathology appears as “silvery plaques”?

Answer 17

Psoriasis

Question 18

Which immune-mediated skin condition causes a rapid turnover of keratinocytes?

Answer 18

Psoriasis

Question 19

Which skin condition appears as white lines?

Answer 19

Lichen planus

Question 20

Which skin condition appears as a “pigmented cauliflower”?

Answer 20

Seborrhoeic keratosis

Question 21

Which skin condition forms “keratin horns”?

Answer 21

Seborrhoeic keratosis

Question 22

Describe the appearance of a sebaceous cyst?

Answer 22

Round, smooth surface, central punctum

Question 23

Which types of invasion is basal cell carcinoma most likely to exhibit?

Answer 23

Perineural or vascular

Question 24

What is Bowen’s disease?

Answer 24

Pre-cancerous stage of squamous cell carcinoma- also called squamous cell carcinoma in situ

Question 25

Which type of skin cancer is most likely to become invasive?

Answer 25

Squamous cell carcinoma

Question 26

What is the fancy name for a mole?

Answer 26

Benign junctional naevus

Question 27

Which type of skin cancer demonstrates upward migration of melanocytes?

Answer 27

Malignant melanoma

Question 28

A lump on the upper lip may be due to which type of cancer?

Answer 28

Metastatic renal cell carcinoma