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HistoPath > Histopathology 11 - Dermatopathology > Flashcards

Histopathology 11 - Dermatopathology Flashcards

1
Q

Give an example of vesiculobullous inflammation?

A

Bullous pemphigoid

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2
Q

What are the aetiological agents of pemphigoid

A

IgG and C3

They attack the basement membrane and destroy the adhesion molecules

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3
Q

How can you confirm the diagnosis of pemphigoid?

A

Immunofluorescence of fresh samples to show IgG and C3

NB IgG binds to hemidesmosomes on the basement membrane

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4
Q

What causes pemphigus vulgaris?

A

Pemphigus antibody attacks proteins that holds cells together in the stratum spinosum, causing “akantholysis”, which leads to formation of *suprabasilar bulla*

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5
Q

On which surfaces does psoriasis tend to present?

A

Extensor (knuckles, knees)

Get silvery plaques

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6
Q

On which surfaces does eczema tend to present?

A

Flexor

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7
Q

What is the appearance of basal cell carcinomas?

A

Pearly white border
Central area of ulceration with telangiectasia

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8
Q

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

A

Pleomorphic
Atypical mitotic figures
All within the epidermis

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9
Q

What is the upward spread of melanocytes known as?

A

Pagetoid spread

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10
Q

When would mitotic figues in the skin not be alarming?

A

Pregnancy

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11
Q

The Breslow thickness is used to stage which skin cancer?

A

Malignant melanoma

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12
Q

Which common skin cancer does not metastasise?

A

Basal cell carcinoma

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13
Q

Is diameter or thickness more important for malignant melanoma?

A

Thickness

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14
Q

Which patient group is most at risk of pemphigus foliaceus?

A

The elderly - but it’s rare

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15
Q

Which cells of the immune system are most involved in eczema? (2)

A

T-cell mediated pathology
Eosinophils recruited to sites of inflammation

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16
Q

Where does fluid build in eczema, and what is this called?

A

Between keratinocytes

Called spongiosis

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17
Q

Which skin pathology appears as “silvery plaques”?

A

Psoriasis

18
Q

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

A

Psoriasis

19
Q

Which skin condition appears as white lines in the mouth + itchy purply red patches and plaques on the distal extensor surfaces?

A

Lichen planus

Called Wickham’s striae

20
Q

Which skin condition appears as a “pigmented cauliflower” + has stuck-on appearance?

A

Seborrhoeic keratosis

21
Q

Which skin condition forms “keratin horns”?

NB this is entrapped keratin surrounded by a proliferating epidermis

A

Seborrhoeic keratosis - get orderly proliferation of epidermis

22
Q

Describe the appearance of a sebaceous cyst?

A

Round, smooth surface, non-mobile, central punctum

23
Q

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

A

Perineural or vascular

24
Q

What is Bowen’s disease?

A

Pre-cancerous squamous cell carcinoma (SCC in situ)

Precedes basal cell carcinoma

25
Q

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

A

Squamous cell carcinoma

26
Q

What is the fancy name for a mole?

A

Benign junctional naevus

27
Q

Which type of skin cancer demonstrates upward migration of melanocytes?

A

Malignant melanoma

28
Q

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

A

Metastatic renal cell carcinoma

29
Q

Where on the body does bullous pemphigoid present?

A

Get tense bullae on flexural surfaces

30
Q

Presentation of pemphigus vulgaris

A

Flaccid-looking blisters, these rupture easily leaving a raw, red surface underneath

31
Q

Aetiology of pemphigus foliaceus

A
  • You don’t see the intact bullae because these are so thin that they come off easily
  • Looks excoriated, the stratum corneum has lifted off (top layer lifts off)
32
Q

Shed time in psoriasis

A

Sheds RAPIDLY - every 7 days

NB normally should take 56 days

This rapid turnover is why epidermis gets a lot thicker

33
Q

Pyoderma gangrenosum aetiology

A
  • This is a form of vasculitis
  • This is NOT actually gangrenous
  • It presents as an ulcer
34
Q

Lichen planus is an example of what type of inflammatory reaction pattern?

A

Lichenoid

35
Q

Rodunt ulcer - has pearly edges + central ulcer + small capillaries seen + in sun-exposed area in elderly

A

Basal cell carcinoma

36
Q

Does basal cellc carcinoma metastasise?

A

Nah - only locally invasive

37
Q

What type of cell change do you get in Bowen’s disease?

A

full thickness dysplasia (so all the way through the epidermis)

NB this is pre-cancerous squamous cell carcinoma

38
Q

Skin lesion with iregular outline + different colours + bleeding + itchy

A

Malignant melanoma

39
Q

A to E for skin lesions

A

asymmetry

border irregularity

colours

diameter

evolution

40
Q

How do normal melanocytes spread?

How does malignant melanoma spread?

A

Move down into the dermis?

get BIGGER and move up through the epidermis – this is known as Pagetoid spread

41
Q

How to stage malignant melanoma

A

Look at depth (in mm)

42
Q

Where in the epidermis does the bullae in pemphigus vulgaris form?

A

Between the keratinocytes: INTRA-EPIDERMAL

HistoPath (21 decks)

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