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Path Y > 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 bullous pemphigoid

A

IgG antibodies & complement C3 bind to hemidesmosomes of basement membrane → SUBepidermal bulla
PemphigoiD - Bullae are Deep

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3
Q

How can you confirm the diagnosis of bullous pemphigoid & pemphigus vulgarisms

A 
BP = LINEAR deposits of IgG along basement membrane. SUBEPIDERMAL BULLA
PV = INTERCEULLAR depsoits of IgG - INTRAEPIDERMAL BULLA
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4
Q

What causes pemphigus vulgaris?

A

IgG Abs bind to desmoglein 1 & 3
IgG attacks between the keratin layers = acantholysis
INTRAepidermal bulla PemphiguS - Bullae are Superficial

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5
Q

On which surfaces does psoriasis tend to present?

A

Extensor

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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

Rolled, pearly-edge, central ulcer, telangiectasia

-“Rodent ulcer” as it burrows away

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8
Q

what do pre-cancerous skin cells (Bowen’s disease) look like histologically? what is It also known as?

A

/intra-epidermanlsquamous carcinoma in situ = pre-malignant
keratinocytes become pleomorphic
larger/atypical mitotic figures
all within the epidermis, basement membrane in tact

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9
Q

What is the upward spread of melanocytes known as?

A

pagetoid spread = vertical growth
junctional melanocytes are not normally maturing and dropping out of the dermis – they are moving up through the dermis instead

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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?

A

T-cell mediated pathology

Eosinophils recruited to sites of inflammation

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16
Q

Where does fluid build in eczema?

A

Between keratinocytes

Eczema is spongiotic because there is oedema in between the keratinocytes

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17
Q

Which skin pathology appears as “silvery plaques”?

A

Psoriasis

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18
Q

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

A

Psoriasis
normal turnover is 56 days
here its 7 days

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19
Q

Which skin condition appears as white lines?

A

Lichen planus

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20
Q

Which skin condition appears as a stuck on “pigmented cauliflower”?

A

Seborrhoeic keratosis

may often get caught on clothing

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21
Q

Which skin condition forms “keratin horns”?

A

Seborrhoeic keratosis

22
Q

Describe the appearance of a sebaceous cyst?

A

transluminates, central punctum, circumscribed

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 stage of squamous cell carcinoma

25
Q

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

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

describe the appearance of bullous pemphigoid? who is it most common in?

A

tense bull on flexor surfaces

elderly

30
Q

describe the appearance of pemphigus vulgar?

A

flaccid blisters

31
Q

what junctions are affected in BP & PV?

A

BP - Dermo-epidermal junction

PV- Epiderma-epidermal junction

32
Q

what type of mediated reaction occurs in pemphigus folacieus? what layer or skin is affected?

A

IgG mediated

outer layer of stratum corneum shears off

33
Q

what are the layers of the skin from top to bottom?

A 
“Come, let’s get some beers” 
stratum corneum
lucidum
granulosum 
spinosum
basale
dermis
34
Q

out of BP and PV which rupture easiest?

A

PV rupture easier

35
Q

what type of hypersensitivity reaction is contact dermatitis? what are some precipitants?

A

type 4
nickel, rubber.
commonly affects ear lobes and neck (from jewellery), wrist (leather watch straps), feet (from shoes)

36
Q

what 2 processes occur in contact dermatitis

A

hyperparakeratosis (thickening)

lichenification

37
Q

what’s the commonest form of psoriasis? what does it look like?

A

chronic plaque psoriasis with salmon pink plaques with silver scale affecting extensor aspects of knees, elbows and scalp.

38
Q

what’s auspitz sign? what condition?

A

pinpoint bleeding under the skin’s surface when psoriasis plaques are scraped/rubbed

39
Q

what’s koebnor’s phenomenon? in what condition?

A

appearance of skin lesions on lines of trauma - psoriasis

40
Q

what’s a cardinal histological sign of psoriasis?

A

munro’s microabscesses - collection of neutrophils in the stratum corneum

41
Q

in what condition are Wickham striae see? how is this condition mediated?

A

look like white lines typically in oral mucosa in lichen planus
t - cell mediated

42
Q

what is pyoderma gangrenous? describe its appearance? what conditions is it seen in?

A

non-infectious ulcer that doesn’t heal
seen in UC & CD
also arthritides

43
Q

histopathological horn cysts are pathognomic of what condition?

A

seborrhoeic keratosis

44
Q

what’s a cafe au lait spot? in what condition are they commonly seen?

A

a form of melanocytic naevus
hyper pigmented skin patch

NF1

45
Q

give a rash associated w coeliac disease. what antibody is involved and where are the bulla

A

dermatitis herpetiformis
IgA
sub-epidermal bullae

46
Q

what’s a premalignant condition that looks similar to SCC.

describe it

A

keratoacanthoma

grows rapidly, w a necrotic crusted core then resolves spontaneously over a few weeks

47
Q

rough, sandpaper, scaly lesions one sun exposed areas =

A

actinic keratosis

48
Q

5 features of actinic keratosis

A 
SPAIN
solar elastosis
parakeratosis
atypia
inflammation
not full thickness
49
Q

3 premalignant skin conditions

A

actinic keratosis
keratoacanthoma
bowen’s disease

50
Q

benign skin neoplasm

A

sebhorreic keratosis

51
Q

cutaneous emergency preicipitated often by sulphonamides & anticonvulsants

A

SJS/TEN - sheets of skin detachment

nikolsky sign +ve

52
Q

salmon pik rash, herald patch =

A

pityriasis rosacea
Christmas tree distribution
after viral illness, resolves spontaneously

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