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Year 5 path SW > Histopathology 13: Skin Pathology > Flashcards

Histopathology 13: Skin Pathology Flashcards

1
Q

Baby with itchy yellow scales on his scalp and nappy rash.

Most likely diagnosis ?

A

Seborrheic dermatitis (cradle cap)

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2
Q

Rain drop plaques seen in children 2 weeks post strep throat infection.

Most likely diagnosis ?

A

Guttate psoriasis

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3
Q

What type of hypersensitivity reaction is psoriasis ?

A

Type IV T cell mediated

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4
Q

Koebner phenomenon
Auspitz’s sign

Histology: Parakeratosis, loss of rete ridges and “test tubes in a rack appearance”

Most likely diagnosis ?

A

Psoriasis

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5
Q

Purple, pruritic, polygonal, papules and plaques with Wickam’s striae

Histology: Hyperkeratosis with sawtoothing of rete ridges

Most likely diagnosis ?

A

Lichen Planus

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6
Q

Histology: Linear deposition of IgG antibodies bound to hemidesmosomes of the basement membrane

Nikolsky’s sign -ve

A

Bullous pemphigoid

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7
Q

Histology: Net like pattern of IgG deposits on desmosomal proteins causing intraepidermal bullae

Nikolsky’s sign +ve

A

Pemphigus

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8
Q

Which premalignant skin lesion is hard to differentiate from SCC and is described as: a dome shaped nodule with a necrotic, crusted centre which spontaneously clears in 2-3 weeks ?

A

Keratocanthoma

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9
Q

What is the difference between Bowen’s disease and SCC ?

A

Bowen’s disease is premalignant and does not invade through the basement membrane

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10
Q

Lesion with pearly rolled edges and telangiectase with palisading nuclei on histology.

Most likely diagnosis ?

A

BCC

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11
Q

List 4 subtypes of malignant melanoma ?

A

Superficial spreading melanoma
lentigo maligna melanoma
nodular malignant melanoma
Acral lentigous melanoma

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12
Q

Where do you see acral lentigous melanoma ?

A

Palms and soles

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13
Q

Salmon pink rash, herald patch, christmas tree distribution.

Most likely diagnosis ?

A

Pityriasis rosea

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14
Q

descibe palmar plantar skin

A

no sebaceous glands

very thick corneal layer

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15
Q

describe bullous pemphigoid

A

vesiculobullous
elderly patients
flexor surfaces
tense bullae
10-20% mortality
AI disorder driven by IgG and C3 which attack the basement membrane
recruit eosinophils which release elastase - further damages the anchoring proteins that are anchoring the keratinocytes onto the basement membrane
damage between lowest layer of bricks and the concrete foundation (BM)

Immunofluorescence can be used to detect IgG and C3 at the dermo-epidermal junction

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16
Q

describe pemphigus vulgaris

A

blisters are more flaccid
rupture easily, revealing the raw surface underneath
IgG disease
damage within the keratinocyte layers = acatholysis

17
Q

what is pemphigus foliaceous

A

rarely see intact bullae as they are so thin and come off easily
‘roof coming appart’
IgG mediated

18
Q

what is discoid eczema

A

flexural surfaces

presents with round plaques

19
Q

common allergen for contact dermatitis and features

A

nickel
get hyperkeratosis
epidermis gets thicker
eczema = spongiotic - oedema between keratinocytes

20
Q

what is plaque psoriasis

A

extensor surfaces
silvery plaques
7 day keratinocyte turnover
dilated vessels

21
Q

what is lichen planus

A

lichenoid reaction pattern
T cell mediated
papules and plaques slightly purpleish in colour on wrists and arms
white lines in mouth (wickam striae)
like the BM has been destroyed by ‘loads of ants’
band-like lymphocytic infiltrate just under the epidermis

22
Q

what is pyoderma gangrenosum

A

form of vasculitis
presents as an ulcer
often first manifestation of a systemic disease

23
Q

what is sebhorreic keratosis

A

‘stuck on’ appearance

horn cysts under microscope

24
Q

features of a BCC

A

rolled pearly edges, central ulcer, telangiectasia
arses from keratinocytes along the bottom of the epidermis
cells infiltrate through the BM
spread via nerves and lymphovascular system
locally infiltrative but don’t metastasis

25
Q

what is bowens disease

A

SCC in situ

26
Q

features of malignant melanoma

A

asymmetry, order irregularity, colours, diameter, EVOLUTION
melanocytes begin to migrate upwards through the epidermis (pagetoid spread)
thickness >4mm has very high mortality

Year 5 path SW (106 decks)

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