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Systemic Pathology > Integument > Flashcards

Integument Flashcards

1
Q

What are the three proposed pathogenesis for interface dermatitis?

A
  1. Cytotoxic T –cell attack on keratinocytes or melanocytes, or basement membrane components
  2. Non-immune mediated damage-drugs
  3. Unknown
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2
Q

moth eaten coat appearance

A

folliculitis/furunculosis

pyoderm (bacterial infection of the follicles)

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3
Q

What are the three most common organisms that colonize follicles causing folliculitis?***

Name two other cause of folliculitis?

A

bacteria

dermatophytes

mites

immune mediate or idiopathic

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4
Q
A

Vesicle

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5
Q
A

hyperpigmentation from chronic inflammation and hypothyroidism (other option idiopathic)

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6
Q

Type of acanthosis?

hyperplasia with long, irregular and anastomosing rete ridges extending into the dermis. Cells in this type of hyperplasia are still well differentiated and maintain orientation with the basement membrane

A

Pseudocarcinomatous

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7
Q

What two patterns are observed for vesicular/pustular dermatitis?

A

A. intraepidermal (subcorneal or suprabasilar)

B. subepidermal (splits epidermis and dermis)

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8
Q

A dog/horse present with edema, cutanous hemorrhage, possible infarction, and sloughing of extremities. What skin disease pattern is likely?

A

vasculitis

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9
Q
A

panniculitis

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10
Q
A

Ichthyosis (marked hyperkeratosis)

SC is sticky and does not exfoliate

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11
Q

What is commonly seen with skin atrophy?

A

comedones- plug of follicular SC & dried sebum in hair follicle

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12
Q
A

Erysipelothrix rhusiopathiae septic emboli

vasculitis

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13
Q

collections of fluid & inflammatory cells in the epidermis or subepidermal region.

A

Pustule

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14
Q

What cells are important components of the skin immune system (SIS)?

A

langerhan cells, keratinocytes, intr-epidermal lymphocytes, and dermal perivascular unit

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15
Q

punch biopsy margins

A

3 cm

place in 10x non-buffered formalin

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16
Q
A

Rabies vaccine associated Vasculitis

(fibrinoid degeneration)

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17
Q
A

Perivascular dermatitis

atopy

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18
Q

Type of gland:

sweat glands

sebaceous glands

A

sweat glands- apocrine

sebaceous- holocrine glands

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19
Q

loss of cohesion
between keratinocytes due to
breakdown of cell to cell attachments

A

acantholysis

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20
Q

What are the adnexa?

A

hair follicles; sweat, sebaceous, mammary, accessory glands

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21
Q
A

Ballooning degeneration

viral cytopathic effect

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22
Q

If an animal presents with perivascular dermatitis with eosinophils, it is highly suggestive of what?

A

hypersensitivity

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23
Q

What are the two sequelae of vasodilation in the skin?

A

erythema (reddening of the skin)

edema

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24
Q

Describe the location of the vesicles below.

A
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25
Q

What are the two types of intracellular edema?

A

hydropic degeneration: affects basal layer, keratinocytes contain vacuoles (lichenoid dermatoses, drug eruptions, dermatomyositis)

ballooning degeneration: swollen eosinophilic keratinocytes in superficial layers of the dermis (viral infection)- can lead to vesicle formation

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26
Q

increase in width of stratum granulosum (increase cells with keratohyalin granules)

A

hypergranulosis

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27
Q

Two causes for acantholysis?

Common sequelae of acantholysis?

A

pemphigus (Type II cytotoxic hypersensitivity)

neutrophilic enzyme destruction

vesicle

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28
Q

What are the structures?

Why do they form?

A

pustules from acantholysis

pemphigus foliaceus

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29
Q

Full or partial thickness necrosis of the epidermis?

A

full thickness

toxic epidermal necrolysis

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30
Q

What are the secondary lesions that form to the primary pustule lesion?

A

crusts

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31
Q

Skin disease?

A

folliculitis/furunculosis

demodecosis

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32
Q

What is the pathogenesis for nodular to difffuse skin disease?

A

persisitent Ag stimulation incites cell-mediated response

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33
Q

Type of hyperkeratosis?

A

parakeratotic

superficial necrolytic dermatitis

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34
Q

skin disease?

A

pemphigus foliaceus

pustules

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35
Q

Type of skin disease pattern?

A

interface dermatitis (bubbles, depigmentation)

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36
Q

The dog’s nose used to be black.

A

hypopigmentation- vitiligo (direct damage to melanocytes d/t immunogens on the surface of these cells)

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37
Q

Type of acanthosis?

A

papillated

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38
Q
A

erythema

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39
Q
A

atrophic dermatoses

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40
Q

What is the primary epidermal change?

Secondary?

A

vesicle

ulcer

(immune-mediated epidermal-dermal separation)

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41
Q

List the 5 follicular changes that can occur?

A

hyperkeratosis

folliculitis

furunculosis (rupture of follicle)

dysplasia (blue/fawn animals)

atrophy

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42
Q

Name for this skin appearance?

Type of infection commonly associated?

A

lichenification (thickening of the skin and accentuation of the skin creases d/t acenthosis)

yeast infection

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43
Q

Hydropic degeneration and apoptosis in basal layer of epidermis accompanied by a diffuse band of lymphocytes, plasma cells, +/- macrophages at the dermal: epidermal junction. Pigmentary incontinence and +/- thickening of the basement membrane. May see clefts or vesicles at the dermal: epidermal junction. Further divided into cell-poor and cell-rich lichenoid dermatoses.

A

interface dermatitis

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44
Q

mild or severe vasculitis?

A

mild (alopecia and atrophy)

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45
Q

mild or severe vasculitis?

A

severe (cuntaneous infarction and ulceration/sloughing)

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46
Q
A

Interface Dermatitis

lymphoplasmacytic

Discoid lupus (immune attack keratinocytes, thick band of cells at D-E jxn)

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47
Q

What condition results in interface dermatitis that is cell poor and is associated with vasculopathy-ischemia?

A

familiar canine dermatomyositis

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48
Q

Pathogenesis for vesicle/pustule formation

A
  1. Enzymatic destruction
  2. Immune destruction- acantholysis or other
  3. Mechanical destruction – burn, friction
  4. Genetic structural defects
  5. Marked spongiosis, hydropic or ballooning degeneration
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49
Q

Skin Disease?

A

nodular to diffuse dermatitis

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50
Q

Major functions of the skin?

A
  1. Temp & and blood pressure regulation
  2. Fluid regulation
  3. Protection- barrier to the outside world
  4. Sensation
  5. Nutrient metabolism
  6. Immune functions: SIS
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51
Q

Conditions associated with nodular to diffuse skin disease

A
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52
Q
A

folliculitis/furunculosis

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53
Q

Name the structure? location?

A

subcorneal pustule

54
Q
A

hydropic degeneration (intracellular edema)

often immune mediated, blister formation

55
Q
A

Feline Herpesvirus dermatitis

ballooning degeneration of keratinocytes

56
Q

What are the layers of the skin from most superficial to deep?

A

stratum corneum

(stratum lucidum- only present in non-haired skin)

Stratum granulosum-dying

stratum spinosum-polyhedral shape, intracell-bridges

stratum basale

Basement membrane

57
Q

Most likely cause of a focal atrophic dermatoses?

58
Q

Name the 2 locations of folliculitis in the follicle and likely types of infections associated with each.

A

luminal- bacterial, fungal, parasitic

mural- hypersensitivity (eosinophilic)

59
Q
A

atrophic dermatoses

60
Q

List the general dermal changes

A
  1. dermatitis
  2. edema
  3. fibrosis
  4. collagen degeneration/lysis
  5. collagen mineralization
  6. collagen atrophy
  7. collagen dysplasia
  8. elastin changes
  9. mucinosis
61
Q

Type of skin disease?

A

perivascular dermatitis (aggregates of inflammatory cells around vessels)

62
Q
A

atypical mycobacteria- nocardia (acid-fast)

panniculitis

63
Q

What is the general term used to describe what is seen in the picture?

Condition?

A

hyperkeratosis

superficial necrolytic dermatitis

64
Q

lesions are most representative of the underlying etiology and most useful for evaluation by the clinician and pathologist.

65
Q

Type of acanthosis?

A

irregular (uneven sized rete ridges)

66
Q

deep ulcers

A

pemphigus vulgaris

suprabasilar vesicles

67
Q

What is the difference between a vesicle and bulla?

A

vesicle < 1 cm

bulla > 1 cm

68
Q

Difference between intercellular and intracellular epidermal edema?

A

intercellular= spongiosis (fluid accumulation between cells that widens the spaces between cells)

intracellular: fluid accumulation within the cells

69
Q

Type of acanthosis?

A

regular (even rete ridges)

70
Q
A

nodular to diffuse dermatitis

habronemiasis

71
Q

Atrophic dermatoses are characterized by what?

A

comedones

telangiectasia

hyperpigmentation

thin skin

hypotrichosis (less hair)

(may or may not see inflammtion)

Epidermal and follicular atrophy with
hyperkeratosis

Sebaceous gland atrophy

72
Q
A

sloughing/ulceration of skin d/t vasculitis

73
Q

What are the pathogenic mechanisms for vesicular/pustular dermatitis?

A

Enzymatic destruction

Immune destruction

Mechanical destruction – burn, friction

Genetic structural defects
Marked spongiosis, hydropic or ballooning degeneration

74
Q
A

Calcinosis cutis (body tries to get rid of Ca through follicles)

75
Q

Types of folliculitis?

76
Q

What are the five cellular infiltrates in skin and what do they indicate?

A
  1. NT- active inflammation
  2. eosinophils- ectoparasites/allergies
  3. mononuclear phagocytes- pesistent antigen in tissue
  4. lymphocytes/plasma cells- local/systemic Ag stimulation (chronic bacterial dermatitis)
  5. mast cells-resident cells, hypersensitivity
77
Q

What are the two types of hyperkeratosis and what is the difference?

A

orthokeratotic: buildup of excess keratin after normal cornification has occurred (anuclear)

parakeratotic: thickening of stratum corneum w/ rentention of nuclei

78
Q

What are the three types of pustules?

A

neutrophilic: bacterial & autoimmune
eosinophilic: parasites, allergic

Pautrier’s microabcesses: epitheliotropic cutaneous lymphoma (mycosis fungoides)

79
Q

Type of hyperkeratosis

A

orthokeratotic

80
Q

Superficial necrolytic dermatitis

Describe the epidermal changes?

A

hyperplasia aka acanthosis

edema

hyperkeratosis- parakeratosis

81
Q

epidermal hyperplasia - thickening due to increased numbers of nucleated cells in the epidermis

A

acanthosis

82
Q
A

Irregular acanthosis

83
Q

What are the 8 basic patterns of non-neoplastic skin disease?

A
  1. perivascular
  2. interface dermatitis
  3. vasculitis
  4. nodular/diffuse granulomatous
  5. vesicular or pustular
  6. folliculitis, furunculosis, sebaceous adenitis
  7. panniculitis
  8. atrophic dermatitis
84
Q
A

interface dermatitis

lymphohistiocytic

Uveodermatologic (VKH) syndrome (immune attack on skin nasal planum and eye)

85
Q

Structure?

Cause?

A

Pautrier’s Microabscess

Mycosis Fungoides

86
Q
87
Q

premature keratinization of cells in the epidermis

often accompanied by what type of hyperkeratosis?

A

dyskeratosis

parakeratosis

88
Q

Type of skin disease with dermis +/- panniculus have nodules, sheets, or diffuse infiltrates of inflammatory cells (granulomatous/pyogranulomatous)

A

nodular to diffuse

89
Q

Skin disease?

A

subepidermal vesicle d/t burn

90
Q
A

atrophic dermatoses

comedones (blockes follicles)

91
Q

rounded up cells, hypereosinophilic, nuclear degeneration

A

dyskeratosis

92
Q

Epidermal change?

Common disease associated?

A

cutaneous atrophy

Cushing’s disease

93
Q

Conditions associated with panniculitis?

94
Q

skin disease pattern?

Condition?

A

perivascular dermatitis

culicoides hypersensitivity (biting midges)

95
Q

What type of acanthosis is the most common?

96
Q

What is the difference between angioedema and urticaria (types of edema in the dermis)?

A

BOTH = HIVES

angioedema- not well circumscribed area, edema involved dermis & SQ

urticaria- well cirumscirbed area, dermal edema

97
Q

Skin Disease?

A

nodular to diffuse dermatitis

98
Q

Sequelae of vasculitis?

What type of hypersensitivity often results in vasculitis?

A

thrombosis, ischemia, edema, hemorrhage, atrophy

Type III (immune complex)

99
Q

Describe the stages of hair cycle?

A
  1. anagen- growing (shedding)
  2. catagen- no cell proliferation, transitional stage
  3. telogen- resting phase
100
Q

Characteristics of interface dermatitis

A
  1. Hydropic degeneration/apoptosis in basal layer
  2. Band of lymphs, plasma cells, macs at the epidermal/dermal junction
  3. Pigmentary incontinence
  4. +/- Vesicles at interface
101
Q

With vasculitis, where do you want to look for lesions?

A

Extremities, pinna, tail, feet

102
Q

What is the dermis primarily made up of? (hint: two components)

A

collagen & elastin in a GAG substance

103
Q

Epidermal change?

A

skin atrophy

104
Q

leukoderma

leukotrichia

A

decreased pigmentation of skin

hair

105
Q

When is edema of the dermis observed? What are the two types?

A

Type I hypersensitivity rxns (immune)

non-immune: heat, cold, sunlight

angioedema & urticaria

106
Q

increases of GAG that trap water leading to myxedema & separation of collagen bundles in the dermis

107
Q
A

atrophic dermatoses

108
Q
A

panniculitis

109
Q

General epidermal change?

Condition?

A

apoptosis (individual cell necrosis)

erythema multiforme

110
Q

What conditions are associated with subcorneal, suprabasilar, and subepidermal vesicles/pustules?

A 
1. Subcorneal – superficial pyoderma,
pemphigus foliaceus (PMN & EOS)
  1. Suprabasilar – pemphigus vulgaris
  2. Subepidermal – bullous pemphigoid, SLE (severe lihenoid dermatoses), TEN, burns, EB (epidermal lysis bullosis)
111
Q

In what condition in cats is collagen atrophy observes where the skin will slough off?

A

Cushing’s

112
Q

Name two common changes in the SQ?

A

panniculitis

fat necrosis

113
Q

Three types of collagen mineralization?

A

dystrophic (calcinosis cutis)

metastatic (Vit D/Ca/P imbalance)

idiopathic

114
Q
A

Follicle surrounded by inflammatory cells

acantholysis in bottom picture with fungus

folliculitis/furunculosis

115
Q

most common type of skin disease pattern?

In general it suggests a ….

A

perivascular dermatitis

hypersensitivity

116
Q

Skin Disease?

A

nodular to diffuse

Dematiaceus fungi – nodule from a horse- traumatic implantation

117
Q

What is the gross and histo characteristics of panniculitis (inflammation of SQ fat)?

A

Histologically – inflammation of the
subcutis – nodular to diffuse
Grossly – papules and nodules that drain, oliy exudate

118
Q

This dog has hyperkeratosis.

You would describe it as (aka signs of scaling, crusting, greasiness)?

119
Q

This pitbull is showing signs of actinic dermatitis d/t solar damage. What type of epidermal abnormalitiy will likely be observed on histo?

A

dyskeratosis

dysplasia

120
Q

Skin Disease?

121
Q
A

intercellular edema (spongiosis)

122
Q
A

cutaneous atrophy in cat with Cushing’s

123
Q
A

acantholysis

124
Q

loss of melanin from the basal region of the epidermis d/t basal cell damage

A

pigmentary incontinence

125
Q

A dog presents with multiple papules, nodules that ulcerated and drained. The local l.n. are inflammed. Skin disease pattern?

A

nodular to diffuse

126
Q

increased thickness of stratum corneum

A

hyperkeratosis

127
Q

Condition?

General epidermal change?

A

erythema multiforme

apoptosis

128
Q
A

subcorneal pustular dermatitis

d/t acantholysis

PF

129
Q

What are the three main pathogenenic mechanisms for vaculitis and associated conditions?

A
  1. Type III (immune complex)- SLE
  2. Primary bacterial skin dz
  3. Bacterial septicemia (Erysipelothrix) or systemic infection w/ epithiotrophic agents (Rickettsii= RMSF)
130
Q

Two most common causes of atrophic dermatoses?

A

Hormonal imbalance
• Hyperadrenocorticism, hypothyroidism, sex hormone imbalance

Ischemia – if focal

131
Q

Form of hyperpigmentation in focal areas d/t melanocyte hyperplasia in orange,cream, tricolored cats (rare in dog).

A

lentigines

132
Q

surface collections of plasma leukocytes and often sequelae to vesicle,s bulla, or pustules

Systemic Pathology (8 decks)

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