Norton Part 5

Question 1

dermatofibroma is also known as what

Answer 1

benign fibrous histiocytoma

Question 2

dermatofibromas are what type of lesion and appear how

Answer 2

benign lesion, slow growing
single or multiple
flesh-colored to pigmented papule

Question 3

dermatofibromas are common where

Answer 3

lower legs

Question 4

the “dimple sign” is commonly seen in what and what is it

Answer 4

dermatofibromas

it depresses when squeezed

Question 5

what can be puritic and patients may complain it bleeds when they shave

Answer 5

dermatofibroma

Question 6

dermatofibromas are what

Answer 6

fibrous reaction to some past trauma to the skin

Question 7

what histological features are seen in dermatofibromas

Answer 7

benign proliferations of fibroblasts with collagen

may be overlying hyperkeratosis and hyper pigmentation (gives reddish brown color)

Question 8

what is the primary fibrosarcoma of the skin

Answer 8

dermatofibrosarcoma protuberans

Question 9

what characteristics are seen dermatofibrosarcoma protuberans

Answer 9

locally aggressive but rarely metastasizes
hypercellular
overlying epidermis is thinned

Question 10

dermatofibrosarcoma protuberans is found in what layers and appears how

Answer 10

expends from dermis into subcutaneous fat into a “honeycomb” pattern

Question 11

fibroblasts in a pinwheel pattern can be seen in what

Answer 11

dermatofibrosarcoma

Question 12

what are the tumors of the dermis

Answer 12

dermatofibroma

dermatofibrosarcoma

Question 13

mycosis fungoides is what the of cancer

Answer 13

t cell lymphoma that presents in the skin and may evolve into a generalized lymphoma

Question 14

mycosis fungoides is usually in what age group and found where

Answer 14

over 40 years old

usually on trunk

Question 15

what are the stages of mycosis fungoides

Answer 15

patch (early)- scaly, red-brown
plaque- raised, indurated, irregular, red, scaly
nodule (tumor)- fungating, red-brown; multiple large nodules often correlates with systemic spread

Question 16

what histological features are seen in mycosis fungoides

Answer 16

T-helper cells (CD4+ sezary cells) form bands in superficial dermis
invade epidermis as single cells or small clusters (paltrier micro abscesses)
nodular lesions grow deeply into dermis and spread asymmetrically

Question 17

Pautrier micro abscesses are what and found in what

Answer 17

T helper cells invading epidermis as single cells or small clusters
seen in mycosis fungoides

Question 18

what types of mastocytosis are there

Answer 18

urticaria pigmentosa

systemic mastocytosis

Question 19

urticaria pigmentosa is usually in what patients

Answer 19

children

Question 20

over 50% of mastocytosis cases are what

Answer 20

urticaria pigmentosa

Question 21

urticaria pigmentosa presents as what

Answer 21

multiple mastocytomas- round too oval, red-brown papule and plaques, pruritic and may blister
appear shortly after birth

Question 22

systemic mastocytosis is usually in what patients

Answer 22

adults

Question 23

systemic mastocytosis presents as what

Answer 23

skin lesions similar to urticaria pigmentosa plus multi-organ mast cell infiltration (bone marrow, liver, spleen, and lymph nodes)

Question 24

Darier sign is what

Answer 24

wheal (dermal edema and erythema) when skin lesion is rubbed

Question 25

Darier sign is associated with what

Answer 25

mastocytosis

Question 26

what are the signs and symptoms of mastocytosis

Answer 26

darier sign dermatographism in systemic- pruritis and flushing triggered by certain foods drugs, EtOH, temp changes

Question 27

what is dermatogrpahism and when is it seen

Answer 27

hive occurs when normal skin is stroked with a pointed instrument seen in mastocytosis

Question 28

fried egg cells are commonly seen in what

Answer 28

mastocytosis

Question 29

what histological features are seen in mastocytosis

Answer 29

metachromatic granules with dendritic mast cells monomorphous dermal infiltrate no epidermatoropism "freid egg cells"

Question 30

what stain helps visualize mast cell granules

Answer 30

giemsa

Question 31

congenital ichthyosis can be due to what

Answer 31

congenital ichthyosiform erythroderma (AR) lamellar ichthyosis (AR) X-linked ichthyosis ichthyosis vulgaris (AD or acquired)

Question 32

how can ichthyosis be acquired

Answer 32

ichthyosis vulgaris (associated with lymphoid and visceral malignancies)

Question 33

what histological features are seen in all ichthyosis

Answer 33

build up of compacted stratum corneum with loss of basket-weave pattern

Question 34

in what type of ichthyosis have stratus granulosum normal to slightly thickened

Answer 34

lamellar x-linked congenital ichthyosiform erythroderma

Question 35

in what type of ichthyosis have stratus granulosum thin or absent

Answer 35

ichthyosis vulgaris

Question 36

urticaria (hives) present with what

Answer 36

wheals (pruritic papules to edematous plaques) | lesions develop and disappear within hours but episodes may last for days to weeks

Question 37

urticaria is due to what

Answer 37

mast cell degranulation and subsequent microvascular hyperpermeability

Question 38

urticaria is common at what sites

Answer 38

trunk, extremities, ears

Question 39

what is the pathogenesis of urticaria

Answer 39

antigen-induced mast cell degranulation through sensitization with specific IgE antibodies

Question 40

urticaria follows exposure to what

Answer 40

multiple allergens (pollens, foods, drugs, insect venom)

Question 41

what histological features are seen in urticaira

Answer 41

superficial dermal perivenular infiltrare (neutrophils early then mononuclear) collagen bundles are more widely spread due to dermal edema dilated lymphatics from absorption of edema fluid usually no epidermal changes

Question 42

what is contact dermatitis

Answer 42

inflammatory reaction caused by an exogenous chemical

Question 43

what forms of contact dermatitis are there

Answer 43

irritant and allergic

Question 44

irritant contact dermatitis is produced by what

Answer 44

substance that has direct toxic effects on the skin (acid detergents, alkalis, frequent hand washing) not an immunologic condition

Question 45

irritant contact dermatitis the rash starts when

Answer 45

shortly after exposure

Question 46

allergic contact dermatitis is due to what

Answer 46

cell-mediated, delated-type hypersensitivity reaction (Type IV)

Question 47

what cells are mediating allergic contact dermatitis

Answer 47

langerhans cells (take up antigen on skin surface) move via dermal lymphatics present to CD4+ T cells

Question 48

sensitization occurs when in allergic contact dermatitis

Answer 48

1-2 week after 1st eposure

Question 49

reexposure causes dermatitis when in allergic contact dermatitis

Answer 49

hours to days

Question 50

what are common allergens that produce allergic contact dermatitis

Answer 50

poison ivy, mangos, iodine, nickel, rubber, cosmetics

Question 51

what is urushiol

Answer 51

common allergenic substance produced in allergic contact dermatitis

Question 52

describe the fluid in the vesicles of allergic contact dermatitis

Answer 52

does not contain allergen and cannot induce disease in others

Question 53

what are the clinical features of allergic contact dermatitis

Answer 53

erythematous papule and vesicles with oozing crusting and scaling very pruritic

Question 54

how is allergic contact dermatitis diagnoses

Answer 54

``` clinically based on H&P, job, hobbies patch testing (non responsive rash or recurring rash) ```