Path 3 Flashcards
storiform/spindle shaped fibroblasts, whirling, excess collagen, hyperpig rete ridges, nonencap mass into subq fat, dimple sign vs t17;22, storiform radial fibroblasts, into subq fat, Factor 3a; imatinib
Dermarofibroma vs dermatofibrosarcoma
in dermis, pruritus, bone pain, osteopenia/porosis, high ALP/LDH/LFT, tryptase/CD25/117
Mastoctytosis
Miescher granuloma, T4HS, deep incisional bx, w/o vasculitis vs punctuated fat lobule -> nec adipocytes -> caseous nec, T4HS, clinical dx or PPD+, w/ vasculitis
Erythema nodusum vs induratum
inc IL4/13, IL5, IL22; spongiosis into epi/dermis, in/extrinsic, acute and subacute/chronic vs urease & protease/lipase -> FFA, nec keratinocytes, dx by clin or patch test vs T4HS: exposure, sensitization, elicit; dx by patch test on unaffected skin
Atopic dermatitis vs irritant contact dermatitis vs allergic contact dermatitis
chronic/vulgaris, guttate, pustular, erythrodermic, inverse, nail (4) vs seroneg spondyloarthropathy, ocular/aortic valve/enthesitis, neg RF & antiCCP
Psoriasis vs psoriatic arthritis
lipid dependent; tx w/ selenium vs band like lymphocytes, civatte bodies, saw tooth, 4 P’s; tx w/ topical steroids
Seb dermatitis vs lichen planus
Congen POMC defic. How does melanosome degrad determine pig?
AR POMC -> nó ACTH/MSH -> red hair, hypopig, adrenal insufficiency, early obesity, hyperphagia. Light skin -> melanosomes small cluster -> faster degrad in spin pain; dark skin -> lg & dispersed -> slower degrad in corneum
Circumscribed vs linear vs general morphea
No internal organs. Epi/dermis w/ epidermal atrophy; dermis/subq w/ atrophy & thick skin vs deep dermis/subq/mm/bone; en coup vs deep dermis/subq/fascia/superficial mm; >/= 4 plaques, >3cm, >2 diff sites
3 main mechanisms for systemic scleroderma
Autoab: ANA, centromere, topo I, RNA pol; endothel cell fibroprolif: imbal vasodil/constrict, thick intima, TGFB/IL1/4/6/PDGF; fibroblast dysfunction: inc collagen in pap/ret dermis.
Extra manifestations of systemic scleroderma
Tight puffy fibers in AM, telanfiectasia; Raynaud, dil capillaries, hem in cuticles; hypomotility GI, watermelon stomach, diverticulosis; proteinuria, inc Cr, tx w ACEI; pulm fib/HTN, DOE; MI, pericardial effusion; arthralgia, synovitis; trigem neuropathy, polyneuropathy; nailfold capillaroscopy (nó giant in late)
AD, nests of hyaline eos BM from laminin 5 defect, from eccrine glands, jigsaw/mosaic vs intradermal eccrine gland; tx is cosmetic
Cylindrical vs syringoma
Keratoacanthoma vs raised nodule covered by erythema skin esp head/neck, pos for CK20, synaptophysin, chronogranin A, neuro enolase
Concentric sq cells, Par3. Rapid prolif: central keratin crater; maturation: dome w central keratin plug/hair/fraf; involution: eject central plug, mass resorption, spont resolution vs Merkel cell ca
macroceph, frontal boss, bifid ribs, wedge vertebrae, ectopic calc, cardiac/ov fibromas, medulloblastomas; PTCH vs neuro -> no DTR, ataxia, nystagmus, sz, dil ventricles, thick skull bones
Nevoid basal cell carcinoid syndrome vs xeroderma
AD CDKN2A Screen whole skin body for melanoma at 10yo and f/u q6mo
FAMMM syndrome
