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D&T test 6 - endocrine, dermatology, MSK > Path: Skin: One > Flashcards

Path: Skin: One Flashcards

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Dermatology Board Prep flashcards
1
Q

what is the Benign epithelial tumor?

A

seborrheic keratosis

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2
Q

What is chc histo of seborrheic keratosis

A

“Horn Cysts” = epidermal invaginations filled with keratin

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3
Q

What is gross appearance of seborrheic keratosis

A

waxy, “stuck on” appearance

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4
Q

What sign is assc with seborrheic keratosis and what is it?

A

Leser-Trelat sign: Large explosion of multiple seborrheic keratosis

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5
Q

What causes leser trelat?

A

transforming GFα (produced by tumor cells)

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6
Q

What does appearance of Sign of Leser-Trelat signify

A

underlying carcinoma of GI tract

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7
Q

define acanthosis nigricans

A

reactive hyperplasia in response to growth factors

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8
Q

how does acanthosis nigricans present

A

Velvety thickened, dark skin most commonly in flexural areas

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9
Q

What 2 conditions is acanthosis nigricans assc with

A

□ Obesity and endocrine abnormalities (DM)

Gastric carcinoma

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10
Q

what causes Actinic keratosis

A

sun exposure

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11
Q

What does actinic keratosis progres to

A

SqCC

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12
Q

3 findings on histo of actinic keratosis

A

parakeratosis
□ Dysplasia of lower epidermis
Solar elastosis

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13
Q

what is 1st and 2nd MC skin cancers

A
  1. Basal cell CA

2. SqCC

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14
Q

WHat 3 things cause SqCC and what is MC

A

MC = sun exposure
arsenic
immunosuppression

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15
Q

what genetic condition predisposes to SqCC

A

xeroderma pigmentosum

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16
Q

gross SqCC

A

red/flesh colored

ulcerative

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17
Q

Histo of SqCC (4)

A

dysplasia of entire dermis
extension of tumor into dermis
squamous “pearls”
solar elastosis

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18
Q

Metastasis difference between SqCC and BCC

A

Sq - may mets

BCCrarely mets

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19
Q

risk for BCC (2)

A

chronic sunlight exposure

Nevoid Basal Cell CA Syndrome (NBCCS)

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20
Q

Gross BCC (3)

A

pink, pearly nodules
telangiectasia
central ulceration (rodent chewed)

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21
Q

Histo BCC

A

Retraction artifact - pulls away from dermis

Peripheral pallisading- cells line up like a fence

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22
Q

What is Nevoid Basal Cell CA Syndrome (NBCCS), and age it occurs

A

mutiple BCCs < 20yo

23
Q

What gene and what gene product are invloved in NCCBS

A

PTCH gene

SHH gene product = increase in “smoothened”

24
Q

Keratocacanthoma: variant of what CA,

A

SqCC

25
Q

Keratocacanthoma: gross

A

gross: cup shaped, keratin-filled plug

26
Q

Vitiligo may respond to what?

A

May respond to light therapy (PUVA)

27
Q

Define Lentigo, contrast with ephelis

A

Benign localized hyperplasia of melanocytes

vs. ephelis = freckle (increased melanin but not increased melanocytes)

28
Q

lentigo micro

A

melanocytic hyperplasia with Elongation of rete pegs

29
Q

define nevi (size too)

A

3 or more melanocytes in a nest < 5mm

30
Q

define
Junctional nevus
intradermal nevus
compund nevus

A

Junctional nevus = growth within epidermis
Intradermal nevus = melanoctyes only in dermis
Compund nevus = melanocytes in epidermis and dermis

31
Q

histo features of nevi

A

no dermal mitotic figures

“maturation” nuclei get smaller with descent into dermis

32
Q

other than size, what is unique about congenital nevi

A

Slightly increased risk for melanoma

33
Q

with dysplastic nevi, what signifies increased risk of melanoma

A

increasing number of lesions

34
Q

MC and other risk factors for melanoma (5)

A

MC = sunlight

others: Dysplastic moles; genetic factors; congenital nevi; blistering sunburns; xeroderma pigmentosa

35
Q

clinical warning signs of melanoma (3)

A

enlarging or new mole as adult
itching or painful mole
ABCDE

36
Q

what does ABCDE stand for

A 
® Assymmetry
					® Border
					® Color
					® Diameter
Evolution
37
Q

Contrast radial growth phase with vertical growth phase in melanoma

A

radial = in-situ; horizontal growth in epidermis and superficial dermis

vertical = significant invasion into dermis, mets potential

38
Q

what is best prognostic indicator of metastasis risk in melanoma

A

Breslow thickness = depth of dermal invasion ()

39
Q

how is breslow measured

A

Measured from granulosa cell layer to deepest melanoma cell

40
Q

what Breslow depth warrants sentinel node procedure

A

> 1mm

41
Q

histo of melanoma (3)

A

abscence of maturation (nuclei same size as depth increases)

single cell breakaways

42
Q

4 types of melanoma (MC?)

A

MC = superficial spreading, good px
lentigo maligna = radial (horizontal growth) = good px
nodular = vertical = bad px
acral lentiginous = palms/soles/dark skinned/ not uV related

43
Q

favorable px indicators Breslow depth less than?

A

Breslow depth less than 1.7 mm

44
Q

favorable px indicator: M or F

A

female

45
Q

favorable px indicator: extremity or ttruncal lesion

A

extremity is better

46
Q

What 2 mutations is assc with melanoma (activating/deletion?)

A

activation of BRAF (a typrisne kinase)

deletion of p16INK4A

47
Q

BRAF is part of what kinase pathway (3)

A

RAS/RAF/MAP

48
Q

what 3 things are in patho report for melanoma

A

1) Breslow depth
2) Presence/absence of ulceration
Mitotic index

49
Q

What cell and type of tumor is mycoses fungioides

A

cutaneous T cell lymphoma

50
Q

What does early mycoses fungioides mimic and what is it’s progression

A

mimcs eczema –> patch (flat, bigger than macule) –> plaque (elevated, solid > 1cm) –> nodule

51
Q

Histo of mycosis fungioides (cutaneous T cell lymphoma) (2)

A
  1. Epidermotropism: lymphocytes in dermis and epidermis (without spongiosis)
  2. Sezary cell- cerebriform contours to nuclei
52
Q

WHat is Sezary Syndrome (aka)

A

Seeding of blood by malignant lymphocytes in mycosis fungiooides
aka: erythrodermic stage

53
Q

CP of Sezary Syndrome

A

all skin is itchy and red

54
Q

what is mycoses fungiodes essentially a disease of?

A

CD4+ clonal subset of T cells

D&T test 6 - endocrine, dermatology, MSK (22 decks)

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