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Dermatology > Pathology > Flashcards

Pathology Flashcards

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Dermatology Board Prep flashcards
1
Q

2 types of dermis

A

Papillary dermis - thin

Reticular dermis - thick, type I collagen

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2
Q

Dermis collagen types

A

I and III

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3
Q

Hyperkeratosis

A

thickening of keratin layer

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4
Q

Parakeratosis

A

peristence of nuclei in keratin layer

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5
Q

Acanthosis

A

thickening of epithelium

psoriasis

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6
Q

Papillomatosis

A

Irregular epithelium thickening

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7
Q

Spongiosis

A

Fluid between squames
Vesicles
Eczema

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8
Q

Koebner phenomonen

A

Eczema at site of trauma

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9
Q

Auspitz sign

A

Pinpoint bleeding in psoriasis

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10
Q

Microabscesses of munro

A

Psoriasis

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11
Q

Features of rosacea

A 
Women
Facial flushing
Visible blood vessels
Malarerythmea
Pustules
Rhinophyma (thickening of skin)
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12
Q

Treatment of rosacea

A

Tetracycline

Avoid spicy food/alcohol

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13
Q

Pathology of rosacea

A

Demodex mite
Vascular ectasia
Patchy inflammation with plasma cells
Perifollicular granulomas

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14
Q

Aetiology of acne

A

Increased androgens at puberty
More sebum produced
Plugging of pilosebaceous units
Infection with P acnes

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15
Q

Immunobullous disorders

A

Pemphigus
Pemphigoid
Dermatitis herpetiformis

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16
Q

Pemphigus

A 
Middle age
IgG antibodies agaisnt desmoglein
Damage to desmosomes
Acantholysis
May affect mucosa
Blisters rupture to form shallow erosions
IgG chickenwire
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17
Q

Pemphigoid

A 
Elderly
No acantholysis
Damage to hemi-desmosomes
Epidermis separates from basement membrane
Linear IgG on basement membrane
Tough tense blisters
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18
Q

Dermatitis herpetiformis

A

Coeliac
Symmetrical itchy lesions, elbows, knees, buttocks
Papillary dermal microabscesses
Granular IgA in dermal papillae - targets gliadin (in gluten)
Immune complexes in dermal papillae

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19
Q

Melanocytes derived from:

A

Neural crest

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20
Q

Melanocytes are in what layer?

A

Basal layer

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21
Q

Eumelanin

A

Brown/black

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22
Q

Phaeomelanin

A

Red

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23
Q

MC1R protein

A

Turns phaeomelanin into eumelanin

24
Q

One defective copy of MC1R

A

Freckling

25
Q

2 defective copies of MC1R

A

Red hair and freckles

26
Q

Ephilides

A

Freckles
Patchy increase in melanin pigmentation, clumpy distribution of melanocytes
Fair skin, red head

27
Q

Actinic lentigines

A

Age/liver spots
UV exposure
Increase in melanin

28
Q

Melanocytic naevi

A

Mole

Usual/Dysplastic/Spitz/Blue

29
Q

How are simple naevi formed?

A

Melanocyte:Keratinocyte ratio breaks down

30
Q

Junctional naevus

A

Clusters of melanocytes at DEJ

31
Q

Compound naevus

A

Clusteres at DEJ and in dermis

32
Q

Intradermal naevus

A

Clusters in dermis

33
Q

Dysplastic naevi

A

Irregular border
Architechtural and cellular atypia
Fibrosis and inflammation
Increased risk of cancer

34
Q

Halo naevi

A

Halo of depigmentation around mole = inflammatory regression

35
Q

Blue naevi

A

Dermal

Dendritic spindle cells

36
Q

Spitz naevi

A

Benign juvenile melanoma, less than 20 years old - benign
Pink - vasculature
Epidermal hyperplasia

37
Q

Malignant melanoma

A

Females, middle age
De novo or dysplastic naevi
Childhood sunburn
Exposed sites

38
Q

When to suspect melanoma

A 
Irregular border
Different colours
Ulceration
Changes shape
Bleeding
New
ABCDE - asymmetry, border, colour, diameter, evolution
39
Q

Superficial spreading melanoma

A

Commonest type

Trunk and limbs

40
Q

Acral lentiginous melanoma

A

Palms/soles

41
Q

Lentigo maligna

A

Sun damaged face/neck/scalp

Large liver spot

42
Q

Nodular melanoma

A

Trunk

VGP - more aggressive

43
Q

When can melanoma metss?

A

Vertical growth phase

44
Q

Prognosis of melanoma

A

Breslow depth and ulceration

Deepest tumour from granular layer

45
Q

What suffix indicates melanoma ulceration?

A

b

e.g. pT3b

46
Q

How does melanoma mets?

A

Local lymph - satelline deposits
Regional node mets
Blood to skin, liver, brain, heart, lungs, GIT

47
Q

Treatment of melanoma

A

Surgery
Remove nodes
Chemotherapy
Immunotherapy (BRAF inhibitor)

48
Q

Sebhorreic keratosis

A 
Ageing skin
Benign proliferation of keratinocytes
Face and trunk
Stuck on, greasy
Horn, acanthosis, hyperkaratosis
49
Q

Leser Trelat sign

A

Eruptive appearance of many seborrheic keratoses in short period of time = malignant

50
Q

BCC

A

Middle aged/elderly
Sun exposed sites
Peripheral palisading, Telangiectasia, well circumscribed, pearly, cords of basal cells
Slow growing, hardly ever mets

51
Q

Precursors of SCC

A

Bowen’s - legs
Actinic keratosis - head/neck/back of hands
Viral lesions

52
Q

Precursors of SCC show:

A

squamous dysplasia

53
Q

Bowen’s disease

A

SCC in situ
Elderly females, lower leg
Scaly patch/plaque, irregular border, no dermal invasion

54
Q

Diagnosis of Bowen’s

A

Punch biopsy

55
Q

Actinic keratosis

A

Sun exposed skin - scalp, hands, face
Precursor of invasive SCC
Crust, elongated rete ridges

56
Q

Viral precursors of SCC

A

Erythroplasia of Queyrat - Bowens of penis

HPV 16 = dysplasia

Dermatology (10 decks)

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