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Dermatology > Pathology > Flashcards

Pathology Flashcards

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Dermatology Board Prep flashcards
1
Q

Aconthosis

A

Thickening of the epithelial layer

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2
Q

Parakeratosis

A

Keratin layer has persisting nuclei

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3
Q

Hyperkeratosis

A

Thickening of the keratin layer

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4
Q

Papillomatosis

A

Irregular epithelial thickening

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5
Q

Spongiosis

A

Oedema fluid between squames increasing prominence of intercellular prickles.

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6
Q

4 Classes of inflammatory skin diseases

A

Psoriaform
Vesiculobullous
Spongiotic
Lichenoid

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7
Q

Describe psoriaform inflammatory diseases

A

Involve elongation of rete ridges (downward thickening of the epidermis between the dermal pappillae)

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8
Q

Describe spongiotic inflammatory diseases

A

Intraepidermal oedema

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9
Q

Describe lichenoid disorders

A

Damage to the basal layer of the epidermis

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10
Q

Describe vesiculobullous disorders

A

Blistering

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11
Q

What is the dermis made up of?

A

Type 1 and Type 3 collagen in a matrix.
Ground substance
Elastic fibres

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12
Q

What are the two regions that the dermis is divided into?

A

The papillary dermis- thin, bundles of type 1 collagen

The reticular dermis- contains appendage structures, sweat glands, pilosebaceous units.

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13
Q

Pathological features of psoriasis

A

Unknown cause- however thought to be partly hereditary
Neutrophils gather in the upper layer of the epidermis- complement mediated due to no infection causing this.
Parakeratosis
Aconthosis
Blood vessels from the dermis come close to the surface- (Ausfitz sign, when scab is picked they bleed)
Dystrophic nails.

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14
Q

Pathological features of lichen planus

A

Irregular saw tooth aconthosis
Orthokeratosis- parakeratosis without the persisting of nuclei
Hypergranulosis (increased thickening of the stratum granulosum)
Band like upper dermal infiltrate of lymphocytes
Basal damage with formation of cytoid bodies.

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15
Q

What other pathological diseases resemble lichen planus?

A

Drug rashes

Discoid lupus

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16
Q

How can you distinguish between lichen planus and other similar pathological diseases?

A

Lichen planus generally involves the oral cavity.

17
Q

What is an immunobullous disorders?

A

Blisters are the PRIMARY feature unlike in most disorders where they are a secondary feature of disease.

18
Q

Pemphigus

A

Rare, autoimmune disease.
Loss of integrity of epidermal cell adhesion (they don’t stick together as well as they should)
Has 4 distinct subtypes- majority are pemphigus vulgaris.

19
Q

What does pemphigus respond to?

A

Steroids.

20
Q

Pathology of pemphigus vulgaris

A

Autoimmune disorder.
IgG antibodies attack desmoglien 3 (maintains desmosomal attachments. Immune complexes form on cell surface causing complement activation and protease release)

21
Q

Appearance of pemphigus vulgaris

A

Fluid filled blisters which rupture to form shallow erosions.

22
Q

Pathology of bullous pemphigoid

A

Sub-epidermal blister

No evidence of acantholysis (lysis of intercellular adhesion sites)

23
Q

Pathology of bullous pemphigoid

A

IgG antibodies react to the major/minor antigen on hemidesmosomes. Hemidesmosomes attach basal cells to the basement membrane. This means the basal cells can detach and blisters can form in the space left (sub-epidermally).
Also local complement activation and tissue damage.

24
Q

Dermatitis herpetiformis

A

Strong association with coeliac disease.

Rare, autoimmune bullous disease.

25
Q

Presentation of dermatitis herpetiformis

A

Intensely itchy symmetrical lesions.

Elbows, knees and buttocks often excoriated (skin has been removed)

26
Q

Pathology of dermatitis herpetiformis

A

Papillary dermal microabscesses
Neutrophil rich microabscess develop just below the epidermis
IgA mediated- target gliadin component of gluten
Granular lumpy deposits in tip of dermis.

27
Q

Pathological process of acne vulgaris

A

Increased androgen at puberty
Increased sensitivity of sebaceous glands to androgen
Keratin and sebum block the pilosebaceous units (causing black heads)
Rupture causes acute inflammation.

28
Q

Rosacea

A

Recurrent facial flushing
Visible blood vessels
Pustules forming
Thickening of the skin (rhinophyma)

29
Q

Pathology of rosacea

A

Vascular dilation (ectasia)
Patchy inflammation with plasma cells
Pustules
Perifollicular (around the hair follicle) granuloma formation.

30
Q

Causes of rosacea.

What can stop rosacea

A

Sunlight, alcohol, spicy foods, stress

Sometimes they respond to tetracyclines

Dermatology (21 decks)

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