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Pathology Flashcards

1
Q

name an endocrine function of the skin

A

UV stimulation of vit D

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2
Q

describe the cells making up the epidermis

A

stratified keratinising squamous epithelium

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3
Q

what does the germinal layer make

A

is the basal layer of the epidermis- makes epidermis

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4
Q

name a granule in the granular layer

A

keratohyalin granules

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5
Q

what cells make up the corneal layer

A

differentiated keratinised cells

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6
Q

what cells shed from skin surface creating house dust

A

corneocytes

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7
Q

where are melanocytes found

A

in basal layer

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8
Q

how is pigment transferred to keratinocytes

A

via dendritic processes

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9
Q

where are langerhans cells located

A

upper and mid epidermis

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10
Q

what do langerhan cells do

A

dendritic

monitor environment for antigens (sentinels- indicator of presence of a disease)

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11
Q

how do langerhans cells initiate inflammation

A

antigens taken up by dendritic cells and make them more immunogenic

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12
Q

what types of collagen make up the dermis

A

type 1 and type 111

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13
Q

describe the papillary dermis

A

thin, lies just beneath epidermis

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14
Q

what is the reticular dermis

A

thicker bundles of type 1 collagen containing appendage structures (sweat glands, pilosebaceous units)

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15
Q

what is the epidermal basement membrane made from

A

laminin and collagen IV

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16
Q

what are the components of the dermis

A

is a matrix of type 1 and type 111 collagen, elastic fibres and ground substances (hyaluronic acid and chondroitin sulphate)

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17
Q

what is hyperkeratosis

A

increased thickness of keratin layer

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18
Q

what is parakeratosis

A

persistence of nuclei in the keratin layer resulting in epidermis turning over too quickly

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19
Q

what is acanthosis

A

increased thickness of epithelium

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20
Q

what is papillomatosis

A

irregular epithelial thickening (causes diabetic thick, velvety plaques in axilla)

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21
Q

what is spongiosis

A

oedema fluid between squames (epithelial cells in the epidermis) appears to increase prominence of intercellular pricles

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22
Q

what is the pathological hallmark of eczema

A

spongiosis

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23
Q

what happens if spongiosis is severe

A

vesicles filled with oedema fluid appear

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24
Q

what are the four main reaction patterns of inflammatory skin diseases and the diseases they are associated with

A

spongiotic- intraepidermal oedema (eczema)

psoriasiform-
elongation of the rete ridges

lichenoid- basal layer damage (lichen plaus and lupus)

vesiculobullous - blistering (pemphigoid, pemphigus, dermatitis herpetiformis)

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25
what common chronic inflammatory dermatosis has epidermal hyperplasia resulting in increased epidermal turnover causing thickened scales
psoriasis
26
what are munro micro abscesses seen in
psoriasis
27
describe the morphology of psoriasis
well defined plaques of erythema with prominent scales, very often symmetrical on the extensor surfaces (adults)
28
what is guttate psoriasis
psoriasis that presents as many small lesions over the upper trunk and proximal extremities
29
what can psoriasis cause in the nails
nail dystrophy; pitting, onycholysis (separates from nail bed), subungual hyperkeratosis, colour change, fungal nail infections
30
what is auspitz sign
when you pick a scale of a psoriasis plaque it may bleed due to the closeness of the vessels to the epidermis
31
what is seen histologically in psoriasis
elongation of rete ridges, aggregates of neutrophils in the surface
32
what are linchenoid disorders characterised by
damage to basal epidermis
33
describe the morphology of lichen planus
itchy flat topped violaceous papules
34
what is seen histologically in lichen planus
irregular sawtooth acanthosis hypergranulosis and orthohyperatosis band like upper dermal infiltrate of lymphocytes basal damage with formation of cytoid bodies
35
name 2 other lichenoid disorder that resemble lichen planus
discoid lupus, drug rashes
36
name 2 other lichenoid disorders that have marked mvacuolar interface change
erythema multiforme, toxic epidermal necrolysis
37
when do you get pigment in the dermis
when basal epidermis is damaged eg lichenoid disorders
38
give examples if 3 skin diseases where vesicles and bullae occur as a secondary phenomenum
eczema, herpes virus infection, burns
39
are blisters in immunobullous diseases a secondary or primary feature
primary
40
give three examples of immunobullous diseases
pemphigus, bullous pemphigoid, dermatitis herpetiformis
41
describe pemphigus
rare autoimmune bullous disease causing loss of integritity of of epidermal cell adhesion (desomosome attachments)
42
what is the most common type of pemphigus
4 types, 80% of cases= pemphigus vulgaris
43
what treatment does pemphigus respond to
steroids
44
describe the pathophysiology of pemphigus vulgaris
IgG auto-antibodies made against desmoglein 3 (which maintains desmosomal attachments) immune complexes form on cell surface complement activation and protease immune mediator response disruption of desmosomes =ACANTHOLYSIS
45
what is acantholysis
lysis of intercellular ahesions sites- resulting in loss of cohesion between keratinocytes
46
describe the presentation of pemphigus vulgaris
fluid filled blisters which rupture to form shallow erosions involves scalp, face, axillae, groin and trunk - may affect mucosae in mouth, resp tract etc
47
what is the common variable across all types of pemphigus
acantholysis- lysis of intercellular adhesion sites
48
what is seen sticking to the dermis in pemphigus vulgaris
basal layer if epithelium as antibodies dont affect this connection
49
describe the pathophsyiology of bullous pemphigoid
circulating antibodies IgG react with a major and/or minor antigen of the hemidesmosomes (which usually anchors basal cells to the basment membrane) = local complement activation and tissue damage, basement membrane detaches from epidermis, space inbetween fills with fluid and inflammatory cells
50
where are the blisters in skin in bullous pemphigoid
subepidermal blister
51
what do the autoantibodies attack in bullous pemphigoid
hemidesmosomes and basement membrane
52
what is the dermal papillae
small, nipple like projections of the dermis into the epidermis (create fingerprints)
53
what does immunofluorescence show in bullous pemphigoid
linear IgG and complement depositied around the BM
54
why do you always send early lesions of bullous pemphigoid to histology
as late lesions shoe re-epithelialisation of their floor mimicking pemphigus vulgaris
55
difference between bullous pemphigoid and pemphigus vulgaris blisters
vulgaris burst very easily pemphigoid tense and well defined, sub epidermal
56
what is dermatitis herpetiformis
autoimmune bullous disease
57
what other conditions is dermatitis herpetiformis associated with
coeliac disease
58
what gene is associated with dermatitis herpetiformis
HLA-DQ2 haplotype
59
describe the lesions in dermatitis herppetiformis
intensely itchy lesions, symmetrical, elbows knees and buttock
60
what is the hallmark of dermatitis herpetiformis
papillary dermal microabscesses
61
what seen histologically in dermatitis herpetiformis
papillary dermal microabscesses neutrophils in upper dermis deposits of IgA in dermal papillae
62
why do 90% of dermatitis herpetiformis patients have gluten sensitive enteropathy
IgA in dermal papillae target gliadin component of gluten but cross react with connective tisse matrix proteins immune complexes form in dermal papillae and activate complement and generate neutrophil chemotaxins
63
what does the distribution of acne (face, upper back, anterior chest)
sebaceous glands
64
describe the aetiology of acne vulgaris
increased androgens at puberty, keratin and sebum plugging of pilosebaceous units keratin and sebum build up to produce comedones (black and white heads) infection with anaerobic bacterium corynebacterium acnes rupture causes inflammation and foreign body graulomas
65
what is the presentation of rosacea
recurrent facial flushing visible blood vessels pustules thickening of skin- rhinophyma
66
what can trigger rosacea
sunlight, alcohol, spicy foods, stress, sometimes tetracyclines
67
what is seen pathologically in roscaea
vascular ectasia (small, dilated blood vessels) patchy inflammation with plasma cells pustules perifollicular granulomas follicular demodex mites often noted
68
where do demodex mites live
in sebaceous duct

Dermatology (23 decks)

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