Pathology - Introduction to Dermatopathology

Question 1

thin walled benign structure

Answer 1

cyst

Question 2

dermal inflammation, main change - accumulation of fluid in the epidermis causing epidermal cells to separate out (spongiosis) indicates what

Answer 2

eczema

Question 3

hyperplasia of the epidermis and inflammation , often with thickened plaques on extensor areas indicates what

Answer 3

psoriasis

Question 4

granulomatous inflammation that can be caused by infection

Answer 4

sarcoid

Question 5

sarcoidosis

Answer 5

chronic granulomatous disorder
affects lung skin and eyes
characterised by accumulation of lymphocytes and macrophages

presentation - cough, breathless, age 20-50, family history, Scandinavian origin

treatment - corticosteroids for skin triamcinolone

if caused by tb - typically get necrosis at the centre

Question 6

pigment and granulomas

Answer 6

reaction to tattoo ink

Question 7

*PT

lots of red cytoplasm cells - eosinophils seen histologically

Answer 7

drug reaction

Question 8

histology showing more cells than usual, necrosis of blood vessel walls, red blood cells leaked out into surrounding tissue

Answer 8

vasculitis

can get in gall bladder, kidneys , lungs, stomach

Question 9

in which condition don you get purple nodules on lower legs

Answer 9

cutaneous vasculitis

can be mistaken as as a consequence of sepsis you can then get vasculitis - non blanching rash as blood has left vessels and can’t go back in

Question 10

female patient in early 20s , damage to epithelium from external source , rest of epithelium normal

Answer 10

Dermatitis artefacta or factitious dermatitis is a psychocutaneous disorder in which the patients consciously create lesions in skin, hair, nail, or mucosae to satisfy a psychological need, attract attention, or evade responsibility

Question 11

epidermal cells starting to differentiate into cancer cells haven’t invaded downwards through the basement membrane into the dermis - enlarged nuclei

Answer 11

Bowens disease (carcinoma in situ)

precancerous condition
linked to sun exposure

Question 12

histology shows infiltrating malignant cells with keratin production

Answer 12

squamous cell carcinoma

Question 13

most common skin cancer, dark staining cells

Answer 13

basal cell carcinoma

DOES NOT SPREAD TO LYMPH NODES
locally destructive

Question 14

cancer arising form epidermis , linked to sun exposure , grows down into dermis , melanocytes, lots of necrosis and mitotic figures

Answer 14

malignant melanoma

Question 15

the measurement of the depth of the melanoma from the surface of your skin down through to the deepest point of the tumour

Answer 15

breslow thickness

Question 16

A 35 year old man has a suspicious skin lesion removed from his arm.
Histology shows malignant cells in the dermis. The cells have abundant cytoplasmic pigment.
Which diagnosis is most likely?
a) Basal cell carcinoma
b) Malignant melanoma
c) Small cell carcinoma
d) Squamous cell carcinoma
e) Tattoo pigment

Answer 16

b) Malignant melanoma

Question 17

A 75 year old man has a scaly lesion on his scalp.
A punch biopsy shows numerous neoplastic epithelial cells which are confined to the epidermis. There is no invasion through the basement membrane into the dermis.
Which diagnosis is most likely?

a) Basal cell carcinoma
b) Carcinoma in situ
c) Malignant lymphoma
d) Malignant melanoma
e) Squamous cell carcinoma

Answer 17

b) Carcinoma in situ

Question 18

A 75 year old man has a scaly rash affecting his elbows and knees in keeping with psoriasis.
A punch biopsy is taken.
Which histology would support the clinical impression?

a) Caseating granulomas
b) Eosinophils in the dermis
c) Epithelial hyperplasia
d) Non caseating granulomas
e) Vessel wall injury

Answer 18

c) Epithelial hyperplasia

Question 19

A 35 year old man has a purpuric rash on his lower legs.
A punch biopsy is performed.
Which histology is most likely?
a) Blood vessel wall injury
b) Caseating granulomas
c) Eosinophils in the dermis
d) Epithelial hyperplasia
e) Non caseating granulomas

Answer 19

e) Non caseating granulomas

non caseating are caused by inflammation conditions

caveating are caused by infections

Question 20

A 78 year old woman has a new widespread rash shortly after starting a new medication.
A drug reaction is suspected. A punch biopsy is performed.
Which cells if present in the dermis would support the clinical impression?
a) Endothelial cells
b) Eosinophils
c) Macrophages
d) Melanocytes
e) Neutrophils

Answer 20

b) Eosinophils