Pathology of Rashes

Question 1

Which type of dermatitis has a strong connection with coeliac disease?

Answer 1

Dermatitis herpetiformis

Question 2

Pemphigus vulgaris is ____ mediated

Answer 2

Pemphigus vulgaris is IgG mediated

Question 3

Pemphigus vulgaris is an autoimmune condition

True or false?

Answer 3

True

Question 4

After taking a skin sample in a patient with rosacea, what is often seen under microscopy?

Answer 4

Demodex folliculorum mites

(in the pilosebaceous units)

Question 5

In which situation may bellous pemphigoid mimic pemphigus vulgaris?

Answer 5

Older lesions of bullous pemphigoid heal and re-epithelialise making the lesions look as if they have involved the epidermis

Question 6

Which type of pemphigus is the most common?

Answer 6

Pemphigus vulgaris

Question 7

How does pemphigus vulgaris often begin?

Answer 7

Mouth blisters

Question 8

How can pemphigus foliaceus be differentiated from pemphigus vulgaris?

Answer 8

Mouth blistering does not occur

Question 9

Which type of pemphigus is described by:

“Thick painful lesions develop in the groin and axilla region”?

Answer 9

Pemphigus vegetans

Question 10

Which type of pemphigus is described by:

“Blistering usually begins on the face and scalp which progresses to the chest and back. Blisters are not sore, but itchy. The skin is host to numerous moist scales and there are no mouth ulcers”

Answer 10

Pemphigus foliaceus

Question 11

What is the least harmful variant of pemphigus?

Answer 11

IgA pemphigus

Question 12

IgA pemphigus is most visually similar to which other form of pemphigus?

Answer 12

Pemphigus foliaceus

Question 13

Which type of pemphigus is very rare and associated with people suffering from cancer?

Answer 13

Paraneoplastic pemphigus

Question 14

What are potential signs and symptoms for paraneoplastic pemphigus?

Answer 14

1. Mouth and lip sores
2. Lesions on the eye and eyelid lining
3. Skin blistering
4. Serious lung issues

It is a very challenging condition to diagnose

Question 15

Which features are associated with Rosacea?

Answer 15

1. Recurrent facial flushing
2. Telangiectasia
3. Pustules
4. Thickening of the skin
5. Rhinophyma

Question 16

Rosacea is more common in which gender?

Answer 16

Females

Question 17

Where are blisters usually present within the skin in a patient with bullous pemphigoid?

Answer 17

Basement membrane of the epidermis

Question 18

Which factors can aggravate rosacea?

Answer 18

1. Hot/spicy food
2. Exercise
3. Emotion
4. Alcohol
5. Sunlight

Question 19

Which term refers to the persistance of nuclei within the keratin layer?

Answer 19

Parakeratosis

Question 20

What is the process behind the development of pemphigus vulgaris?

Answer 20

1. IgG antibodies form to desmoglein 3
2. Desmosomal attachments are destroyed as immune complexes form and complement/proteases are released
3. Blisters form
4. Acantholysis occurs - the loss of intercellular connections

Question 21

Spongiotic oedema is characteristic of which condition?

Answer 21

Eczema

Question 22

In psoriasis, new lesions form at sites of trauma, what is the term given to describe this?

Answer 22

Koebner phenomenon

Question 23

What do immunobullous diseases involve?

Answer 23

Formation of vesicles and bullae

Question 24

What is the epidermal basement membrane composed of?

Answer 24

Laminin and collagen type IV

Question 25

Why does acne affect adolescents worse than other age groups?

Answer 25

1. Androgens increase the size of sebaceous glands 2. Sebum production increases

Question 26

Which factor is common to all type of pemphigus

Answer 26

Acantholysis

Question 27

Which type of collagen is bundled in the reticular dermis?

Answer 27

Type 1

Question 28

What is the hallmark of dermatitis herpetiformis?

Answer 28

Papillary dermal microabscesses

Question 29

In which way do melanocytes look distinctive?

Answer 29

Cells with a pale halo

Question 30

Which type of people does pemphigus characteristally affect?

Answer 30

Ashkenazi Jewish origin

Question 31

Which type of people does bullous pemphigoid characteristically affect?

Answer 31

Elderly

Question 32

Bullous pemphigoid heals without scarring True or false?

Answer 32

True

Question 33

What is shown around the basement membrane upon fluoresence in a patient with bullous pemphigoid?

Answer 33

IgG and complement

Question 34

Which genes are associated with a higher risk of dermatitis herpetiformis?

Answer 34

1. HLA-DQ2 2. HLA-DQ8

Question 35

What is targerted by the immune system in dermatitis herpetiformis?

Answer 35

Epidermal transglutaminase (found in dermal capillaries, basal cells of the epidermis)

Question 36

Which condition involves IgG antibodies reacting with antigen within hemidesmosomes, complement activation and tissue damage?

Answer 36

Bullous pemphigoid

Question 37

What causes dermatitis herpetiformis?

Answer 37

IgA deposition in the dermis

Question 38

Irregular sawtooth acanthosis is characteristic of which condition?

Answer 38

Lichen planus

Question 39

Which term(s) can describe an irregular thickening of the epithelium?

Answer 39

1. Acanthosis 2. Papillomatosis

Question 40

Which sign is described by: "Punctate bleeding spots where the scales are scraped off in psoriasis"

Answer 40

Auspitz sign

Question 41

What mediates lichen planus?

Answer 41

T cells

Question 42

Where does lichen planus most commonly affect?

Answer 42

1. Ankles 2. Wrists 3. Mouth 4. Back 5. Legs 6. Genitalia

Question 43

How may the lesions in lichen planus be described?

Answer 43

1. Itchy 2. Flat-topped 3. Red/purple in colour 4. Shiny

Question 44

What is the term given to: "A fine surface network of white lines or dots" And in which condition is it seen?

Answer 44

Wickham's striae Lichen planus

Question 45

How can the irritation experienced by lichen planus be treated?

Answer 45

Topical steroids (fairly potent) (lichen planus is a self-limiting condition)

Question 46

Where are melanocytes found in the skin?

Answer 46

Dermo-epidermal junction

Question 47

What is spongiosis?

Answer 47

Oedema between cells in the epidermis

Question 48

Which condition is associated with Munro's microabscesses?

Answer 48

Psoriasis (collections of neutrophils attracted from the papillary dermis to the keratin layer by complement release)

Question 49

Which type of dermis houses the appendage structures?

Answer 49

Reticular dermis

Question 50

Which clinical signs are characteristic of psoriasis?

Answer 50

1. Auspitz sign 2. Munro's microabscesses 3. Rete pegs fusion

Question 51

Lichenoid disorders are characterised by damage in which location in the skin?

Answer 51

Basal epidermis