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Systemic Pathology I > Pathology of the Integumentary System - Part 2 > Flashcards

Pathology of the Integumentary System - Part 2 Flashcards

1
Q

List the components of skin

A

Epidermis
Basement membrane zone
Dermis
Adnexal structures
Subcutis (hypodermis)

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2
Q

The basement membrane zone is located?

A

Between the epidermis and dermis.

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3
Q

The subcutis is composed of _____ tissue

A

adipose

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4
Q

Describe the adenxal structures

A

Hair follicles, apocrine glands
(epitrichial), eccrine glands
(atrichial), sebaceous glands,
arrector pili muscles

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5
Q

Describe the subcutis

A

No subcutis in some areas (cheek,
eyelid, anus, and external ear)

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6
Q

What can be seen in this image?

A

Hair follicle, sweat gland, etc.

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7
Q

Label the image accordingly

A
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8
Q

Components of the epidermis
* _______ ______ _______ epithelium
* Four cell types: ?

A

Keratinized, stratified, squamous,
* Keratinocytes (85%)
* Langerhans cells (3-8%)
* Melanocytes (5%)
* Merkel cells (2%)

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9
Q

Label the image accordingly

A
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10
Q

What are the functions of kertatinocytes?

A
  • Permeability barrier
  • Structural support
  • Immunoregulation (secretes cytokines and inform Langerhaans cells).
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11
Q

Label the image accordingly

A
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12
Q

Structural support
* Contain _____
* _____ filaments that connects to _____
* Type varies in the layers of ______ and body _____
* Provide _______ integrity
* Intermediate filaments are used for _______ _____
* Abnormal keratins lead to
_______ ______.

A

keratin, Intermediate, desmosomes, epidermis, site, structural, diagnostic purposes, cornification defects

Tumor we suspect to be neoplastic, we stain for cytokeratin. If it is Positive = tumor that derives from epithelium so either an adenoma or carcinoma.

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13
Q

Describe kertatinocyte differentiation and cornification.

A

Stratum basale have nucleus. When differentiate into stratum corneum they lose their nucleus. This is a normal process that takes 21 days to occur.
Secrete lipids into spaces in between keratinocytes.

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14
Q
A

Keratinocytes are wedged in between lipids. This is why we like to put lotions on body —> keeps skin integrity intact.

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15
Q

Hyperkeratosis is defined as excessive _______ or ________ of the stratum _____

A

thickening, hyperplasia, corneum

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16
Q

What is the primary cause of Hyperkeratosis?

A

Primary - Mutation (lipid, enzyme, structural protein)
* Example: ichthyosis

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17
Q

What is the secondary cause of Hyperkeratosis?

A

Secondary - Chronic irritation
* Example: Allergic skin disease, endocrine disorders, parasitic and bacterial
infections, etc

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18
Q

Describe the image below

A

Orthokeratosis: the keratinocytes undergo complete
cornification and thus lose their nucleus. This is essentially programmed cell death.

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19
Q

Describe the image below

A

Parakeratosis: keratinocytes undergo only partial
or incomplete cornification and thus retain their
nucleus. Increased and faster turn over, hence why we see retention of nuclei.

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20
Q

What can be seen in this image?

A

Golden retriever ichthyosis

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21
Q

Ichthyosis is defined as a _______ and/or ______
defect in the formation of the _______ ________.

A

congenital, hereditary, stratum corneum

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22
Q

In cases of Ichthyosis, there is strong _____ predilection; genetic
testing for ______ (______) or _____

A

breed, ICH-1, PNPLA1, ICH-2

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23
Q

Ichthyosis is characterized by ?

A
  • Trunk
  • Generalized scaling
  • Lamellar orthokeratotic hyperkeratosis
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24
Q

Label the image accordingly

A
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25
Q

Primary seborrhea is used to describe?

A

Excessive scaling.

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26
Q

What is the controversy surrounding primary seborrhea?

A
  • NOT a diagnosis
  • Need to rule out other causes of scaling (e.g. ectoparasitism,
    metabolic diseases and endocrinopathies, allergic disease, etc.)
  • Likely represents a variety of conditions such as pyoderma,
    Malassezia dermatitis, sebaceous adenitis, allergic dermatitis,
    Vitamin A-responsive dermatosis
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27
Q

Epidermal hyperplasia =

A

acanthosis

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28
Q

Epidermal hyperplasia is characterized by thickening due to ________ number of
cells within the _______, especially of
the _______ ______.

A

increased, epidermis, stratum spinosum

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29
Q

Epidermal hyperplasia is a common response to ______ irritation
such as ?

A

chronic, inflammation, trauma, metabolic
or nutritional disorders

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30
Q

What is an example of Epidermal hyperplasia?

A

acral lick dermatitis

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31
Q

What is this an image of?

A

Epidermal hyperplasia

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32
Q

Acral lick dermatitis = ?

A

Acral lick granuloma

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33
Q

Acral lick dermatitis is commonly seen in what species?

A

Dogs

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34
Q

Acral lick dermatitis is a _________ disorder often associated
with _______ diseases such as ?

A

multifactorial, underlying, atopy,
food allergy, trauma, endocrinopathy, bone
pain, neuropathy, or behavioral causes

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35
Q

Acral lick dermatitis is a consequence of ?

A

chronic focal trauma +/-
secondary deep pyoderma.

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36
Q

Lesions caused by acral lick dermatitis can be found on what part(s) of the body?

A

Dorsal carpus, or dorsolateral metatarsus

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37
Q

How would a lesion caused by acral lick dermatitis be described?

A

Focal alopecic, firm, raised plaque or
nodule

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38
Q

What can be seen in this image?

A

Acral lick dermatitis

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39
Q

Label the image accordingly. What disease is this?

A

Acral lick dermatitis

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40
Q

What is the response of the epidermis to injury?

A

Apoptosis, Necrosis, intercellular edema, intracellular edema, epidermal atrophy, acantholysis

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41
Q

Define apoptosis. What causes apoptosis? Provide an example.

A
  • Programmed cell death
  • Cause: physiologic process, immune-
    mediated disease
  • Example: erythema multiforme
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42
Q

Define necrosis. What is the cause of necrosis? Give an example.

A
  • Death of cells and is characterized by
    nuclear pyknosis, karyorrhexis, or karyolysis
  • Cause: physical injury, chemical injury,
    ischemia
  • Example: Photosensitization
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43
Q

What can be seen in this image?

A

Apoptotic cell

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44
Q

Intercellular edema is also called?

A

Spongiosis

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45
Q

Intracellular edema is defined as? Give an example.

A
  • Ballooning degeneration: superficial layer;
    Example: viral infections such as pox virus
  • Hydropic degeneration: basal layer;
    Example: cutaneous lupus erythematosus
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46
Q

What can be seen in the image provided?

A

Intercellular edema = spongiosis

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47
Q

What can be seen in the image provided?

A

Intracellular edema, specifically? superficial layer

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48
Q

What can be seen in the image provided?

A

Intracellular edema, specifically? basal layer

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49
Q

What is the cause of epidermal atrophy?

A

Cause: hormonal imbalances (e.g. hyperadrenocorticism)
19

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50
Q

What can be seen in the image provided?

A

Epidermal atrophy
cushings, hyperadrenocortism

thinning of the skin, can see vessels

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51
Q

What can be seen in the image provided?

A

Epidermal atrophy

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52
Q

Acantholysis is a response of the epidermis to injury and can be defined as the disruption of
_________ junctions
(_______) between _________ of the epidermis
* Example: ?

A

intercellular, desmosomes, keratinocytes, pemphigus foliaceus,
pemphigus vulgaris

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53
Q

What can be seen in the image provided?

A

Acantholysis

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54
Q

Acantholysis
* Clinically – vesicle and bullae ?

A
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55
Q

What can be seen in the image provided?

A

Pemphigus foliaceus

56
Q

What can be seen in the image provided?

A

Pemphigus vulgaris

57
Q

List the Inflammatory Lesions of the Epidermis

A

Exocytosis, pustules, crusts

58
Q

Exocytosis is defined as the aggregation of _______ _____ in the epidermis

A

migrating leukocytes

59
Q

Pustules (________) are accumulations of ________ cells (___) within the epidermis

A

microabscesses, inflammatory, pus

60
Q

Crusts: dried _____ and cellular ___ (i.e., dried _______) located on
the epidermal ____

A

fluid, debris, exudates, surface

61
Q

Label these three images accordingly

A

A = exocytosis
B = pustules
C = crusts

62
Q

Langerhans cells are important in the skin _______ _____. They are _______ cells.

A

immune system, dendritic

63
Q

Where are Langerhans cells produced in the body? What is their function?

A
  • Bone marrow derived
    monocyte-histiocyte lineage
  • Process and present antigens
    to T cells (antigen-presenting
    cells)
64
Q

Label the image accordingly.

A

Langerhans cells

65
Q

What can be seen in this image?

A

Contact hypersensitivity (allergic contact dermatitis)

66
Q

Contact hypersensitivity (allergic contact dermatitis)

A
  • Hapten-type delayed hypersensitivity
    (type IV hypersensitivity)
  • Name a dermatologic test using the
    same principle
67
Q

hapten-protein complexes

A
68
Q

Melanocytes make up the _____ cell layer of epidermis,
anagen hair ______
* Transfer melanin to _______
* Epidermal _____ unit
* One melanocyte per __-___
keratinocytes

A

basal, follicles, keratinocytes, melanin, 10-20

69
Q
A

Melanocytes

70
Q

What are the functions of Melanocytes?

A
  • Solar protection
  • Protect and absorb UV light
  • Scavenge free radicals
71
Q

What are some examples of hyperpigmentation?

A

Lentigo simplex, post-inflammatory hyperpigmentation

72
Q

What are some examples of hypopigmentation?

A

Vitiligo, copper deficiency

73
Q

What are some examples of pigmentary incontinence?

A

cutaneous lupus erythematosus, uveodermatologic
syndrome

74
Q

Define pigmentary incontinence.

A

The loss of melanin pigment

75
Q

What is the pathogenesis of pigmentary incontinence?

A

damage to the cells of the basal layer or of the follicular
components → accumulation of the pigment in macrophages in the
upper dermis or perifollicular regions

76
Q

What can be seen in this image?

A

Post-inflammatory hyperpigmentation

77
Q

What can be seen in this image?

A

Lentigo simplex
Benign condition common in calico/tabby cats

78
Q

What can be seen in these images?

A

Vitiligo

79
Q

Uveodermatologic syndrome is also known as?

A

Vogt‐Koyanagi‐Harada‐like syndrome

80
Q

What is Uveodermatologic syndrome?
What are the breed dispositions, if any?
What is it characterized by?
How would you diagnose it?

A
  • Breed predispositions: Akita and arctic
    breeds
  • Acute uveitis, photophobia,
    blepharospasm → blindness
  • Depigmentation of nose, lips, eyelids,
    and hair
  • Diagnosis: Biopsy + ophthalmic workup
81
Q

What can be seen here?

A

Uveodermatologic syndrome
This disease attacks the melanocytes and the eye (uveitis –> blindness).

82
Q

What can be seen in this image?

A

Pigmentary incontinence
MQ phagocytizing melanin

83
Q

What can be seen in this image?

A

Merkel Cells
* Mechanoreceptors in tylotrich pads and hair follicles

84
Q

What is the function(s) of the basement membrane?
Provide an example of a basement membrane

A
  • Anchors epidermis to dermis
  • Protective barrier
  • Wound healing (any wound that goes beyond basement membrane zone interferes with ability to heal; less likely).
  • Site of many pathologic processes
  • Example: Subepidermal blistering diseases like epidermolysis bullosa
85
Q

What can be seen in this image?

A

Basement membrane

86
Q

What can be seen in this image?

A

Subepidermal blistering disease
* Vesicles → ulcers

87
Q

What can be seen in this image?

A

Subepidermal cleft

88
Q

What is the dermis made up of? What is its function?

A
  • Collagen, elastin, proteoglycans
  • Perivascular dendritic cells,
    lymphocytes, mast cells
  • Tensile strength
  • Supports blood vessels,
    lymphatics, nerves
89
Q

What can be seen in this image?

A

The dermis

90
Q

What are the responses of the dermis to injury?

A
  • Alterations in growth, development, or tissue maintenance
    • Dermal Atrophy
    • Fibrosis
    • Collagen Dysplasia
    • Solar Elastosis
  • Abnormal deposits in the dermis
    • Calcinosis cutis & calcinosis circumscripta
    • Mucin
91
Q

Ehlers-Danlos syndrome is also known as?

A

Collagen dysplasia, cutaneous asthenia, hyperelastosis cutis, dermatosparaxis

92
Q

Ehlers-Danlos syndrome affects what species?

A

Dogs, cats, horses, cattle, sheep

93
Q

Ehlers-Danlos syndrome is an ________ _____ defect in ______ collagen
* Specific enzyme defects affecting ______
synthesis or processing

A

inherited congenital, dermal, collagen

94
Q

What is Ehlers-Danlos syndrome characterized by?

A

Cutaneous hyperextensibility and laxity,
tears, wounds, scars

95
Q

In cases of Ehlers-Danlos syndrome, the histopathology may be? The diagnosis?

A

Histopathology may be inconclusive.
Diagnosis requires skin extensibility index

96
Q

What can be seen in this image?

A

Ehlers-Danlos syndrome

97
Q

Solar dermatitis is caused by?

A

Chronic exposure to sun light →
altered fibroblast function

98
Q

What breeds are predisposed to solar dermatitis?

A

Lightly skinned, short‐coated breeds

99
Q

What is solar dermatitis characterized by?

A

Erythema and scales → thick, firm
and wrinkled skin, with erosions,
ulcers, comedones

100
Q

What parts of the body are affected by solar dermatitis?

A

Flank, groin, axilla

101
Q

Solar dermatitis is associated with the development of?

A

squamous cell carcinoma,
hemangioma, and cutaneous
hemangiosarcoma

102
Q

What can be seen in this image?

A

Solar dermatitis

103
Q

What causes calcinosis cutis?
What parts of the body are affected?
What is it characterized by?

A
  • Cause: hypercortisolemia
  • Dorsal neck region or axilla
    and groin
  • Erythematous or white
    plaques with ulcers
  • Dermal mineralization with
    granulomatous dermatitis
104
Q

What can be seen in this image?

A

Calcinosis cutis

105
Q

Label the image accordingly.

A

Calcinosis cutis
Red box = Multinucleated giant cells
Blue box = mineralized collagen fibers

106
Q

Describe the inflammatory patterns of the dermis

A
107
Q

What are the functions of hair follicles?

A
  • Physical and photoprotective
    barrier
  • Thermoregulation
  • Social communication
  • Sensory perception
  • Wound healing
108
Q

Which species have simple hair follicles?

A
  • Simple follicles
  • Humans, cattle, horses, pigs
109
Q

Label the image accordingly

A
110
Q

What type of hair follicle is this?

A

Compound primary with secondary hair follicles

111
Q

Describe the hair growth cycle

A
112
Q

What can be seen in this image?

A

Anagen: growth phase

113
Q

What can be seen in this image?

A
114
Q

What are two examples of tactile hairs?

A

Sinus hairs, such as whiskers and vibrissae, and tylotrich hairs

115
Q

Sinus hairs, such as whiskers and vibrissae, are ______-adapting mechanoreceptors

A

Slow

116
Q

Tylotrich hairs
* ______ adapting mechanoreceptors
* ______ among normal hair
* _______ cells in tylotrich pads

A

Rapid, Scattered, Merkel

117
Q

What type of tactile hair can be seen here?

A

Sinus hairs

118
Q

What type of tactile hair can be seen here?

A

Tylotrich hairs
Carpal whiskers

119
Q

What are the responses of the adnexa to injury?

A
  • Atrophy
  • Example: Endocrine dermatopathy
  • Hair follicle dysplasia
  • Example: color dilution alopecia
  • Hair cycling disorders
  • Inflammation – folliculitis/perifolliculitis/furunculosis
120
Q

Which hormones stimulate anagen (influence hair cycle)?

A
  • Hormones which stimulate anagen
  • Thyroid hormone
  • Androgens
121
Q

Which hormones inhibit anagen?

A
  • Hormones which inhibit anagen
  • Glucocorticoids
  • Estroge
122
Q

What can be seen in each of these images?

A
123
Q

What can be seen in this image?

A

Adenexal atrophy, e.g. endocrine dermatopathy
Mostly telogen

124
Q

What can be seen here
?

A

Normal anagen

125
Q

What are sebaceous glands?
What is their function?
Provide an example.

A
  • Holocrine glands open into the hair follicle
  • Sebocytes degenerate to form sebum
  • Provides moisture for stratum corneum,
    water repellant
  • Antibacterial activity, pheromone
    production
  • Example: Sebaceous adenitis = very common
126
Q

What can be seen in this image?

A

Sebaceous glands

127
Q

Describe the breed predilection for sebaceous adenitis.
What age(s) are affected?
Describe its pathogenesis.

A
  • Breed predilection! Standard
    Poodle, Akita, Samoyed, Vizsla
  • Young adult – middle-aged
  • Pathogenesis unknown
  • Dorsum, head, pinnae
  • Scales, thinning of hair coat (long-
    haired dogs) or annular alopecia
    (short-haired dogs), follicular casts
  • Diffuse loss of sebaceous glands or
    granulomatous sebaceous adenitis
128
Q

What can be seen in this image?

A

Sebaceous adenitis
Lots of scales/follicular cast = when you pluck the hair, see yellow greasy material adhered to the hair shaft.

129
Q

What can be seen in this image?

A

Loss of sebaceous glands with periadenexal (adjacent to the adenexa) inflammation

130
Q

Sweat glands are ______ glands (_______) that empty into ______ follicles.

A

apocrine, epitrichial, hair

131
Q

What can be seen in this image?

A

Sweat glands

132
Q

Apocrine glands are ______ glands (______) present in paw ______ and empty directly onto the ______ of the skin.

A

eccrine, atrichial, pads, surface

133
Q

What can be seen in this image?

A

Apocrine glands

134
Q

What can be seen in this image?

A

Apocrine glands
Sample from paw pad (no hair)
Glands deep in subcutis
Sweat through eccrine glands

135
Q

Where is the subcutis is located?
What is the subcutis made up of?
What is its function?

A
  • Between the dermis and skeletal muscle
  • Adipose tissue (panniculus) and loose connective tissue.
  • Metabolic storage pool
  • Protects deeper structure
  • Inflammation of panniculus = panniculitis (Ref: Lecture 5)
136
Q

What are the functions of blood vessels?

A
  • Blood vessels
  • Skin metabolism
  • Temperature regulation
  • Defense against microorganisms
137
Q

What are the functions of lymphatics?

A
  • Lymphatics
  • Supply, drainage of tissue fluid
  • Defense against microorganisms

Systemic Pathology I (27 decks)

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