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pathology > Pathology, skin 1 > Flashcards

Pathology, skin 1 Flashcards

1
Q

What are the 5 layers of the epidermis?

A 
stratum basale, 
stratum spinosum,
 stratum granulosum, 
stratum lucidum,
 stratum corneum
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2
Q

What are the 4 thing in the dermis?

A 
Dermal papillae,
 hair follicle,
 basaL. Cell, 
sebaceous gland, 
desmosome
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3
Q

Name 4 disorders of pigmentation

A

vitiligo,
Melasma,
Freckles (ephelides,
Benign lentigo.

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4
Q

Name the three non-malignant melanocytic tumors.

A

Congenital melanocytic tumor (birthmark),
Nevocellular Nevus (mole),
Dysplastic Nevi,

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5
Q

Name 4 malignant melanomas.

A

lentigo Maligna melanoma,
Superficial spreading melanoma,
acral lentiginous melanoma,
nodular melanoma

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6
Q

What is the prognosis for malignant melanoma?

A 
Level 1 - 100%, 
Level 2 - 93%, 
Level 3 - 71%, 
Level 4 - 59%, 
Level 5- 36%
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7
Q

How is malignant melanoma treated? Three ways

A

wide surgical excision, or
chemo if systemic,
may resolve spontaneously

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8
Q

What melanoma has the worst prognosis?

A

Nodular Melanoma,

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9
Q

What are used to help ID nodular melanoma?

A

Elevation,
Firm and
Growing, EFG

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10
Q

Most common melanoma in darker skinned people?

A

Acral lentiginous Melanoma

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11
Q

Where does acral lentiginous melanoma affect?

A

Palms,
under nails,
soles, and
sublingual

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12
Q

What is the most common melanoma over all?

A

superficial spreading melanoma

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13
Q

Pattern for growth of spreading malignant melanoma?

A

Horizontal growth, not deep.

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14
Q

What malignant melanoma has best prognosis?

A

Lentigo maligna melano, ususally found on face and neck

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15
Q

What is the danger of a giant gongenital nevi?

A

They have an increased risk of developing melanoma

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16
Q

What disorders of pigmentation has a loss of melanocytes?

A

vitiligo

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17
Q

What disorder of pigmentation has proliferation of melanocytes on the face?

A

melasma

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18
Q

What pigment disorder is caused by hormones?

A

melasma

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19
Q

What pigment order doesn’t change or get better?

A

vitilago, once melanocytes are gone you won’t have pigment

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20
Q

What causes freckles?

A

Same number of Melanocytes are making more pigment, melanin

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21
Q

What is the other name for freckles?

A

ephelides

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22
Q

what pigmentation disorder has melanocytic hyperplasia?

A

benign lentigo, it?s the local proliferation of melanocytes that you are not born with.

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23
Q

what is a benign tumor of melanocytes?

A

Mole, Nevocellular Nevus

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24
Q

What are the three types of Nevi?

A

Junctional,
compound,
intradermal

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25
Q

gross appearance of a mole or nevocellular nevus

A

uniform color,
defined borders,
stable size and shape,

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26
Q

What can look like a dysplastic Nevi?

A

cutaneous melanoma

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27
Q

What is dysplastic nevus syndrome?

A

specific gene causes one to have multaple dysplastic nevi and an increased risk of melanoma

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28
Q

What is a dysplastic nevi?

A

Large, irregular shape and color.

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29
Q

What does dysplastic nevi show microscopically?

A

cytological and archeticular atypia

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30
Q

Risk factors for Malignant melanoma?

A 
sunburns,
 chronic uv exposure, 
fair skin, 
dysplastic nevus syndrome,
 familia mutation of tumor supressor gene.
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31
Q

what location generally gets the least malignant melanoma?

A

head

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32
Q

where do men get malignant melanoma most?

A

trunk, upper back

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33
Q

Woman, malignant melanom most oftern?

A

back and legs.

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34
Q

what melanoma is often found in the face or neck of older individuals and has the best prognosis?

A

lentigo Maligna melanoma,

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35
Q

what melanoma has a horizontal growth pattern?

A

superficial spreading melanoma

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36
Q

what melanoma is most common in darker skinned people and sublingually?

A

acral-lentiginous melanoma

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37
Q

what is the melanoma that you don?t want the most?

A

Nodular Melanoma,

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38
Q

describe nodular melanoma

A

nodular tumor, vertical growth patter that allows it to spread fast.

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39
Q

List epidermal - dermal lesions

A

Acanthrosis nigricans - seborrheic Keratosis - Psoriasis - pempigus - Bullous emhigoid - Ichthyosis vulgaris - xerosis - Eczema - polymouphus light eruption - Chronic cutaneous lupus erythematous - erythema multiforme - Pityriasis Rosea - Granuloma Annulare - erythema Nodosum - Epidermal inclusion cyst -

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40
Q

What should hold adjacent epidermal cells together?

A

Desmosomes

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41
Q

Acanthosis Nigricans looks like what?

A

thickened hyperpigmented skin at neck, armpit and groin

Ring around the collar

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42
Q

what skin conditon is assciated with obesity and hyperisnulinism?

A

acanthosis nigricans.

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43
Q

What more dangerous pathology could be associatate with acanthosis nigricans?

A

stomach and gastrointestinal malignancies.

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44
Q

what is the key feature of Seborrheic Keratosis?

A

stuck on appearance.

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45
Q

How would Seborrheic keratosis look microscopically?

A

basaloid epidermal hyperplasia - horn cysts.

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46
Q

what could sudden development of suborrheic keratosis accompany?

A

underlying malignancy

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47
Q

where would the middle aged and elderly develop suborrheic keratosis?

A

trunk,
head,
neck
extreamities.

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48
Q

Seborrheic keratosis

A

benign squamoproliferative neoplasm -
stuck on -
old/middle aged -
Leser trelat, underlying malignancy

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49
Q

What % of population is affected by Psoriasis?

A

One %

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50
Q

most common form of Psoriasis?

A

Psorisis vulgaris

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51
Q

What can psorisis also be associated with?

A

arthritis,
enteropathy,
myopathy

52
Q

Psoriasis

A

autoimmune disorder accompanied by increased proliferation and turnover of epidermal keratinocytes

53
Q

Common Psoriasis sites?

A

knees,
elbows,
scalp

54
Q

What would psoriasis look like?

A

well demarcated erythematous plaque with silvery scale

55
Q

What is auspitz sign?

A

scraping off scales and the layer below causing pinpoint bleeding

56
Q

Under microscope what would elongation of the dermal ridges indicate?

A

psoriasis

57
Q

What pathology has hyperkeratinization with parakeratosis?

A

psoriasis

58
Q

How is psoriasis treated?

A

steroids,
UV radiation
methotrexate

59
Q

What skin pathologies cause blisters?

A
  • Pemphigus both vulgaris and foliaceus,
  • bullous Pemphigoid
  • dermatitis herpetiformis
60
Q

What sign can indicate pemphigus?

A

Nikolski’s sign, blister border expands and its easily torn

61
Q

What type of disorder is pemphigus?

A

autoimmune, pemphigus vulgaris is the most common,

62
Q

What type of Antibodies that attack desmosomes in pemphigus?

A

IgG

63
Q

acantholysis is what?

A

loss of intercellular adhesions

64
Q

What is pemphigus?

A

rare autoimmune disorder, potentially fatal, blisters, acantholysis,

65
Q

Is pemphigus or bullous pemphigoid more common?

A

Bullous pemphigoid

66
Q

What is bullous pemphigoid?

A

autoimmune disorder of older people, Separation of the epidermis from dermis causing subepidermal blister formation, so they are hard to pop

67
Q

What could indicate the difference betweem pemphigus and bullous pemphigoid?

A

Pemphigus blisters tear easily and the edges spread, bullous pempigoid blisters do not tear easily

68
Q

What is the antibody that attacks epidermal junction in buuous pemphigus?

A

IgG

69
Q

what is dermatitis herpetiformis often associated with?

A
  • celiac sprue

- subepidermal blisters often in a line that form at tips of dermal papille

70
Q

what antibodies attack gliadin and other antigens that deposit in tips of papillae?

A

IgA

71
Q

what skin disorder can be treated with gluten free diet?

A

dermatitis herpetiformis

72
Q

what conditon looks like aligator?

A

ichthyosis vulgaris

73
Q

how does one get ichthyosis vulgaris?

A

common inherited disorder

74
Q

what is ichthyosis vulgaris?

A 
characterized by thickened stratum corneum and nearly absent granulosum. 
Hyperkeratotic fry skin 
-palm 
-soles and 
-extensor areas
75
Q

what is Xerosis?

A

Abnormal dryness of the skin or musus membranes

76
Q

eczema

A

group of inflammatory skin disoriders characterized by pruitus (iching)

77
Q

what is puritus?

A

Another word for iching

78
Q

types of Eczema?

A

acute,
chronic,
atopic dermitius,
contact dermitiis

79
Q

What does acute eczema cause?

A

vesicular erythematous (red) rash

80
Q

What does erythematous mean?

A

Red, so a red rash

81
Q

what does chronic eczema look like?

A

chronic scratching followed by dry, thickened hyperkeratonic skin.

82
Q

What mediates atopic dermititus hypersensitivity?

A

IgE mediated, causes dry skin and eczema

83
Q

what is the most common form of photodermatosis?

A

polymorphous light eruption

84
Q

polymouphous light eruption,

A

erythematous(red) macules,
papules,
plaques, or
vesicles on exposure to sun

85
Q

macule

A

change in surface color w/o elevation or depression.

86
Q

Papule

A

solid elevation of skin with no visible fluid

87
Q

Plaque

A

solid raised flat topped leison greater than 1 cm

88
Q

vesicule

A

small fluid filled sacks that form on skin

89
Q

What does chronic cutaneous lupus erythematous cause?

A

epidermal atrophy, DNA anti DNA complexes in basment membrane of epideris.

90
Q

How does lupus often appear?

A

butterfly rash on face - red, erythematous maculopapular eruption

91
Q

Erythema multiforme?

A

hypersensitivity skin reaction to infection that gives bullseye rask

92
Q

How is erythema multiforme characterized?

A

bullae (blisters),
targetoid red lesions, and
vesicles.

93
Q

Bullae

A

blister bigger than 1 cm.

94
Q

pityriasis Rosea

A

Christmas tree,
puritic rash,
herald patch,
following upper respiratory infection

95
Q

Granuloma annulare

A

rare,
autoimmune reddish bumps in
form of ring

96
Q

Granuloma is caused by an overproductive what?

A

WBC - leukocyttosis - they can flow freely the clump.

97
Q

who is more likely to have granuloma annulare?

A

women

98
Q

Erythema nodosum?

A

raised erythematous (red) painful nodules of subcutaneous fat, anteror shins.

99
Q

How is erythema nodosum treated?

A

pain killers and it ususally resolves spontaneously in 3-6 weeks

100
Q

On what age is erythema nodosum found mostly

A

12 -20 years

101
Q

What is filled with keratin debries?

A

epidermal inclusion cyst

102
Q

What are the types of malingant tumors?

A
  • squamous carcinoma -

- basal cell carcinoma -

103
Q

What can be a precursor or basal cell carcinoma?

A

actinic keratosis - old people hands

104
Q

actinic keratosis characteristics?

A
  • rough, red papules on face, arms and hands,

- induced by sun

105
Q

What is happenning cellularly in actinic keratosis?

A

sun induced dysplasia of keratinocytes

106
Q

Characteristic of squamous cell carcinoma?

A

tan nodular mass which commonly ulcerates

107
Q

Microscopic squamous cell carcinoma?

A

nests of atypical keratinocytes that invade dermis, keratin pearls,

108
Q

Keratoacanthoma

A

horn, rapidly growing domeshaped nodules with a central keratin filled crater

109
Q

what is the normal prognosis for squamous cell carcinoma?

A

rarly metastazie, cut out will cure

110
Q

What is the most common tumor in adults in the western world

A

basal cell carcinoma

111
Q

where does basal cell carcinoma arise from?

A

basal cells of hair follicles

112
Q

what does basal cell carcinoma look like?

A 
sun exposed surfaces, 
pearly papules,
nodules with translucent borders, 
telangiectasia, 
ulceration
113
Q

what does basal cell carcinoma look like microscopically?

A

invasive nests of basoloid cells with palisading groth pattern

114
Q

Prognossis for basal cell carcinoma?

A

slow growing, rarly metastasize

115
Q

treatment for basal cell carcinoma?

A

complete excision

116
Q

What is histocytosis X?

A

proliferation of langerhans cells, which are normally in epidermis.

117
Q

variants of histocytosis X?

A

unifocal, multifocal, acute diseminated.

118
Q

What are 4 main points about Psorisis?

A

Autoimmune with increased proliferation and turnover of epidermal keratinocytes

  • effects 1% of pop
  • genetic component
  • associated with arthritis, enteropath and myopathy
119
Q

Main characteristics of Actinic keratosis (old lady hands)

A
  • SUn induced dysplasia of keratinocytes
  • possible precursor to SCC
  • rough red papules on face arms and hands
120
Q

Vitilago characteristics

A
  • irregular patches of depigmentation
  • possible genetic component
  • missing melanocytes
121
Q

Pemphigus character

A
  • rare but possibly fatal
  • pemphigus vulgaris is most common
  • autoantibodies: acantholysis
  • attack desmoglein 3 of desmosime
122
Q

Acantosis Nigricans

A
  • thickened hyperpigmented skin at neck and pits
  • hyperinsulenism
  • obesity
  • malignancy , (digestive tract)
123
Q

Dysplastic nevi

A
  • increased risk of melanoma
  • cmm1 gene, chromosome 1, autosomal dominant
  • may have more than one
124
Q

Malignant melanoma

A
  • increasing in US
  • fair skinned more common
  • familial form, loss of function in p16 tumor suppressor gene on chromosome 9
125
Q

Nevocellular Nevi

A
  • sharp well defined borders
  • stable shape and size
  • malignant transformation uncommon
  • uniform color

pathology (7 decks)

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