Pathology, skin 1 Flashcards
(125 cards)
1
Q
What are the 5 layers of the epidermis?
A
stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, stratum corneum
2
Q
What are the 4 thing in the dermis?
A
Dermal papillae, hair follicle, basaL. Cell, sebaceous gland, desmosome
3
Q
Name 4 disorders of pigmentation
A
vitiligo,
Melasma,
Freckles (ephelides,
Benign lentigo.
4
Q
Name the three non-malignant melanocytic tumors.
A
Congenital melanocytic tumor (birthmark),
Nevocellular Nevus (mole),
Dysplastic Nevi,
5
Q
Name 4 malignant melanomas.
A
lentigo Maligna melanoma,
Superficial spreading melanoma,
acral lentiginous melanoma,
nodular melanoma
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%
7
Q
How is malignant melanoma treated? Three ways
A
wide surgical excision, or
chemo if systemic,
may resolve spontaneously
8
Q
What melanoma has the worst prognosis?
A
Nodular Melanoma,
9
Q
What are used to help ID nodular melanoma?
A
Elevation,
Firm and
Growing, EFG
10
Q
Most common melanoma in darker skinned people?
A
Acral lentiginous Melanoma
11
Q
Where does acral lentiginous melanoma affect?
A
Palms,
under nails,
soles, and
sublingual
12
Q
What is the most common melanoma over all?
A
superficial spreading melanoma
13
Q
Pattern for growth of spreading malignant melanoma?
A
Horizontal growth, not deep.
14
Q
What malignant melanoma has best prognosis?
A
Lentigo maligna melano, ususally found on face and neck
15
Q
What is the danger of a giant gongenital nevi?
A
They have an increased risk of developing melanoma
16
Q
What disorders of pigmentation has a loss of melanocytes?
A
vitiligo
17
Q
What disorder of pigmentation has proliferation of melanocytes on the face?
A
melasma
18
Q
What pigment disorder is caused by hormones?
A
melasma
19
Q
What pigment order doesn’t change or get better?
A
vitilago, once melanocytes are gone you won’t have pigment
20
Q
What causes freckles?
A
Same number of Melanocytes are making more pigment, melanin
21
Q
What is the other name for freckles?
A
ephelides
22
Q
what pigmentation disorder has melanocytic hyperplasia?
A
benign lentigo, it?s the local proliferation of melanocytes that you are not born with.
23
Q
what is a benign tumor of melanocytes?
A
Mole, Nevocellular Nevus
24
Q
What are the three types of Nevi?
A
Junctional,
compound,
intradermal
25
gross appearance of a mole or nevocellular nevus
uniform color,
defined borders,
stable size and shape,
26
What can look like a dysplastic Nevi?
cutaneous melanoma
27
What is dysplastic nevus syndrome?
specific gene causes one to have multaple dysplastic nevi and an increased risk of melanoma
28
What is a dysplastic nevi?
Large, irregular shape and color.
29
What does dysplastic nevi show microscopically?
cytological and archeticular atypia
30
Risk factors for Malignant melanoma?
```
sunburns,
chronic uv exposure,
fair skin,
dysplastic nevus syndrome,
familia mutation of tumor supressor gene.
```
31
what location generally gets the least malignant melanoma?
head
32
where do men get malignant melanoma most?
trunk, upper back
33
Woman, malignant melanom most oftern?
back and legs.
34
what melanoma is often found in the face or neck of older individuals and has the best prognosis?
lentigo Maligna melanoma,
35
what melanoma has a horizontal growth pattern?
superficial spreading melanoma
36
what melanoma is most common in darker skinned people and sublingually?
acral-lentiginous melanoma
37
what is the melanoma that you don?t want the most?
Nodular Melanoma,
38
describe nodular melanoma
nodular tumor, vertical growth patter that allows it to spread fast.
39
List epidermal - dermal lesions
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 -
40
What should hold adjacent epidermal cells together?
Desmosomes
41
Acanthosis Nigricans looks like what?
thickened hyperpigmented skin at neck, armpit and groin
| Ring around the collar
42
what skin conditon is assciated with obesity and hyperisnulinism?
acanthosis nigricans.
43
What more dangerous pathology could be associatate with acanthosis nigricans?
stomach and gastrointestinal malignancies.
44
what is the key feature of Seborrheic Keratosis?
stuck on appearance.
45
How would Seborrheic keratosis look microscopically?
basaloid epidermal hyperplasia - horn cysts.
46
what could sudden development of suborrheic keratosis accompany?
underlying malignancy
47
where would the middle aged and elderly develop suborrheic keratosis?
trunk,
head,
neck
extreamities.
48
Seborrheic keratosis
benign squamoproliferative neoplasm -
stuck on -
old/middle aged -
Leser trelat, underlying malignancy
49
What % of population is affected by Psoriasis?
One %
50
most common form of Psoriasis?
Psorisis vulgaris
51
What can psorisis also be associated with?
arthritis,
enteropathy,
myopathy
52
Psoriasis
autoimmune disorder accompanied by increased proliferation and turnover of epidermal keratinocytes
53
Common Psoriasis sites?
knees,
elbows,
scalp
54
What would psoriasis look like?
well demarcated erythematous plaque with silvery scale
55
What is auspitz sign?
scraping off scales and the layer below causing pinpoint bleeding
56
Under microscope what would elongation of the dermal ridges indicate?
psoriasis
57
What pathology has hyperkeratinization with parakeratosis?
psoriasis
58
How is psoriasis treated?
steroids,
UV radiation
methotrexate
59
What skin pathologies cause blisters?
- Pemphigus both vulgaris and foliaceus,
- bullous Pemphigoid
- dermatitis herpetiformis
60
What sign can indicate pemphigus?
Nikolski's sign, blister border expands and its easily torn
61
What type of disorder is pemphigus?
autoimmune, pemphigus vulgaris is the most common,
62
What type of Antibodies that attack desmosomes in pemphigus?
IgG
63
acantholysis is what?
loss of intercellular adhesions
64
What is pemphigus?
rare autoimmune disorder, potentially fatal, blisters, acantholysis,
65
Is pemphigus or bullous pemphigoid more common?
Bullous pemphigoid
66
What is bullous pemphigoid?
autoimmune disorder of older people, Separation of the epidermis from dermis causing subepidermal blister formation, so they are hard to pop
67
What could indicate the difference betweem pemphigus and bullous pemphigoid?
Pemphigus blisters tear easily and the edges spread, bullous pempigoid blisters do not tear easily
68
What is the antibody that attacks epidermal junction in buuous pemphigus?
IgG
69
what is dermatitis herpetiformis often associated with?
- celiac sprue
| - subepidermal blisters often in a line that form at tips of dermal papille
70
what antibodies attack gliadin and other antigens that deposit in tips of papillae?
IgA
71
what skin disorder can be treated with gluten free diet?
dermatitis herpetiformis
72
what conditon looks like aligator?
ichthyosis vulgaris
73
how does one get ichthyosis vulgaris?
common inherited disorder
74
what is ichthyosis vulgaris?
```
characterized by thickened stratum corneum and nearly absent granulosum.
Hyperkeratotic fry skin
-palm
-soles and
-extensor areas
```
75
what is Xerosis?
Abnormal dryness of the skin or musus membranes
76
eczema
group of inflammatory skin disoriders characterized by pruitus (iching)
77
what is puritus?
Another word for iching
78
types of Eczema?
acute,
chronic,
atopic dermitius,
contact dermitiis
79
What does acute eczema cause?
vesicular erythematous (red) rash
80
What does erythematous mean?
Red, so a red rash
81
what does chronic eczema look like?
chronic scratching followed by dry, thickened hyperkeratonic skin.
82
What mediates atopic dermititus hypersensitivity?
IgE mediated, causes dry skin and eczema
83
what is the most common form of photodermatosis?
polymorphous light eruption
84
polymouphous light eruption,
erythematous(red) macules,
papules,
plaques, or
vesicles on exposure to sun
85
macule
change in surface color w/o elevation or depression.
86
Papule
solid elevation of skin with no visible fluid
87
Plaque
solid raised flat topped leison greater than 1 cm
88
vesicule
small fluid filled sacks that form on skin
89
What does chronic cutaneous lupus erythematous cause?
epidermal atrophy, DNA anti DNA complexes in basment membrane of epideris.
90
How does lupus often appear?
butterfly rash on face - red, erythematous maculopapular eruption
91
Erythema multiforme?
hypersensitivity skin reaction to infection that gives bullseye rask
92
How is erythema multiforme characterized?
bullae (blisters),
targetoid red lesions, and
vesicles.
93
Bullae
blister bigger than 1 cm.
94
pityriasis Rosea
Christmas tree,
puritic rash,
herald patch,
following upper respiratory infection
95
Granuloma annulare
rare,
autoimmune reddish bumps in
form of ring
96
Granuloma is caused by an overproductive what?
WBC - leukocyttosis - they can flow freely the clump.
97
who is more likely to have granuloma annulare?
women
98
Erythema nodosum?
raised erythematous (red) painful nodules of subcutaneous fat, anteror shins.
99
How is erythema nodosum treated?
pain killers and it ususally resolves spontaneously in 3-6 weeks
100
On what age is erythema nodosum found mostly
12 -20 years
101
What is filled with keratin debries?
epidermal inclusion cyst
102
What are the types of malingant tumors?
- squamous carcinoma -
| - basal cell carcinoma -
103
What can be a precursor or basal cell carcinoma?
actinic keratosis - old people hands
104
actinic keratosis characteristics?
- rough, red papules on face, arms and hands,
| - induced by sun
105
What is happenning cellularly in actinic keratosis?
sun induced dysplasia of keratinocytes
106
Characteristic of squamous cell carcinoma?
tan nodular mass which commonly ulcerates
107
Microscopic squamous cell carcinoma?
nests of atypical keratinocytes that invade dermis, keratin pearls,
108
Keratoacanthoma
horn, rapidly growing domeshaped nodules with a central keratin filled crater
109
what is the normal prognosis for squamous cell carcinoma?
rarly metastazie, cut out will cure
110
What is the most common tumor in adults in the western world
basal cell carcinoma
111
where does basal cell carcinoma arise from?
basal cells of hair follicles
112
what does basal cell carcinoma look like?
```
sun exposed surfaces,
pearly papules,
nodules with translucent borders,
telangiectasia,
ulceration
```
113
what does basal cell carcinoma look like microscopically?
invasive nests of basoloid cells with palisading groth pattern
114
Prognossis for basal cell carcinoma?
slow growing, rarly metastasize
115
treatment for basal cell carcinoma?
complete excision
116
What is histocytosis X?
proliferation of langerhans cells, which are normally in epidermis.
117
variants of histocytosis X?
unifocal, multifocal, acute diseminated.
118
What are 4 main points about Psorisis?
Autoimmune with increased proliferation and turnover of epidermal keratinocytes
- effects 1% of pop
- genetic component
- associated with arthritis, enteropath and myopathy
119
Main characteristics of Actinic keratosis (old lady hands)
- SUn induced dysplasia of keratinocytes
- possible precursor to SCC
- rough red papules on face arms and hands
120
Vitilago characteristics
- irregular patches of depigmentation
- possible genetic component
- missing melanocytes
121
Pemphigus character
- rare but possibly fatal
- pemphigus vulgaris is most common
- autoantibodies: acantholysis
- attack desmoglein 3 of desmosime
122
Acantosis Nigricans
- thickened hyperpigmented skin at neck and pits
- hyperinsulenism
- obesity
- malignancy , (digestive tract)
123
Dysplastic nevi
- increased risk of melanoma
- cmm1 gene, chromosome 1, autosomal dominant
- may have more than one
124
Malignant melanoma
- increasing in US
- fair skinned more common
- familial form, loss of function in p16 tumor suppressor gene on chromosome 9
125
Nevocellular Nevi
- sharp well defined borders
- stable shape and size
- malignant transformation uncommon
- uniform color
