Pictures Flashcards by michelle granstrom

Which layers of skin are shown here? Top–>Bottom

Top:

stratum corneum

stratum granulosum (darker color)

stratum spinosum (pretty big)

stratum basale

Bottom

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What is shown here? Where is this structure found in the body?

apocrine gland

found in axilla & groin

nonfcnl

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What is shown here? What is its fcn?

these are secretory glands–eccrine sweat glands

secrete sweat & fcn in thermoregulation of skin

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Where is this type of skin found?

on the soles of feet & palms of hands

note the thick keratin & absence of adnexal structures in the dermis

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What is macroscopic lesion?

this is a hypopigmented patch

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What type of macroscopic lesion does this picture show?

hyperpigmented patch

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What type of macroscopic lesion is shown in this picture?

pinpoint macules of hypopigmentation

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What type of macroscopic lesion is shown in this picture?

a papule

it is dome shaped, well circumscribed

less than 5 mm

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What type of macroscopic lesion is shown here?

a papule

it is dome shaped, well circumscribed

less than 5 mm

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What type of macroscopic lesion is shown in this picture?

a papule

it is dome shaped, well circumscribed

less than 5 mm

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What type of macroscopic lesion is shown in this picture?

nodule

papule’s larger body, greater than 5 mm

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What type of macroscopic lesion is shown in this picture?

a nodule

the larger buddy of a papule, greater than 5 mm

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What type of macroscopic lesion is shown in this picture?

a nodule

larger buddy of the papule

greater than 5 mm

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Which type of macroscopic lesion is shown here?

plaque

elevated flat top lesions that are greater than 5 mm

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Which types of macroscopic lesions are shown here?

plaques

flat topped lesions that are greater than 5 mm

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What type of macroscopic lesion is shown here?

pustule

raised lesions that are pus filled

like abscesses or acne

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what type of macroscopic lesion is shown here?

vesicle

less than 5 mm

fluid-filled blister

the little sibling of the bulla

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What type of macroscopic lesion is shown here?

bulla

greater than 5 mm

fluid-filled blisters

larger sibling of the vesicle

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What type of macroscopic lesion is shown here?

wheal

itchy transient elevated lesions

some blistering & dermal edema

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What is shown here?

wheal

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What type of microscopic lesion is shown here?

hyperkeratosis

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What type of microscopic lesion is shown here?

parakeratosis

the nuclei will be in the top layer

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What type of microscopic lesion is shown here?

acanthosis

epidermis is thickened

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What type of microscopic lesion is shown here?

papillomatosis

thickened epidermis + distinct papillary fragments

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What type of microscopic lesion is shown here?

spongiosis space b/w keratinocytes, edema pushes them apart

What type of microscopic lesion is shown here?

lentigionous melanin that is produced in the basal layer linearly--a pattern of pigmentation

What type of microscopic lesion is shown here?

dyskeratosis abnormal keratinization b/c of malignancy pink in the epidermis

§A 25 year old male presents to the emergency room with complaints of diffuse itch and changes in his skin. He states that he went over to a friends house where there was a dog and cat. He also says that this has happened before when he is around cats. What is his diagnosis?

urticaria, hives see here the edematous plaques or wheals local mast cell degranulation

§A 35 year old female presents to her primary care physician with complaints of dry and cracked skin and intense itch. She states that she has been under the care of psychologist for obsessive compulsive behavior. She has been known to wash her hands and arms up to 100 times per day.

acute eczematous dermatitis she is sensitive to the soap she was using--qualifies for the primary irritant dermatitis category of it.

§A 15 year old female presents to the ER with complaints of multiple blisters on her lips. She stated that for a week prior she had mild flu-like symptoms. The blisters appeared suddenly within the last 3 days. She states that she originally thought they were “cold sores” because she has a history of recurrent herpes simplex infections

erythema multiforme associated with herpes simplex virus in this case

A 33 year old female presents to a new dermatologist. She was previously under long term care of another dermatologist, but was not satisfied with her care. She states that she has a skin condition, that she has had for over 18 years. Her skin has red scaly patches all over her back. Her sister has a similar condition

psoriasis

§A 35 year old female presents to her pediatrician with her 8 month old son. She states that for the past month her son has had redness on his head and ears and lots of dandruff

seborrheic dermatitis involves regions with high density of sebaceous glands

What does this show?

urticaria normal epidermis in the papillary dermis you see edema sparse inflammation

What does this pic show?

acute eczematous dermatitis spongiosis: space b/w keratinocytes parakeratosis: retain their nucleus in the stratum corneum sometimes intraepidermal vesicles form

What does this pic show?

acute eczematous dermatitis spongiosis: space b/w keratinocytes parakeratosis: retain their nucleus in the stratum corneum sometimes intraepidermal vesicles form

What does this pic show?

erythema multiforme plaques with crust in the center can present differently

What does this pic show?

erythema multiforme note the spongiosis (space b/w keratinocytes) dermal edema perivascular lymphocytes necrotic keratinocytes parakeratosis

What does this pic show?

erythema multiforme spongiosis dermal edema perivascular lymphocytes necrotic keratinocytes parakeratosis (retain nuclei)

What does this pic show?

psoriasis spongiosis acanthosis lymphocytes in dermis & epidermis parakeratosis

What does this pic show?

psoriasis spongiosis acanthosis lymphocytes in dermis & epidermis parakeratosis

A 55 year old male presents to his primary care physician with complaints of a “rash” on his leg. He states that he first noticed the rash a few weeks ago and it has gotten progressively worse. He describes the rash a purple and itchy

lichen planus

Which condition does this pic show?

lichen planus see the purple plaques

What does this pic show? What sign is shown?

lichen planus also note hte Wickham's striae--white streaky lines in the middle of the purple plaque

What does this pic show?

lichen planus note: Hyperkeratosis in epidermis Hypergranulosis (darker color) Dermal-epidermal junction thick band of lymphocytic infiltration: lichenoid

§A 55 year old female presents to her primary care physician due to “sores” in her mouth. She stated that the sores appeared suddenly within the last few days.

pemphigus, a blistering disorder this particular type of blister will break & crust if you touch it.

Which type of inflammatory blistering disorder is shown here?

pemphigus vulgaris you can see that there is a blister, you can see that the basal layer is intact. Think suprabasal blister--\>vulgaris.

Which type of inflammatory blistering disorder is shown here?

pemphigus vulgaris note the crust

Which type of inflammatory blistering disorder is shown here?

pemphigus foliaceus you can see the bluish granular layer here. Not all the way down to the basal level. Clearly, there is a blister. Think subcorneal blister--\>foliaceus.

What type of inflammatory blistering disorder is shown here?

this immunofluorescence w/ IgG shows a swiss cheese pattern. This is indicative of pemphigus foliaceus.

§A 63 year old female presents to her primary care physician with complaints of blisters on her abdomen. She states that she has been having skin issues for a while. At first she was having episodes of hives, but these have been progressing and are now blisters.

bullous pemphigoid \*\*before they progress, they are often mistaken for hives.

What inflammatory blistering disorder is shown here? Will this person scar when they heal?

bullous pemphigoid might not scar! Yay!

Which type of inflammatory blistering disorder is shown here? What are some of the important features?

bullous pemphigoid not the subepidermal blister inflammatory infiltrate seen

Which type of blistering disorder is represented in this immunofluorescent image?

bullous pemphigoid note the linear pattern of IgG on the roof of the blister--that's the key!

§A 25 year old Caucasian male presents to his primary care physician due to a group of boils on his knees over the past few weeks. He states that the boils are itchy and they burn. The patient states that he has no other significant medical history except that he believes that he is gluten sensitive.

dermatitis herpetiformis from celiac disease, urticaria & grouped vesicles

What does this pic show?

dermatitis herpetiformis Note: usu occurs at elbows or knees

This histo slide indicates which inflammatory blistering disorder? What are the important features seen here?

dermatitis herpetiformis subepidermal blister note the infiltrate of eosinophils & neutrophils

Which type of inflammatory blistering disorder is shown by this immunofluorescent image?

dermatitis herpetiformis note the granular pattern of IgA prominent around the peaks of the papillary dermis

Which condition is shown here?

epidermolysis bullosa, dystrophic type

Which blistering disorder is represented in this histo slide?

epidermolysis bullosa subepidermal blister you don't see inflammatory infiltrate

Which type of blistering disorder is shown in this immunofluorescent image?

epidermolysis bullosa note the IgG on the floor of the blister

What is shown here?

benign epithelial tumor sebhorreic keratosis round flat lesion that is waxy & velvety. Here: the pigment is uniform, can also be darkly pigmented

What is shown here?

benign epithelial tumor sebhorreic keratosis here see the darkly pigmented kind

What is shown in this histo slide?

benign epithelial tumor sebhorreic keratosis note the papillomatosis & hyperkeratosis, sometimes histological features of this.

What does this histo image show?

benign epithelial tumor sebhorreic keratosis note the horn cyst--invagination of epidermis w/ keratin production, a sign of this!

What is shown in this histo image?

skin tag aka fibroepithelial polyp loose stroma surrounded by epidermis

What is shown here?

keloid, hypertrophic scar prompted first with acne on the chest

What is shown here?

keloid! Hypertrophic scar sometimes seen where people have had their ears pierced

What is shown in this histo image?

keloid note the dense dermis from collagen deposition

What is shown in this histo image?

keloid note the collagen deposition

What is shown here?

benign epithelial tumor epidermal inclusion cyst can rupture & cause inflammatory response when keratin spills out

What is shown in this histo image?

benign epithelial tumor epidermal inclusion cyst note that hte epidermis was invaginated into the dermis & then keratin was produced.

What does this pic show?

actinic keratosis this lesion can be due to sun damage it would feel like sandpaper

What does this histo slide show?

actinic keratosis note the solar elastois atypical keratosis

What does this histo slide show?

actinic keratosis note the dyskeratosis solar elastosis

What does this histo pic show?

squamous cell carcinoma in situ note the atypical cells from the basal layer--\>stratum corneum. lots of keratin production shows the pink color see dark atypical nuclei--even to the granular layer

What does this histo pic show?

squamous cell carcinoma in situ note the atypical cells from the basal layer--\>stratum corneum. lots of keratin production shows the pink color see dark atypical nuclei--even to the granular layer

What does this pic show?

squamous cell carcinoma a more progressed & invasive form of squamous cell carcinoma in situ

What does this pic show?

squamous cell carcinoma

What does this pic show?

squamous cell carcinoma invasive has invaded thru the basement membrane atypical keratinocytes dyskeratosis

What does this histo pic show?

squamous cell carcinoma dyskeratosis invasion thru basement membrane atypical keratinocytes

What condition is shown here?

basal cell carcinoma malignant epidermal tumor

What is shown in this histo pic?

basal cell carcinoma cells of the stratum basale are blue see the retraction artifact--due to peripheral palisading...tissue processing.

What is shown here?

basal cell carcinoma see pigment! shown infiltrating into dermis

What is shown in this histo pic?

sun related damage this could be a freckle or cafe au lait you might see some solar elastois & hyperpigmentation. see the lentiginous pattern--pigment only in the basal layer of the cells

What is shown in this pic?