Quiz 2: Dermatology Flashcards
What are the 5 primary characteristics (gross morphology) of eczema?
Red, oozing, crusting, papules, vesicles
What is an acute inflammation of the epidermis?
Eczema
Scratching eczema may lead to what?
Lichen simplex chronicus
What are the characteristics of the histopathology of eczema?
Spongiosis, epidermal microvesicles, parakeratosis, acanthosis, dermal edema, dermal infiltrates
What is the primary immunological difference between contact dermatitis and atopic dermatitis?
Contact dermatitis is cell mediated hypersensitivity (type IV); atopic dermatitis is an allergy (IgE/Type I)
What is the characteristic lesion of erythema multiforme?
Target lesion
What are 6 common etiologies of erythema multiforme?
Herpes simplex, any serious infection, drug rashes, paraneoplastic syndromes, Lupus/polyarteritis/dermatomyositis, idiopathic
What are 3 characteristics of the histopathology of erythema multiforme?
Early perivascular lymphocytic infiltrate, dermal edema, vesicles and lymphocytes along the d/e junctio
What is a severe form of erythema multiforme?
Stevens-Johnson syndrome
What causes large regions of epidermis to come off in Stevens-Johnson syndrome?
Lysis between epidermis and dermis
What are 3 common etiologies of psoriasis?
Drugs (B-blockers, Ca channel blockers, antimalarials), alcohol, HLA-C
2/3 of patients with psoriasis have a strong association to what?
HLA-C
What is the characteristic gross morphology of psoriasis?
Pink, salmon, or violaceous plaques (annular or serpiginous shape); silvery scales, erythroderma
What are 6 primary skin locations for psoriasis?
Elbows, knees, scalp, lumbosacral areas, intergluteal cleft, glans penis
What is present in 30% of psoriasis cases?
Nail morphology
What is an Auspitz sign?
Multiple, minute bleeding points when the scale is lifted from the plaque.
What are the primary characteristics of the histopathology of psoriasis?
Acanthosis, downward elongation of rete ridges, miotic figures, stratum granulosum thinned or absent
Thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin.
Hyperkeratosis
Modes of keratinization characterized by the retention of the nuclei in the stratum corneum. On the mucous membranes, … is normal.
Parakeratosis
Hyperplasia in the stratum granulosum, often due to intense rubbing.
Hypergranulosis
Diffuse epidermal hyperplasia
Acanthosis
Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae
Papillomatosis
Abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum.
Dyskeratosis
Intercellular edema of the epidermis
Spongiosis
Intracellular edema of keratinocytes, often seen in viral infections
Hydropic swelling (ballooning)
Infiltration of the epidermis by inflammatory or circulating blood cells
Exocytosis
Discontinuity of the skin exhibiting incomplete loss of the epidermis
Erosion
Discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis and subcutaneous fat
Ulceration
Formation of vacuoles within or adjacent to cells; often refers to basal cell-basement membrane zone area.
Vacuolization
Referring to a linear pattern of melanocyte proliferation within the epidermal basal cell layer. ….. melanocyte hyperplasia can occur as a reactive change or as part of a neoplasm of melanocytes.
Lentiginous
What are the 4 major skin cancers?
Actinic keratosis, squamous cell carcinoma, basal cell carcinoma, malignant melanoma
What condition is localized atypia of the epidermis, a precursor to SCC in situ?
Actinic keratosis
What is the etiology of actinic keratosis (2)?
UV light, arsenic
What is the morphology of actinic keratosis?
Tan, brown, red, or skin color lesions less than 1cm, rough like sand paper
What is the clinical significance of actinic keratosis?
If untreated, may progress to SCC
What histopatholotical characteristic of actinic keratosis proceeds SCC in situ?
Full thickness atypia
What is the 2nd most common skin cancer in older people exposed to sun?
Squamous cell carcinoma
What is the gross morphology of squamous cell carcinoma?
Exophytic, sharply defined red, scaling plaques, nodular, may ulcerate
What is the histopathology of squamous cell carcinoma?
Highly atypical cells at all epidermal levels, can spread to the dermis, metastasis is a late event
What is a “symmetrical, cup shaped tumor with a central depression filled with keratin debris”?
Keratocanthoma
What is the most common skin cancer in older people exposed to sun?
Basal cell carcinoma
Where is the only place basal cell carcinoma grows?
Only grows where there are hair follicles
What is the gross morphology of basal cell carcinoma?
Telangiectactic papule or nodule, may or may not be pigmented, a “rodent ulcer”
What are the 2 types of basal cell carcinoma?
Multifocal, superficial; nodular
Where is basal cell carcinoma mostly located?
On the face
What are the ABCDE of malignant melanoma?
Asymmetry, Border, Color, Diameter, Elevation
What are a few other suspicious signs of malignant melanoma?
Rapid growth, bleeding, itchy, sloughing
What are the 4 types of malignant melanoma?
Lentigo maligna, superficial spreading, acral-lentigous, nodular
Which type of melanoma is the most common?
Superficial spreading
Which 2 types of melanoma are the most aggressive?
Nodular, acral-lentigous
