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Pathology > Skin > Flashcards

Skin Flashcards

1
Q

What is the top layer of skin?

A

Horny Layer

Stratum corneum

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2
Q

What layer is between the Corneum and Spinosum?

A

Stratum Granulosm

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3
Q

What does the Granule in Granulosm refer to?

A

Keratinohyaline granules

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4
Q

What layer is between the Stratum Granulosm and the Stratum basalis?

A

Stratum Spinosum

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5
Q

What is below the dermis in skin?

A

Subcutaneous fat

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6
Q

What is septae made up

A

fibrous connective tissue

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7
Q

Why is it important to know about fat lobules?

A

Because there are inflammatory diseases of fat tissue as well - panniculitis

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8
Q

What is an excoriation?

A

Scratch: A lesion breaking the epidermis and causing a red linear mark

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9
Q

What is lichenification

A

Thick/rough skin

Usually occurs due to repeated rubbing

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10
Q

What is a macule

A

flat circumscribed area that is 5mm or less and distinguished by differing skin color

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11
Q

What is a papule

A

elevated lesion 5mm or less in diameter

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12
Q

What do you call a macule if it is greater than 5mm?

A

Patch

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13
Q

nodule

A

papule that is greater than 5mm

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14
Q

Pustule

A

Discreet, pus-filled, raised lesion

Pus filled Papule

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15
Q

Scale

A

Dry, plate-like

from defects in keratinization

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16
Q

Small blister

A

vesicle

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17
Q

Large blister

A

bulla

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18
Q

Acantholysis

A

loss of intercellular adhesion of keratinocytes

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19
Q

Aconthosis

A

diffuse epidermal hyperplasia

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20
Q

What does -tosis mean

A

Too much of something and no inflammation

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21
Q

Dyskeratosis

A

Abnormal keratinization occurring prematurely within individual cells or groups of cells below stratum granulosum

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22
Q

Hyperkeratosis

A

Hyperplasia of the stratum corneum

Typically a qualitative abnormality of keratin

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23
Q

Lentiginous

A

Linear melanocyte proliferation along the epidermal basal cell layer

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24
Q

Papillomatosis

A

Hyperplasia and enlargement of the dermal papillae

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25
Q

Parakeratosis

A

Keratinization characterized by retention of the nuclei in the stratum corneum

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26
Q

Where is parakeratosis normal?

A

Buccal mucosa (and in some other mucosae)

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27
Q

Spongiosis

A

Edema of the epidermis

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28
Q

What does acute inflammation mean in dermatology

A 
Days to weeks (not 24 hours)
Mononuclear infiltrate (vs. Neutrophilic)
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29
Q

Describe a plaque

A

elevated, flat-topped lesion

usually greater than 5mm in diameter

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30
Q

What is the common name for urticaria

A

hives

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31
Q

What causes hives

A

dermal microvascular hyperpermeability

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32
Q

What cell is integral to hives

A

Mast Cells

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33
Q

Urticaria is a Type ___ Hypersensitivity

A

Type 1

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34
Q

What molecule is released by mast cells to cause hives

A

Histamine

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35
Q

What are wheals?

A

Pruritic plaques specific to hives

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36
Q

Type 1

A

Exposed to antigen
IgE
Mast Cells

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37
Q

Type 2

A

IgG/IgM

Sensitivity to autoantigen

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38
Q

Type 3

A

Immune Complex Mediated
Deposition of complex in distant tissue sites
e.g. Lupus

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39
Q

Type 4

A

Cell mediated
Activated T Cells activate Macrophages
e.g. MS

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40
Q

Allergic contact dermatitis

A

topical exposure to antigen

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41
Q

Atopic dermatitis

A

allergic exposure that may have a genetic component

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42
Q

Drug related eczematous dermatitis

A

Hypersensitivity to a drug

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43
Q

What is pruritus

A

itching

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44
Q

Erythema Multiforme

A

Uncommon
Self-limited
Hyper response to drugs

45
Q

What type of lesion is associated with erythema multiforme

A

Targetoid

this and lyme disease are the only diseases with it

46
Q

What causes life threatening forms of E. multiforme

A

Drugs

47
Q

What happens with serious forms of E. multiforme?

A

Sloughing of epidermis (life threatening)

48
Q

Chronic Inflammatory Dermatoses

A

Months to Years
Lichenification
e.g. psoriasis, lichen planes, lichen simplex chronicus

49
Q

Psoriasis

A

T cells home to dermis and induce hyperplasia and proliferative changes

50
Q

What risk is increases with psoriases

A

cardiovascular

51
Q

What lesions indicate Psoriasis

A

Salmon colored plaques with silver/white scales

52
Q

What joint condition is associated with Psoriasis?

A

Arthritis

53
Q

Lichen Planus

A

CD8 response to basal cell layer at dermoepidermal junction

54
Q

What age group gets lichen planus

A

Middle aged adults

55
Q

Prognosis of lichen planus

A

resolves in 1-2 years but oral version requires treatment

56
Q

Necrotic basal cells of lichen planus

A

Civatte bodies

57
Q

Other lichen planus key terms

A

Wickham striae
Zig zag dermoepidermal interface
chronicity
Reticular lesion pattern

58
Q

Lichen simplex chronicus

A

Roughening of the skin with appearance of lichen on a tree

59
Q

What causes LSChronicus

A

response to local trauma such as rubbing or scratching

60
Q

What is ectasia

A

dilation of anything in pathology

61
Q

Impetigo lesion

A

Small macule that evolves to larger lesion

Honey colored crust of dried serum

62
Q

What bacterium causes Impetigo

A

Staph aureus

Strep pyogenes

63
Q

What causes warts

A

HPV

64
Q

What kind of proteins do HPV virions produce

A

oncoproteins

65
Q

verruca vulgaris

A

standard wart

papular rough surface

66
Q

verruca plana

A

flat, on palms and face

67
Q

verruca plantaris/palmaris

A

foot/hands

68
Q

Condyloma acuminatum

A

HPV genital warts

69
Q

Pemphigus

A

Group of rare autoimmune blistering disorders

70
Q

What causes pemphigus lesions

A

loss of intercellular attachment between epidermal cells and squamous mucosae
Due to autoantibodies to intercellular adhesion molecules

71
Q

pemphigus vulgaris

A

suprabasal acantholytic blisters

72
Q

Pemphigus foliaceus

A

cutaneous only

subcorneal acantholytic blisters

73
Q

IgA pemphigus

A

subcorneal/intraepidermal acantholytic blisters

74
Q

Paraneoplastic permphigus

A

He said “bear in mind” when describing the term Paraneoplastic

75
Q

Pemphigus Pathophysiology

A

Type II hypersensitivity

IgG in vulgaris

76
Q

Pemphigus vulgaris direct immunofluorescence

A

Deposition of antibodies in between all epithelial cell layers

77
Q

Pemphigus foliaceus immunofluorescence

A

Autoantibodies deposited mostly in superficial layers of epidermis (sub-corneal acantholytic blister)

78
Q

Pemphigus vulgaris clinical

A

middle aged or older

painful blisters

79
Q

fogo selvageum

A

bite of black fly lesion

80
Q

Bullous pemphigoid

A

Know the difference b/w this and pemphigus for test

81
Q

Describe pemphigoid bullae

A

Non acantholytic subepidermal

Rich in eosinophils

82
Q

Bullous pephigoid clinical

A

tight bullae don’t rupture (missed the rest)

83
Q

Dermatitis herpetiformis

A

very itchy urticaria and grouped vesicles

84
Q

What is dermatiti herpetiformis associated with

A

celiac disease

85
Q

/What type of antibodies are assiciated with D. herpetiformis

A

granular IgA to epidermal transglutaminase

86
Q

Where are the IgA deposits found in immunoflurorescene for dermatitis herpetiformis?

A

Tips of dermal papillae

Discontinuous - only disease with this pattern

87
Q

Seborrheic Keratosis

A

Pigmented epidermal tumors in middle to older aged persons

Stuck on appearance

88
Q

What mutation is associated with SK?

A

FGF3

89
Q

What other disease is associated with FGF3 mutations

A

Achondroplasia

90
Q

Paraneoplastic

A

Tumor triggers other problems around the body

91
Q

What is characteristic of SK from a histologic standpoint

A

Horn cysts of keratin

92
Q

Actinic keratosis

A

Premalignant sun exposure related lesions with prominent hyperkeratosis

Atypia of lower portion of epidermis

recommend excision

93
Q

Solar elastosis

A

Grey blue damaged layer due to sun exposure

94
Q

Squamos cell carcinoma

A

More men than women

sun exposure

p53 mutation

mutation of HRAS oncogene

Invasion of basement membrane into underlying stroma

95
Q

What does in-situ mean

A

full layer thickness without basement membrane penetration

96
Q

Invasive SCC

A

Projections of atypical cells into basement membrance

The infiltrative tongues often have keratinization

97
Q

Basal Cell Carcinoma

A

Slow growing
Rarely metastasizes
Sun exposure in fair skinned people

98
Q

Describe BCC lesion

A

Pearly papule with prominent vascular markings

99
Q

BCC and Dentistry

A

Gorlin syndrome with PTCH mutations

100
Q

What is Gorlin syndrome

A

Hereditary
Multiple BCCs even at a young age

Keratocystic odotogenic tumors of jaw

Palmar pits

101
Q

What is Gorlin Syndrome also known as?

A

Nevoid basal cell carcinoma syndrome

102
Q

What are benign melanocytic leasions

A

Nevus

103
Q

Malignant melanocytic lesions

A

melanoma

104
Q

Junctional nevus

A

flat and pigmented

105
Q

Compound

A

Raised and pigmented

106
Q

Intradermal

A

Raised and less pigmented because it is skin being pushed up from below

107
Q

Dysplastic nevi

A

Features in between benign and malignant

108
Q

Melanoma v. Nevus

A

Larger than nevi
Variation in pigmentation
Irregular borders

109
Q

ABCs of melanoma

A 
Asymmetry
Borders
Color
Diameter
Evolution

Pathology (12 decks)

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