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High Yield Pathoma > Skin > Flashcards

Skin Flashcards

1
Q

Connects the keratinocytes in the stratum spinosum.

What is the disease process involved with auto antibodies targeting the desmoglein which is a component in this structure?

A

Desmosomes
— structural support via intermediate filament interactions: cytokeratin, desmoplakin

Pemphigus vulgaris

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2
Q

Increased thickness in epidermis

Proliferation of keratinocytes

A

Acanthosis

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3
Q

Excess keratin (hyperkeratosis) with retention of nuclei

A

Parakeratosis

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4
Q

Acanthosis with parakeratosis

A

Psoriasis

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5
Q

Collection of neutrophils within stratum corneum seen in Psoriasis

A

Munro microabscesses

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6
Q

What is the mechanism behind Auspitz sign?

A

In psoriasis, dermal papillae is elongated. Epidermis above this is thinned (granulosum)
Easier to expose the blood vessels.
When silvery plaque is scraped, pin point bleed from exposed blood vessels — Auspitz sign

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7
Q

Saw tooth appearance at the dermal epidermal junction (lymphocytic infiltration)

A

Lichen planus

6 Ps
Polygonal
Purple
Planar Papules
Pruritic
Plaques
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8
Q

What infection is associated with Lichen Planus

A

Hepatitis C virus infection

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9
Q

Separation of the epidermal cells

A

Acantholysis

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10
Q

What is the pathophysiology in Pemphigus vulgaris?

A

Autoimmune destruction of desmosomes

IgG antibodies against desmoglein (component of desmosome)

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11
Q

Why is the basement layer intact in Pemphigus Vulgaris?

A

Desmosomes connect the cells in stratum spinosum.

Hemidesmosomes anchor the basement membrane at the dermal epidermal junction and are unaffected in Pemphigus vulgaris.

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12
Q

Affectation of Pemphigus vulgaris include

A

Skin

Oral mucosa

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13
Q

Pemphigus Vulgaris immunofloresence finding.

A

Fish net/reticular pattern around epidermal cells

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14
Q

Row of tombstones

A

Pemphigus vulgaris

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15
Q

Autoimmune

IgG antibodies against hemidesmosomes (epidermal basement membrane)

A

Bullous pemphigoid

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16
Q

Why is there tense bullae in Bullous pemphigoid?

A

Separation is under the epidermis, and so the bullae composed of the entire thickness of the epidermal layers

Contain eosinophils

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17
Q

IF of Bullous pemphigoid

A

Linear patter at the epidermal-dermal junction

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18
Q

T or F

Bullous pemphigous affects the oral mucosa

A

False

Spares the oral mucosa, affects the skin

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19
Q

Associated with Celiac Disease

A

Dermatitis herpetiformis

20
Q

Autoimmune deposition of IgA at the tip of the dermal papillae

A

Dermatitis herpetiformis

Deposition create little blisters at the tip of dermal papillae resembling herpes vesicles

21
Q

Why is a gluten free diet in Celiac Disease, helpful in treatment of dermatitis herpetiformis?

A

IgA antibody are anti bodies against gluten that cross react with reticulin fibers that attach the basement membrane to the dermis

22
Q

Targetoid rash bullae

A

Erythema multiforme

Targetoid appearance due to central necrosis

23
Q

Stuck on appearance

Proliferation of squamous cells with pseudocyst/horn cysts (HM: circular spaces with abundant pink keratin)

A

Seborrheic keratosis

24
Q

Sudden onset of multiple seborrheic keratoses

A

Leser-Trelat sign

25
Q

What is a Leser Trelat sign associated with?

A

Underlying malignancy (GI, lymphoid, paraneoplastic process)

26
Q

Associated with insulin resistance or malignancy

Epidermal hyperplasia with hyperpigmentation

A

Acanthosis nigricans

27
Q

Autosomal recessive defect in enzymes necessary for nucleotide excision repair?

Carcinoma most at risk for is?

A

Xeroderma pigmentosum
— no nucleotide excision repair pathway that excise and repair pyrimidine dimers from sun exposure

At risk for
— Basal Cell CA

28
Q

Elevated nodule
Central area of ulceration
Surrounded with telangiactasia

Classically arise in the upper lip

A

Basal Cell Ca

29
Q

Classic finding in histology of Basal Cell CA

A

Peripheral palisading

30
Q

How does UV B sunlight cause damage?

A

Induce DNA damage by forming pyrimidine dimers

31
Q

Risk factors for squamous cell CA

A

Immunosuppressive therapy
Arsenic poisoning
Chronic inflammation

32
Q

Ulcerated, nodular mass

Usually on the face, classically involving the lower lip

A

Squamous cell CA

33
Q

Hyperkeratotic, scaly plaque on face back or neck

Precursor to SCC

A

Actinic keratosis

34
Q

Where is melanin made?

A

Melanosomes

Passed of to keratinocytes resulting in skin pigmentation

35
Q

Melanocytes are derived from which embryonic structure?

A

Neural crest cells

36
Q

Autoimmune destruction of melanocytes

Localized

A

Vitiligo

37
Q

Due to enzyme defect (usually tyrosinase) that impairs melanin production

A

Albinism

38
Q

What is increased in freckles?

A

Melanosomes

39
Q

Malignant neoplasm of melanocytes

Most common cause of death from skin CA

A

Melanoma

40
Q

Most common subtype of Melanoma, dominant early radial phase, good px

A

Superficial Spreading

41
Q

Lentiginous proliferation, good prognosis

Melanoma subtype

A

Lentigo Maligna melanoma

42
Q

Early vertical phase
Subtype melanoma
Poor prognosis

A

Nodular

43
Q

Arises on palms or soles
Often in dark skinned
Not related to UV light exposure

A

Acral lentiginous

44
Q

Where is the separation at Staphylococcal Scalded Skin Syndrome?

A

Stratum granulosum

45
Q

Where is the separation at TEN?

A

Dermal epidermal junction

46
Q

Firm, pink umbilical papules

Most often arise in children

A

Molluscum contagiosum

47
Q

What is the causative agent from molluscum contagiosum and what is the hallmark finding in LM

A

Pox virus, molluscum bodies (viral inclusion bodies of pox virus)

High Yield Pathoma (2 decks)

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