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Pathology 2 > Skin and Mucosal Disease 2 > Flashcards

Skin and Mucosal Disease 2 Flashcards

1
Q

What are the 2 stains/analyzing tools used for biopsies to distinguish between pemphigus, pemphigoid, and lichen planus?

A
  • Half formalin-fixed for H&E

* Half frozen for direct immunofluorescence (DIF) ->Michel’s solution

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2
Q

________ immunofluorescence is a biopsy

• Performed on the patient’s tissue (biopsy specimen) using an anti-human antibody panel

A

• Direct immunofluorescence

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3
Q

______ immunofluorescence is a serological test

• Performed on animal tissue (esophagus) using the patient’s serum antibodies

A

• Indirect immunofluorescence

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4
Q 
Histopathology of \_\_\_\_\_\_\_
•Hyperkeratosis
•Saw tooth rete ridges -> elongated
•Band- like infiltrate of lymphocytes
•Liquefaction degeneration of basal cell layer
A

Lichen Planus

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5
Q

Does pemphigus destroy desmosomes or hemidesmosomes?

A

Desmosomes

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6
Q

Does pemphigoid destroy desmosomes or hemidesmosomes?

A

hemi desmosomes

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7
Q

Which disease shows a fish net pattern on DIF?

A

Pemphigus

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8
Q

Which disease shows an intraepithelial split?

A

Pemphigus

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9
Q

Which disease shows a sub epithetlial split?

A

Pemphigoid

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10
Q

Which disease shows a dark green band at basement zone on DIF?

A

Pemphigoid

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11
Q

An immunologically mediated self limited
mucocutaneous disease
Young adults
Sudden onset of widespread painful superficial
mucosal ulcers and target lesions of skin
Crusted ulcers on lips
May be recurrent

A

Erythema multiforme

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12
Q

Which disease shows bullseye/target/iris lesions?

A

erythema multiforme

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13
Q

Which type of hypersensitivity occurs in erythema multiforme?

A

Type 3

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14
Q

•Antibody response to an exogenous antigen produces circulating
immune complexes which are deposited in vessels

A

Type III Hypersensitivity Response seen in EM

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15
Q 
The following are associated with \_\_\_\_\_\_:
Drugs
• Sulfonamides
• Penicillin
• Diphenylhydantoin
• Tetracycline
• Codeine
• Ibuprofen
• ~ 30 others
Bugs
• Herpes simplex
• Mycoplasma pneumoniae
• Epstein Barr Virus
• Hepatitis B
• Streptococci
Other
• Tumors (Leukemia, Lymphoma)
• Immunization (DPT)
• Inflammatory bowel disease 
• Sarcoidosis
• Sunlight
A

EM

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16
Q 
• Prodromal symptoms
• Sudden onset of 
mucocutaneous lesions
• Self-limiting disease
• Lasts 2-6 weeks
• Avoid dehydration
• Recurrent episodes
• Lesions may be limited 
to oral mucosa
A

Erythema Multiforme

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17
Q

•Stevens-Johnson Syndrome, a severe form of erythema multiforme, usually triggered by a drug, rather than an infection

A

Erythema Multiforme Major

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18
Q
  • Most severe form of erythema multiforme, usually seen in older individuals, almost always triggered by drug exposure
  • Diffuse sloughing of epidermis leading to a scalded appearance, fluid loss and infection
  • Treated as severe burn victims
A

Toxic Epidermal Necrolysis (Lyell Disease)

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19
Q
  • A multisustem autoimmune disease most common in adult women in child-bearing years
  • Autoantibodies - anti-nuclear antibodies (ANA)
  • Immune complexes are deposited throughout the body, especially kidney and blood vessels
A

Lupus Erythematosus

20
Q

____ lupus erythematous
• Skin
• No systemic involvement

A

Discoid LE

21
Q

____ lupus erythematous
• Skin
• Limited systemic involvement

A

Subacute cutaneous LE

22
Q

____ lupus erythematous
• Systemic involvement
• Periodic skin rashes

A

Systemic LE

23
Q
  • Chronic, limited to skin and mucosa
  • Sun-exposed skin
  • Scaly, erythematous patches
  • Cosmetic problems
  • Cutaneous atrophy
  • Scarring
  • Pigmentation
A

Discoid Lupus Erythematosus

24
Q 
Oral Mucosal Lesions in \_\_\_\_\_\_\_\_\_
•May be seen in any form of disease
•Red and white lesions that 
may be clinically identical to 
erosive lichen planus
A

Lupus Erythematosus

25
Q
  • Most common form of lupus
  • Highest morbidity
  • Kidney involvement –glomerulonephritis - renal failure
  • Butterfly rash 50% - malar area and nose, aggravated by sunlight
  • Libman-Sacks endocarditis
  • Arthritis, arthralgia, heart and lung involvement, anemia, bone marrow depression, vasculitis, skin rashes
A

Systemic Lupus Erythematosus SLE

26
Q

Tx of ________:
• Systemic corticosteroids
• Antimalarial drugs - Plaquenil
• Avoid excessive exposure to sunlight
• Prognosis depends on organs affected and disease activity
• Renal failure most frequent cause of death

A

Systemic lupus ery

27
Q
  • An autoimmune disease of adults, predominately females, characterized by excessive fibrosis
  • May be limited to the skin or be widespread affecting various organ systems
  • May be associated with other autoimmune diseases
A

Systemic Sclerosis

28
Q
  • Slow continuous replacement of loose fibrovascular connective tissue with dense collagen
  • Fibrosis causes loss of mobility and altered function of organs - skin, esophagus, salivary glands, kidneys, lungs, heart, muscle
A

Systemic sclerosis

29
Q 
Oral manifestations of \_\_\_\_\_\_\_
•Microstomia
•Xerostomia
•Generalized widening 
of PDL space
•Mandibular 
resorption
A

Systemic scleorsis

30
Q

Mask-like face
•Telangiectasia
•Raynaud phenomenon

A

Systemic sclerosis

31
Q 
• Arterial spasm in 
response to cold or 
emotional stress 
• Pallor, cyanosis and 
then erythema
• Numbness, tingling 
or pain on recovery.
A

Raynaud Phenomenon

32
Q 
Hands and Fingers
•Fibrosis, stiffness, 
deformity
•Ischemia, atrophy and 
ulceration
A

Systemic sclerosis

33
Q

What makes up CREST syndrome seen in systemic sclerosis?

A 
• Calcinosis
• Raynaud’s
Phenomenon
• Esophageal
dysfunction
• Sclerodactly
• Telangiectasia
34
Q

• A group of mechanobullous diseases involving structural
defects in the attachment apparatus
• Many hereditary forms involving different defects in the
attachment apparatus
• Recessive dystrophic form is most severe, involving defective
type VII collagen anchoring fibrils
• Not an autoimmune disease. Defective structural proteins

A

Hereditary

Epidermolysis Bullosa

35
Q

• Primarily a severe and debilitating skin
disease in which blisters form at sites of
minor trauma and may heal with scarring
(Nikolsky + )

A

Hereditary Epidermolysis Bullosa

36
Q

Oral Sequalae
of _________
•Normal diet produces bullae that heal with scarring leading to obliteration of vestibule, ankyloglossia, microstomia and esophageal stricture
-Can have enamel hypoplasia in junctional type

A

Epidermolysis bullosa

37
Q

What condition does this person have?
• My hands have been like this as long as I can remember
• I lost all my fingernails by age 2 and they fused into this fist shape
• I have never had hand surgery because I have chosen not to
• I have a lot of thumb space still free, meaning my thumbs have not fused, so I can do things such as write, type etc. with no problem

A

Epidermolysis Bullosa –Recessive Dystrophic

38
Q
  • A common, chronic, genetically-determined, inflammatory and hyperproliferative skin disease
  • Exacerbations and remissions
  • Association with certain HLA types
  • Immunoregulatory disorder –T cells trigger inflammation
  • Defect in control of keratinocyte proliferation -turnover rate 8x normal
A

Psoriasis

39
Q
  • Well-demarcated, red plaques covered by silvery scales
  • Auspitz Sign - removal of scale leaves pinpoint bleeding area
  • Koebner Phenomenon - lesions develop following trauma to normal-appearing skin
A

Psoriasis

40
Q

•Removal of scale leaves small
pinpoint bleeding
-associated with psoriasis

A

Auspitz Sign

41
Q

Development of lesions
following trauma to normal-
appearing skin
-associated with psoriasis

A

Koebner Phenomenon

42
Q

Histopathology of ______

Intra-epithelial microabscesses

A

Psoriasis

43
Q

What condition presents as the same lesion intra-orally as psoriasis?

A

Erythema migrans

44
Q 
Treatment of \_\_\_\_\_\_\_
•Topical medications 
- corticosteroids
•Phototherapy - UVB
•Photochemotherapy 
–PUVA (psoralen and UVA)
A

Psoriasis

45
Q

•Hereditary, autosomal
dominant mutation of
keratin genes that
requires no treatment

A

White Sponge

Nevus

46
Q

• Asymptomatic, bilateral, white lesions with a thick, folded, consistency
“spongy” appear before puberty
• Primarily involves buccal mucosa, but may affect other mucosal
surfaces –anogenital, esophageal

A

White sponge nevus

47
Q

Histopath of ______:

Perinuclear keratin condensation

A

White Sponge Nevus

Pathology 2 (15 decks)

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