Skin Diseases Flashcards
heterogenous group of disorder with different prognoses; characterized by blisters, ulcer, or erosions of skin, mucosa, or both; many with immunological etiology
vesiculobullous diseases
superficial skin infection (s. pyogenes and s. aureus); most common in children with poor hygeine, crowded living conditions and hot and humid climates
impetigo
arises in areas of trauma; multiple vesicles that rupture, leaving a honey-colored crust
impetigo
common chronic mucocutaneous disease; probably immune-mediated; may have only skin, only oral, or both; skin lesions- purple, polygonal, pruritic papules
lichen planus
reticular or erosive oral lesions; reticular-interlacing white lines, buccal mucosa; erosive-ulcers with erythema and white streaks
lichen planus
hyperkeratosis; degeneration of basal cell layer; “saw-toothed” rete ridges
lichen planus
“band-like” infiltrate of lymphocytes
lichen planus
shaggy band of fibrinogen at basement membrane zone seen with direct immunofluorescence
lichen planus
drug of choice for lichen planus
betamethasone gel
chronic skin disease characterized by an increase in the proliferative activity of keratinocytes; both genetic and environmental factors
psoriasis
2nd decade, waxing and waning course with lesions improving during the summer; scalp, elbows, knees
psoriasis
erythematous plaques with silvery scales
psoriasis
marked hyperparakeratosis; elongated rete ridges; perivascular inflammation; munro abscesses
psoriasis
PUVA (treatment for psoriasis) stands for
psoralen and ultraviolet A
hetergeneous group of inherited blistering mucocutaneous disorders; autosomal dominant or recessive; 3 broad categories: Simplex, Junctional, Dystrophic
epidermolysis bullosa
which form of epidermolyis bullosa?: vesicles/bullae that become ulcers and erosions that heal with scarring; gingival erythema, recession and reduction in vestibular depth
dominant dystrophic
which form of epidermolysis bullosa?: much more serious; secondary infection; mitten deformity; microstomia
recessive dystrophic
Intraepithelial clefting
epidermolysis bullosa (simplex)
subepithelial clefting (lamina lucida or lamina densa)
epidermolysis bullosa (junctional and dystrophic)
increased incidence of cutaneous squamous cell carcinoma
epidermolysis bullosa
acute, self-limiting ulcerative disorder, probably immune-mediate; 50%-unknown, 25%-drugs, 25%-herpes
erythema multiforme
EM- skin or mucosa only
erythema multiforme minor
EM (Stevens-Johnson syndrome)- at least two mucosal sites plus skin involvement
erythema multiforme major
EM- Lyell’s disease
toxic epidermal necrolysis
young adults; may experience prodrome; hemorrhagic crusting of lips; widespread oral ulcers with ragged margins; labial, buccal mucosa and tongue; “target” lesions of skin
EM
diffuse sloughing of the skin and mucosa; older patients
toxic epidermal necrolysis
destruction of keratinocytes; subepithelial edema; mixed inflammatory infiltrate; perivascular inflammation
EM
benign lesion associated with HPV types 2,4 and 40; relatively contagious, with potential for autoinoculation
verruca vulgaris (common wart)
most commonly in children; skin of hands; more commonly sessile; variable color, but typically white
verruca vulgaris
papillary, hyperkeratotic proliferation of epithelium; rete ridges appear to converge toward the center of the lesion; course keratohyaline granules
verruca vulgaris
koilocytosis
verruca vulgaris
controversial lesion of unknown etiology; UV exposure may play a role in its pathogenesis; self-limiting lesion with clinical and histopathologic resemblance to well-differentiated squamous cell carcinoma
keratoacanthoma
predominantly a lesion of skin; sessile, dome shaped lesion with central keratin plug
keratoacanthoma
commonly involves the vermilion border of the upper of lower lip; rapid enlargement allows for clinical differentiation from squamous cell carcinoma
keratoacanthoma
proliferation of squamous epithelium that may be difficult to distinguish from squamous cell carcinoma; dyskeratosis, keratin pearl formation
keratoacanthoma
central keratin-filled; adjacent epithelium appears normal; acute angle is formed between the adjacent epithelium and the lesion
keratoacanthoma
lesions will usually regress spontaneously in 6-12 months, but leave an unaesthetic depressed scar
keratoacanthoma
common lesion of the elderly; unknown etiology, but correlated with sun exposure; may be hereditary
seborrheic keratosis
exclusively a skin lesion; face, trunk, extremities; tan to brown roughened plaques; “stuck on” apperance
seborrheic keratosis
exophytic, papillary proliferation of basaloid cells; horn cysts and pseudo-horn cysts; 3 main types
seborrheic keratosis
multiple seborrheic keratoses may be an indicator of internal malignancy
Leser-Trelat sign
benign proliferation of nevus cells, which are derived from neural crest and are related to melanocytes; acquired or congenital; intraoral lesions are uncommon
acquired melanocytic nevus (mole)
3 stages of acquired melanocytic nevus
junctional; compound; intradermal
proliferation of nevus cells that vary in morphology depending upon their depth; superficially arranged in theques
acquired melanocytic nevus
proliferation of melanocytes within the subepithelial connective tissue; 2nd most common intraoral; tyndall effect
blue nevus
dendritic melanocytes in the connective tissue; usually arranged parallel to the surface
blue nevus
common premalignant lesion of skin; secondary to cumulative sun exposure (UV radiation)
actinic keratosis (solar keratosis)
face, dorsum of hands, scalp; irregular scaly plaques of variable color; rough “sandpaper” feel
actinic keratosis
hyperkeratosis and acanthosis; some degree of epithelial dysplasia; basophilic degeneration of underlying connective tissue
actinic keratosis
malignant neoplasm of melanocytes; may arise from preexisting benign melanocytic lesions or from skin subject to a history of acute solar damage; 3rd mors common cancer but #1 cause of death among skin cancers
melanoma
4 main types: lentigo maligna, superficial spreading(most common), nodular, acral lentiginous(most oral)
melanoma
A of ABCDs
asymmetry
B of ABCDs
irregular borders
C of ABCDs
color variegation
D of ABCDs
diameter greater than 6 mm
s of ABCDs
symptoms
atypical melanocytes along the basal epithelial layer (lateral growth phase); vertical growth begins as these celles invade the connective tissue
melanoma
melanocytic distribution throughout the epithelium seen in melanoma
pagetoid spread
extremely common low-grade cutaneous malignancy secondary to chronic sun exposure; tumor cells arise from the basal cell layer of skin and appendages
basal cell carcinoma
most common location is the middle of the face; associated with nevoid basal cell carcinoma syndrome
basal cell carcinoma
several forms, with noduloulcerative being the most common
basal cell carcinoma
basaloid cells in islands, strands and nests that arise from the basal layer of the epithelium and penetrate the underlying connective tissue
basal cell carcinoma
distinct peripheral palisading and stromal retraction
basal cell carcinoma
2nd most common of skin cancers; similar risk factors as basal cell carcinoma
squamous cell carcinoma
autosomal dominant genodermatosis characterized by a lack of cohesion among the surface epithelial cells; mutation affects the integrity of the desmosomal complex
darier’s disease (keratosis follicularis)
erythematous, pruritic papules of the skin; pits and keratoses of the palms and soles; nails that feature longitudinal lines, ridges, or splits
darier’s disease
multiple normal to white flat-topped papules; frequently seen on the palate or alveolar mucosa
darier’s disease
suprabasilar acantholysis; “test tube” rete ridges; central keratin plug; corps ronds and grains
darier’s disease
