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patho II > Skin I (b) > Flashcards

Skin I (b) Flashcards

1
Q

patho of Seborrhoeic Keratosis

A

Mutations in fibroblast growth factor (FGF) receptor 3

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2
Q

Epi of Seborrhoeic Keratosis

A

middle-aged or older persons

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3
Q

**

CF of Seborrhoeic Keratosis

A
  • Round, exophytic, coin-like plaques
  • “Stuck-on” appearance
  • Tan to dark brown colour
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4
Q

What do you observe? what skin disorder is this?

A

Disorder : Seborrhoeic Keratosis
obv: Dark brown, Round, exophytic, coin-like plaques

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5
Q

**

Microscopic Findings:
* Monotonous sheets of small cells that resemble the basal cells of the normal epidermis
* Variable melanin pigmentation is present within these basaloid cells
* Hyperkeratosis at the surface
* Presence of small keratin-filled cysts (Horn cysts)
* Down-growth of keratin into the main tumour mass (Pseudo-Horn cysts)

features of?

A

Seborrhoeic Keratosis

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6
Q

Patho of Acitinic Keratosis

A

TP53 mutations caused by UV light-induced DNA damage

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7
Q

Risk factors of Acitinic Keratosis

A

Chronic exposure to sunlight

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8
Q

**

Clinical presentation of Acitinic Keratosis

A

Small (<1cm), Rough, erythmatous(red) or brownish papules

  • rough –> sandpaper- like on touch
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9
Q

**

Macro features:
- red, scaly lesions w/ rough texture
Microscopic findings:
* Cytologic atypia in the lower portions of the epidermis
* Accompanying hyperplasia of basal cells or atrophy and diffuse thinning of the epidermal surface
* Thickened, blue-gray elastic fibers in the dermis (dermal solar elastosis)
* Thickened stratum corneum, with retained nuclei (parakeratosis)

features of?

A

Actinic Keratosis

* rough texture –> sand paper like

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10
Q

Acitinic Keratosis is asso. w/ an increased risk of developing?

A

SCC- Squamous Cell Carcinoma

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11
Q

Risk factors of SCC?

A
  • Chronic exposure to sunlight (e.g. Acitinic Keratosis)
  • Industrial carcinogens (tars and oils)
  • Chronic ulcers
  • Old burn scars
  • Ingestion of arsenicals
  • Ionising radiation
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12
Q

Epi of SCC

A

Older people; M > F

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13
Q

Patho of SCC

A
  • TP53 mutations caused by UV light-induced DNA damage
  • Mutations in HRAS
  • Loss-of-function mutations in Notch receptors,
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14
Q

Clinical presentation of SCC in situ

A

Sharply defined, red, scaling plaques

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15
Q

Clinical presentation of invasive SCC

A

Nodular, with variable scale and ulceration

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16
Q

Micro features : Highly atypical cells at all levels of the epidermis, with nuclear crowding and disorganisation

Features of SCC in situ or Invasive SCC?

A

SCC in situ

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17
Q

Micro features: Penetration of the basement membrane

features of SCC in situ or invasive SCC?

A

Invasive (infiltrating) SCC

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18
Q

What do you observe? what skin condition causes this?

A

Disorder: SCC
Obv: sharply defined, ulcerative red lesions

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19
Q

CF of SCC

A

Ulcerative Red lesions (that appear on the face, lips and ears)

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20
Q

**

What skin cancer presents w/ Keratin pearls on Histology?

A

Squamous Cell Carcinoma (Well-diffrentaited form)

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21
Q

Risk factors of Basal Cell Carcinoma

A

Chronic exposure to sunlight

22
Q

Epi of Basal Cell Carcinoma

A

Older people

23
Q

Patho of Basal Cell Carcinoma

A

Dysregulation of the Hedgehog pathway

24
Q

**

Clinical presentation of Basal Cell Carcinoma

A
  • Pearly papules, often with prominent, dilated sub-epidermal blood vessels (Telangiectasia)
  • Some tumours contain melanin pigment
25
Q

What do you observe? What skin condition causes this?

A

Disorder: Basal Cell Carcinoma
Obv: A–> Paerly papule
B –> Dilated sub-epidermal blood vessels (Telangiectasia)

26
Q

Microscopic Findings:
* Tumour cells resemble the normal epidermal basal cell layer
* Palisading (aligned) nuclei
* Separation of the peripheral border from the stroma (reduced stroma), with a creation of a characteristic cleft

features of?

A

Basal Cell Carcinoma

27
Q

————: Benign congenital or acquired neoplasm of melanocytes

A

Melanocytic Naevus (Common mole)

28
Q

Patho of Melanocytic Naevus

A

Activating mutation in BRAF

29
Q

What strongly predisposes to Skin cancer?

A

Skin exposure

30
Q

Epi of Melanocytic Naevus

A

Very common

31
Q

Clinical presentation of Melanocytic Naevus

A
  • Small papules; Size: ≤5 mm
  • Tan-to-brown, uniformly pigmented
  • Well-defined, rounded borders
32
Q

the 3 types of Melanocytic Naevus

A

1) Compound
2) Junctional
3) intradermal naevus

33
Q

What is the diffrence (Microscopically) btw Compound and Junctional Melanocytic Naevus ?

A

Junctional –> Nest of Mealnocytes grow along the dermo-epidermal junctions
Compound –> Melanocytes grow within the Dermis only

34
Q

how do junctional / compound Melanocytic Naevus look like?

A

Compound–> well-defined, Brown nodule w/ rounded borders
Junctional –> Flat uniform bronw macule

35
Q

micro: Epidermal nests lost entirely, and the cells grow into the underlying dermis in nests or cords

type of Melanocytic Naevus

A

Intradermal naevi

36
Q

———– : Presence of a melanocytic lesion at birth

A

Congenital Naevus

37
Q

what do you observe? Cause

A

medium and giant hairy naevus
syndrome: Congential Naevus

38
Q

Microscopic Findings:
* Junctional component
* Stromal component
* Nevomelanocytes extend into the reticular dermis
* Patterns of dermal involvement: i. Diffuse, ii. Interstitial or iii. Perivascular
* Commonly, adnexal involvement
* Possible involvement of nerves

features of?

A

Congenital Naevus

39
Q

Epi of Dysplastic Naevus

A

Sporadic or familial (Familial Dysplastic Naevus Syndrome)

40
Q

patho of Dysplastic naevus

A

Activating mutation in BRAF

41
Q

**

CP of Dysplastic naevus

A
  • Larger than acquired naevi (>5 mm)
  • Numerous (in Familial Dysplastic Naevus Syndrome)
  • Flat macules to slightly raised plaques, with a “pebbly” surface
  • variable pigmentation (variegation) * Irregular borders
42
Q

Macroscopic features:
- Uneven colour with dark brown centers and lighter, uneven edges
- Large and irregular in shape

Microscopic features:
- irregular nuclear contours & hyperchromasia
- Nevus cell nests within the epidermis may be enlarged and exhibit abnormal fusion or coalescence with adjacent nests (bridging)
- Melanin pigment that is phago- cytosed by dermal macrophages
- Subepidermal lamellar sclerosis (‘lamellar fibroplasia’)

features of?

A

Dysplastic Naevus

43
Q

Risk factors of Melanoma

A

1) Sun exposure (intense)
2) Hereditary predisposition under Familial Dysplastic Naevus Syndrome

44
Q

patho of melanoma

A
  • Somatic activating mutations in the proto-oncogenes BRAF or NRAS
  • Activating mutations in the c-KIT receptor tyrosine kinase
45
Q

who is at most risk of Melanoma

A

Fair-skinned individuals

46
Q

Clincial presentaitons of melanoma

A
  • Rapid enlargement of a pre-existing naevus
  • Itching or pain
  • Development of a new pigmented lesion, during adult life
  • Irregularity of the borders of a pigmented lesion
  • Variegation of colour within a pigmented lesion
47
Q

**

THE ABCDE of melanoma

A
48
Q

the 4 types of melanoma

A

1) Superficial spreading melanoma
2) Lentigo maligna
3) Nodular melanoma
4) Acral melanoma

49
Q

state the diffrence (Macro) btw Superficial spreading melanoma and Letingo Maligna

A

Letingo maligna: Asymmetric complex macular pigmented lesion
Superficial spreading melanoma: Asymmetric comples Silhoutte

50
Q

**

Microscopic Findings:
* Malignant cells grow as poorly formed nests or as individual cells at all levels of the epidermis (pagetoid spread) and in expansile dermal nodules (radial and vertical growth phases)
* large nuclei with irregular contours
* Chromatin is characteristically clumped at the periphery of the nuclear membrane
* Prominent “cherry red” eosinophilic
nucleoli

features of?

A

Melanoma

51
Q

**

tumour marker used to detect melanoma

A

1) S-100
2) MART-2/ Melan-A
3) HMB45
4) AE1/AE3
5) Vimentin

52
Q

**

Prognosis of Melanoma

A

Depth of tumor (Breslow thickness) correlates w/ risk of metastasis

patho II (29 decks)

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