Skin Patho Day 1 Flashcards
Macule
Primary Lesion
Flat, non-palpable
<1 cm in diameter
Patch
Primary lesion
Flat, non-palpable, >1 cm in diameter
Papule
Primary lesion
Elevated or depressed, palpable
<1 cm
Plaque
Primary lesion
elevated or depressed, palpable, >1 cm
Nodule
Primary lesion
Palpable, >1 cm in diameter and round
Vesicle
Primary lesion
Fluid-filled blister, <1 cm in diameter
Bulla
Primary lesion
Fluid filled lesion, >1 cm
Pustule
Primary lesion
Pus-filled blister
Wheal
Primary lesion
Edematous papules and plaques characteristic of hives
Telangiectasia
Primary lesion
dilated blood vessels
Purpura
Primary lesion
Area of hemorrhage, flat or elevated
Petechiae
Primary lesion
Pinpoint purpura
Scale
Secondary Change
Accumulation of stratum corneum
Crust
Secondary Change
Dried serum, pus
Lichenification
Secondary Change
Epidermal thickening with accentuation of skin markings
Induration
Secondary Change
Dermal thickening causing firm feeling
Excoriation
Secondary Change
Linear erosion caused by scratching
Erosion
Secondary Change
Open area with partial or full loss epidermis
Ulcer
Secondary Change
Open area with loss of part of dermis
(fissure=linear ulcer)
Nummular
Coin shaped
Geographic
irreg bordered
Polycyclic
Multiple round lesions coalesced together
Serpinginous
Wavy lines
Annular
Ring-like with central clearing
Arcuate
curved
Linear
Straight line
Targetoid
Like bull’s eye
Intertriginous
Within body folds
Keratohyalin granules
Filaggrin, involucrin, loricrin
Lamellar granules
Ceramides, cholesterol, fatty acids, hydrolyic enzymes (top lipid barrier of stratum corneum)
Pemphigus Vulgaris
Autoimmune IgG against desmoglein 1+3 in stratum spinosum –> intraepidermal erosions
- Oral and mucosal lesions
- Pos Nikolsky’s sign–> separation epidermis with stroke
- Can be fatal – tx prednisone, azathioprine, mycophenolate mofetil, ritixmab
Ichthyosis Vulgaris
Autosomal Dom. mutation in profilaggrin gene–defect in conified envelope
“Fish scales”, dry skin, hyperlinear palms (associated with atopic dermititis, allergies, asthma)
Physical blockers of UVB
Reflect and scatter UV
(zinc oxide, titanium dioxide)
Chemical blockers of UVB
Absorb UV
(PABA, oxybenzone, avobenzone)
Difference between papillary dermis and reticular dermis
Papillary dermis: rete ridges, more cellular, fine/loose collagen
Reticular dermis: more coarse/packed collagen
Marfan Sx
Autosomal Dominant–Fibrillin defect
- tall/thin body type
- long limbs/scoliosis
- flexible joints
- nearsightedness/dislocation eyes
- aortic dilation/mitral valve prolapse
Ehlers-Danlos Sx
Abnormalities in collagen production
- Fragile skin, scar prone
- flexible joints
- scoliosis of spine –> breathing affected
- rupture of organs
Morphea (Localized scleroderma)
Autoimmune aquired w/ sclerosis (thickening of collagen)
- erythematous/indurated plaques
- fibrotic/atrophic scars
- neuro
- limb issues
Systemic Sclerosis (CREST)
Aquired autoimmune characterized by sclerosis; puffy taut skin and pitting (middle aged women)
CREST [anti centrome antibody]
Calcinosis cutis
Raynaud phenomena
Esophageal dysmotility
Sclerodactyl
Telangiectasia
Systemic Sclerosis (Diffuse)
Aquired autoimmune characterized by sclerosis; puffy taut skin and pitting (middle aged women)
Diffuse–anti DNA topiosmerase I ab
sclerosis
pulmonary fibrosis
renal failure
GI disease
heart disease
Erythema Nodosum
Acquired disorder in women
Triggers=upper resp. strep, oral contraceptives, sarcoidosis, IBD, malignancy
Tender red nodules ON SHINS
BP230
Plakin responsible for cytoskeleton organization
BP 180
Type XVII collagen, basal keratinocyte to dermis
Bullous Pemphigoid
Autoimmune against BP230 and BP180 (hemidesmosomes)
- Nikolsky sign negative; less severe than Pemphis Vulgaris
- Antibodies BULL-OW the epidermis
- Pruritic uriticaria w/out blistering –> tense stable blisters
DIF=IgG and C3 along BMZ; IIF=staining at epidermal side
TX: steroids or immunosuppressants in elderly
Generalized Atrophic Benign Epidermolysis Bullosa
Genetic–> mutated BMZ protein (i.e. BP180)
- blisters, skin fragile, hair problems, minimum trauma causes blisters
- immunofluroscence shows less protein/none in BMZ
Mucous Membrane Pemphigoid
Autoimmune: antibodies against BP 180 or BP 230, IB4, laminin 332
- erosions/lesions in eye=blindness
- in older people; 70% association with other malignancies
- Blistering of mucous membranes; scars, strictures, synechiae, etc.
DIF=deposits along BMZ
IIF: staining epidermal/dermal and epidermal/dermal based on specific issue
Anti-Laminin 332–> also cancer, dermal split
Herlitz Junctional Eb
Inherited laminin 332 malfunction
- prevalent in kids, no cure, will die
- mucosal linings poor, can’t eat
- fingers/joints fuse
- too much granulation tissue –> difficulty breathing
Epidermolysis Bullosa Acquisita
Autoimmunity type VII collagen
- Slight trauma=blistering/erosions
- healing leaves atrophy, scars, pigmentation issues
- fibrosis hands and feet
- sometimes oral mucosa hemorrhages
- nail dystrophy
DIF=IgG and C3 on BMZ
IIF=on dermal side
Inherited Epidermolysis Bullosa
Erosions/blisters after light trauma
EB Simplex: Keratin 5, 14 (autosomal dom)
Junctional EB: laminin 332, BP 180, integrins (autosomal rec)
Dystrophic Eb: type VII collagen (children can live to adulthood but hard life) (both patterns inheritance)
Kindler Sx: Kindlin 1
