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Pathology > Skin Pathology 1 > Flashcards

Skin Pathology 1 Flashcards

1
Q

What can skin lesion classification be based on?

A
  • Underlying pathogenetic mechanism (used in this presentation)
    • E.g. Vasculitis, immune-mediated disorder, inflammatory
  • Lesion type (pruritus, alopecia, etc…)
  • Distribution
  • Aetiological agents (not always clarified)
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2
Q

What are the 2 broad layers?

A
  1. skin - cutis
  2. Subcutis
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3
Q

What are the different parts of the skin?

A

*Epidermis
*Dermis
*Hair follicle
*Sebaceous Gland
*Apocrine Gland

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4
Q

Histologically what is seen in the epidermis?

A

*Keratin
*Keratinocytes
*Desmosomes
*Melanocytes

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5
Q

What is the difference between primary and secondary hair follicle?

A

*Primary = Larger hairs, with
deeper bulb and with its own sebaceous and apocrine gland
*Secondary = Smaller one, with more superficial bulb and lack of apocrine gland

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6
Q

What is the difference between simple and compound follicle?

A

Simple = one hair per follicle
Compound = Multiple hair per follice

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7
Q

What are the 4 phases of hair follicles + the outcome/function?

A

*Anagen - growing HF
*Catagen - Regressing HF
*Telogen - Resting HF
*Kenogen - Latent (Hairless)

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8
Q

What are basic histological lesions of the skin?

A

*Acantholysis
*Epidermal hyperplasia
*Ballooning degeneration (intra-cellular oedema)
*Intercellular oedema (spongiosis)
*Dermatitis
*Flames figure
*Folliculitis & furuncolosis
*Hyperkeratosis (para & ortho)
*Vesicle
*(Micro)pustule
*Pigmentary incontinence

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9
Q

What occurs during hyperplasia?

A

*Increase in number of keratinocytes (usually increased epidermal thickness)
*Non-specific change, as usually secondary to a broad range of chronic different injuries (e.g. inflammation, parasites, friction)

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10
Q

What occurs during hyperkeratosis? What are the 2 different types?

A

*Orthokeratotic hyperkeratosis
*Parakeratotic hyperkeratosis
*Increase in thickness of the keratin layer with (parak.) or without (orthok.)
retention of the nucleus
*Can be primary (abnormal keratin production) or secondary (e.g inflammation)

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11
Q

What occurs during intercellular oedema (Spongiosis)?

A

*Oedema of the intercellular space between keratinocytes
* Usually associated to broad range of acute or subacute inflammatory dermatological diseases.

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12
Q

What occurs during intracellular oedema (Ballooning degeneration)?

A

*Oedema of keratinocytes showing swelling and cytoplasmic clearing
*Ballooning degeneration is used when the swelling is very severe.
*The latter is considered a characteristic change of viral infections

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13
Q

What is a vesicle?

A

*Intra-epidermal fluid-filled blister < 1cm in diameter
*It can be considered a severe expression of spongiosis and ballooning degeneration and caused by a broad range of acute and subacute injuries.

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14
Q

What is a (micro)pustule?

A

*Intra-epidermal accumulation of neutrophils
*Usually associated with bacterial or auto-immune conditions

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15
Q

What is Acantholysis?

A

*Detached and round keratinocytes showing cellular hypereosinophilia
*Hallmark of pemphigus complex disease, but can also be present in severe inflammatory neutrophilic or eosinophilic processes

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16
Q

What is dermatitis?

A

*Infiltration of inflammatory cells within the skin
*Can be elicited by numerous type of injuries
*Must be classified accordingly to the type of infiltrates (e.g. neutrophilic, eosinophilic, mixed)

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17
Q

What is folliculitis (Furunculosis)?

A

*Infiltration of inflammatory cells targeting hair follicles (inflammation of follicle)
*Can be located in any part of the hair follicle (e.g. lumen, wall)
*Can end up to destruction of the hair follicle with release of keratin in the dermis
(furunculosis)

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18
Q

What is a flame figure?

A

*Collagen bundles replaced by amorphous eosinophilic material
*Usually associated with conditions where there is strong eosinophilic infiltration (e.g. hypersensitivities, mast cell tumour).

19
Q

What is pigmentary incontinence?

A

*Presence of melanocytes or melanin-laden macrophages within dermis
*Characteristic of any process ( e.g. inflammatory, neoplastic) basal cell damage, from where the melanocytes “fall” within the dermis.

20
Q

What are the basic gross lesions?

A

*Crusts
*Ulcer
*Papula
*Nodule
*Bulla
*Pustule
*Comedo
*Lichenification
*Cyst

21
Q

What is a nodule?

A

*Elevated, often firm, circumscribed, solid palpable lesion ≥1 cm in diameter.
*Can be neoplastic/inflammatory

22
Q

What is a cyst?

A

*Cavity lined by epithelium and filled with liquid or semisolid material and located in the dermis or subcutis; may communicate with surface via a pore.

23
Q

What is a vesicle/bulla

A

*Collections of fluid within or below the epidermis measuring < than 1 cm (vesicle) or >1.0 cm in diameter (bulla)

24
Q

What is crust

A

*Dried exudate composed of various components, including fluid, blood, pustular debris, scale, or microorganisms on the skin surface

25
Q

What is lichenification?

A

*Exaggeration of the normal skin markings resulting from long-standing surface trauma or friction. Lichenified areas are often hyperpigmented.

26
Q

What is a scale?

A

*Flat plate accumulations of stratum corneum.

27
Q

What is a macule/patch?

A

*Non-raised lesions of <1.0 cm diameter in which the colour differs from that of the surrounding normal skin (macule). A patch is a macule that measures >1 cm.

28
Q

What is a papule?

A

*solid, circumscribed, elevations in the skin that are <1 cm in diameter.

29
Q

What is a plaque?

A

*solid, circumscribed, elevations in the skin that are <1 cm in diameter.

30
Q

What is a comedo?

A

Plug of stratum corneum and sebum within the lumen of a hair follicle that leads to follicular distention
*AKA - blackhead

31
Q

What is an ulcer?

A

Full-thickness loss of epidermis and basement membrane, and at least a portion of the dermis with depression of the exposed surface

32
Q

What does VITAMIN D stand for?

A

*Vascular
*Inflammatory
*Trauma
*Autoimmune
*Metabolic, nutritional and
hormonal
*Idiopathic
*Neoplastic
*Developmental & Degenerative

33
Q

What species is affected by trauma? - bruise

A

*It can occur in animal species

34
Q

What can cause trauma?

A

*Any type of mechanical trauma might induce a localized extravasation of erythrocytes

35
Q

What does trauma look like grossly?

A

*It is characterized by shiny, dark red, dermal to subcutaneous lesion(s)

36
Q

trauma

A
37
Q

What can cause vasculitis?

A

*Endotheliotropic organisms (virus, bacteria), hypersensitivity, tumours, toxins or
idiopathic
*Any cause inducing the immune system targeting antigens ( e.g. hypersentitivites,
viruses) within vessel wall

38
Q

What species are susceptible to vasculitis?

A

*Common in horses and dogs ; rarer in other animals.

39
Q

What are the consequences of vasculitis and what areas of the body?

A

*Erythematous plaques or macules, oedema, necrosis, well demarcated ulcers.
*Paws, pinnae, lips, tail, and oral mucosa are most commonly affected

40
Q

What does vasculitis look like histologically?

A

*fibrinoid necrosis
*Intramural accumulation of inflammatory cells
*perivascular oedema, haemorrhage, or fibrin exudation

41
Q

What causes erysipelas (skin lesions)?

A

*Erysipelothrix rhusiopathiae
*Bacteria able to induce bacteraemia and then inducing dermal vessels vasculitis with
characteristic dermal infarcts

42
Q

What species is affected by erysipelas?

A

*Pigs - potentially zoonotic

43
Q

What does erysipelas look like grossly?

A

*blue-to-purple discoloration of the skin, macules and also square, rectangular, or
rhomboid plaques (“diamond” skin lesions)

44
Q

What does erysipelas look like histologically?

A

*Neutrophilic vasculitis and dermal infarcts

Pathology (7 decks)

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