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PATHPROS > SKIN PATHOLOGY-1 > Flashcards

SKIN PATHOLOGY-1 Flashcards

Covers the first ppt

1
Q

What is Leser-Trélat sign?

Deborah Dalmeida MD

A

•Paraneoplastic syndrome

Numerous seborrheic keratosis secondary to stimulation of keratinocytes by transforming growth factor-α produced by tumor cells, most commonly carcinomas of the gastrointestinal tract

Deborah Dalmeida MD

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2
Q

gray-black patches of verrucous hyperkeratosis on the skin.

mc seen with obesity and insulin resistance

Axilla and neck

Deborah Dalmeida MD

A

Acanthosis nigricans

Deborah Dalmeida MD

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3
Q

List 3 substances that cause urticaria via directly inciting degranulation of mast cells

(Mast cell-dependent, IgE-independent)

Deborah Dalmeida MD

A

opiates, vancomycin, and radiographic contrast media

Deborah Dalmeida MD

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4
Q

What’s the morphologic description of the lesion shown?

Deborah Dalmeida MD

A

buildup of compacted stratum corneum

Deborah Dalmeida MD

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5
Q

Pemphigus /Bullous pemphigoid/ Dermatitis herpetiformis?

Deborah Dalmeida MD

A

Bullous pemphigoid

[§continuous and linear deposition of IgG along the basement membrane]

Deborah Dalmeida MD

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6
Q

IHC Markers for melanoma

Deborah Dalmeida MD

A

HMB 45, S100

Deborah Dalmeida MD

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7
Q

What is the pathogenesis of this condition?

extremely pruritic, bilateral, symmetric and grouped vesicles

responds to a gluten free diet

Deborah Dalmeida MD

A

anti-gliadin antibodies cross react with reticulin

Deborah Dalmeida MD

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8
Q

When do you suspect a melanaoma in a pigmented lesion?

(Hint: The first 5 letters of the english alphabet)

Deborah Dalmeida MD

A

Asymmetry

irregular Borders

variegated Color

increasing Diameter

Evolution or change over time, especially if rapid

Deborah Dalmeida MD

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9
Q

round, flat, coin-like, waxy plaques

stuck on appearance

1. Diagnosis?

2. What does microscopy show?

Deborah Dalmeida MD

A
  1. Seborrheic keratosis
  2. small keratin filled cysts- horn cysts

Deborah Dalmeida MD

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10
Q

Compare and contrast pemphigus and bullous pemphigoid

Deborah Dalmeida MD

A
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11
Q

See the attached image. Identify the risk factors associated with this condition that worsens on sun exposure

Deborah Dalmeida MD

A

The condition shown is melasma.

Risk factors include:

1.Pregnancy

2.OCP use

3.Hormone replacement therapy

Deborah Dalmeida MD

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12
Q

List 4 causes for the condition described below:

poorly defined, exquisitely tender, erythematous plaques and nodules on the the anterior portion of the shins

Deborah Dalmeida MD

A

Diagnosis is erythema nodosum.

Causes:

TB, Leprosy

Sulfonamides

Sarcoidosis

Inflammatory bowel disease

Deborah Dalmeida MD

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13
Q

Microscopic features of actinic keratosis

Deborah Dalmeida MD

A

pale bluish appearance (basophilic degeneration) of collagen in the dermis

atypia of the basal cell layer

Deborah Dalmeida MD

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14
Q

List 4 risk factors for the tumor shown

Deborah Dalmeida MD

A
  1. exposure to UV light
  2. chronic ulcers and draining osteomyelitis
  3. old burn scars
  4. xeroderma pigmentosum
  5. actinic keratoses

Deborah Dalmeida MD

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15
Q

1. Identify the lesion described:

Red, itchy rash caused by a substance (poison ivy and nickel in jewelry) that comes into contact with the skin

2. What type of hypersensitivity reaction is this?

Deborah Dalmeida MD

A
  1. Contact dermatitis
  2. Type IV

Deborah Dalmeida MD

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16
Q

What is rhinophyma?

Deborah Dalmeida MD

A

Part of Rosacea

Characterised by :permanent thickening of the nasal skin, hypertrophy of sebaceous glands

Deborah Dalmeida MD

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17
Q

Compare and contrast Steven Johnson Syndrome with Toxic epidermal necrolysis

Deborah Dalmeida MD

A
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18
Q
  1. Diagnosis?
  2. Etiology?

Deborah Dalmeida MD

A
  1. Albinism
  2. tyrosinase deficiency

Deborah Dalmeida MD

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19
Q

elderly

increased in sun exposed areas

Microscopy?

Deborah Dalmeida MD

A

This is a solar lentigo.

Microscopic feature: linear (nonnested) melanocytic hyperplasia restricted to the cell layer immediately above the basement membrane

Deborah Dalmeida MD

20
Q

Dystrophic nail changes in psoriasis

Deborah Dalmeida MD

A
  1. Nail pitting
  2. Onycholysis

Deborah Dalmeida MD

21
Q

Identify the morphologic phase of melanoma from the given description:

horizontal spread of melanoma within the epidermis and superficial dermis

tumor cells seem to lack the capacity to metastasize.

Deborah Dalmeida MD

A

Radial growth phase

Deborah Dalmeida MD

22
Q

Identify the lesion described:

  • well-demarcated, pink to salmon-colored plaque covered by loosely adherent scale that is characteristically silver-white in color
  • multiple, minute, bleeding points when the scale is lifted from the plaque - Auspitz sign

Deborah Dalmeida MD

A

Psoriasis

Deborah Dalmeida MD

23
Q

Histologic hallmark of all types of acute eczematous dermatitis

Deborah Dalmeida MD

A

Spongiosis

Deborah Dalmeida MD

24
Q

Joint deformity assoc with psoriatic arthritis

Deborah Dalmeida MD

A

Pencil in cup

Deborah Dalmeida MD

25
Q

List 3 factors involved in the pathogenesis of the condition depicted

Deborah Dalmeida MD

A
  1. development of a keratin plug that blocks outflow of sebum to the skin surface
  2. hypertrophy of sebaceous glands during puberty under the influence of androgens
  3. lipase-synthesizing bacteria (Cutibacterium acnes)

Deborah Dalmeida MD

26
Q
  1. List 4 causes for the lesion shown
  2. What ype of hypersensitivity reaction does it represent?

Deborah Dalmeida MD

A
  1. Herpes simplex, mycoplasma

Sulfonamides

Malignant disease

Collagen vascular disease

  1. Type 4 hypersensitivity reaction

Deborah Dalmeida MD

27
Q

Pemphigus /Bullous pemphigoid/ Dermatitis herpetiformis?

Deborah Dalmeida MD

A

Pemphigus

[deposition of immunoglobulin along the plasma membranes of epidermal keratinocytes in a reticular or fishnet-like pattern.]

Deborah Dalmeida MD

28
Q

Pemphigus /Bullous pemphigoid/ Dermatitis herpetiformis?

Deborah Dalmeida MD

A

Dermatitis herpetiformis

[discontinuous, granular deposits of lgA selectively localized in the tips of dermal papillae]

Deborah Dalmeida MD

29
Q

Identify the condition characterised by the eosinophilic inclusions shown.

What are they called and what do they represent?

Deborah Dalmeida MD

A

Lichen planus

Civatte (Colloid bodies)/apoptotic keratinocytes

Deborah Dalmeida MD

30
Q

Potential marker or precursor of melanoma

Deborah Dalmeida MD

A

Dypslastic nevus

Deborah Dalmeida MD

31
Q

List 4 histopathologic features of psoriasis

Deborah Dalmeida MD

A

Acanthosis

Parakeratosis

Hypogranulosis/absent granular layer

Munro microabscess

Deborah Dalmeida MD

32
Q

What is the infectious condition associated with the lesion described?

multiple, symmetric , itchy, violaceous, flat-topped papules on the wrist and elbows

Wickham striae

Deborah Dalmeida MD

A

Th lesion described is Lichen planus. The infectious condition assoc with it is HCV induced chronic hepatitis

Deborah Dalmeida MD

33
Q

tan to brown, uniformly pigmented, small macules to papules with well-defined, rounded borders

Microscopy: aggregates or nests of round cells that grow along the dermoepidermal junction

Deborah Dalmeida MD

A

Junctional nevus

Deborah Dalmeida MD

34
Q

1. Identify the tumor described:

Location: Inner canthus eye

Clinical presentation: Pearly papule with telangiectasias

2. What kind of an ulcer can this lesion exhibit?

A
  1. Basal cell carcinoma
  2. Rodent ulcer
35
Q

List 3 histopathologic features seen in the attached image.

Which condition is it associated with?

A
  1. a. Hyperkeratosis
    b. Hypergranulosis
    c. Saw tooth appearance of rete ridges
    d. Band like lymphocytic infiltrate
  2. Lichen planus
36
Q

Identify the morphologic phase of melanoma from the given description:

appearance of a nodule

correlates with the emergence of a clone of cells with metastatic potential

A

Vertical growth phase

37
Q

Middle aged female

erythematous papules and pustules over the face

Flushing episodes exacerbated by spicy food/ alcohol/stress

A

Rosacea

38
Q

I) Identify this Skin malignancy

a. See attached image
b. HMB 45 , S100 positive

II) What are the 2 mutations assoc with this tumor?

A

i) Malignant melanoma
ii) loss of p16/INK4a and

activating mutations in BRAF

39
Q

How do freckles differ from lentigo, morphologically?

A

Freckles: normal number of melanocytes with ↑ melanin pigment

Lentigo: linear (nonnested) melanocytic hyperplasia (which means melanocytes are increased in number)

40
Q

Hyperkeratotic, pearly gray-white

sandpaper consistency

Can lead to squamous cell carcinoma of skin

A

Actinic keratosis

41
Q
  1. Identify the lesion indicated by the white arrow
  2. What’s the cause?
A
  1. Senile purpura

  1. ↑X-linking collagen/elastic tissue → fragile vessels → Senile purpura
42
Q

Dermatologic condition resulting from localized mast cell degranulation and resultant dermal microvascular hyperpermeability

Wheals present

A

Urticaria

43
Q
  1. Etiology?
  2. Which investigation highlights the depigmented areas?
A
  1. Autoimmune
  2. Woods Lamp
44
Q

Identify the lesion described:

cords and islands of variably basophilic cells with hyperchromatic nuclei; tumor cells at the periphery of the island exhibit palisading; retraction artifacts

A

Basal cell carcinoma

45
Q

What are the two scales used to determine the depth of invasion in malignant melanoma

A
  1. Breslow Index
  2. Clark’s levels of invasion

PATHPROS (36 decks)

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