Skin Pathology

Question 1

what cells make up the epidermis

Answer 1

keratinocytes and sq epi cells

Question 2

what are the layers of the epidermis

Answer 2

corneum
lucidum
granulosum
spinosum
basale

Question 3

what lies in the dermis

Answer 3

blood vessels, glands, follicles, nerves

Question 4

changes in hyperkeratosis

Answer 4

inc s. corneum and inc keratin

Question 5

parakeratosis

Answer 5

thickening of skin due to scratching

Question 6

changes in acanthosis

Answer 6

inc s. spinosum

Question 7

changes in acanthylosis

Answer 7

dec in adhesions between keratinocytes

Question 8

what is spongiosis

Answer 8

intracellular oedema between keratinocytes

Question 9

4 inflammatory patters

Answer 9

vesiculobullous - forms bulla
spongiotic - becomes oedematous
psoriaform - thickened
lichenoid - forms sheeny plaque

Question 10

3 types of eczema/dermatitis

Answer 10

atopic
contact (TIV hypersensitivity)
suborrhoeic (inflam R to yeast)

Question 11

acute changes in eczema/dermatitis

Answer 11

spongiosis, inflam infiltrate in dermis. dilated capi

Question 12

chronic changes in eczema/dermatitis

Answer 12

acanthosis, crusting, scaling

Question 13

presentation of psoriasis

Answer 13

well demarcated salmon-pink scaly plaques on knees, elbows and scalp

Question 14

path of psoriasis

Answer 14

rapid turnover of keratinocytes -> thicker epidermis, S granulosum disappears
layer of parakeratosis on top

Question 15

what are munro’s microabscesses

Answer 15

change seen in psoriasis

abscess (collection of neutrophils) in the s corneum due to the infiltration of neutrophils from papillary dermis

Question 16

what nail changes might you see in psoriasis

Answer 16

pitting, oncholysis, subungual hyperkeratosis

Question 17

how will lichen planus present

Answer 17

itchy, purple plaque and papules on wrists/arms

Question 18

mouth changes in lichen planus

Answer 18

wickham striae - white lines

Question 19

cell cahnges seen in lichen planus

Answer 19

hyperkeratosis with saw toothing of the rete ridges and basal cell deg

Question 20

how will erythema multiforme present

Answer 20

annular target lesions on hands/feet

Question 21

what are the main causes of erythema multiforme

Answer 21

inf - hsv/mycoplasma

drugs - SNAPP (sulphonamides, NSAIDs, allopurinol, penecillin, phenytoin)

Question 22

how will dermatitis herpetiformis present

Answer 22

itchy vesicles on the extensor surfaces of elbow/butt

Question 23

what condition is derm herpetiformis asso with

Answer 23

coeliac disease

Question 24

what mediated derm. herpetiformis

Answer 24

IgA - binds to basement memb -> subepidermal bulla

Question 25

what is the histology of derm. herpetiformis

Answer 25

microabsesses, subepidermal bulla, IgA deposits

Question 26

what is the path of bullous pemphigoid

Answer 26

IgG Abs bind to hemidesmosomes of BM -> deep bulla

Question 27

how will bullous pemphigoid present

Answer 27

large, deep bulla on an erythematous base | on the forearms/groin of elderly

Question 28

histopath of bullous pemphigoid

Answer 28

subepidermal bulla | linear IgG deposits

Question 29

what is the path of pemphigus vulgaris

Answer 29

IgG Abs bind to hemidesmosomal prot -> superficial bulla

Question 30

how will pemphigus vulgaris present

Answer 30

bulla are intraepidermal (easily rupture) | found on skin and mucous memb

Question 31

what is the histo finding in pemphigus vulgaris

Answer 31

intercellular IgG deposits

Question 32

how will suborrhoeic keratosis present

Answer 32

waxy, stuck on plaques

Question 33

how will bowes disease present

Answer 33

flat, red, scaly patches on sun exposed areas | basement memb intact

Question 34

what are the risks of bowens disease

Answer 34

premalig for SCC

Question 35

when does bowens disease become SCC

Answer 35

once the cancer invades the basement memb

Question 36

how will a basal cell c present

Answer 36

pearly surface with rolled edges | telegiectasia

Question 37

where will Basal cell C metastasize to

Answer 37

does no metastasize

Question 38

how will a malig melanoma present

Answer 38

irreg border, variable pigment, itchy, bleeding, growing

Question 39

how will a malig melanoma grow

Answer 39

radial then vertical growth [hase

Question 40

how is a malig melanoma staged

Answer 40

breslow thickness