skin pathology

Question 1

erythematous (red), edematous, and pruritic (itchy) papules and plaques (wheals)

Answer 1

urticaria (hives)

Question 2

pathogenesis of urticaria

Answer 2

mast cell degranulation, increased dermal vascular perm, dermal edema

Question 3

urticaria is a ____ hypersensitivity rxn

Answer 3

type I (IgE)

Question 4

treatment of urticaria

Answer 4

antihistamines

Question 5

pruritic inflammatory erythematous papules and scaly plaques; can becomes vesicular and crusted

Answer 5

acute eczema

Question 6

acute eczema demonstrates _______ on histo

Answer 6

spongiotic dermatitis (epidermal edema, perivascular lymphocytic infiltrate, and mast cell degranulation)

Question 7

types of eczema

Answer 7

atopic (autoimmune related)
allergic contact (ex: nickel allergy, poison ivy, neosporin)
photoezematous (abnormal rxn to UV light)
irritant dermatitis (ex: lip licking)

Question 8

hypersensitivity rxn most often due to medication/drug and certain infections

Answer 8

erythema multiforme

Question 9

common meds that cause EM:

Answer 9

sulfonamides, penicillin, , NSAIDS, hydroquinone

Question 10

common infections that cause EM:

Answer 10

HSV and mycoplasma

Question 11

EM is on the same spectrum as ____ (more mucosal involvement and wider SA) and _____ (full thickness epidermal necrosis)

Answer 11

stevens johnson; toxic epidermal necrolysis

Question 12

EM is characterized by _____

Answer 12

targetoid lesions

Question 13

autoimmune, T cell mediated rxn char by erythematous, pink, salmon-colored plaques with silvery scale

Answer 13

psoriasis

Question 14

induce lesion by local trauma

Answer 14

Koebner psoriasis

Question 15

punctate bleeding when overlying scale is removed

Answer 15

Auspitz sign

Question 16

4 things to describe lichen planus

Answer 16

pruritic, purple, polygonal, planar papules and plaques

Question 17

infection of staph aureus or strep pyogenes; more common in children, spread by direct contact; starts as small macule and enlarges as honey-colored crust

Answer 17

impetigo

Question 18

lysis of intercellular junctions between squamous cells

Answer 18

acantholysis

Question 19

blister formation of pemphigus vulgaris

Answer 19

suprabasal (above basal cell) with acantholysis

Question 20

blister formation of pemphigus foliaceus

Answer 20

subcorneal (at stratum granulosum) with acantholysis

Question 21

blister formation of bullous pemphigoid

Answer 21

subepidermal (below DEJ) without acantholysis

Question 22

rare disease of the elderly; female predominance; mucosal and skin involvement; flaccid blisters that easily rupture leaving denuded skin with extensive erosions and crusting

Answer 22

pemphigus vulgaris

Question 23

DIF of pemphigus vulgaris shows ____ pattern with intercellular ___ deposition around keratinocyte cell membranes throughout the epidermis

Answer 23

fishnet; IgG

Question 24

gestational pemphigoid (subtype of bullous pemphigoid) in 2nd/3rd trimester

Answer 24

herpes gestationis

Question 25

pigmented, round, exophytic, velvety plaques that appear stuck on; mainly on trunk; proliferation of uniform basal keratinocytes

Answer 25

seborrheic keratoses (benign tumors)

Question 26

red, rough patches on chronically sun exposed skin (mainly head/neck, lips, dorsal hands)

Answer 26

actinic keratosis/cheilitis

Question 27

histology of actinic keratosis/cheilitis shows _____ with hyperplasia of basal cells with overall epidermal thinning

Answer 27

cytologic atypia

Question 28

pearly pink, translucent papules with telangiectasias; can become nodular and ulcerate

Answer 28

BCC

Question 29

BCC is frequently found on the _____ or _____

Answer 29

nasolabial fold; upper lip

Question 30

genetic disorder- AD with variable expressivity; defect of hedgehog signaling pathway; mutation of PTCH1 tumor suppressor gene

Answer 30

Basal Cell nevus syndrone (gorlin syndrome)

Question 31

migration of nevi from DEJ into dermis

Answer 31

cellular senescence

Question 32

growth pattern of nevi with nests at DEJ

Answer 32

junctional

Question 33

growth pattern of nevi with nests at DEJ and dermis

Answer 33

compound

Question 34

nests primarily dermal

Answer 34

intradermal growth pattern (+/- cellular senescence)

Question 35

dysplastic nevi are a ____ for melanoma, not precursor; vast majority will not transform into melanoma

Answer 35

marker

Question 36

dysplastic nevi > 100s with strong melanoma risk

Answer 36

familial dysplastic nevus syndrome

Question 37

nodular lesions connote _____

Answer 37

invasion into dermis (vertical growth)

Question 38

____ is the key factor in nature of melanomas

Answer 38

vertical growth

Question 39

risk factors for metastasis of melanoma

Answer 39

``` depth of invasion tumor size ulceration mitoses lymph node involvement ```