Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards Pathology > Skin Pathology > Flashcards

Skin Pathology Flashcards

1
Q

Layers of epidermis from surface to basement membrane

A

Stratum corneum — keratin and anucleate cells
Stratum granulosum — granules in keratinocytes
Stratum spinosum — desmosomes between keratinocytes
Stratum basalis — stem cell layer; regenerates new epidermis
Basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

______ _______ = pruritic, erythematous, oozing rash with vesicles and edema, often involving face and flexor surfaces. It is a type ____ HSR associated with asthma and allergic rhinitis.

A

Atopic dermatitis; Type I HSR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pruritic, erythematous, oozing rash with vesicles and edema that arises upon exposure to allergens

A

Contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contact dermatitis = Pruritic, erythematous, oozing rash with vesicles and edema that arises upon exposure to allergens. Examples of irritants include poison ivy and nickel jewelry, which would constitute a type ___ HSR. Other irritants include chemicals like detergents, or drugs like PCN. Treatment is removal of offending agent and topical steroid if needed

A

Type IV HSR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acne vulgaris may include comedones (whiteheads and blackheads), pustules (pimples), and nodules. Acne is due to chronic inflammation of _______ and ________. Hormone-related increases in sebum and excess keratin block follicles (comedones). __________ infection leads to inflammation (pustules and nodules)

A

Hair follicles; sebaceous glands; Propionibacterium acnes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for acne may include _____ ____ as an antimicrobial, as well as vitamin A derivatives like ______ which reduce keratin production

A

Benzoyl peroxide; isotretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Psoriasis involves well-circumscribed salmon-colored plaques with silvery scale, usually on extensor surfaces and scalp. Pitting of nails may also be present. This condition is due to excessive ______ proliferation and may have autoimmune etiology. It is associated with HLA-____. Lesions often arise in areas of trauma (environmental trigger).

Treatment includes corticosteroids, UVA light with _____, and immune-modulating therapy

A

Keratinocyte; HLA-C

Psoralen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Inflammatory dermatosis characterized by pruritic, planar, polygonal, purple plaques, often with reticular white lines on surface (wickham striae), commonly involving wrists, elbows, and oral mucosa

Key histological finding is inflammation at dermal-epidermal junction (sawtooth appearance).

A

Lichen planus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The etiology of lichen planus is unknown, but it is associated with chronic ________ infection

A

Hepatitis C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Classic histology shows hyperplasia with increased thickness of epidermis (acanthosis), excess keratin on surface of epidermis with retention of nuclei (parakeratosis), collections of neutrophils at surface (monroe microabscesses), and elongation of dermal papillae (may result in pinpoint bleeds = auspitz sign)

A

Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Autoimmune destruction of desmosomes due to IgG antibody against desmoglein; immunofluorescence highlights IgG surrounding keratinocytes with ‘fish net’ appearance. May involve oral mucosa as well

A

Pemphigus vulgaris

[primarily affects stratum spinosum resulting in acantholysis. Note that basal layer remains intact because they are attached by hemidesmosomes — tombstone appearance]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Autoimmune destruction of hemidesmosomes due to IgG antibody against basement membrane; presents as subepidermal blisters of skin that spare the oral mucosa. These are tense bullae that do not rupture easily

A

Bullous pemphigoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Autoimmune deposition of IgA at tips of dermal papillae, presenting as pruritic vesicles and bullae that are grouped; strong association with celiac disease

A

Dermatitis herpetiformis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypersensitivity reaction with targetoid rash and bullae; most commonly associated with HSV infection

A

Erythema multiforme

[can also be seen with mycoplasma, drugs like PCN, autoimmunity (lupus, etc.), malignancy, etc]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Erythema multiforme with oral mucosa involvement and fever is termed ______________.

______________ is a severe form of the above condition, characterized by diffuse sloughing of skin resembling a large burn. This most often arises due to adverse drug reaction

A

Stevens johnson syndrome

Toxic epidermal necrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Epithelial tumor classified as benign squamou proliferation; common in the elderly. Gross exam reveals raised discolored plaque, with “stuck-on” appearance. Histology reveals pseudocysts.

A

Seborrheic keratoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sudden onset of many seborrheic keratoses is termed _____ sign and suggests underlying carcinoma of the ______

A

Leser-Trelat; GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Epidermal hyperplasia with darkening of skin (‘velvet like’ skin), often involving groin or axilla. Associated with insulin resistance or malignancy

A

Acanthosis nigricans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Basal cell carcinoma is a malignant proliferation of basal cells of the epidermis. What are some risk factors?

A

Prolonged exposure to sunlight
Albinism
Xeroderma pigmentosum

[All related to excess UVB exposure]

20
Q

Classic histological finding in basal cell carcinoma

A

Peripheral palisading

21
Q

Treatment for BCC is surgical excision.

T/F: metastasis of BCC is rare

A

True

22
Q

SCC is a malignant proliferation of squamous cells. Like BCC, risk factors include exposure to UVB sunlight and conditions like albinism and xeroderma pigmentosum. What are 3 additional risk factors for SCC specifically?

A

Immunosuppressive therapy

Arsenic poisoning

Chronic inflammation (e.g., scar from burn or draining sinus tract)

23
Q

SCC presents as ulcerated, nodular mass usually on the face, classically involving the lower lip (if upper lip, think more BCC). Treatment is excision.

T/F: metastasis is common

A

False — metastasis is uncommon

24
Q

Precursor lesion to SCC, presents as hyperkeratotic, scaly plaque on face, back, or neck

A

Actinic keratosis

25
Q

Well-differentiated SCC that develops rapidly and regresses spontaneously; presents as a cup-shaped tumor filled with keratin debris

A

Keratoacanthoma

26
Q

Melanocytes are responsible for skin pigmentation. They are present in the _______ layer of the epidermis and are derived from ______ ______. They synthesize melanin in melanosomes

A

Basal; neural crest

27
Q

______ occurs due to localized loss of skin pigmentation due to autoimmune destruction of melanocytes

A

Vitiligo

28
Q

Albinism is a congenital lack of pigmentation due to enzyme defect (usually _______) that impairs melanin production. May involve eyes (ocular form) or both the eyes and skin (oculocutaneous form). These pts are at increased risk for skin cancer.

A

Tyrosinase

29
Q

Freckles are small, tan-brown macules that darken when exposed to sunlight. Why are freckles darker than the rest of the skin?

A

They have increased numbers of melanosomes

[NOT DUE TO INCREASED MELANOCYTES]

30
Q

Mask-like hyperpigmentation of the cheeks associated with pregnancy and oral contraceptives

A

Melasma

31
Q

Benign neoplasm of melanocytes; when congenital they are present at birth and often associated with hair

A

Nevus (mole)

[note that melanoma will not have hair growing out of it]

32
Q

Acquired nevi arise later in life. A _______ nevus is the most common mole in children. A _______ nevus describes a mole that eventually extends into the dermis. A _______ nevus is the most common mole in adults

A

Junctional; compound; intradermal

33
Q

T/F: Risk factors for melanoma are similar to SCC and BCC in that they involve UVB exposure and conditions like albinism and xeroderma pigmentosum

A

True

34
Q

Dysplastic nevus syndrome is a ______ _____ inherited disorder characterized by formation of dysplastic nevi that may progress to melanoma

A

Autosomal dominant

35
Q

Melanoma are distinguished from benign nevi by the ABCDs — what are the ABCDs?

A

Asymmetry

Borders are irregular

Color is not uniform

Diameter > 6 mm

36
Q

Melanoma is characterized by what 2 growth phases and how do they correlate with risk of metastasis?

A

Radial growth horizontally along epidermis and superficial dermis — low risk of metastasis

Vertical growth into deep dermis — high risk of metastasis (key risk for metastasis is depth of invasion)

37
Q

Subtype of melanoma characterized by radial growth; good prognosis

A

Lentigo maligna melanoma

38
Q

Most common subtype of melanoma; characterized by dominant early radial phase and a good prognosis

A

Superficial spreading melanoma

39
Q

Subtype of melanoma characterized by early vertical phase and a poor prognosis

A

Nodular melanoma

40
Q

Subtype of melanoma that arises on palms or soles, often in dark-skinned individuals; is NOT related to UV light exposure

A

Acral lentiginous melanoma

41
Q

Superficial bacterial skin infection most commonly due to S aureus or S pyogenes, commonly affects children and is extremely contagious; presents as erythematous macules that progress to pustules on the face, eventually resulting in erosions and dry, crusted, honey-colored serum

A

Impetigo

42
Q

Deeper (dermal) infection usually due to S aureus or S pyogenes that presents as red, tender, swollen rash with fever. Risk factors include recent surgery, trauma, and insect bite.

A

Cellulitis

43
Q

Cellulitis may progress to ______ _______, which is characterized by necrosis of subcutaneous tissue due to infection with anaerobic ‘flesh-eating’ bacteria. Production of ______ leads to crepitus. This is a surgical emergency!

A

Necrotizing fasciitis; CO2

44
Q

Staphylococcal scalded skin syndrome results in sloughing of skin with erythematous rash and fever, leading to significant skin loss. This is caused by S aureus infection, producing ___________ toxins that result in epidermolysis of the stratum _______

A

Exfoliative A and B; granulosum

45
Q

Verruca (wart) are flesh-colored papules with rough surface due to ______ infection of keratinocytes. Hands and feet are common locations

A

HPV

46
Q

________ _________ = firm, pink umbilicated papules due to _____virus infection of keratinocytes. Most often arise in children; also occur in sexually active adults and immunocompromised individuals.

A

Molluscum contagiosum; poxvirus

Boards Pathology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions