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OS2 > Skin Pathology > Flashcards

Skin Pathology Flashcards

1
Q

Hypersensitivity reaction characterized by targetoid rash and bullae

A

Erthema multiforme

*Targetoid appearance is due to central epidermal necrosis surrounded by erythema

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2
Q

Indomethacin acts as a nonselective NSAIDs. What are it’s additional modes of action?

A
  • It inhibits motility of polymorphonuclear leukocytes, similar to colchicine.
  • It uncouples oxidative phosphorylation in cartilaginous (and hepatic) mitochondria, like salicylates.
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3
Q

Classic location for basal cell carcinoma

A

Upper lip

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4
Q

NSAIDs have an increased risk of hepatotoxicity when given with __________.

A

alcohol, barbiturates, anticonvulsants, rifampin

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5
Q

Risk factors for cellulitis

A

Recent surgery

Trauma

Insect bite

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6
Q

Immunofluorescence highlights IgG surrounding keratinocytes in a “fish net” pattern

A

Pemphigus vulgaris

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7
Q

Additional functions of celcoxib.

A

Reduce the numbr of colorectal polyps in people who suffer from FAP

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8
Q

Cellulitis can progress to _________.

A

Necrotizing fascitis with necrosis of subcutaneous tissues due to infection with anaerobic “flesh-eating” bacteria

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9
Q

Malignant proliferation of squamous cells characterized by formation of keratin pearls

A

Basal cell carcinoma

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10
Q
  • Well-circumscribed, salmon colored plaques with silvery scale, usually on extensor surfaces and the scalp
A

Psoriasis

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11
Q

treatment for psoriasis

A

Corticosteroids

UV light with psoralen (destroy keritonocytes)

Immune modulating therapy

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12
Q

Tniea Versicolor

A
  • Caused by Malassezia
  • Inhibition of tyrosinase
    • Hypopigmentation
  • Hyperpigmentation associated with inflammatory response
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13
Q

What effects can be seen if indomethacin is used with vasopressin?

A

Edema

Hyperkalcemia

Hypernatremia

Hypertension

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14
Q

pemphigus vulgaris is due to _______ antibodies against desmoglein.

A

IgG

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15
Q

Epidermal hyperplasia with darkening of the skin

A

Acanthosis nigricans

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16
Q

Regenerative stem cell layer of epidermis

A

Stratum basalis

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17
Q

Why doesn’t celecoxib affect platelet aggregation?

A

COX2 selective NSAIDs

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18
Q

malignant proliferation of squamous cells characterized by formation of keratin pearls

A

Squamous cell carcinoma

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19
Q

Celebrex increases the risk of ________ and _______.

A

Heart attack and stroke

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20
Q

_________- is the sudden onset of multiple suborrheic ketoses and suggests underlyinf carcinoma of the GI tract.

A

Leser- Trelat sign

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21
Q

Locations of lichen planus

A

Wrists, elbow, and oral mucosa

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22
Q

___________ is a precursor leasion of squamous cell carcinoma and presents as a hyperkeratotic scaly plaque, often on the face, back or neck.

A

Actinic keratosis

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23
Q
  • Pruitic, erythematous, oozing rash with vesicles and edema
  • Exposure to allergens
  • Type IV hypersensitivity
A

Contact dermatitis

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24
Q

Melanoma risk factors

A

UVB-induced DNA damage

Prolonged exposure to sunlight

Albinism

Xeroderma pigmentosum

Dysplastic nevus syndrome

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25
Q

__________ is associated with HLA-C.

A

Psoriasis

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26
Q

Cuase of comedone formation in acne vulgaris

A
  • Due to chronic inflammation of hair follicles and associated sebaceous glands
    • Hormone-associated increase in sebum production and excess keratin production block follicles, forming comedones
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27
Q

Autoimmune destruction of desmosomes between keratinocytes

A

pemphigus vulgaris

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28
Q

most common mole inadults

A

Intradermal nevus

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29
Q

What are adnexal structures?

A

Hair shafts

Sweat glands

Sebaceous glands

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30
Q

Presentation for basal cell carcinoma

A

Elevated nodule with a central, ulcerated crater surrounded by dilated (telangiectatic) vessels

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31
Q

Flesh colored papule with central umbilication

A

Mollucuscum contagiosum

*Associated with poxvirus

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32
Q

Indomethacin treats….

A

Gout, RA, and OA

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33
Q

How is SSSS distinguised histologically from toxic epidermal necrolysis?

A

Separation in toxic epidermal necrolysis occurs ar the dermal-epidermal junction

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34
Q

Histology: inflammation of the dermal-epidermal junction with a ‘saw-tooth’ appearance

A

lichen planus

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35
Q

most common mole in children

A

Acquired nevus that begins as nests of melanocytes at the dermal-epidermal juntion (junctional nevus)

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36
Q

Vitiligo

A
  • localized loss of skin pigmentation
  • Due to autoimmune destruction of keratinocytes
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37
Q
  • Begign squamous proliferation; common in the elderly
  • Presents as raisied discoled plaque on the extremities or face
  • Often has a coin-like, “stuck on” appearance.
A

Seborrheic keratosis

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38
Q

Children and teenagers with viral infections, who take NSAIDs, are at risk for __________.

A

Reyes syndrome

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39
Q

Epidermal layer characterized by keratin in anucleate cells

A

Stratum corneum

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40
Q

Dysplastic nevus syndrome is __________ (autosomal dominant/autosomal recessive)

A

Autosomaldominant

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41
Q

How does pemphigus vulgaris present?

A
  • Acantholysis of stratum spinosum keratinocytes, results in suprabasal blisters
  • Basal layer cells remain attached to basement membrane membrane via hemidesmosomes
  • Nikosky sign
42
Q

Treatment for acne vulgaris

A

Benzoly peroxide (antimicrobial)

Vitamin A derivatives (reduce keratin production)

43
Q

Wickham striae

A

Reticular while lines on the surface

*Associated with Lichen planus

44
Q

Pemphigus vulgaris is a type ______ hypersensitivity.

A

II

45
Q

___________ is a severe form of SJS characterized by diffuse sloughing of skin, resembling a large burn.

A

Toxic epidermal necrolysis

*most often due to an adverse drug reaction

46
Q

Ingestion of large doses of acetaminophen can produce _____________.

A

N-acetyl-benzoquinoneimine (NABQNE)

*highly reactive intermediate is formed in amounts sufficient to deplete hepatic glutathione

47
Q

Firm, pink, umbilicated papules due to poxvirus

A

Molluscum contagiosum

*Affected keratinocytes show cytoplasmic inclusions

48
Q

Classic location for squamous cell carcinoma

A

Lower lip

49
Q

Furunculosis

A

A furuncle (abscess) forms when a hair follicle and the skin surrounding it become infected.

50
Q

Autoimmune destruction of hemidesmosomes between basal cells and the underlying basement membrane

A

Bullous pemphigoid

*IgG antibodies specifically against BP180 component of hemidesmosome

51
Q

Acetaminophen toxicity

A

Hepatic necrosis

*Treated with sulfhydryl compounds, which replenish stores of glutathione

52
Q

Compund nevus

A

Grows by extension into the dermis

53
Q

Lentigo maligna melanoma

A

Radial growth; good prognosis

54
Q

Epidermal layer characterized by granules in keratinocytes

A

Stratum granulosum

55
Q

Patients with high GI and low CV risks should receive a ____________.

A

cyclooxygenase-2 inhibitor plus a proton-pump inhibitor

56
Q

In cellulitis, production of ______ leads to crepitus.

A

CO2

57
Q

Acral lentiginous

A

Arises on the palms or soles; often on dark-skinned individuals; not related to UV light exposure

58
Q

Dermatophytes

A

Microsporum

Trichophyton

Epidermophyton

59
Q

Dermatitis herpetiformis has a strong association with __________ disease.

A

Celiac

60
Q

Mutation in dysplastic nevi syndrome

A

CMM1 on chromosome 1

61
Q

Celecoxib relieves pain and inflammation in what conditions?

A

OA and RA

62
Q

Nikolsky sign

A

Thin-walled bullae rupture easily

63
Q

Patients with low GI and high CV risks should receive _________.

A

naproxen

64
Q

Carbunculosis

A

A carbuncle is made up of multiple furuncles, and goes much deeper into the skin.

65
Q

___________ infection produces lipases that break down sebum, releasing proinflammatory fatty acids; results in pustule or nodule formation.

A

Propionibacterium acnes

66
Q

Munro microabscesses

A

Collection of neutrophils in the stratum corneum

*Seen in psoriasis

67
Q

Components of dermis

A

Connective tissue

Nerve endings

Blood and lymphatic vessels

Adnexal structures

68
Q

Pruritic, planar, polygonal, purple papules

A

Lichen planus

69
Q
  • Pruritic, erthematous, oozing rash with vesicles and edema
  • Type I hypersensitivity
  • Associated with asthma and allergic rhinitis
A

Atopic (eczematous) dermatitis

70
Q

Cause of psoriasis

A

Excessive keratinocyte proliferation

71
Q

How does squamous cell carcinoma present?

A

An ulcerated, nodular mass, usually on the face

72
Q

Risk factors for basal cell carcinoma

A

UVB-induced DNA damage

Prolonged exposure to sunlight

Albinism

Xeroderma pigmentosum

73
Q

Erythematous macules that progress to pustules, usaully on the face; rupture of pustules results in erosions and dry, crusted, honey-colered serum

A

Impetigo

*Most commonly caused by S. Aureus or S. pyrogenes

74
Q

Squamous cell carcinoma has the same risk factors as basal cell carcinoma. What are some additional risk factors?

A

Immunosuppresive therapy

Arsenic exposure

Chronic inflammation

75
Q

Albinism increases risk for..

A

Squamous cel carcinoma, basal cell carcinoma, and melanoma due to reduced protectin against UVB

76
Q

Erythema multiforme with oral mucosa/lip involvement and fever is termed _________.

A

Stevens-Johnson syndrome

77
Q

Histology of seborrheic keratosis

A

Keratin pseudocysts

78
Q

Histology of basal cell carcinoma

A

Nodules of basal cells with peripheral palisading

79
Q

Histology of psoriasis

A
  • Acanthosis (epidermal hyperplasia)
  • Parakeratosis
  • Munro microabscesses
  • Thinning of the epidermis above elongated dermal papillae
80
Q

Bugs associated with condyloma acuminata

A

HPV 6 and 11

*Warts, koilocyte

81
Q

Autoimmune deposition of IgA at the tips of dermal papillae

A

Dematitis herpetiformis

*presents as pruritic vesicles and bullae that are grouped

82
Q

Malignancy associated with acanthosis

A

Gastric carcinoma

*Also associated with insulin resistance

83
Q
  • Gingivostomatitis
  • Keratoconjunctivitis
  • Herpes labiallis
  • herpetic whitlow on finger
  • temporal lobe enchephalitis
  • esophagitis
  • erythema multiform
A

HSV1

84
Q

Breslow thickness

A

The most important prognostic fact in predicting metastasis, depth of extension

85
Q

Patients with low GI and low CV risks should receive a __________.

A

traditional NSAID

86
Q

In SSSS, exfoliative A and B toxins result in epidermolysis of the _________.

A

Stratum granulosum

87
Q

What is the most common complication of shingles?

A

Herpetic neuralgia

88
Q

How do you test for HSV?

A
  • Viral culture for skin/genitalia
  • CSF PCR for herpes encephalitis
  • Tsanck test
89
Q

__________ is a mask-like hyperpigmentation of the cheeks, associated with pregnancy or oral contraceptives.

A

Melasma

90
Q

What inflammatory dermatoses is associated with chronic hep C infection?

A

Lichen planus

91
Q

Erythema multiforme is most commonly associated with __________ infection.

A

HSV

*Also associated with Mycoplasma infection, drugs (penicillin and sulfonamides), autoimmune disease and malignancy

92
Q

Diameter must be greater than _________, to be a melanoma.

A

6mm

93
Q

Verruca (wart) is due to _____ infection of keratinocytes.

A

HPV

*Characterized by koilocytic change

94
Q

Celebrex contains a sulfonamide derivative as one of its components, which are well known to cause ___________.

A

Stevens-Johnson syndrome

95
Q

___________ is a well-differentiated squamous cell carcinoma that develops rapidly and regresses spontaneously.

A

Keratoacanthoma

96
Q

Epidermal layer characterized by desmosomes between keratinocytes

A

Stratum spinosum

97
Q

Common location for acanthosis nigricans

A

Axilla; groin

98
Q

How does keratoacanthoma present?

A

Cup-saped tumor filled with keratin debris

99
Q

Due to an increased # of melanosomes

A

Freckle (Ephelis)

*melanocytes are NOT increased

100
Q

Treatment for basal cell carcinoma

A

Surgical excision

*metastasis is rare

101
Q

Nodular melanoma

A

Early vertical growth; poor prognosis

OS2 (10 decks)

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