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SBL Exam 2 > Skin Pathology > Flashcards

Skin Pathology Flashcards

1
Q

What are the layers of the epidermis?

A 
Stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale

come, lets get sun burned

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2
Q

excoriation

A

traumatic lesion breaking the epidermis and causing a raw linear area; often self-induced

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3
Q

lichenification

A

thickened, rough skin; usually the result of repeated rubbing

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4
Q

macule

A

circumscribed, flat lesion distinguished from surrounding skin by color

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5
Q

onycholysis

A

separation of nail plate from nail bed

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6
Q

papule

A

elevated, dome-shaped of flat-topped lesion

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7
Q

plaque

A

elevated, flat-topped lesion usually greater than 5mm

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8
Q

scale

A

dry, horny, platelike, excrescence, usually the result of imperfect cornification

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9
Q

pustule

A

discrete, pus-filled, raised lesion

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10
Q

vesicle (blister)

A

fluid-filled raised lesion

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11
Q

wheal

A

itchy, transient, elevated lesion with variable blanching and erythema formed as the result of dermal edema

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12
Q

acanthosis

A

diffuse epidermal hyperplasia

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13
Q

dyskeratosis

A

abnormal, premature keratinization within cells below the stratum granulosum

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14
Q

erosion

A

discontinuity of the skin showing incomplete loss of the epidermis

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15
Q

exocytosis

A

infiltration of the epidermis by inflammatory cells

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16
Q

hydropic swelling

A

intracellular edema of keratinocytes, often seen with viral infections

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17
Q

hypergranulosis

A

hyperplasia of the stratum granulosum, often due to intense rubbing

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18
Q

hyperkeratosis

A

thickening of the stratum corneum, often associated with qualitative abnormality of the keratin

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19
Q

lentiginous

A

a linear pattern of melanocyte proliferation within the epidermal basal cell layer

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20
Q

papillomatosis

A

surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae

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21
Q

parakeratosis

A

keratinization with retained nuclei in the stratum corneum. normal in mucous membranes

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22
Q

spongiosus

A

intercellular edema of the epidermis

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23
Q

ulceration

A

discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutaneous

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24
Q

vacuolization

A

formation of vacuoles within or adjacent to cells; usually basement membrane

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25
Q

what are the disorders of pigmentation and melanocytes

A 
freckles (ephelis)
lentigo
melanocytic nevus
dysplasic nevus
melanoma
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26
Q

what are the benign epithelial tumors?

A

seborrheic keratoses
acanthosis nigricans
fibroepithelial polyp
epithelial or follicular inclusion cyst

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27
Q

what are the premalignant and malignant epithelial tumors?

A

actinic keratosis
squamous cell carcinoma
basal cell carcinoma

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28
Q

what are the tumors of the dermis?

A

benign fibrous histiocytomas (dermatofibroma)

dermatofibrosarcoma protuberans

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29
Q

what are the tumors of cellular migrants to the skin?

A

mycosis fungoides

mastocytosis

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30
Q

what is a lentigo?

A

localized melanocytic hyperplasia

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31
Q

congenital nevus

A

present at birth

deep dermal and subcutaneous growth
includes neurovascular bundles

increased risk of melanoma

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32
Q

blue nevus

A

non-nested dermal infiltration often associated with fibrosis

highly dendritic, heavily pigmented cells

black-blue nodule, often confused with melanoma

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33
Q

spitz nevus

A

fascicular growth

large, plump cells with pink-blue cytoplasm; fusiform cells

common in children

red-pink nodule often confused with hemangioma

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34
Q

halo nevus

A

lymphocytic (T-cell) infiltration surrounding nevus cells

host immune response against nevus cells and surrounding normal melanocytes

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35
Q

dysplastic nevus

A

coalescent intraepidermal nests

cytologic atypia

potential marker or precursor for melanoma

36
Q

malignant melanoma

A

most deadly of all skin cancers

strongly linked to sun exposure

inherently immunogenic due to T-cell response

37
Q

what is the pathological marker for melanoma?

A

HMB-45 (monoclonal antibody)

38
Q

seborrhetic keratosis

A

waxy exophytic lesions common in older people

mostly found on the trunk

confused with melanoma

39
Q

What is Leser-Trelat sign?

A

crops of seborrhetic keratosis that may indicate cancer

40
Q

acanthosis nigricans

A

mostly benign aquired tumor associated with obesity or DM

rarely inherited (AD)

20% associated with malignancy (GI cancer)

41
Q

fibroepithelial polyp

A

skin tag or acrochordon

42
Q

epithelial inclusion cyst

A

also called a sebaceous cyst or a wen

collections of skin cells that have a tendency to become infected

43
Q

what are the different adenexal appendages?

A 
eccrine poroma
cylindroma
syringoma
sebaceous adenoma
pilomatricoma
44
Q

what cell signaling molecule is key in the development of normal tissue homeostasis?

what occurs if this pathway is mutated?

A

SHH binding to PTCH

BCC occurs with mutation

45
Q

benign fibrous histiocytoma (dermatofibroma)

A

dermal neoplasm

asymptomatic and non-tender lesions that may change in size over time

associated with antecedent trauma suggesting abnormal response to injury

46
Q

mneumonic for painful skin lesions

A

“GLEN DAB”

Glomus tumor (under the nail)
Leiomyoma
Eccrine spiradenoma
Neurofibroma

Dermatofibroma
Angiolipoma
Blue rubber bleb nevus

47
Q

dermatofibrosarcoma protuberans

A

primary fibrosarcoma of the dermis

translocation involving genes COL1A1 and PDGFB

48
Q

mycosis fungoides

A

cutaneous CD4 T-cell lymphoma

circulating phase = sezary syndrome

49
Q

mastocytosis

A

cutaneous cases termed urticaria pigmentosum

increased mast cells in the skin

predominantely children

associated with RTK mutation

50
Q

What is Darier sign?

A

localized area of dermal edema and erythema that occurs when mastocytosis lesional skin is rubbed

51
Q

What are the disorders of epidermal maturation?

A

ichthyosis

52
Q

what are the acute inflammatory dermatoses?

A

urticaria
acute eczematous dermatitis
erythema multiforme

53
Q

what are the chronic inflammatory dermatoses?

A

psoriasis
seborrheic dermatitis
lichen planus

54
Q

what are the blistering diseases?

A 
pemphigus 
bullous pemphigus
dermatitis herpteiformis
epidermolysis bullosa
porphyria
55
Q

what are the disorders of epidermal appendages?

A

acne vulgaris

rosacea

56
Q

what are the panniculitis disorders?

A

erythema nodosum

erythema induratum

57
Q

what are the infectious disorders?

A

varrucae
molluscum contagiosum
impetigo
superficial fungal infections

58
Q

ichthyosis

A

a group of inherited disorders apparent soon after birth characterized by excessive keratin buildup resulting in fish-like scales

acquired variants may be manifestations of malignancy

59
Q

urticaria

A

characterized by mast cell degranulation and resultant dermal microvascular hyperpermeability

FcERI receptor binds to Fc portion of IgE

Type 1 hypersensitivity

60
Q

what are the subtypes of acute eczematous dermatitis?

A 
allergic contact dermatitis
atopic dermatitis
drug-related dermatitis
photoeczematous dermatitis
primary irritant dermatitis
61
Q

erythema multiforme

A

uncommon self-limited type 4 hypersensitivity reaction to certain infections and drugs

bulls-eye lesion

62
Q

what infections cause erythema multiforme?

A 
herpes simplex
mycoplasmal
histoplasmosis
coccidoidomycosis
typhoid 
leprosy
63
Q

what drugs cause erythema multiforme?

A 
sulfonamides
penicillin
barbiturates
salicylates
hydantoins
antimalarials
64
Q

what diseases present with erythema multiforme?

A

SLE
dermatomyositis
polyarteritis nodosa

65
Q

psoriasis

A

chronic inflammatory dermatosis with autoimmune basis

pink-salmon colored plaques with loosely adherent silver-white scales

cytology shows monroe microabcesses

15% have associated arthritis

30% have nail changes (yellow-brown)

66
Q

What is Auspitz sign?

A

small bleeding points after removing scales from psoriasis plaques

67
Q

what is the Koebner phenomenon?

what disorders are associated with this phenomenon?

A

appearance of new lesions after cutaneous injury on previously healthy skin

psoriasis
dermatofibroma
lichen planus

68
Q

what is treatment for psoriasis?

A

anti-TNF and anti-IL17 therapy

CD4 target

69
Q

seborrhetic dermatitis

A

chronic inflammatory dermatosis in areas with high density sebaceous glands

cytology shows CD4 or neutrophils

70
Q

what diseases are associated with seborrhetic dermatitis?

A

HIV with low CD4

Parkinson’s disease

71
Q

Lichen planus

A

pruritic, purple, polygonal, planar, papules and plaques

involves skin and mucousa

spontaneously resovles 1-2 years after onset with residual post-inflammatory hyperpigmentation

SCC associated with chronic mucosal lesions

72
Q

pemphigus

A

blistering disorder caused by autoantibodies that result in dissolution of intercellular attachments within the epidermis and mucosal epithelium

IgG autoantibodies against desmogleins

73
Q

bullous pemphigoid

A

generally affects elderly patients

caused by autoantibodies that bind to proteins required for adherence of basal keratinocytes to basement membrane

74
Q

dermatitis herpetiformis

A

rare disorder characterized by urticaria and grouped vesicles

associated with celiac disease and responds to gluten-free diet

granular deposits of IgA that localize to the dermal papillae

75
Q

epidermolysis bullosa

A

blanket term for disorders caused by inherited defects in structural proteins that lend mechanical stability to the skin

prone to blisters at or soon after birth

76
Q

porphyria

A

inborn or acquired disturbances of porphyrin metabolism

urticaria and vesicles associated with scarring - exacerbated by sun exposure

77
Q

acne vulgaris

A

chronic inflammatory dermatitis associated with P. acnes bacteria

also caused by hormal fluctuations and androgens

treat with abx and retinoids

78
Q

rosacea

A

chronic inflammatory dermatitis associated with increased/abnormal catheliciden and peptides

associated with activation of TLR

persistent erythema and rhinophyma

79
Q

panniculitis

A

inflammation of subcutaneous fat layer

80
Q

erythema nodosum

A

type of panniculitis

mneumonic for causes:
NO cause found in 60% of cases
Drugs
Oral contraceptives
Sarcoidosis or Lofgren's syndrome
Ulcerative colitis, crohn's, bechet's
Micro: TB, viral, bacterial and parasitic
81
Q

erythema induratum

A

uncommon panniculitis that affects adolescents and menopausal women

possible primary vasculitis of deep vessels supplying fat nodules of subcutaneous skin

erythematous nodules that ulcerate

82
Q

what bacteria are known to cause impetigo?

A

S. aureus and group A beta hemolytic strep

83
Q

what are toxic epidermal necrolysis (TEN) and steven johnson syndrome (SJS)?

A

severe adverse cutaneous drug reactions

potentionally fatal

hemorrhagic erosions, erythema and severe epidermal detachment presenting as blisters

SJS less severe covering <10% of the body
TEN most severe covering >30% of the body

84
Q

actinic keratosis

A

premalignant tumor

tendency to progress to SCC

hard, horn-like lesion

85
Q

what condition is associated with subcorneal acantholysis?

A

pemphigus foliaceous

86
Q

what condition is associated suprabasal acantholysis?

A

pemphigus vulgaris

87
Q

what conditions are associated with subepidermal acantholysis?

A

bullous pemphigoid

dermatitis herpetiformis

SBL Exam 2 (7 decks)

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