Skin Pathology I Flashcards

1
Q

What is Vitiligo?

A

Chronic depigmenting condition from destruction of epidermal melanocytes

Autoimmune

Associated with pernicious anemia and Hashimoto’s thyroiditis

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2
Q

How does Vitilgo present?

A

Asymptomatic white patches that appear in acral areas and orifices (but can present anywhere)

Acquired during childhood or early adulthood

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3
Q

What is a freckle?

A

Flat, brown macules

Results from basal layer hyperpigmentation

Darken with sun exposure

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4
Q

What is lentigo?

A

Small pigmented macules that appear in older patients as a result of skin exposure

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5
Q

What are benign melanocytic nevi?

A

Small, uniformly pigmented macules

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6
Q

What is a junctional melanocytic nevus?

A

Melanocytic nests at the dermal-epidermal junction

None reside in the dermis

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7
Q

What is a compound melanocytic nevus?

A

Junctional and dermal nests of nevus cells

Results in more raised and dome shaped nevus than junctional

With increasing dermal depth, nevus cells become smaller - sign of benign lesion

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8
Q

What is a dermal melanocytic nevus?

A

All nests reside in the dermis

Causes a raised papule with little to no pigment

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9
Q

What is a Spitz nevus?

A

Deep red color, common in children

Unique histologic features

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10
Q

What are Kamino bodies?

A

Eosinophilic collection of basement membrane material

Associated with Spitz Nevus

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11
Q

What is a dysplastic melanocytic nevus?

A

Commonly larger, oval and multiple with irregular pigment borders

Irregular proliferation of melanocyti nests along junction with melanocyte atypia

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12
Q

What is dysplastic nevus syndrome?

A

Patients display multiple dysplastic nevus

AD

High-risk for development of malignant melanoma

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13
Q

What is melanoma?

A

Malignancy of melanocytes

Develops de novo or from a pre-existing nevus

Number one cause of skin cancer deaths worldwide

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14
Q

What are the radial and vertical growth phases of melanoma?

A

Radial - horizontal spread within the epidermis and papillary dermis

Vertical - tumor cells invade downward into deeper dermal layers

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15
Q

What is superficial spreading melanoma?

A

Most common

Typically on sun-exposed skin

Lesions may be multiple shades of red

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16
Q

What is lentigo maligna?

A

Melanoma subtype that typically prevents on the face of older patients

Slow-growing, long radial growth phase

Predominantly junctional growth of atypical melanocytes

17
Q

What is acral lentiginous melanoma?

A

Least common, but most common inf african and asian descent

Melanoma occurs on palms, soles, and beneath nail plate

18
Q

What is nodular melanoma?

A

Highly atypical melanomas that occur in the dermis, no radial growth phase - only vertical

Darkly pigmented nodules

19
Q

What is the breslow thickness?

A

Tumor thickness measurement from the skin surface

Most closely correlates with survival statistics

20
Q

What are the excision guidelines for tumors?

A

In situ - 0.5 cm margin

Tumor < 1 mm, 1 ccm margin

21
Q

What is seborrheic keratosis?

A

Most common benign tumor in oder individuals

Light brown, flat macules

Tumor of keratinocytes

22
Q

What is the sign of Leser-Trelat?

A

Multiple eruptive seborrheic keratoses

Associated with internal malignancy

23
Q

What is acanthosis nigricans?

A

Hyperpigmentation and thickening of the skin folds

May signal an underlying disorder like endocrine (DM)

24
Q

What is an epidermal inclusion cyst?

A

Aka sebaceous cyst

Derived from hair follicles

Granulomatous inflammation when ruptured

25
Q

What is actinic keratosis?

A

Earlies identifiable lesion that can develop into squamous cell carcinoma

Erythematous scaly papules on sun-exposed skin

26
Q

What are the histologic features of actinic keratosis?

A

Parakeratosis in stratum corneum

Hyperplasia and cytoligic atypia of lower third

27
Q

What is the most common nonmelanoma skin cancer?

A

Basal cell carcinoma

Followed by squamous cell carcinoma

28
Q

What is Bowens disease?

A

Squamous cell carcinoma in situ

Confined to the epidermis and do not break the basement membrane

29
Q

What is erythroplasia of Queyrat?

A

Bowens disease specifically of the glans penis

30
Q

How does Bowens disease present?

A

Scaly pink plaque or a thin keratotic papule on the sun-exposed skin

31
Q

How does invasive squamous cell carcinoma present?

A

Raised, firm, pink-to-flesh colored keratotic papule or plaque

Penetrate the dermis

Metastasizes to regional lymph nodes <5%

32
Q

What is a keratoacanthoma?

A

Variant of squamous cell carcinoma

Erythematous nodule with central keratin filled crater (volcani)

33
Q

What is basal cell carcinoma?

A

Most common cutaneous malignancy

Pearly papule with telangiectasia

Can cause local destruction and disfigurement if neglected or inadequately treated

34
Q

What is nodular basal cell carcinoma?

A

Most common type

Waxy papules with central depression, pearly appearance with telangiectasia

35
Q

What are the histological features of BCC?

A

Nestsof basaloid cell swhich palisade at the border of the nest

Nests in fibromyxoid stroma

36
Q

What is Gorlin-Goltz syndrome?

A

Nevoid basal cell carcinoma syndrome

Autosomal dominant - mutation in PTCH gene

Abnromal facies, multiple BCCs, skeletal abnormalities

37
Q

What is a dermatofibroma?

A

Benign lesion that most often occurs on the lower legs

Benign dermal proliferation of fibroblasts

Displays the “dimple-sign” in whicch it depresses when squeezed (as opposed to a mole)

38
Q

What is Icthyosis?

A

Disorders of epidermal maturation

Most cases are congenital

Acquired - Icthyosis vulgaris

39
Q

What is ichthyosis vulgaris associated?

A

Lymphoid and visceral malignancies

Paraneoplastic syndrome