Skin Pathology II Flashcards
skin tag
fibroepithelial polyp
neck, trunk, face, intertriginous zones
benign - middle aged and older individuals
fibrovascular stalk covered in benign epidermis
areas of rubbing**
lesion filled with keratin and lipid and other debris
epithelial cyst of wen
subclassified based on cyst wall
epithelial inclusion cyst
aka wen, follicular cyst
face, scalp, upper trunk - lots of hair follicles
obstruction of hair follicle
-filled with keratinous debris
lined by granular cell layer**
granular cell layer
lines epithelial inclusion cyst
foreign body giant cell rxn
with rupture of epithelial inclusion cyst
painful
seborrheic keratosis
middle aged older pts
-on trunk
postage stamp**
-proliferation of epidermal basal cells
B9
proliferation of epidermal basal cells
- looks like postage stamp
- forms pseudocyst
seborrheic keratosis
pseudocyst
seborrheic keratosis
keratin filled horn cyst composed of benign basal cells with keratin filled horn - communicate with surface (pseudohorn cyst)
FGFR3
mutation of suborrheic keratosis
onset of suborrheic keratosis and GI malignancy
leser trelat
tumor elaborating TGF-a
hyperpigmentation of flex regions
acanthosis nigricans
epidermal hyperplasia of stratum spinosum
acanthosis nigricans prognosis
80% B9 - childhood
20% - underlying malignant adenocarcinoma - middle age and older individuals - GI malignancy
adnexal neoplasms
99% benign
from ductal or glandular epithelial cells
B9 adnexal tumors
symmetrical
small <1cm
superficial
vertical in orientation
malignant adnexal tumors
asymmetrical, large, deep, wide
cowden syndrome
multiple tricholemmomas with dominant inheritance
family history**
PTEN mutation
tricho-
hair follicle
sebaceous adenoma with associated colorectal malignancy
muir torre syndrome
massive confluent cylindroma on forehead
turban tumor
inactivation mutations in CYLD tumor suppressor gene
lower eyelid
syringoma
forehead and scalp
cylindroma
palmar and plantar regions
poroma
cylindroma
eccrine duct tumor
lined with membranous eosinophilic cuticles
perinasal papules and small nodules
trichoepithelioma
buds of basaloid cells that resemble primitive hair follicles
anucleate ghost cell
with pilomatrixoma
red dermal bump
hemangioma
yellow dermal bump
xanthoma
tan dermal bump
fibrohistiocytic lesion
hemangioma
can regress over time in children
multiple eruptive xanthomas
think hypercholesterolemia
dermatofibroma
benign fibrous histiocytoma
firm tan papule on leg of women
-proliferation of benign spindle cells
epidermal hyperplasia with fibroblasts surrounding collagen bundles
dermatofibroma
compress in and get fold in middle**
increased melanin in keratinocytes, no change number of melanocytes
sun tan
freckles
cafe au lait spots
melasma
with increased estrogen - lesion on face
melasma
-increased melanin in keratinocytes
ephelis
freckles
increased melanin in keratinocytes and slight increased in number of melanocytes
solar lentigo
loss of melanin in keratinocytes
vitiligo - acute
albinism
tyrosine kinase deficiency
albinism
involved in melanin synthesis
loss of melanocyte, permanent
chronic vitiligo
suntan
increased melanin in keratinocytes
reversible
increased protection against solar radiation (UVB)
UVB - increases melanosome production
chronic - skin aging
mask of pregnancy
melasma
aka chloasma
hypermelanosis characterized by sharply demarcated blotchy brown macules on face
cheek and forehead
-pregnancy, women taking oral contraceptives, and menopause
hyperpigmented macules on chronically sun exposed skin in adults
solar lentigo
-B9
increased melanin in keratinocytes
and variable increase in number of melanocytes**
old people hands brown spotty
lentiginous
proliferation of melanocytes
in situ melanom arising in sum exposed skin of face
lentigo maligna
permanent loss of melanocytes
chronic vitiligo
acute transient vitiligo
tx people with normally dark pigmented skin with keratinolytic agent
-results are dramatic
melanocytic nevi
aka nevocellular
acquired moles
-uniform tan brown papule 6mm or less
B9 neoplasm of melanocytes**
mutation in NRAS and BRAF
NRAS and BRAF mutations
melanocytic nevi
B9
melanocytic nevi stages
1 junctional - dermoepidermal junction
2 compound - nests or cords of melanocytes into underlying dermis / also in junction
3 dermal - epidermal component lost
4 neurotization - maturation
as enter dermis - mature and become smaller/nonpigmented, resembling neural tissue
melanomas - no maturation**
junctional nevus
flat
-nevus cells at dermoepidermal junction
compound nevus
rounded
nevus cells at junction and into dermis
intradermal nevus
smooth stretched surface on rounded nodule
no nests in dermalepidermal junction**
do not shave biopsy
variants of nevocellular nevi
congenital blue spindle and epithelioid halo dysplastic
congenital nevus
present at birth
-deep dermal and subQ growth around adnexa, neurovasculature, and blood vessels
large and hairy - risk for melanoma
blue nevus
flat and blue
completely B9
dermal infiltration, associated fibrosis
highly dendritic
often confused with melanoma
spindle and epitheliod cell nevus
spitz nevus
fascicular growth
large plump cells with pink blue cytoplasm
fusiform cells
often confused with hemangioma and melanoma
halo nevus
lymphocytic infiltration around nevus cells
host immune response against nevus cells
dysplastic nevus
clark nevus
parker for precursor of melanoma
has cytologic atypia**
in intraepidermal nests
