Skin Pathology IV Flashcards
mastocytosis
spectrum of rare disorders - increased numbers of cutaneous mast cells
pruritis, flushing, rhinorrhea, dermal edema, erythema
darier sign
wheal formation with rub skin of mastocytosis
urticaria pigmentosa
cutaneous form of mastocytosis - mainly in children
favorable prognosis
systemic mastocytosis
in adults
-much poorer prognosis
mutations in c-KIT
urticaria
hives
mast cell and IgE dependent
acute allergic rxn
medical emergency
mast cell dependent and IgE independent
usually drug or other substance
mast cell independent and IgE independent
aspirin - vasodilation
hereditary angioneurotic edema - C1 inhibitor deficiency
wheal
transient edematous erythematous plaque secondary to acute allergic rxn seen in hives
eczema
spongiotic dermatitis
epidermial edema
spongiosis
intercellular edema**
boiling over papulovesicular lesion that is oozing or crusty
spongiotic dermatitis
prominent lymphocytes in dermis and epidermis with epidermal edema
T cell type IV hypersensitivity rxn
with spongiotic dermatitis
target with red center
erythema multiforme
erythema multiforme
CD8 T cell hypersensitivity - to drugs, infection, malignancy, collagen vascular disorder
herpes, histoplasmosis, salmonella, leprosy, antibiotics, salicylates, anti-malarials
stevens johnon syndrome
febrile form of erythema multiforme
-in children
erosions and hemorrhagic crusting of lips, oral mucosa, urethra
bacterial superinfection life threatening
toxic epidermal necrolysis
variant of erythema multiforme
-mucocutaneous epithelial necrosis and sloughing
analagous to 3rd degree burns
seborrheic dermatitis
involves skin with high density of sebaceous glands - scalp, forehead, nasolabial bolds, presternum
-but NOT disease of sebaceous glands
chronic dermatitis - more common than psoriasis
A skin condition that causes scaly patches and red skin, mainly on the scalp
seborrheic dermatitis
greasy scaly scalp
seborrheic dermatitis
infection with seborrheic dermatitis
malassezia furfur
improved by use of topical antifungal
psoriasis
associated with arthritis, myopathy
-elbows, knees, scalp, lumbosacral region, glans penis
also see nail changes
koebner phenomenon
trauma induces psoriatic lesions
well demarcated, pink salmon colored plaque
psoriasis
association with psoriasis
HLA-Cw0602
increased CD4 T cells sensitize cells set off other T cells causing increased cytokines leading to epidermal proliferation
bleeding if tear it off
auspitz sign - with psoriasis
lichen simplex chronicus
chronic rubbing or scratching
if nodular - prurigo nodularis
lichen planus
self limited disease - leaves postinflammatory hyperpigmentation
chronic inflammatory condition of skin and oral cavity
lichen planus
spontaneously resolves after 1-2 years
koebner phenomenon
skin lesion on lines of trauma
seen with lichen planus
sawtoothing
infiltrate of lymphocytes at dermoepidermal junction, hyperkeratosis, hypergranulosis and rete ridges
seen in lichen planus
civatte bodies
apoptotic squamous cells
-seen in lichen planus
discoid lupus erythematous
cutaneous manifestations of SLE with no systemic sx
excessive sun exposure triggers skin lesions - butterfly malar rash
1/3 of SLE patients
will have cutaneous findings
granular deposits of IgG and C3 at dermoepidermal junction
positive band test in lupus erythematous**
basal lamina deposition
1/3 of all SLE patients
will have cutaneous findings
rosascea
30-60yo females
pre-rosascea - flushing
erythematotelengiectatic
papulopustular
phymatous
perifollicular inflammation
rhinphyma
thick nose with rosacea
intraepidermal blister beneath stratum granulosum with scant or no inflammation
common friction blister
pemphigus
life threatening autoimmune disorder
- IgG autoAb to desmosomes
- 30-60yo patients
tx- immunosuppression
multiple variants - determined by level of blister and clinical manifestations
subcorneal blister
roof of blister is stratum corneum
suprabasal blister
portion of epidermis forms roof
subepidermal blister
epidermis splits from dermis
pemphigus vulgaris
80% of cases
mucosa and scalpe, face, axilla, groin
-classic bullous disease
pemphigus vegetans
rare
verrucous plaques instead of blisters - axilla, groin, flexural surfaces
pemphigus foliaceus
benign course
-face, scalp, chest, back
epidemic in south america
pemphigus erythematous
mild localized form of foliaceus which involves malar area of face
paraneoplastic pemphigus
with malignancy - lymphoma
autoAb against desmoglein 1 and 3
pemphigus vulgaris
most common
reticualr or fishnet pattern of deposition - loss of cell cell adhesions - suprabasal acantholysis**
untreated - fatal
deeper suprabasal epidermis blisters
Dsg 1 vs. 3
1 - superficial lesion
3 - low lesion - worse
AutoAb against Dsg1
pemphigus foliaceous
superficial subcorneal blister
autoAbs for BPAG2
bullous pemphigoid
-BPAG2 - component of hemidesmosome
blisters more resistant to rupture
-areas more prone to rubbing - inner thigh, flexor surfaces of arms and axilla
blisters at level of lamina lucida and BM
IgA autoAbs to fibrils anchoring hemidesmosomes
dermatitis herpetiformis
IgA for gliadin attacks reticulin in dermal papillae fibrils
dermatitis herpetiformis
dermatitis herpetiformis
rare
-males, 30-40yo
associated with celiac disease - anti-gliadin Abs**
intensely pruritic plaques and vesicles
inflammation of subQ adipose tissue
panniculitis
septal or lobular**
septal fatty inflammation
erythema nodosum
with infection
lobular fatty inflammation
unknown etiology - possible fasculitis
relapsing febrile nodular panniculitis in kids and adults
webere christain disease
