Skin QandA explanations Flashcards
Robbins 4: The figure shows a _____ with _____ borders and variability of pigmentation. Any change in pigmented lesion suggests possibility of _____. Some ____ are familial, arising from conditions such as what?
melanoma; irregular; melanoma; melanomas, dysplastic nevus syndrome
Robbins 7: Actinic keratoses are
premalignant lesions associated with sun exposure. Older individuals are more likely to have actinic keratoses because of greater cumulative sun exposure, NOT NECESSARILY aging alone
Robbins 8: what is producing the intense pruritis in this patient?
Small scabies mites burrow through stratum corneum to produce linear lesions, and mites along with their eggs and feces produce intense pruritus
Robbins 9: What is the key word here?
Pink cytoplasmic inclusions, called MOLLUSCUM bodies; immunocompromised individuals may have multiple, larger lesions. Infectious agent is a poxvirus
Robbins 12: 6P’s question
Distinctive bandlike infiltrate of lymphocytes at dermal-epidermal junction; lesions of lichen planus typically self-limited; oral lesions may persist longer and no risk of MALIGNANCY!!
Robbins 13: Athlete’s foot is
a common disorder resulting from superficial dermatophyte infection by various fungal species, including Trichophyton, Epidermophyton, Microsporium; infections involving the foot produce condition known as tinea pedis (METs play like they have Athletes foot)
Robbins 15: If the man eats the cookies
he will have “hives,” or urticaria, from an allergy to antigen in the nuts; a type I hypersens reaction occurs when IgE Abs are bound to IgE receptor on mast cells, leading to degranulation when antigen is encountered
Robbins 16: The clinical ppearance, distribution, and occurrence in two siblings here suggests
lesions represent dysplastic nevus syndrome. These nevi are precursors of malignant melanoma, and most important gene in familial cases is CYCLIN-DEPENDENT KINASE INHIBITOR 2 (CDNK2), which encodes for several tumor suppressors including p16/INK4A
Robbins 25: Tinea versicolor is a
common condition caused by a superficial fungal infection of Malassezia furfur; lesions can be lighter or darker than the surrounding skin
Robbins 26: Time course of this case
suggests a drug reaction producing an acute erythematous dermatitis
Robbins 27: ____ is a form of panniculitis that can be associated with
Erythema nodosum;
infections, drug ingestion, inflammatory bowel disease, and malignancies; inflammation primarily involves DERMAL ADIPOSE TISSUE
Robbins 28: What is the most common form of epithelial cyst. This is a
Epidermal inclusion cyst;
cystic structure formed from downward growth of epi or expansion of a hair follicle and is lined by squamous epi that desquamates keratinaceous debris in the center of the expnading cyst. Ruputre produces local inflamm rxn.
Robbins 29: This patient has
urticaria pigmentosa, a localized form of mastocytosis; cutaneous lesions often show the characteristic Darier sign on rubbing, some perhaps systemic mastiocytosis, and maybe point mutations in C-KIT oncogene present
Robbins 30: ____ also known as
an acrochordon or skin tag; these common lesions are composed of a central core of fibrovascular CT covered by normal-appearing squamous epi. They may become irritated, but are otherwise incidental findings
Robbins 31: The figure shows
a form of nevocellular nevus known as a congenital nevus
Rubin’s 1: Sudden appearance of numerous _____ has been associated with
seborrheic keratoses; internal malignancies (sign of Leser-Trelat), especially gastric adenocarcinoma
Rubin’s 2: Germline mutation in the what gene has been found in some patients who have
CDKN2A tumor suppressor gene (aka p16); dysplastic nevus/melanoma
Rubin’s 3: Actinic keratoses
develop in sun-damaged skin as circumscribed keratotic patches or plaques, commonly on backs of hands or face; stratum corneum replaced by dense parakeratotic scale, underlycing basal keratinocytes have significant atypia, and these AK’s could develop into ultimate invasive squamous cell
Rubin’s 4: Kaposi sarcoma is a
malignant tumor derived from endothelial cells; important cutaneous sign in the AIDS pandemic; HHV-8 thought to play a role in Kaposi sarcoma pathogenesis; histologic appearance of sarcoma is highly variable, either resembling simple capillary hemagioma or could be highly cellular and vascular spaces less prominent
Rubin’s 6: Ichthyosis vulgaris is an
autosomal dominant disorder of keratinization characterized by mild hyperkeratosis and reduced or absent keratohyaline granules in the episdermis. Scaly skin results from increased stratum corneum cohesiveness. Use topical treatments.
Rubin’s 7: Lentigo maligna melanoma is
a large, pigmented macule that occurs on sun-damaged skin; it develops almost exclusively in fair-skinned usually elderly whites; talking about UV light exposure; acral lentiginous melanoma is the most common form of melanoma in dark-skinned people is generally is limited to palms, soles, and subungual regions, while mucosal lentiginous melanoma is mucous membranes!!
Rubin’s 12: Verruca vulgaris
is an elevated papule with verrucous surface; warts might be single or multiple and are most frequent on the dorsal surfaces of the hands or face
Rubin’s 13: EN is a
cutaneous disorder that manifests as self-limited, nonsuppurative, tender nodules over extensor surfaces of lower extremities; triggered by exposure to agents, like drugs and microorganisms; early neutrophilic inflammation suggests that EN may be a response to activation of complement with resulting neutrophilic chemotaxis
Rubin’s 19: Mycosis fungoides
is a variant of cutanoues T-cell lymphoma; look for lymphocytes in the epidermis; in late stages, the dermal infiltrate becomes dense to the point of forming tumor nodules
Rubin’s Cutanoues necrotizing vasculitis
presents as palpable purpura and also called allergic cutaneous vasculitis, leukocytoclastic vasculitis, and hypersens angiitis; you see immune complexes deposited in vascular walls and C5a complement compnent attracts neutrophils, which degranulate and release lysosomal enzymes, resulting in endothelial damage and fibrin deposition; can be associated with specific infectious agent or chronic disease like Hep B and ulcerative colitis, respectively
