Vascular tumours of the skin, skin infections, cutaneous mycoses Flashcards

1
Q

Angiosarcoma definition

A

Rare blood vessel malignancy typically occurring in the head, neck, and breast areas
Usually in older adults, on sun-exposed areas
Very aggressive and difficult to resect due to delay in diagnosis

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2
Q

Associations of angiosarcoma

A

Associated with radiation therapy and chronic postmastectomy lymphedema

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3
Q

Stewart-Treves syndrome definition

A

Cutaneous angiosarcoma developing after chronic lymphedema

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4
Q

What is hepatic angiosarcoma associated with

A

Vinyl chloride and arsenic exposures

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5
Q

Bacillary angiomatosis definition

A

Benign capillary skin papules found in patients with AIDS
Caused by Bartonella infections
Frequently mistaken for Kaposi sarcoma, but has neutrophilic infiltrate

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6
Q

Cherry hemangioma definition

A

Benign capillary hemangioma commonly appearing in middle-aged adults
Does not regress
Frequency increased with age

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7
Q

Glomus tumour definition

A

Benign, painful, red-blue tumour, commonly under fingernails
Arises from modified smooth muscle cells of the thermoregulatory glomus body

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8
Q

Kaposi sarcoma definition

A

Endothelial malignancy most commonly affecting the skin, mouth, GI tract, respiratory tract

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9
Q

Epidemiology of Kaposi sarcoma

A

Classically seen in older Eastern European males, patients with AIDS, and organ transplant patients

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10
Q

Associations & type of infiltrate in Kaposi

A

Associated with HHV-8 and HIV
Lymphocytic infiltrates, unlike bacillary angiomatosis

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11
Q

Pyogenic granuloma definition & association

A

Polypoid lobulated capillary hemangioma that can ulcerate and bleed
Associated with trauma and pregnancy

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12
Q

Strawberry (infantile) hemangioma definition

A

Benign capillary hemangioma of infancy
Appears in first few weeks of life (1/200 births); grows rapidly and regresses spontaneously by 5–8 years old

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13
Q

Define Impetigo and the organisms involved

A

Skin infection involving superficial epidermis
Usually from S aureus or S pyogenes
Highly contagious

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14
Q

Clinical findings in impetigo and define bullous impetigo

A

Honey-coloured crusting.
Bullous impetigo has bullae and is usually caused by S aureus

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15
Q

Define Erysipelas & presentation

A

Infection involving upper dermis and superficial lymphatics, usually from S pyogenes
Presents with well-defined, raised demarcation between infected and normal skin

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16
Q

Define cellulitis

A

Acute, painful, spreading infection of deeper dermis and subcutaneous tissues
Usually from S pyogenes or S aureus
Often starts with a break in skin from trauma or another infection

17
Q

define abscess

A

Collection of pus from a walled-off infection within deeper layers of skin
Offending organism is almost always S aureus

18
Q

define necrotizing fasciitis

A

Deeper tissue injury, usually from anaerobic bacteria or S pyogenes
Pain may be out of proportion to exam findings

19
Q

what does necrotizing fasciitis result in

A

Crepitus from methane and carbon dioxide production
“Flesh-eating bacteria”
Causes bullae & skin necrosis = violaceous colour of bullae, surrounding skin (Surgical emergency)

20
Q

Staphylococcal scalded skin syndrome

A

Exotoxin destroys keratinocyte attachments in stratum granulosum only (vs toxic epidermal necrolysis, which destroys epidermal-dermal junction)
Commonly seen in newborns and children/adults with renal insufficiency

21
Q

Clinical findings of staph scalded skin syndrome

A

Characterized by fever and generalized erythematous rash with sloughing of the upper layers of the epidermis that heals completely
⊕ Nikolsky sign (separation of epidermis upon manual stroking of skin)

22
Q

Define herpes infection and where they occur

A

Herpes virus infections (HSV-1 and HSV-2) of skin can occur anywhere from mucosal surfaces to normal skin
These include herpes labialis, herpes genitalis, herpetic whitlow (finger)

23
Q

Molluscum contagiosum

A

Umbilicated papules caused by a poxvirus
While frequently seen in children, it may be sexually transmitted in adults

24
Q

Varicella zoster

A

Causes varicella (chickenpox) and zoster (shingles)

25
Varicella presentation
Varicella presents with multiple crops of lesions in various stages from vesicles to crusts
26
Zoster presentation
Zoster is a reactivation of the virus in dermatomal distribution (unless it is disseminated)
27
Hairy leukoplakia
Irregular, white, painless plaques on lateral tongue that cannot be scraped off EBV mediated Occurs in patients living with HIV, organ transplant recipients Contrast with thrush (scrapable) and leukoplakia (precancerous)
28
Define Tinea (dermatophytes)
Clinical name for dermatophyte (cutaneous fungal) infections Dermatophytes include Microsporum, Trichophyton, and Epidermophyton Associated with pruritus
29
Dx of tinea
Branching septate hyphae visible on KOH preparation with blue fungal stain
30
Tinea capitis
Occurs on head, scalp Associated with lymphadenopathy, alopecia, scaling
31
Tinea corporis
Occurs on body (usually torso) Characterized by enlarging erythematous, scaly rings (“ringworm”) with central clearing Can be acquired from contact with infected pets or farm animals
32
Tinea cruris
Occurs in inguinal area (“jock itch”) Often does not show the central clearing seen in tinea corporis
33
Tinea pedis
Three varieties (“athlete’s foot”): Interdigital most common Moccasin distribution Vesicular type
34
Tinea unguium
Onychomycosis; occurs on nails
35
Tinea (pityriasis) versicolor organism and pathogenesis
Caused by Malassezia spp. (Pityrosporum spp.), a yeastlike fungus (not a dermatophyte despite being called tinea) Degradation of lipids produces acids that inhibit tyrosinase (involved in melanin synthesis) = hyper/hypopigmentation, and/or pink patches can also occur from inflammatory response Less pruritic than dermatophytes
36
When does tinea versicolor commonly occur and how does it appear on microscopy
Can occur any time of year, but more common in summer (hot, humid weather) “Spaghetti and meatballs” appearance on microscopy
37
Tx of tinea versicolor
Selenium sulfide, topical and/or oral antifungal medications