Dermatopathology

Question 1

list 3 reasons to take a skin biopsy for inflammatory skin disease

Answer 1

1. make diagnosis
2. confirm a diagnosis before starting therapy
3. rule out other conditions

Question 2

list 4 reasons to take a skin biopsy of neoplasia

Answer 2

1. identify and confirm neoplasia
2. confirm excision
3. prognosis
4. monitor progression or effect of therapy

Question 3

how long should you ideally remove a patient from treatment for prior to biopsy

Answer 3

2-3 weeks prior

Question 4

how many skin biopsies should you take to sending in

Answer 4

multiple (3-5)

Question 5

how should a skin biopsy be fixed

Answer 5

in 10-20x volume buffered formalin

Question 6

name the pattern of skin disease

very common pattern but as a consequence is the least diagnostic;
caused by hypersensitivity reactions, response to ectoparasites, bacterial infections, etc

Answer 6

perivascular dermatitis

Question 7

name the pattern of skin disease

lesion targets the upper level of dermis/dermato-epidermal junction / lower levels of epidermis;
there is hydropic degeneration and apoptosis of cells in the stratum basale;
can be cell poor or cell-rich;
caused by drug eruptions, discoid and systemic lupus erythematosus, erythema multiforme

Answer 7

interface dermatitis

Question 8

name the pattern of skin disease

reaction is targeted AGAINST blood vessels themselves so there will be evidence of vascular endothelial cell damage

Answer 8

vasculitis

Question 9

name the inflammatory cell type involved

abscess, cellulitis

Answer 9

neutrophils

Question 10

name the inflammatory cell type involved

Mycobacterial infections,
Leishmaniasis,
foreign body ractions

Answer 10

macrophage

Question 11

name the inflammatory cell type involved

fungal infections

Answer 11

neutrophils & macrophages
(pyogranulomatous)

Question 12

name the inflammatory cell type involved

eosinophilic granuloma complex

Answer 12

eosinophils

Question 13

name the inflammatory cell type involved

vaccine reactions

Answer 13

lymphocytes

Question 14

name the pattern of skin disease

these can form either by an extension of spongiosis, hydropic change, acantholysis or frictional cleavage;
may be dominated by neutrophils or eosinophils

Answer 14

intraepidermal vesicular and/or pustular dermatitis

Question 15

what cell dominates the intraepidermal vesicular / pustular dermatitis

superficial bacterial infection,
Pemphigus foliaceous

Answer 15

neutrophil

Question 16

what cell dominates the intraepidermal vesicular / pustular dermatitis

parasitic disease,
allergic reactions

Answer 16

eosinophils

Question 17

name the pattern of skin disease

RARE;
top of the bulla/vesicle comprises the entire epidermis;
ex: bullous pemphigoid

Answer 17

subepidermal vesicular and/or pustular dermatitis

Question 18

name the pattern of skin disease

subcutaneous adipose tissue is involved in the inflammatory reaction;
often in assoc. with deep dermal infection;
most common type: pyogranulomatous (assoc. with foreign body, vaccine reactions, deep fungal infections, etc)

Answer 18

panniculitis

Question 19

name the pattern of skin disease

atrophy of hair follicles and adnexal structures;
can also affect dermis and epidermis;
most important cause: endocrinopathies

Answer 19

atrophic dermatosis

Question 20

name 4 typical features associated with endocrinopathies

(skin)

Answer 20

1. follicular atrophy
2. sebaceous gland atrophy
3. diffuse orthokeratotic hyperkeratosis
4. secondary bacterial infection

Question 21

name the term

loss of cohesion between epidermal cells

Answer 21

acantholysis

Question 22

name the term

increased thickness of stratum spinosum specifically (thickening of non-cornified cells, often accompanied by rete peg formation)

Answer 22

acanthosis

Question 23

name the term

circumscribed fluid filled cavity either within or beneath the epidermis greater than 0.5 cm diameter

Answer 23

bulla

Question 24

name the term

circumscribed fluid filled cavity either within or beneath the epidermis less than 0.5 cm diameter

Answer 24

vesicle

Question 25

name the term

surface accumulation of keratin, serum and cellular debris (often pyknotic) +/- bacteria

Answer 25

crust

Question 26

name the term

penetrating or perforating folliculitis resulting in hair follicle rupture

Answer 26

furunculosis

Question 29

name the term

intracellular oedema leading to vacuolated cytoplasm;
usually focal in stratum basale or spinosum

Answer 29

hydropic degeneration

Question 30

name the term

thickening of the stratum corneum

Answer 30

hyperkeratosis

Question 31

name the term

excessive deposition of melanin in epidermal cells

Answer 31

hyperpigmentation

Question 32

name the term

band of inflammatory cells just below epidermis

Answer 32

lichenoid band

Question 33

name the term

leakage of melanin granules from pigmented basal layer of epidermis into the underlying dermis;
melanin often seen in macrophages in that zone (melanophages)

Answer 33

pigmentary incontinence

Question 34

name the term

sapce filled with proteinaceous fluid and inflammatory cells (neutrophils and possibly acantholytic cells);
in or just below the epidermis

Answer 34

pustule

Question 35

name the term

cores or peg-like formations of hyperplastic epidermis projecting downwards into the dermis

Answer 35

Rete peg

Question 36

name the term

literally: abnormal flow of sebum;
used to indicate altered keratinization producing syndromes ranging from dandruff to pruritic inflammation with scaling and crusting

Answer 36

seborrhea

Question 37

name the term

intercellular oedema leading to separation of cells or sponge-like appearance histologically

Answer 37

spongiosus