Path Flashcards

1
Q

Increased melanin pigmentation along basal layer of epidermis (stratum basalis) but without acanthosis of epidermis

A

Ephelis (Freckle)

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2
Q

Similar to ephelis but with acanthosis of epidermis with elongation of rete ridges and increased melanin pigmentation at base of rete ridges

A

Lentigo

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3
Q

Nests of melanocytes at dermo-epidermal junction only

A

Junctional melanocytic Nevi

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4
Q

Nests of melanocytes in dermis only

A

Intradermal melanocytic Nevi

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5
Q

Nests of melanocytes both at dermo-epidermal junction and in dermis

A

Compound melanocytic nevi

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6
Q

Spindle-shaped melanocytes usually with lots of melanin pigmentation usually in dermis

A

Blue melanocytic nevi

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7
Q

Nests of melanocytes at dermo-epidermal junction stretching from rete ridge to adjoining rete ridge, surrounding lamellar fibrosis and peri-vascular chronic inflammation

A

Dysplastic Melanocytic Nevi

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8
Q

Localized loss of skin pigmentation due to autoimmune destruction of melanocytes

A

Vitiligo

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9
Q

Cells showing Melanocytic differentiation. Positive for S-100 antigen and HMB-45 antigen, melanosomes and pre-melanosomes in cytoplasms on transmission electron microscopy

A

Malignant melanoma

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10
Q

This usually begins de novo with atypical nested proliferation at dermo-epidermal junction then with PAGETOID GROWTH within epidermis (in situ) then invades dermis

A

Malignant melanoma histologic Dx

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11
Q

What is the greatest neoplastic depth of invasion in mm from granular layer of epidermis (measurement scale in malignant melanoma)

A

Breslow’s levels

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12
Q

Malignant Melanoma in situ (in epidermis only - should NOT metastasize). = Clark’s level _____

A

One

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13
Q

Clarks Level _____: Neoplasm invading but not filling papillary dermis

A

2

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14
Q

Clark’s Level _____: Neoplasm invading and filling papillary dermis

A

3

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15
Q

Clark’s Level ____: Neoplasm invading into reticular dermis

A

4

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16
Q

Clark’s Level _____: Neoplasm invading into adipose tissue of subcutis

A

5

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17
Q

Cells showing Melanocytic differentiation. Positive for S-100 antigen and HMB-45 antigen, melanosomes and pre-melanosomes in cytoplasms on transmission electron microscopy

A

Malignant melanoma

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18
Q

This usually begins de novo with atypical nested proliferation at dermo-epidermal junction then with PAGETOID GROWTH within epidermis (in situ) then invades dermis

A

Malignant melanoma histologic Dx

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19
Q

What is the greatest neoplastic depth of invasion in mm from granular layer of epidermis (measurement scale in malignant melanoma)

A

Breslow’s levels

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20
Q

Malignant Melanoma in situ (in epidermis only - should NOT metastasize). = Clark’s level _____

A

One

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21
Q

Clarks Level _____: Neoplasm invading but not filling papillary dermis

A

2

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22
Q

Clark’s Level _____: Neoplasm invading and filling papillary dermis

A

3

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23
Q

Clark’s Level ____: Neoplasm invading into reticular dermis

A

4

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24
Q

Clark’s Level _____: Neoplasm invading into adipose tissue of subcutis

A

5

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25
Q

A subtype of Malignant Melanoma: predominantly horizontal growth

A

Superficial spreading

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26
Q

A subtype of Malignant melanoma: Vertical growth

A

Nodular

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27
Q

A subtype of malignant melanoma: Occurs on hands/feet

A

Acral-Lentiginous… Note: Acral = hands/feet

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28
Q

A subtype of Malignant Melanoma: Spindle cell differentiation - malignant form of blue melanocytic nevus - usually does not show epidermal involvement

A

Neurotropic

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29
Q

INTRADERMAL BULLA WITH EOSINOPHILS as predominant inflammatory cell.
Direct immunofluorescence: LINEAR deposition of IgG BETWEEN KERATINOCYTES IN EPIDERMIS

A

Pemphigus

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30
Q

SUBEPIDERMAL bulla with EOSINOPHIL as predominant inflammatory cell.
Direct Immunofluorescence: LINEAR deposits of IgG ALONG BASEMEMT MEMBRANE (Dermo-epidermal junction)

A

Bullous Pemphigoid

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31
Q

SUBEPIDERMAL bulla with INFILTRATES OF NEUTROPHILS mostly in PAPILLARY DERMIS (Papillitis).
Direct Immunofluoresnce: Deposits of IgA mostly in Papillary dermis

A

Dermatitis Herpetiformis

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32
Q

SUBEPIDERMAL bulla with NEUTROPHILS and/or EOSINOPHILS.

Direct immunofluoresnce: LINEAR deposition of IgA along Basement membrane (Dermo-epidermal junction)

A

Linear IgA Bullous Dermatosis - A cross between Bullous Pemphigoid and Dermatitis Herpetiformis

33
Q

Masklike zone of facial hyperpigmentation commonly seen in pregnancy and oral contraceptive use

A

Melasma

34
Q

2 Histologic types of melasma

A
  1. Epidermal: increased melanin deposition along the basal layer of the epidermis. 2. Dermal type: characterized by macrophages which have melanin pigment in their cytoplasm (melanin pigment incontinence)
35
Q

Precursor of malignant melanoma

A

Dysplastic melanocytic nevus: either junctional or compound which shows nests of melanocytes which stretch from rete ridge to rete ridge.

36
Q

In a malignant Melanoma - the depth with delinates a good prognosis from bad is ____

A

0.76 mm of tumor invasion

37
Q

Round, flat, coinlike plaques. arise spontaneously. Epidermis shows proliferation of benign basaloid keratinocytes with hyperkeratosis and horn pseudocyst formation.

A

Seborrheic keratoses

38
Q

Sign of Leser-Trelat.

A

Explosively large number of Seborrheic keratoses indicative of paraneoplsatic syndrome (GI)

39
Q

Thickened and hyperpigmented zones of skin involving most commonly teh flexural areas.

A

Acanthosis Nigricans.
Benign: Puberty
Malignant: middle age. Assocaition with internal adenocarcinoma

40
Q

Soft, flesh-colred baglike tumor attached to the skin surface by a stalk. Has a fibrovascular core.

A

Fibroepithelial Polyp/ Skin Tag Acrochordon/ Squamous papilloma

41
Q

Formed by the down growth and cystic expansion of the epidermis or the keratinizing epithelium forming the hair follicle. Filled with keratin and variable amounts of admixed lipid-containing debris derived from sebaceous glands.

A

Epithelial cyst (Wen)

42
Q

Type of Epithelial cyst: lined with bening epithelium resembling the normal epidermis

A

Epidermal inclusion cyst

43
Q

Type of Epithelial cyst: lined by epithelium resembling the follicular eptihelium without a granular layer and are not filled with keratin. Are filled with homogenous eosinophilic material with can undergo dystrophic calcification

A

Pilar or Trichilemmal cysts

44
Q

Type of Epithelial cyst: epidermal eappendages srrounding the wall of the cyst

A

Dermoid cyst

45
Q

Type of Epithelail cyst: lined by epithelium resembling a sebaceous gland duct in which there are numerous compressed lobules of sebaceous galnds

A

Steatocystoma multiplex

46
Q

Charactertic “Glassy” eosinophilic cytoplasm - central, keratin-filled crater. Rapidly devleoping. Spontaneously healing. Benign. Flesh-colored, dome-shaped nodule with a central, keratin-filled plug

A

Keratoacanthoma

47
Q

Rough-sandpaper-like consistency lesion of less than 1 cm in diameter. May have so much keratina cutaneous horn devleops. Cytologic atypia. Increased elastin fibers in teh dermis (solar elastosis)

A

Actinic Keratosis

48
Q

in-situ: Red scaling plaque. Invasive: nodular, variable keratin production, hyperkeratotic lesion that may ulcerate. Oral = Leukoplakia.

A

Squamous Cell Carcinoma

49
Q

Slow growing cutanous carcinoma. Presents as PEARLY PAPULES and often show prominent dilated dermal blood vessels (telangiectasia. Advanced tumors may ulcerate(local invasion of bone or facial sinuses = “rodent ulcer”. Palisaded growth of basaloid epithelial cells

A

Basal Cell Carcinoma

50
Q

***What is the worst subtype of Basal Cell carcinoma?

A

Morphea (Sclerosing) subtype

51
Q

Potentially lethal tumors composed of small, round, malignant cells which contain neurosecretory-type cytoplasmic granules **

A

Merkel Cell Carcinoma (Cutaneous Neuroendocrine Carcinoma)

52
Q

Heterogenous family of realted bening dermal neoplasms of fibroblasts and histiocytes. Seen on LEGS. Benign proliferation of fibroblasts with deposits of dense collagen. Infiltrate of histiocytes = Foamy macrophages.

A

Benign Fibrous Histiocytoma (Dermatofibroma = most common kind)

53
Q

Slow growing, locally aggressive. Most common on TRUNK. develop as aggregated “protuberant” tumors within a firm, indurated plaque and can ulcerate. atypical fibroblasts arranged in a basket-weave pattern = “Storiform”

A

Dermatofibrosarcoma Protuberans

54
Q

Tumor like collections of foamy histiocytes within the dermis.

A

Xanthoma

55
Q

Sudden showers of yellow papules which increase and decrease secondary to variations in plama triglyceride - butt, posterior thigh, knee, elbow

A

Eruptive Xanthoma

56
Q

Birbeck granules on electron microscope. Eosinophils - lesion is an eosinophilic granuloma.

A

Langerhans cell Histiocytosis, Histiocytosis X

57
Q

Cutaneous lesions show scaly, red-brown patches; raised.
Seeding of blod by malignant T-lymphoid cells accompanied by diffuse erythema and scaling of the entire body surface (erythroderma) = SEZARY SYNDROME (CD4 +); PAUTRIER’S MICROABSCESSES

A

Mycosis Fungoides

58
Q

Localized mast cell degranulation and resultant dermal microvascular hyperpermeability which results in pruritic edematous wheals

A

Urticaria

59
Q

Uticaria locatiosn

A

Trunk, distal extremities, ears

60
Q

Rash resulting froma ntigen-induced release of vasoactive mediators from mast cell granules after sensitization of specific IgE antiboides

A

Urticaria

61
Q

Red, papulovesiculr, oozing and crusted lesions and with persistence will change into raised scaling plaques

A

Eczematous Dermatitis

62
Q

Self-limiting skin disorder which is believed to be a hypersensitivity response to certain infections and drugs. TARGET LESIONS. HALLMARK = NECROTIC KERATINOCYTES IN THE EPIDERMIS

A

Erythema Multiforme

63
Q

Extensive and symptomatic febrile from of erythema multiforme - more common in children. Cutaneous erosions and hemorrhagic crusts involve teh lips and oral mcuosa and the conjuctiva, urethra, and genital

A

Steven-Johnson sydnrome

64
Q

Diffuse necrosis and sloughing of the entire cutaneous and mucosal epithelial surface. related to erytehma multiforme

A

Toxic epidermal necrolysis

65
Q

Inflammatory reaction of teh subcutaneous adipose tissue which can affect either principally the connective tissue septa separating lobules of fat or predominantly the lobules of fat themselves.

A

Panniculitis

66
Q

Most common form of Panniculitis. Acute presentation. Ass with B hemolytic strep, TB, leprosy, drug admin (sulfonamids, OC)

A

Erythema nodosum

67
Q

Panniculitis usually involves ____

A

lower legs

68
Q

relapsing febrile nodular panniculitis. lobular, nonvasculitic panniculitis. Erythematous plaques or nodules. Lower extremities. Foamy histiocytes mixed with lymphocytes, neutorphoils, and giant epitheloid phistiocytes

A

Weber-Christian Disease

69
Q

well-demarcated pink plaque covered by loosely adherent silver-white scale. Mostly on elbows, knees, calp, lumbosacral, intergluteal cleft, and glans penis

A

Psoriasis

70
Q

Yellow-brown discoloration with pitting, dimpling, separation of the nail plate from underlying bed

A

Onycholysis - in Psoriasis

71
Q

A self-limiting dermatosis leaving a zone of post-inflammatory hyperpigmentation. Lesion was pruritic, violaceous flat-topped papule

A

Lichen Planus

72
Q

Version of Lupus Erythematousus NOT systemic

A

Discoid lupus erythematosus

73
Q

Gets worse with sun exposure. See telangiectasia through atrophitic skin. Vaculoar degeneration. CHARACTERISTIC granular deposition of Ig and complememtn along the basement membrane

A

SLE

74
Q

Autoimmune blistering disorder which occurs because of the lossof normal intercellular attachemtns between normal keratinocytes of the epidermis and squamous mucosal epithelium. 40-60 yo IgG, eosinophils

A

Pemphigus

75
Q

Most common form of Pemphigus. Ruptures Easily!

A

Pemphigus vulgaris - scalp, face, axilla, groun, trunk, points of pressure.

76
Q

IgG, eosinophils, subepidermal, nonacantholytic blisters with tense bullae (no rupture), inner aspects of thighs, flexor surface of arms, axillae, groin, and lower abdomine

A

Bullous Pemphigoid

77
Q

IgA, neutorphils/fibrin. Extremely pruritic - bilaterally. Extesnor surfaces of elbows, knees, upper back and butt. Characterized by uticaria and vesicls. Celiac disease

A

Dermatitis Herpetiformis

78
Q

Heal with scaring. exacerbated by exposure to sun. subepidermal vesicle with thickening surrounding the superficial blood vessels in dermis

A

Porphyria cutanea tarda

79
Q

Blisters at sites of pressure

A

Epidermolysis bullosa