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UWorld > Derm Pathology > Flashcards

Derm Pathology Flashcards

1
Q

Steven Johnson Syndrome is a more severe form of

A

Erythema Multiforme

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2
Q

Steven Johnson Syndrome includes

A

Oral mucosa and lips

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3
Q

Psoriasis

A

Pink to Salmon colored plaque

Abnormal T cell release of cytokines causing speedy growth of skin cells and increased bloodflow

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4
Q

Auspitz sign

A

Bleeding when peeling back the silvery salmon plaques.

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5
Q

Parakeratosis with Monroe microabscesses

A

aggregates of neutrophils within parakeratotic scale

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6
Q

Lichen Planus lesions

A

Papules
Pruritic
Purple
Papules can form Plaques

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7
Q

Wickham Striae

A

white dots or lines on the papules

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8
Q

Colloid or Civatte bodies

A

Anucleate necrotic keratinocytes in the papillary dermis

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9
Q

Bullous pemohigoid

A

Blisters that are very tense and do not rupture easily. Blisters are typically filled with clear fluid on an erythematous base.

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10
Q

Subepidermal nonacantholytic blister

A

Bullous pemphigoid

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11
Q

Linear deposition of immunoglobulin and complement at the dermal-epidermal junction

A

Bullous pemphigoid immunofluorescence

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12
Q

Pemphigus vulgaris

A

vesicles and bullae that rupture easily.

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13
Q

Acantholytic suprabasalar blister

A

Pemphigus vulgaris

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14
Q

Netlike pattern of intercellular IgG

A

Pemphigus vulgaris

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15
Q

Antibodies against desemogelin 3

A

Pemphigus vulgaris

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16
Q

Basal cell layer remains attached to the roof of the dermis in

A

Pemphigus vulgaris

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17
Q

Shallow erosions and scarring after blister rupture associated with?

A

Pemphigus vulgaris

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18
Q

Dermatitis Herpatiformis

A

Associated with celiac disease.
Gluten free diet may help reduce the symptoms.
Fibrin and neutrophils accumulate at the tips of the dermal papillae forming dermal - epidermal separations.

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19
Q

Antibodies to gliadin cross react with skin

A

Dermatitis herpatiformis.

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20
Q

Granular deposits of IgA at the tips of dermal papillae is found in ?

A

Dermatitis herpatiformis

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21
Q

Seborrheic Keratosis

A

Flat, waxy,

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22
Q

What type of malignancy may be associated with paraneoplastic emergence of seborrheic keratosis?

A

GI malignancies most often.

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23
Q

Actinic keratosis is premalignant lesion for?

A

Squamous cell carcinoma.

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24
Q

Actinic keratosis is related to ?

A

Chronic sun exposure - higher incidence in lighter skinned individuals

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25
Q

Parakeratosis, cytologic atypia at the lowe most epidermal layer, and elastosis characterizes?

A

Actinic Keratosis

26
Q

Squamous cell carcinoma of the skin is typically caused by?

A

Sunlight.

Chronic ulcers, tars, oils, carcinogens, HPV has been attributed to squamous cell carcinoma too.

27
Q

What areas are MC to see squamous cell carcinoma?

A

Lip, scalp, ear, face.

28
Q

Basal cell carcinoma

A

MC Skin malignancy. MC seen in lighter skinned individuals.

Pink pearly papular appearance. Often have

29
Q

Most common skin malignancy?

A

Basal cell carcinoma.

30
Q

Tumor islands in the dermis show palisading peripherally in

A

Basal cell carcinoma.

31
Q

Rodent ulcers

A

Invasive basal cell carcinoma subtype

32
Q

Central ulcerations with rolled margins

A

Commonly seen in basal cell carcinoma.

33
Q

Benign melanocytic nevi

A

most of the superficial cells are immature, large, and melanin producing.

34
Q

Maturation refers to

A

Ways to determine melanoma or melanocytic nevi based on the cell age.

35
Q

Notched borders, different colorations, asymmetry

A

Dysplastic nevus with risk for progression toward melanoma.

36
Q

In patients who are darker pigmented melanomas typically develop melanomas in their

A

Acral skin regions–> palms, soles, nailbeds more often than other locations.

37
Q

ABCDE of Melanomas

A

Assymetry
Borders
Color
Evolving - changing with time.

38
Q

Melanomas can also be found in

A

esophagus, oral mucosa.

39
Q

Dyskeratosis

A

abnormal keratinizaton occurring prematurely in cells below the stratum granulosum

malignancies may be associated with dyskeratosis

40
Q

Acantholysis

A

Loss of connections between keratinocytes within epidermis.

41
Q

Spongiosis

A

Fluid accumulation in the epidermis- epidermal intercellular edema.

42
Q

Acanthosis

A

Diffuse Hyperplasia of the epidermis

43
Q

Ulceration vs. Errosion

A

Ulceration is a complete loss of the epidermis

44
Q

Hyperkeratosis

A

Thickening of the stratum corneum by abnormal keratin

Scaling appearance to the skin

45
Q

Parakeratosis

A

Nuclei retention within the stratum corneum

46
Q

Lentiginous

A

Continuous linear pattern of melanocytes along the basal cell layer of the epidermis.

47
Q

Urticaria

A

Hives
Pruritic edematous plaques and papules- wheals

Angioedema- edema deeper in the dermis and subcutaneous tissues and fat.

Usually rapid onset and termination to the presence of lesions in urticaria.

48
Q

What causes urticaria ?

A

Type I Hypersensitivity Reaction

IgE antibodies are produced in response to exposure to an antigen. IgE antibodies bind to and induce degranulation of mast cells. Mast cells degranulate and cytokines and other mediators cause vasodilation and edema to develop.

49
Q

Is urticaria always IgE dependent reaction?

A

No.

50
Q

Eczema

A

Red papulovesicular lesions that eventually rupture into scaling raised plaques.

51
Q

Acute eczematous dermatitis may result from what common environmental exposure?

A

Poison ivy

52
Q

What is the underlying morphological change that results in eczematous dermatitis?

A

Spongiosis is the predominant underlying cause of eczematous dermatitis leading to intraepidermal edemal and formation of blisters- vessicles and bullae.

53
Q

What is the primary pathogenesis of acute eczematous dermatitis?

A

Langerhans cells- dendritic cells- pick up an antigen they encounter and bring them via lymphatics to lymph node for presentation to naive T cells CD4+–> lead to activation and generation of memory CD4 T lymphocytes as well as effector cells. In future exposure - cytokines released.

54
Q

Erythema multiforme

A

Acute dermatosis
Hypersensitivity reaction related to exposure to drugs or infections by different pathogens.

Multiformed lesions - vessicles, papules, bullae usually symmetrical and on the extremities

55
Q

Target lesions are characteristic of

A

Erythema multiforme. Center of the target lesion often ruptures and leaves behind an errosion on the skin.

56
Q

Pathology of erythema multiforme

A

Accumulation of lymphocytes along the dermal epidermal junction where they are associated with necrotic keratinocytes.

Vacuolated DE junction and necrotic keratinocytes ***

57
Q

Superficial perivascular lymphocytic infiltrate with dermal edema indicates

A

Erythema multiforme

58
Q

Koebner phenomenon

A

lesions develop where skin trauma occurs.

59
Q

Erythroderma

A

Red edematous appearance of the skin associated with psoriasis.

60
Q

Psoriasis on histology appears as

A

Acanthosis (epidermal thickening) with downward elongations of the rete ridges/pegs.

Parakeratosis scaling

61
Q

Munro bodies

A

Microabscesses with neutrophil infiltrate seen in psoriasis.

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