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pathoma > Skin > Flashcards

Skin Flashcards

1
Q

Epidermis layers: superficial to deep

A

corneum
Granulosum
spinosum
basalis

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2
Q

Stem cell layer of epidermis

A

Basalis

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3
Q

Layer with desmosomes

A

Spinosum

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4
Q

Granules in keratinocytes

A

Granulosum

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5
Q

Keratin in anucleate cells

A

Corneum

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6
Q

Structures found in dermis

A

CT, nerve endings, blood and lymphatic vessels, adnexal structures (hair shafts, sweat glands, sebaceous glands)

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7
Q

Atopic Dermatitis

A

Eczema
Pruritic, erythematous, oozing rash with vesicles and edema
Face/flexor surfaces
Type 1 hypersensitivity

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8
Q

Atopic Dermatitis associated with

A

Asthma and allergic rhinitis

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9
Q

Contact dermatitis

A

Pruritis, erythematous, oozing rash with vesicles and edema
Allergen exposure: Poison ivy/nickel jewelry (T4H), Irritant chemicals, Drugs
TX: remove allergen & topical glucocorticoids

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10
Q

Acne Vulgaris

A

Comedones (white & blackheads)
Pustules (pimples)
Nodules (scars)

Chronic inflammation of hair follicles and sebaceous glands

P acnes - lipases break down sebum - result in proinflammatory FA

TX: benzoyl peroxide & VIT A Derivatives

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11
Q

Psoriasis

A

Salmon-colored plaques w/ silvery scale
Extensor surfaces & scalp
PItting of nails
Excessive keratinocyte proliferation

AI: HLA-C
In areas of trauma

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12
Q

Psoriasis HLA association

A

HLA-C

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13
Q

Histology of psoriasis

A
  1. Acanthosis (epidermal hyperplasia)
  2. Parakeratosis (hyperkeratosis w/ retention of keratinocyte nuclei in corneum - results in silvery scale)
  3. Neutrophils in corneum (Muncro microabscesses)
  4. Thinning of epidermis above elongated dermal papillae (Auspitz sign)
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14
Q

TX psoriasis

A

Corticosteroids, PUVA, immune-modulating therapy

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15
Q

Lichen Planus

A

4 P’s
Pruritic, planar, polygonal, purple papules
Wrists, elbows, mucosa (Wickham striae - reticular white lines on surface)

Saw tooth appearance of inflammation at dermal/epidermal junction

Associated w/ chronic Hep C

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16
Q

Pemphigus vulgaris

A

AI destruction of desmosomes in spinosum
IgG against desmoglein (T1H0
Skin and oral bullae

Acanthyolysis of spinosum - suprabasal blisters
Thin walled/rupture easily (Nikolsky sign)
IF: IgG surrounding keratinocytes: Fish net pattern

17
Q

Bullous pemphigus

A

AI of hemidesmosomes between basal cells and BM
IgG against hemidesmosomes (BP180) of BM
Skin blisters - mucosa spared
Basal cell detaches from BM - tense bullae hard to rupture

IF: linear pattern - IgG along BM

18
Q

Dermatitis Herpetiformis

A

IgA deposition at tips of dermal papillae
Pruritic pustules/bullae
Associated with celiac dz - Ab against gluten

19
Q

Erythema Multiforme

A

Hypersensitivity Rxn
Targetoid rash and bullae - targetoid d/t necrosis at center

HSV most common
Other: Mycoplasm infection, drugs, AI, malignancy

20
Q

Erythema Multiforme with oral mucosa/lip involvement and fever:

A

SJS

TEN (toxic epidermal necrolysis is severe form SJS) - diffuse sloughing of skin - adverse drug rxn

21
Q

Seborrheiic keratosis

A

Benign squamous proliferation

22
Q

Sudden onset of multiple seborrheic keratosis related to (and name of sign)

A

Sign: Leser Trelat

Suggests underlying GI carcinoma

23
Q

Acanthosis nigricans

A

Insulin resistance or gastric carcinoma

24
Q

Basal cell carcinoma

A

Most common form of cutaneous malignancy
UVB (also albinism/xeroderma pigmentosum)

Histology shows peripheral palasading nodules of basal cells

TX: excision

25
Q

Classic location BCC vs SCC

A

BCC: upper lip
SCC: lower lip

26
Q

SCC

A

Keratin pearls
UVB (also albinism/xeroderma pigmentosum)

Additional factors: Immunosuppressive therapy, arsenic exposure, chronic inflammation

TX: excision

27
Q

SCC precursor

A

Actinic keratosis - hyperkeratotic, scaly plaque, face, neck, back

28
Q

Keratoacanthoma

A

Develops rapidly/regresses spontaneously

Cup shaped tumor w/ keratin debbis

29
Q

What are melanocytes derived from?

A

neural crest

30
Q

Melanin synthesis

A

Tyrosine to melanin then pass malanosomes to keratinocytes

31
Q

Freckle d/t

A

increased number of melanosomes

32
Q

Nevus

A

Benign neoplasm of melancytes

Children: dermal-epidermal junction (junctional nevus)
Adults - lose junctional component - results in intradermal nevus

33
Q

Variants of Melanoma

A
  1. Superficial spreading - most common: early radial growth
  2. Lentigo maligna melanoma - lentiginous proliferation (radial growth)
  3. Nodular: early vertical growth (poor prognosis)
  4. Acral lentiginous - palms/soles of dark skin people - no related to UV
34
Q

Impetigo

A 
Superficial infection
S aureus/S pyogenes
Erythematous macule - progress to pustules
Face
Erosion & dry - honey crusted
35
Q

Cellulitis

A

deeper (dermal/subcutaneous) infection
S aureus/S pyogenes
Surgery, trauma, bug bite

36
Q

What can cellulitis progress to

A

Necrotizing fasciitis
Necrosis of subcutaneous tissue d/t infection w/ anaerobic “flesh eating” bacteria
Co2 production = crepitus
Surgical emergency

37
Q

Staph Scalded Skin syndrome

A

Sloughing of skin w/ erythematous rash
Skin loss
Exfoliative toxin A & B - epidermolysis of stratum granulosum

38
Q

SSSS vs TEn

A

SSSS: stratum granulosum
TEN: between dermis and epidermis

39
Q

Molluscum contagiosum virus

A

poxvirus

keratinocytes show cytoplasmic inclusions

pathoma (12 decks)

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