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Medicine Dermatology > Pathology > Flashcards

Pathology Flashcards

1
Q

Functions of the skin

A 
Strong barrier to antigens and organisms
Thermoregulation
Fluid and electrolyte balance
Endocrine function
Protection from UV rays
Immune function
Sensory function
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2
Q

Ground substances in the dermis

A

Hyaluronic acid and chondroitin sulphate

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3
Q

Which type of the dermis contains appendage structures?

A

Reticular dermis

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4
Q

Acanthosis

A

Increase in thickness in epithelium. Hyperplasia

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5
Q

Hyperkeratosis

A

Increased thickness in the keratin layer

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6
Q

Parakeratosis

A

Persistence of nuclei in the keratin layer

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7
Q

Papillomatosis

A

Irregular epithelial thickening

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8
Q

Spongiosis

A

Oedema fluid between squames appears to increase the prominence of intercellular prickles.

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9
Q

4 main reaction patterns in skin

A

Spongiotic-intraepidermal oedema
Psoriasiform
Lichenoid
Vesiculobullous

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10
Q

Psoriasiform

A

Elongation of the rete ridges

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11
Q

Which condition is spongiotic-intraepidermal oedema seen in?

A

Eczema

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12
Q

Which condition is psoriasiform seen in?

A

Psoriasis

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13
Q

Which condition is lichenoid seen in?

A

Lichen planus and lupus

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14
Q

Which conditions is vesiculobullous seen in?

A

Pemphigoid, pemphigus and dermatitis herpetiformis

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15
Q

What are lichenoid disorders?

A

Damage to basal epidermis

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16
Q

Histology in lichenoid disorders

A

Irregular saw tooth acanthosis
Hypergranulosis and orthohyperkeratosis
Band-like upper dermal infiltrate of lymphocytes
Basal damage with formation of cytoid bodies

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17
Q

Prototypic condition in lichenoid disorders

A

Lichen planus

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18
Q

Disorders falling under the heading lichenoid disorders

A 
Lichen planus (main)
Discoid lupus
Some drug rashes
Erythema multiforme
Toxic epidermal necrolysis
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19
Q

Main primary feature of immunobullous disorders

A

Blisters

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20
Q

True or false: pemphigus is a common autoimmune bullous disease

A

False - it is a rare autoimmune bullous disease

21
Q

What happens to the epidermis in pemphigus?

A

There is loss of integrity of epidermal cell adhesion

22
Q

Which type of drugs does pemphigus respond to?

A

Steroids

23
Q

Most common subtype of pemphigus

A

Pemphigus vulgaris

24
Q

In pemphigus vulgaris, __ antibodies are made against __ _

A

IgG antibodies are made against desmoglein 3

25
Q

What does desmoglein 3 maintain?

A

Desmosomal attachments

26
Q

Steps in pemphigus vulgaris that leads to acantholysis

A 
IgG antibodies against desmoglein 3
Immune complexes form on cell surface
Complement activation and protease release
Disruption at desmosomes
End result is acantholysis
27
Q

Which parts of the body are most commonly affected by pemphigus vulgaris?

A

Skin - face, scalp, axillae, groin, trunk

28
Q

Which parts of the body may be affected by pemphigus vulgaris, but are not as common as skin?

A

Mucosa. Extensive mucosal involvement may be fatal

29
Q

Investigations for pemphigus vulgaris

A

Microscopy or fluorescence imaging

30
Q

What is bullous pemphigoid?

A

A condition where there is development of a subepidermal blister

31
Q

True or false: there is acantholysis in bullous pemphigoid

A

False - there is no evidence of acantholysis

32
Q

Pathophysiology of bullous pemphigoid

A

Circulating IgG antibodies react with antigen of the hemidesmosomes anchoring basal cells to basement membrane, resulting in local complement activation and tissue damage

33
Q

What does immunofluorescence show in bullous pemphigoid?

A

Linear IgG plus complement deposited around the basement membrane

34
Q

What do older lesions of pemphigoid show?

A

Re-epithelialisation of their floor, mimicking pemphigus vulgaris

35
Q

What does immunofluorescence in pemphigus vulgaris show?

A

Intraepidermal IgG

36
Q

What is dermatitis hepatoformis?

A

An autoimmune bullous disease

37
Q

Which condition does dermatitis hepatoformis have a strong association with?

A

Coeliac disease

38
Q

Clinical presentation of dermatitis hepatoformis

A

Intensely itchy lesions which are usually symmetrical, commonly found on the elbows, knees and buttocks

39
Q

Hallmark of dermatitis hepatoformis

A

Papillary dermal microabscesses

40
Q

Histology in dermatitis hepatoformis

A

Papillary dermal micro abscesses and deposits of IgA found in dermal papillae

41
Q

Pathogenesis of dermatitis hepatoformis

A

IgA antibodies target gliadin component of gluten but cross react with connective tissue matrix proteins
Immune complexes form in dermal papillae and activate complement and generate neutrophil chemotaxis

42
Q

What does distribution of acne vulgaris reflect?

A

Sebaceous gland sites - face, upper neck, anterior chest

43
Q

Aetiology of acne vulgaris

A

Increased androgens at puberty
Perhaps increased androgen sensitivity of sebaceous glands
Keratin plugging of pilosebaceous units
Infection with bacterium Corynebacterium acnes

44
Q

Bacteria that causes acne

A

Corynebacterium acnes

45
Q

Which gender is rosacea most common in?

A

Females

46
Q

Clinical presentation of rosacea

A

Recurrent facial flushing, visible blood vessels, pustules, thickening of the skin - rhinopehyma

47
Q

Triggers of rosacea

A

Sunlight, alcohol, spicy foods, stress

48
Q

Pathology in rosacea

A 
Vascular ectasia
Patchy inflammation
Look for plasma cells and pustule formation
Perifollicular granulomas
Follicular demodex mites often noted
Perhaps allergic reaction to mites

Medicine Dermatology (19 decks)

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