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DERM (18) Skin Growths > Cysts > Flashcards

Flashcards in Cysts Deck (63)
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1
Q

What cysts have a granular layer?

A

EIC dialted pore of Winer, milia, pilar sheath acanthoma, dermoid cyst, eruptive vellus hair cyst, verrucous epidermal cyst, pigmented follicular cyst +/- steatocytoma

2
Q

Differentiation between EIC and millia?

A

<3mm = milia

3
Q

Pathology of EIC?

A

Cystic cavity w/ laminated keratin w/ stratified squamous epithelium w/ granular layer. NO ADNEXAL STRUCTURES IN WALL like vellus hair cyst or dermoid cyst

4
Q

Associations with EIC?

A

Gardners syndrome, Basal Cell Nevus Syndrome, multiple cysts can lead to scrotal calcinosis

5
Q

What meds lead to EIC?

A

BRAF inhibitor

6
Q

Pathology of a dilated pore of Winer?

A

Lined by a granular layer, ancathotic finger-like projections pushing into the dermis. Squamous epithelium.

7
Q

Difference between pilar sheath acanthoma and dilated pore of Winer?

A

Thicker epithelium with the pilar sheath acanthoma that extends further and deeper than a dilated pore of Winer.

8
Q

Name of milia on the hard palate of an infant?

A

Epstein’s pearls (Bohns nodules are more lateral at the buccal and lingual dental ridges)

9
Q

Describe Epstein’s pearls?

A

Keratin-filled cysts with squamous epithelial lining (like an epidermal inclusion cyst) that are often found on the palate.

10
Q

What dz can lead to EIC?

A

Blistering dz like EBA and PCT –> scarring dz, going to trap some follicular structures

11
Q

Path of milia?

A

Same as EIC but smaller <3

12
Q

Pathology of a pilar sheath cyst?

A

They do not have granular layer, compact, keratinization analogous to that of outer root sheath of the hair follicle at the isthmus, homogenous material w/ freq foci of cacification

13
Q

What are 2 categories of milia?

A

Scarring vs non scarring

14
Q

Why do scarring cause milia?

A

Traps eccrine gland, contents can’t get out

15
Q

Histology of a proliferating pilar cyst?

A

Proliferating trichilemmal tumor. broad anastomosing bands and nodules of squamous epithelium, proliferation… like pilar cysts that are together

16
Q

Histology of a vellus hair cyst?

A

Has granular layer, loose laminated keratinizing with numerous vellus hairs

17
Q

What are the most common locations of vellus hair cysts?

A

Trunk

18
Q

Associated things with hair cyst?

A

Eruptive vellus hair cysts / a/w steatocystoma multiplex

19
Q

Histology of steatocystoma?

A

Shark tooth lining (serrated appearing), associated w/ sebaceous gland in the wall (not always visible), loose material in the center, decapitative secretion.

Sometimes no granular layer (sources vary on this)

20
Q

What associations are seen with steatocystoma?

A

Steatocystoma multiplex, associated with pachyonychia congenita type 2.

21
Q

Mutation in steatocystoma multiplex?

A

Keratin 17

22
Q

Another name for pachyonychia congenita type 2?

A

Jackson-Lawler

23
Q

What is the difference on histology between steatocystoma and cutaneous keratocyst?

A

Similar path to steatocystoma but w/ no sebaceous gland associated w/ it

24
Q

Most common location of dermoid cyst?

A

Located around the eyes in an infant, lateral eyebrow is the m/c place

May be a/w underlying skull defect in embryonic fusion planes **don’t bx w/o imaging

25
Q

Pathology of a dermoid cyst?

A

Has granular layer, stratified squamous epithelium, contains other normal cutaneous structures such as hair (terminal hairs not vellus hairs), sebaceous lobules, eccrine, apocrine glands, smooth muscle

26
Q

Where do ear pits come from?

A

Incomplete fusion of 3 tubercles from the first 2 branchial arches

27
Q

What is the follicular occlusion tetrad?

A
  1. acne congloblata
  2. hidradenitis suppuratie
  3. dissecting cellulits of scalp
  4. pilonidal cyst ask about other sx’s present
28
Q

What epidermal cysts have non-stratified squamous epithelium?

A

Hidrocystoma (eccrine, apocrine), bronchogenic cyst, thyroglossal duct cyst, branchial cleft cyst, cutaneous ciliated cyst, ciliated cyst of the vulva, median raphe cyst, omphalomesenteric duct cyst.

29
Q

What is the most common non-granular layer cyst?

A

Pilar cyst

30
Q

What is the most common granular layer containing cyst?

A

EIC

31
Q

What is the differentiation of a cyst if it doesn’t have a granular layer?

A

3 choices from squamous epi: pilonidal, ear pit cyst, steatocystoma (sort of) or developmental cysts

32
Q

What are the cutaneous manifestations of Schopf-Schulz-Passarge syndrome?

A

Apocrine hidrocystomas, palmoplantar keratoderma, hypotrichosis, and onychodystrophy

33
Q

Clinical of hidrocystoma?

A

BLUISH cysts, mc on face can be by the eye. apocrine or eccrine. solitary (smith) or multiple (robinson) apocrien usually solitary eccrine usually muptole

34
Q

Histology of hidrocystoma?

A

Pigmented sweat in the middle, two cell lining, not connected to epidermis usually

35
Q

What is the clinical presentation of the bronchogenic cyst?

A

2nd or 3rd decades, most often occurring on the midline near the manubrium sterni. Can present as a cyst or a draining sinus

36
Q

thyroglossal duct cyst?

A

movement w/ swallowing (dif from bronchogenic cyst), midline cystic nodules on ontaerior neckline in kids and young adults.

37
Q

branchial celft cyst clinical

A

do not move w/ swallowing, mc preauricualr, mandibular, anterior border of SCM, more lateral as compared to thyroglossal duct cyst.

38
Q

What is the clinical presentation of a median raphe cyst?

A

Most commonly located near the glans, ventral aspect of the penis, they do not connect to the urethra, can be cut out

39
Q

What is the clinical presentation of a omphalomesenteric duct cyst?

A

Vitelline cyst, failure of closure of the connection between midgut and yolk sac, may occur anywhere between intestines and umbilicus

Looks like a polyp-like structure on the umbilicus

40
Q

What is a urachal cyst?

A

Connects fetal bladder to the umbilicus, normally closes during development

Urine leakage from incomplete urachal duct remnant occurs

These can be painful, should be ultrasounded

41
Q

Treatment of urachal cyst?

A

US and you do want to excise to prevent infxn

42
Q

Mucocele clinical presentation?

A

Lower labial mucosa is the most common location, also on the floor of mouth buccal mucosa tongue

Dome-shaped, arise as a result of the disruption of ducts of minor salivary glands.

43
Q

Clinical presentation of digital mucous cyst?

A

Filled w/ mucus, on the dorsal surface of the distal finger by nail

Longitudinal depression of the nail plate may be seen distal to the lesion

44
Q

Clinical presentation of a ganglion cyst?

A

Can be attached to tendon sheath (often) do not often communicate with the joint space. mc on dorsal surface

45
Q

What is the clinical presentation of a psedocyst of the auricle?

A

Cauliflower ear, scaphoid fossa of the ear, middle-aged men, unilateral, chronic trauma is the cause.

46
Q

What cysts arise from the follicular infundibulum?

A

EIC, milium, pigmented follicular cyst, vellus hair cyst

47
Q

What cysts arise from the follicular isthmus?

A

Pilar cyst

48
Q

What cysts arise from the sebaceous ducts?

A

Steatocystoma

49
Q

What two genetic dz’s are EIC’s associated with?

A

Gardner’s syndrome and Gorlin syndrome

50
Q

What is the mutation in steatocystoma multiplex?

A

Keratin 17

51
Q

How is steatocystoma multiplex inherited?

A

AD

52
Q

What is it called when you have multiple steatocystoma w/ eruptive vellus hair cysts?

A

Pachyonychia congenita type 2

53
Q

What is the other name for pachyonychia congenita type 2?

A

Jackson Lawler

54
Q

What are the mutations in pachyonychia congenita type 2 or Jackson-Lawler syndrome?

A

keratin 6b, 17

55
Q

What syndrome is associated with hybrid cysts with pilomatrical changes?

A

Gardner’s syndrome

56
Q

What are the 3 genoderms associated w/ dermoid cysts?

A

Gorlin Syndrome, klippel-feil syndrome, goldenhar syndrom

57
Q

What is Goldenhar syndrome?

A

AR, a/w limbal-epibulbar (ocular) dermoid cysts, which are caused secondary to defects in the 1st and 2nd branchial arches, also a/w accessory tragus, auricular fistula, deafness, Golden”HARd” of hearing

58
Q

What are the non-stratified squamous epithelium lined cysts?

A

Hidrocystoma (eccrine/apocrine), bronchogenic cyst, thyroglossal duct cyst, branchial cleft cyst, cutaneous ciliated cyst, ciliated cyst of the vulva, meidan raphe cyst, omphalomesenteric duct cyst

59
Q

What is a solitary hydrocystoma called?

A

Smith hydrocystoma

60
Q

What are multiple hidrocystomas called?

A

Robinson

61
Q

What is the pathology of the omphalomesenteric duct cyst?

A

Looks like gi mucosa, must be distinguished from gi metastasis

62
Q

What cysts do not have an epithelial lining?

A

Mucocele, digital mucous cyst, ganglion cyst, pseudocyst of auricle, cutaneous metaplastic synovial cyst

63
Q

Histology of a branchial cleft cyst?

A

Pseudostratified columnar or stratified squamous epithelium with surrounding dense lymphoid tissue including lymphoid follicles w/ germianl centers (this prominent lymphoid aggregates and follicles is a key)