Derm 2

Question 1

Is seborrheic keratoses malignant? sun induced?

Answer 1

Benign

Not sun induced

Question 2

Describe the histology of a seborrheic keratoses?

Answer 2

flat bottomed bland epidermal proliferation with PSEUDO HORN CYSTS

Question 3

What is a concentrically laminated collections of surface keratin within the acanthotic epithelium

Answer 3

pseudo horn cyst

Question 4

What is acanthosis?

Answer 4

epidermal hyperplasia

Question 5

What is an achrocordon?

Answer 5

skin tag

Question 6

What are achrocordons associated with?

Answer 6

Obesity in area of friction

Question 7

Are dermatofibromas malignant? Where are they most often located? What is the key characteristic of pinching them?

Answer 7

1. Benign
2. Shoulders and legs
   3 firm and dimple in when pinched

Question 8

What is the his to characteristic of dermatofibromas?

Answer 8

fibrohistiocytic proliferation in the DERMIS

Question 9

Are neurofibromas malignant? Where are they found? what type of tissue proliferation are they?

Answer 9

1. Benign
2. trunk of middle aged individuals
3. neuromesenchymal tissue

Question 10

Is neurofibromatosis autosomal recessive? What gene is problematic?

Answer 10

1. Autosomal Dominant

2. Neurofibromin gene

Question 11

What are 5 physical signs (marks) of neurofibromatosis?

Answer 11

Neurofibromas
Cafe au lait macules
Lisch nodules
axillary freckling
optic glioma

Question 12

What does a neurofibroma look like under a microscope?

Answer 12

spindled, schwann cells, has a pinkish color that is different than the collagen of dermatofibroma

Question 13

What is a epidermoid cyst filled with?

Answer 13

keratin- with a stratified squamous wall

Question 14

What is excessive fibroblast proliferation and collagen production in response to a injury? Does it stay within the original area of injury?

Answer 14

Keloid
no extends beyond

[higher incidence in those with african ancestry]

Question 15

What is red blanching macules that are present at birth? Do they go away? biopsy shows what?

Answer 15

1. nevus flammeus
2. many do fade
3. capillary dilation (telangiectasia)

Question 16

Port wine stain is a capillary malformation with a bright red blotchy pattern and has V1 and V2 involvement? What syndrome is it associated with?

Answer 16

1. port wine stain
2. sturge-weber syndrome
   - cns angiomatosis
   - mental retardation
   - contralateral seizure
   - ipsilateral glaucoma

Question 17

When do strawberry hemangiomas appear? When do they go away?

Answer 17

1. appear shortly after birth

2. Grow rapidly for 9 mo to 12 mo and then slowly involute

Question 18

When do cherry hemangiomas come about? where are they most numerous? how long to the last? what is proliferated?

Answer 18

1. middle age
2. most numerous on trunk
3. persists indefinitely
4. capillary proliferation

Question 19

Kaposi’s sarcoma effects what two groups? what is the virus involved? what is the histology?

Answer 19

1. elderly mediterranean males and HIV positive patients
2. HHV8
3. atypical vascular proliferation

Question 20

What is the indolent form of cutaneous T-cell lymphoma? how do they progress?

Answer 20

1. Mycosis fungoides

2. dermatitis like patch–> plaque–> then tumor

Question 21

What is sezary’s syndrome?

Answer 21

leukemic form of cutaneous T-cell lymphoma- patients are very pruritic and erythroderma

Question 22

When does pemphigus vulgaris come about? where are they located? the circulated antibodies are to what proteins? Does it show the Nikolsky sign?

Answer 22

1. mid adult life
2. oral mucosa and skin
3. desmosomal proteins- desmoglein 1 & 3
4. Yes- lateral pressure on skin gives blister

Question 23

What does pemphigus immunofluorescence look like?

Answer 23

chicken wire

Question 24

Is pemphigus foliaceous deep or superficial? does it effect oral mucosa? Where is it endemic? What are the antibodies against?

Answer 24

1. superficial
2. spares oral mucosa
3. Brasil
4. desmoglein 1 (why it spares oral mucosa)

Question 25

Who is bullous pemphigoid primarily seen? What specific type of blisters are present? Does it have a nikolsky sign? What are the antibodies against?

Answer 25

1. in the elderly 2. tense, subepidermal 3. no nikolsky sign 4. hemi-desmosomal proteins

Question 26

T-F-- bullous pemphigoid has an eosinophil-rich upper dermal infiltrate?

Answer 26

True

Question 27

What does the immunofluorescence look like for bullous pemphigoid?

Answer 27

straight line- think hemidesmosomes

Question 28

Where are the intensely pruritic vesicles of dermatitis herpetiformis found?

Answer 28

1. elbows, knees, scalp, buttocks

Question 29

What skin disease do we know that is associated with gluten sensitivity enteropathy?

Answer 29

dermatitis herpetiformis

Question 30

T-F- dermatitis herpetiformis is Nikolsky positive?

Answer 30

False- negative

Question 31

Where are the micro abscesses of dermatitis herpetiformis found histologically speaking?

Answer 31

in the dermal papillae

Question 32

What does the direct immunofluorescence of dermatitis herpetiformis logo like?

Answer 32

Granular IgA in dermal papillae

Question 33

What are the 3 types of epidermolysis bullosa?

Answer 33

Simplex, junctional, dystrophic

Question 34

Which epidermolysis bullosa is split through upper dermis; defect in type VII collagen?

Answer 34

dystrophic

Question 35

Which epidermolysis bullosa is split through the basement zone, defective proteins include laminin 5, A6B4 integrin, type XVII collagen?

Answer 35

junctional

Question 36

Which epidermolysis bullosa is split through the basal layer of the epidermis and the defects are in the K5 or K14?

Answer 36

simplex

Question 37

T-F- epidermolysis bullosa is an inflammatory bullae?

Answer 37

False- non-inflammatory

Question 38

Review Porphyria Cutanea Tarda

Answer 38

- defect in heme pathway - blisters and fragility of sun exposed skin - defect in uroporphyrin decarboxylase - associations- can get hirsuitism, alcoholism, estrogens, hemochromatosis and hepatitis C