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Flashcards in Derm 2 Deck (38):
1

Is seborrheic keratoses malignant? sun induced?

Benign
Not sun induced

2

Describe the histology of a seborrheic keratoses?

flat bottomed bland epidermal proliferation with PSEUDO HORN CYSTS

3

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

pseudo horn cyst

4

What is acanthosis?

epidermal hyperplasia

5

What is an achrocordon?

skin tag

6

What are achrocordons associated with?

Obesity in area of friction

7

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

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

8

What is the his to characteristic of dermatofibromas?

fibrohistiocytic proliferation in the DERMIS

9

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

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

10

Is neurofibromatosis autosomal recessive? What gene is problematic?

1. Autosomal Dominant
2. Neurofibromin gene

11

What are 5 physical signs (marks) of neurofibromatosis?

Neurofibromas
Cafe au lait macules
Lisch nodules
axillary freckling
optic glioma

12

What does a neurofibroma look like under a microscope?

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

13

What is a epidermoid cyst filled with?

keratin- with a stratified squamous wall

14

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

Keloid
no extends beyond

[higher incidence in those with african ancestry]

15

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

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

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?

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

17

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

1. appear shortly after birth
2. Grow rapidly for 9 mo to 12 mo and then slowly involute

18

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

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

19

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

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

20

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

1. Mycosis fungoides
2. dermatitis like patch--> plaque--> then tumor

21

What is sezary's syndrome?

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

22

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

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

23

What does pemphigus immunofluorescence look like?

chicken wire

24

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

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

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?

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

26

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

True

27

What does the immunofluorescence look like for bullous pemphigoid?

straight line- think hemidesmosomes

28

Where are the intensely pruritic vesicles of dermatitis herpetiformis found?

1. elbows, knees, scalp, buttocks

29

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

dermatitis herpetiformis

30

T-F- dermatitis herpetiformis is Nikolsky positive?

False- negative

31

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

in the dermal papillae

32

What does the direct immunofluorescence of dermatitis herpetiformis logo like?

Granular IgA in dermal papillae

33

What are the 3 types of epidermolysis bullosa?

Simplex, junctional, dystrophic

34

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

dystrophic

35

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

junctional

36

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

simplex

37

T-F- epidermolysis bullosa is an inflammatory bullae?

False- non-inflammatory

38

Review Porphyria Cutanea Tarda

- 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