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Derm Path & Definitions Flashcards

(71 cards)

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1
Q

Freckle (ephelis)

A

Inc melanin pigmentation along basal layer of epidermis (stratum basalis)

NO acanthosis (thickening) of epidermis
NO melanocytic nest formation
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2
Q

Lentigo

A

Inc melanin pigmentation along basal layer of epidermis (basalis)

WITH acanthosis (thickening) of epidermis
WITH elongation of rete ridges
INC melanin pigmentation at base of rete ridges
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3
Q

Vitiligo

A

Hypopigmented patched skin - auto-immune
ABSENCE of melanocytes

Rule out tinea versicolor (M. furfur)

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4
Q

Junctional Melanocytic Nevus (benign mole)

A

Nests of melanocytes at derma-epidermal junction only

New in adults = worrisome

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5
Q

Intradermal Melanocytic Nevus (benign mole)

A

Nests of melanocytes in dermis only

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6
Q

Compound Melanocytic Nevus (benign mole)

A

Nests of melanocytes at BOTH derma-epidermal junction and in dermis

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7
Q

Blue Melanocytic Nevus (benign mole)

A

Spindle-shaped melanocytes usually w/ lots of melanin pigmentation usually in dermis

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8
Q

Dysplastic Melanocytic Nevus (benign mole)

A

Nests of melanocytes at dermo-epidermal junction stretching from rete ridge to adjoining rete ridge, surrounding lamellar fibrosis and peri-vascular chronic inflammation

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9
Q

Halo Melanocytic Nevus (benign mole)

A

Halo around nevus
Mod–> severe infiltration of lymphocytes that are attacking the melanocytes = auto-immune

Possibly malignant

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10
Q

Most malignant melanomas arise…

A

de novo

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11
Q

Dysplastic nevus syndrome

A

Multiple pigmented lesion of trunk, chets abdomen

All a little bit irregular

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12
Q

Hyperkeratosis

A

Orthokeratotic thickening of stratum corneum

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13
Q

Orthokeratosis

A

Normal state of keratinocytes in most superficial layer of epidermis = NO NUCLEI IN KERATINOCYTES

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14
Q

Acanthosis

A

Thickening of all 4-5 layers of the epidermis

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15
Q

Exocytosis

A

Extension of any leukocyte inflammatory cells into epidermis

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16
Q

Malignant melanoma

A

Malignant neoplasm of cells showing melanocytic differentiation
S-100+
HMB-45+

Begins de novo w/ atypical nested proliferation at D-E junction w/ PAGETOID GROWTH –> dermis

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17
Q

Most important factor determining melanoma mets

A

Thickness/depth of invasion

Must be <0.76mm to be unlikely to met

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18
Q

Breslow’s Level

A

Greatest neoplastic depth of invasion in millimeters from granular layer of epidermis

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19
Q

Clark’s Level

A

I - in situ (epidermis only, should not met)
II - invading but not filling papillary dermis
III - invading and filling papillary dermis
IV - invading into reticular dermis
V - invading into adipose tissue of cubcutis

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20
Q

Superficial spreading malignant melanoma

A

Horizontal growth

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21
Q

Nodular malignant melanoma

A

Vertical growth

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22
Q

Aral-Lentiginous malignant melanoma

A

Occurs on acral skin (hands/feet)

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23
Q

Neurotopic

A

Spindle cell differentiation - malignant form of blue melanocyitc nevus - usually does not show epidermal involvement

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24
Q

Seborrheic Keratosis

A

Benign proliferations of keratinocytes

“Stuck-on” lesions

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25
Spongiosis
Edema fluid separating keratinocytes from each other in epidermis
26
Acantholysis
Breakdown of normal desmosomal attachments b/w keratinocytes in epidermis
27
Parakeratosis
Abnormal state of keratinocytes having nuclei in stratum corneum - ALWAYS ABNORMAL IN KERATINIZING SKIN
28
Hypergranulosis
Thickening of stratum granulosum
29
Koilocytosis
Peri-nuclear clearing around nulei in keratinocytes - usually indicative of HPV
30
Skin vs. squamous mucosa
No nuclei in stratum corneum in skin vs. keratinocytes ALWAYS having nuclei in non-keratinizing squamous mucosa
31
Dyskeratosis
Abnormal kerainization of keratinocytes usually individually below the layer of the stratum granulosum
32
Lentigo malinga/Hutchinson's freckle
Elderly, sun-exposed area
33
#1 place for melanoma metastasis
Liver
34
MOA of corticosteroids
Inc lipocortins --> Inhibits phospholipase A2 --> Less arachadonic acid anti-inflammatory, less edema, less erythema, less pruritis, less plaque
35
Corticosteroid abs
Minimal percutaneous - LT occlusion inc - Inflammation inc - Genitals abs 30%!!!
36
Low potency corticosteroids*
``` Low (VII) - hydro - dexa - methylprednisolone, prednisolone Tx - atopic, seborrheic, psoriasis ``` Intermediate - Fluticasone
37
High potency corticosteroids*
``` High (class I) - Betamethasone - Clobetasol - Halobestasol Tx - Pemphigus, vitiligo, keloids, hypertrophic scars, acne cysts ```
38
Corticosteroids toxicity
1. Suppression of Pituitary-adrenal axis --> Cushing 2. Growth retardation in kids Topical - atrophy - rosacea - telangectasia - striae
39
DOC for psoriasis*
* Topical steroids 2x/d* | - hands - more potent, less continuous (5-10%)
40
Psoriasis causes & epidemiology*
*SMOKING*, climate, stress 20-30 & 50-60 Whites > Blacks KNUCKLES, elbows, knees, scalp Drug causes - Lithium - BBs - anti-malarials - SYSTEMIC steroids
41
Tazarotene MOA
Modulates differentiation and proliferation of epithelial cells --> antiinflammatory and anti-proliferative
42
Tazarotene SE*
*NOT IN PREGNANCY*
43
Calcipotriene
D3 derivative | Extremely effective - 1-2wks
44
Coal Tar
ONLY in-combination w/ other therapies for psoriasis - UVB therapy
45
Acitretin*
Vit A retinoid - pustular psoriasis Tx 3-6mo *NOT IN PREGNANCY or 3 YEARS AFTER*
46
Etanercept
Dimeric fusion protein Binds TNF receptor SubQ a couple times a month SE - life-threatening infections & sepsis
47
Adalimumab
Human IgG1 TNF Ab --> downreg of MO & T-cell fxn Psoriatic arthritis SE - latent TB, opportunistic infections
48
Infliximab
Chimeric IgG1 TNF Ab --> downreg of MO & T-cell fxn SE - demyelinating = CI in MS
49
PUVA (Psoralens and UVA)
Psoralens - makes them more light sensitive (320-400nm)
50
Methorexate MOA
Mod-severe psoriasis Inhibits dihydrofolate reductase --> inhibits DNA synthesis
51
MTX dosing & SE
Oral triple-dose - q12hrs for 26hrs BM SUPPRESSION --> agranulocytosis/pancytopenia - Dec dose for several months at a time - Rescue = LEUCOVORIN
52
MTX toxicities*
CI - pregnancy, hepatic *TMP-SMX*, Probenecid, salicylates, NSAIDs
53
Anti-trichogenic
Inhibits ornithine decarboxylase
54
Repigmentation - tx of vitiligo
Trioxsalen & Methoxsalen (Psoralens + UVA)
55
Penicillin Rxn
Utricarial - exanthematous --> stop, tx w/ anti-histamine, steroids
56
*OCs & sulfa rxns*
Erythema nodosum - tender, subq nodules, PRE-TIBIAL Self-limiting - STOP offending agent
57
Anti-convulsants, Barbs, sulfa rxns
Erythema multiforme - Maculopapular, bullous, "target lesions" ``` #1 = HSV TEN or SJ syndrome ```
58
Acral Skin
Normal thick skin of palms and soles w/ all five layers
59
Skin other than acral
Other than palm and soles w/ 4 layers - NO stratum lucidum
60
Vesicles
Cystic area in epidermis b/c spongiosis and/or acantholysis in epidermis (intradermal vs. subdermal)
61
Intraepidermal bulla
At least the stratum basal is remains attached to the basement membrane and dermis
62
Subepidermal bulla
ENTIRE epidermis is detached from dermis
63
Erosion
complete loss of epidermis
64
Exfoliative dermatosis/dermatitis
Some particular skin disease whose major feature is loss of epidermis from dermis either locally or systemically
65
Apoptotic necrosis of keratinocytes
Focal necrosis of individual keratinocytes in epidermis usually seen in the classic differential diagnosis: 1. Erythema multiforme 2. TEN 3. Fixed Drug Eruption 4. Phototoxic Dermatitis 5. GVHD
66
Pemphigus vulgaris
``` Pemphigus = intraepidermal Cytotoxic Abs (Type II HS) LINEAR deposition of IgG on desmosomes = acantholysis FLACCID bulla Eosionphils ```
67
Bollous pemphigoid
Pemphigoid = SUBepidermal LINEAR IgG to BM/hemidemisomes TENSE bulla Eosinophils
68
Dermatitis Herpetiformis
Celiac disease IgA deposition in papillary dermis Neutrophils in papillary dermis
69
Porphyria
Porphyria cutanea tarda | Inc porphrin excretion - illuminated w/ woods lamp
70
Epidermolysis bullosa
Congenital abnormalities w/ BM - epidermis cleaves from dermis w/ little trauma
71
Psoriasis
Neutrophils in paraketatotic scale

Derm (1 decks)

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