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Flashcards in Dermatopathology 2 Deck (101):
1

Dermatofibroma is also known as

benign fibrous histiocytoma

2

Dermatofibroma usually occurs where on the body

lower legs

3

how fast does Dermatofibroma grow

slow

4

clinical signs for Dermatofibroma

Flesh-colored to pigmented papule
- "dimple-sign" depresses when squeezed

5

what proliferates in Dermatofirbroma

fibroblasts with collagen

6

histo pic for dermatofibroma

whirling (pinwheel or storiform) fibroblasts with collagen bundles

7

Does Dermatofibroma metastasize

no

8

what happens to overlying epidermis in Dermatofibroma

thins

9

Dermatofibroma extends where in the skin and how

dermis to subcutaneous fat
"honeycomb" pattern

10

What happens in Mycosis Fungoides

T cell lymphoma presents in skin and may evolve into generalized lymphoma

11

where does Mycosis Fungiodes occur

trunk

12

what are the 3 stages of Mycosis Fungoides

Patch: scaly, red, brown
plaque: raised
nodule ( tumor)

13

the three stages of Mycosis Fungoides is similar to what other disease

Kaposi Sarcoma

14

Explain histo process of Mycosis Fungoides

- T-helper cells form bands in superficial dermis
- single cells or small clusters invade epidermis

15

what are two types of Mastocytosis

Urticaria pigmentosa
Systemic mastocytosis

16

Urticaria pigmentosa usually presents in who

children

17

Systemic Mastocytosis usually occurs in who

adults

18

what are two signs and symptoms for Mastocytosis

Darier sign
Dermatographism

19

Darier sign

Wheal ( dermal edema and erythema) when skin lesion is rubbed

20

Dermatographism

hive occurs when normal skin is stroked with pointed instrument

21

Why do these signs and symptoms occur in mastocytosis

release of histamines, heparin, and other mast cell content

22

In systemic disease of Mastocytosis, foods, drugs, alcohol can trigger what

Pruritus and flushing

23

what do the dendritic mast cells look like in mastocytoma

metachromatic granules within dendritic mast cells
- Fried egg cells : central nuclei with rigid rim of peripheral cytoplasm

24

what stain is good for Mastocytoma

Giemsa

25

define Ichthyosis

disorders which impair epidermal maturation

26

what are two types of Ichthyosis

congenital
acquired

27

histo for Ichthyosis: stratum corneum

build up of compacted stratum corneum with loss of basket-weave pattern

28

which types of Ichthyoses has stratum granulosum normal to slightly thickened

-lammellar
- X-linked
- congenital ichthyosiform erythroderma

29

which types of Ichthyosiss has stratum granulosum thin or absent

ichthyosis vulgaris

30

what is a common name for urticaria

hives

31

how does urticaria form

from mast cell degranulation through sensitization with specific IgE
and microvascular hyper-permeability

32

histo for Urticaria

pervenular infiltrate
dermal edema
no epidermal changes

33

another name for Acute Eczematous Dermatitis

Spongiotic Dermatitis

34

what are 2 forms of contact dermatitis

irritant and allergic

35

Allergic contact dermatitis creates what type of reaction

cell-mediated, delayed-type hypersensitivity reaction type 4

36

Allergic contact dermatitis, explain process form skin contact

-Antigen on skin taken up by langerhans cell
- dermal lymphatics to lymph nodes
-CD 4 helper T cells

37

what are common allergic contact dermatitis

Nickel, poison ivy/oak

38

for allergic contact dermatitis characterize the vescicles

fluid in vesicles do not contain allergen and cannot induce disease in others.

39

for allergic contact dermitis when does sensitization occur for first time exposure? reexposure?

1st: 1-2 weeks
2nd: hours to days

40

Mechanism of actin for irritant and allergic

irritant: direct effect
allergic: type IV

41

onset for irritant and allergic

Irritant: few hours
allergic: 12-72 hours

42

incidence for irritant and allergic

I: anyone
A: only sensitized person

43

lesionfor irritant and allergic

I: erythema, vesicles, crust
A: erythema, papules, vesicles, scale

44

common name for atopic dermatitis

eczema

45

clinical feature for atopic dermatits? when does it start?

chronic waxing and waning
dry skin
extremely pruritic, papules, vesicles, oozing, crusting
beginning first yr of life

46

where do babies usually get atopic dermatitis

face, diaper area

47

where do children and adults get atopic dermatitis

neck, face, axillae

48

chronic atopic dermatitis can lead to what

Lichenification: epidermal thickening, visible and palpable skin thickening with accentuated skin lines

49

Nummular dermatits is what shape? clinical presentation

coin-shaped
- itchy red plaques with vesicles and distinct borders

50

asteatotic dermatitis is known as what? clinical presentation

winter itch
- dry cracked skin

51

histo what does acute eczyematous dermatitis ( spongiotic dermatitis) look like

Spongiosis: intracellular edema
exocytosis: infiltration of epidermis by inflammatory cells

52

what happens in erythema multiforme

CD8 T cells, hypersensitivity reaction resulting in epidermal cell injury

53

what is a clinical diagnostic factor for erythema multiforme? other clinical features

- target lesions
- macules, papules, vesicles, bullae, puritic

54

what can trigger Erythema multiforme

HSV
mycoplasma pneumonia

55

histo for Erythema multiforme

early: dermal edema
degenerating and necrotic keratinocytes

later: lymphocytes migrate into epidermis

56

which is more severe Stevens-Johnson syndrome or erythema multiforme

Steves-Johnson syndrome

57

who usually gets Stevens-Johnson Syndrome

children

58

what involves Stevens-Johnson Syndrome

mucous membranes ( mouth and conjuctivae)
fever, difficulty eating, renal failure

59

how is a Stevens-Johnsone syndrome patient treated

burn patient

60

what my cause Steven-Johnson syndrome

sulfa drugs and anticonvulsants

61

toxic Epidermal Necrolysis what happens

detachment of large areas of epidermis

62

body surface involvement for EM, Steven johnson, TEN

EM: less than 30%
SJ: 10-30%
TEN: more than 30

63

Pityriasis Rosea is possibly related to what virus

herpes virus 7

64

What time of year does Pityriasis occur

winter

65

Clinically what does PItyriasis Roasea look like

-Initial "herald patch" resembles ringworm
- pink, scaling near border
-"Christmas tree pattern"

66

what does the histo for pityriasis rosea

spongiosis with erthrocyte extravasation

67

where is Pityriasis Rosea commonlyfound

trunk, upper arms, thighs
not face

68

what is venous insufficiency

venous incompetence causes increased hydrostatic pressure and capillary damage
- extravasation of RBCs and serum

69

clinically what does venous insufficiency look like

edema and hyperpigmentation
- pruritic erthema and stasis dermatitis
-ulceration above medial malleoulus

70

what is the histo features for stasis dermatitis of venous incompetence

subacute spongiotic dermatitis
- intracellular epidermal edema

71

how is venous insufficiency treated

compression stocking

72

what is Psoriasis

accelerated proliferation of skin cells resulting in scaling

73

clinically what does Psoriasis look like

well-demarcated, erythematous plaques and plaques with SILVER SCALING
- symmetrical

74

what is Auspitz' sign

pinpoint bleeding on removal
- Psoriasis

75

what is the koebner phenomenon

trauma to the skin and stress can cause exacerbations
- Psoriasis

76

histo for Psoriasis

- Downward elongation of rete ridges
- thining on stratum granulosum
- parakertosis above granulosum layer
capillaries in dermal papillae brought close to the surface

77

Erythrodermic psoriasis

entire skin, very serious

78

Guttate psoriaisis

scattered, drop-like, pink, scaly plaques
may follow Strep

79

Pustular psoriasis

pustules on erythematous skin,

80

Psoriasis effects on nails

oil spotting: focal brown discoloration of nail plate
onycholysis: distal separation of plate from bed
subungural hyperkeratosis
pitting

81

Psoriasis can cause what other health problem? what does it look like

arthritis
"pencil-in-cup"

82

what should you not give a psoriasis patient

oral steroids

83

what are common names for Seborrheic dermatitis

"cradle cap"
dandruff

84

what causes seborrheic dermatitis

Malassezia furfur

85

what areas on the skin does seborrheic dermatitis impact

sebaceous gland rich areas

86

Seborrheic dermatitis is usually found in patients who have what conditions

Parkinson and HIV

87

what does Seborrheic dermatitis look like

yellow, greasy, scaly patches with surrounding erythema

88

what is the histo for Seborrheic dermatitis

features of both spongiotic dermatitis and psoriasis
- mounds of parakeratosis with neutrophils
- serum at ostia of hair follicle

89

what is Lichen Planus

idiopathic Inflammatory disorder

90

what are the 5 P's for Lichen Panus

Pruritic
Purple
Polygonal
Planar
Papules
Plaques

91

where is Lichen Panus common

wrists and ankle

92

clinical presentation of Lichen Panus

Wickham's striae: fine, reticulated, white lines
mucous involvement
Koebner phenomenon
severe ithcing

93

Lichen Planus can be associated with what disease

Hep. C

94

Histo for Lichen Planus

- many lymphocytes along dermo-epidermal junction
- Civatte bodies
- saw-tooth pattern

95

Civatte bodies

incorporation of necrotic basal keratinocytes into inflammaed papillary dermis

96

Systemic Lupus Erythematosus involves what organs

autoimmune disease involving connective tissue and blood vessel

97

Who is more likely to have Systemic Lupus Erythematosus

African Americans

98

Which gender is more likely to get Systemic Lupus Erythematosus

females

99

what are some clinical symptoms of Systemic Lupus Erythematosus

skin lesions
fatigue
fever
weight loss
CNS symptoms

100

what are classic symptoms of Systemic Lupus Erythematosus

Malar rash- butterfly rash ( spares nasolabial folds)

101

histo for lupus

epidermal atrophy
thickening of basal membrane