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Flashcards in Dermatopathology 3 Deck (96):
1

Pemphigus vulagris what happens

IgG autoantibodies against desmogleins 1 and 3 in desomosomes in suprabasal deep epidermis and mucosal epithelium

2

what is Nikolsky sign and what are Pemphigus vulgaris tests results

pressure on blister causes lateral spread of lesion
- positive

3

where do 80-90% of pemphigus vulgaris begin

oral lesions

4

what forms the roof of the blister for pemphigus vulagris

stratum corneum

5

what happens in pemphigus foliaceus

autoantibodies against Dsg1 alone

6

histo for pemphigus

row of tombstomes
acantholysis
net like pattern of intracellular IgG deposists

7

what does pemphigus vegetans look like

large, moist, verrucous, plaques rather than blisters

8

common lesion site for pemphigus vegetans

oral lesions

9

what other disorder is pemphigus vegetans related to

ulcerative colitis

10

what country is pemphigus foliaceus found

Brazil

11

what happens in bullous Pemphigoid

autoantibodies bind BPAg1 and BPAg2 ( only one causing blister) in hemidesosome

12

At what layer of the skin does bullous Pemphigoid form a blister

lamina lucida of the basement membrane

13

age groups of pemphigus and Bullous Pemphigoid

P: 30-50
BP: elderly

14

target antigen for pemphigus and Bullous Pemphigoid

P: demoglein 1 and 3
BP: BPAg1 and BPAg2 in hemidesmosomes

15

Blister ( bulla) pemphigus and Bullous Pemphigoid

P: suprabasal, ancantholytic, positive Nikosky sign
BP: subepidermal, nonacantholytic, sturdy

16

oral mucosa for pemphigus and Bullous Pemphigoid

P: many early lesions
BP: few after cutaneous lesions

17

what happens in Dermatitis Herpetiformis

IgA autoantibodies to transglutaminases bind to TG in gut and cross-react with reticulin in fibrils in skin

18

what is the onset and gender of Dermatitis Herpetiformis

20-60
males

19

clinical presentation of Dermatitis Herpetifromis

symmetrically grouped lesions
-papules and plaques progressing to vesicles and bullae

20

For Dermatitis Herpetiformis what other disease is present and what is used to show this

Gluten senstive
small bowel biopsy

21

Histo feature for Dermatitis Herpetiformis

subepidermal blister
microabscesses at dermal papillae

22

what is epidermolysis bullosa

group of disorders caused by inherited defects ( 10 genes) in proteins that lend stability to skin

23

when do symptoms of Epidermolysis bullosa occur

at or soon after birth

24

Name 4 types of Epidermolysis Bullosa

simplex
junctional
dystrophic
non-Herlitz junctional

25

Simplex type

mutations in gene encoding keratin 14 or 5 ( form keratin fiber)
- basal cell layer defect

26

Junctional type

blisters formed from separation lamina lucida

27

Dystrophic types

blisters below lamina densa, from defect in collagen VII

28

Non-Herlitz Junctional

defect in laminin Vbeta3

29

histo for Epidermolysis Bullosa? similiar to what?

fibrin deposition in floor of blister cavity
- bullous pehphigoid

30

what happens in prophyria cutanea tarda

uroporphyrinogen decarboxylase (UROD) deficiency
- excessive accumulation of porphyrins

31

who is prone for Prophyria cutanea tarda

30-50 yrs
- females on OCP
-alcohol
-hep C

32

what are the types of Porphyria cutanea tarda

Type I: acquired
type II: autosomal dominant, deficient in RBC and fibroblasts

33

what does Porphyria cutanea tarda do to skin

make it photosenstivie

34

what does Porphyria cutanea tarda do to face

hypertrichosis ( hairy face)

35

how does one diagnose Porphyria cutanea tarda

uroprophryin in urine

36

what 3 things must be avoided for porphyria cutanea tarda

alcohol
estrogens
fungicides

37

histo for porphyria cutanea tarda

subepidermal vesiculation
- protuberance of rigid dermal papillae into blister cavity( festooning
- thickening of walls of superficial dermal vessels

38

what happens in acne vulgaris

obstruction of sebaceous follicles by sebum
-promotes proliferation of propionibacterium acnes ( anaerobe)

39

what do obstructive acne look like

closed
whiteheads
flesh colored dome

40

what do inflammatory acne look like

papules/pustules to nodules to cysts

41

Risk factors for Acne vulgaris

male
puberty
Cushing
oily complexion
androgen excess

42

what are 4 components of acne vulgaris

1. keratinization of lower portion of follicular infundibulum
-development of keratin plug, block outflow of sebum
2. hypertrophy of sebaceous gland
3. lipase-synthesizing bacteria ( propionibacterium acnes_ colonizing upper hair follicle
4. inflammation of follicle
-release of cytoxic and chemotactic factors

43

Acne Rosacea what is it

chornic inflammatory disorder that affects blood vessels and pilosebaceous units

44

4 stages of acne rosacea

1. flushing
2. persistent erthyema and telangiectasias
3. pustules and papules
4. Rhinophyma

45

what is rhinophyma

skin on nose becomes thick and greasy, hyperplasia of sebaceous glands, connective tissue and vasculature

46

what areas of the face are impacted with acne rosaceae

nose and cheeks including nasolabial folds

47

histo for rosacea

perfollicular infiltrate of lymphocytes

48

Panniculitis

inflammation of lobules or connective tissue septa separating fat lobules

49

what is Erythema nodosum

inflammatory reaction of connective tissue septa separating fat lubules

50

gender of who gets it more for Erythema nodosum

females

51

clinical for Erythema nodosum

red, painful, elevated nodules, poorly circumscribed

52

where is erythema nodosum usually ocur

anterior aspect of tibial

53

what are some crazy things that cause Erythema nodosum

strep
pregnancy
OCP
syphilis
TB

54

histo erythema nodosum

widening of septa from fibrin, edema, and neutrophilic infiltrate

55

what is warts

infection of epidermal cells with human papilloma virus

56

who usuallly gets warts

children and young adults

57

who are warts transmitted

skin to skin

58

in warts, intralesional borwn-black dots are pathognomonic and represesent what

thrombosed vessels

59

scientific name for common wart

Verruca vulgaris

60

scientific name for flat wart?
location

verruca plana
-chin, dorsum of hand, legs

61

scientific name for war on foot? what can cause this

Verruca platnaris
HPV1

62

Condyloma acuminatum

anogenital wart

63

what causes Condyloma acuminatum

most common STD, HPV6 and 11

64

hist for warts

Church spire

65

who usually gets Molluscum contagiosum

viral infection in kids and sexually active adults

66

what causes Molluscum contagiosum

poxvirus

67

how is Molluscum contagiosum transmitted

skin to skin

68

clinical representation of Molluscum contagiosum

asymptomatic smooth, dome-shaped papules with central umbilication

69

hist for Mollluscum contagiosum

Molluscum bodies in stratum corneum and granulosum

70

what is impetigo

superficial bacterial infection of skin

71

what are the two forms of impetigo

nonbullous and bullous

72

what is the most common form of impetigo

nonbullous

73

what is the most common cause of impetigo

Staph aureus

74

histo for impetigo

neutrophils beneath stratum corneum

75

Sacabies how long in incubation

1 month

76

scabies is infection with

Sarcoptes scabiei

77

where does scabies usually occur

finger webs, wrists, and penis

78

the egg and feces causes what reaction to the body

type IV hypersensitivity
- extremem itching at night

79

how does one confirm scabies

scraping burrow with scalpel
look under microscope

80

what is Xanthelasma ( Xanthoma)

collection of macrophages containing lipid droplets

81

Mongolian spots clinical picture

single-gray-blue lesion over lumbosacral area

82

who usually gets Mongolian spots

Asian and Native Americans

83

what goes wrong in Mongolain spots

melanocytes located in dermis instead of epidermis

84

what is cherry angioma

bright red, domed, vascualar lesions on trunk
- increase with age

85

what is the most common tumor of infancy

Hemangioma of infancy

86

what is Hemangioma of infancy? what does it look like

benign hyperplastic blood vessels,
- blanchable bright red to deep purple lesions

87

over time what happens to hemangioma of infancy

regressses

88

when do you treat hemangioma of infancy

do not treat until ulcerates or blocks ears, eyes, larynx

89

what are the 3 phases of hair devleopment

anagen
catagen
telogen

90

what is alopecia

common cause of hair loss in adults

91

Xeroderma pigmentosum how is it inherited?

Autosomal recessive

92

Xerdomera pigmentosum

decrease ability to repair DNA following UV damage

93

timeline of Xeroderma pigmentusm

1st year of life: scaling
later: atrophy
5-6 yeras: squamous and basal cell cancer

94

Chediak-Higashi syndrome

immunodiciency due to defect in neutrophil phagosome lysosome fusions
-abonormal giant lysosomal inclusions visible on peripheral blood smear

95

Wiskott-Aldrich Syndrome

X-linked
immunodeficiency
Exzema
thrombocytopenia
B and T lymphocyte disorder

96

albinsim

melanocytes normal in number and location
- production of melanin defective
- due to complete absence of tyrosinase