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Dermatopathology > Dermatopathology > Flashcards

Dermatopathology Flashcards

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1
Q

A: Identify

B: What are the 2 types of Biopsy

A

B: Punch (shown in image) vs. Shave

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2
Q

A: Identify

B: What is the Epidermis composed of (4)

C: Define Hyperkeratosis

D: Define Parakeratosis

E: What connects [Basal Layer] to Dermis (2)

A

Cancel Lab, Get Some Beer

B: MLK belongs in the Epidermis - [Melanocytes & Merkels Disc] / Langerhan / Keratinocytes]

C: When [Stratum Corneum] becomes thick

D: When [Straum Corneum] retains Nuclei

E: Hemidesmosomes & [Undulated Projections from Rete Ridge]

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3
Q

A: How long does [Epidermal maturation] from basal cell to [cornified cell] take

B: What’s the result of [Disordered maturation]

C: What condition shortens this maturation

A

A: 25 Days = [Desquamatization Vertical Maturation]

B: Skin thickening due to No Desquamation

C: Inflammation

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4
Q

A: Define Ichythosis

B: What’s the most common subtype and its [Mode of Inheritance]

C: Name the other 3 subtypes

A

A: Hereditary DO that appears at birth = Defective Desquamatization –> build up of compacted scales

B: Ichthyosis Vulgaris (AD vs. acquired)

C:

  • [Congenital Ichthyosiform Erythroderma (AR)]
  • [Lamellar Ichthyosis (AR)]
  • [X-linked Ichthyosis–> Defective steroid sulfatase]
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5
Q

A: Describe the Histology (2)

B: Dz

A

Ichthyosis Vulgaris

Orthokeratosis = Thickening of Stratum Corneum = Hyperkeratosis without Parakerotosis

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6
Q

A: Describe Histology

B: Dz

A

Ichthyosis Vulgaris

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7
Q

A: Describe Histology

B: Dz

C: Location

D: Demographic

A

A: Stuck-on,” waxy appearing brown papules or plaques

B: Seborrheic Keratosis

C: Anywhere on Skin [except palms/soles]

D: Pt > 30 y/o

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8
Q

A: Describe Histology (5)

B: Dz

C: Location

D: Demographic

A

A:

  • [Hyperkeratosis (light purple in top L)]
  • Epidermal Acanthosis made of uniform small keratinocytes
  • Horn Cyst
  • [Flat Base String Sign] = no infiltration into dermis
  • [Papillated Undulated Epithelium] (Papillomatosis)

B: Seborrheic Keratosis

C: Anywhere on Skin [except palms/soles]

D: Pt > 30 y/o

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9
Q

A: Describe Histology (3)

B: Dz

C: Location (2)

D: What’s this Dz caveat

A

A: image

B: Acanthosis Nigricans

C: Axilla and Neck Creases

D: THERE IS NO ACANTHOSIS ON HISTOLOGY

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10
Q

A: Describe Histology (3)

B: Dz

C: Location (2)

D: What’s this Dz caveat

A

A: image

B: Acanthosis Nigricans

C: Axilla and Neck Creases

D: THERE IS NO ACANTHOSIS ON HISTOLOGY

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11
Q

A: Describe the sign associated with [Seborrheic Keratosis​]

B: Demographic

A

Leser Trelat Sign

A: Paraneoplastic Syndrome accompanied with acute onset of multiple SK

B: Pts with metastatic CA

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12
Q

What are the 2 Types of [Acanthosis Nigricans]

A
  • Benign type = childhood (Obesity/Endocrine vs. Hereditary)
  • Malignant = middle age and up pts who have other internal malignancies
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13
Q

A: Describe Histology (2)

B: Dz

C: Composition

A

A: image

B: [STAFP: Skin Tag Achrochordon Fibroepithelial Polyp]

C: [Outgrowth of (Fibroblast/Collagen/Vessels) covered in acanthotic epidermis]

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14
Q

Name 2 common [Epithelial Neoplasms]

A

[Seborrheic Keratosis] & [Acanthosis Nigricans]

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15
Q

A: [Actinic Keratosis] is a precursor to ______

B: Tx (2)

A

A: [Actinic Keratosis] is a precursor to [Squamous Cell Carcinoma]

B:

  1. Cryotherapy
  2. Topical tx
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16
Q

A: Describe Histology (3)

B: Dz

C: What’s the primary leukocyte in the skin

A

A: image

-Solar Elastosis=Grayish-bluish color of the Dermis from sun damage

B: [Actinic Keratosis-PreMalignant]

C: Lymphocyte

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17
Q

A: Describe Histology (3)

B: Dz

C: What’s the primary leukocyte in the skin

A

A: image

-Solar Elastosis=Grayish-bluish color of the Dermis from sun damage

B: [Actinic Keratosis-PreMalignant]

C: Lymphocyte

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18
Q

A: Name the 2nd most common Skin Tumor

B: Risk Factors (11)

C: What’s the BIGGEST Risk Factor and why

A

A: Squamous Cell Carcinoma

B: HAIR IN WOMBS

  1. [HRAS activating mutation]
  2. Arsenic
  3. Immunosuppresion (HPV)
  4. Radiation-ionizing
  5. Industrial
  6. [Notch receptor LOSS OF FUNCTION mutation]
  7. Wounds-chronic
  8. Older
  9. Males
  10. Burn Scars
  11. SUN!!!!! = BIGGEST RISK FACTOR!

C: Sun–>[TP53 mutation at pyrimidine dimers] (INC potential in Xeroderma Pigmentosum pts)

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19
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: [Squamous Cell Carcinoma]

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20
Q

A: Describe Histology in each image

B: Dz

A

A: image

B: [Squamous Cell Carcinoma]

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21
Q

A: Describe Histology (3)

B: Dz

C: How would this appear Clinically

D: Tx

A

A: image

B: [SQC IN SITU] = BOWEN’S DZ

C: Plaque

D: Excision (will not regress on its own-but won’t metastasize once excised)

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22
Q

What is [Bowenoid Papulosis] (3)

A

Same Histology as [SQC IN SITU Bowen’s Dz] but is

  • HPV induced
  • Genital location
  • Frequent multiple papules
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23
Q

Basal Cell Carcinoma

A: Statistic

B: Risk factors (3)

C: Pathogenesis (2)

A

A: Most common invasive CA in humans

B:

  1. [Sun exposed sites of Older pts]
  2. Immunosuppressed
  3. [Xeroderma Pigmentosa (DNA mismatch repair syndromes)

C: [PTCH Hedgehog signaling mutation] vs. [P53 mutation]

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24
Q

A: Describe Histology (3)

B: Dz

A

A: image

B: Basal Cell Carcinoma

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25
A: *Describe Histology* (3) B: Dz
A: image B: Basal Cell Carcinoma
26
[**Nevoid Gorlin** **Basal Cell Carcinoma Syndrome**] A: Pathogenesis B: Mode of Inheritance C: What is this often accompanied with (3)
A: [**2 Hit** Hypothesis] involving [**PTCH** Chromo 9 Hedgehog signaling mutation] B: Auto Dom C: Medulloblastoma/Ovarian Fibroma/ [Odontogenic Keratocyst]
27
Name the most common [Melanocytic Neoplasms] (3)
1. Lentigos 2. Melanocytic Nevi 3. Melanoma
28
A: *Name these cells* B: Where are they found C: What's their **ratio** to other cells D: Function
B: [Basal Layer of **Epidermis**] (*along with Merkel Disk*) C: [1:10 ratio = (1 melanocyte):(10 Basal Keratinocytes)] D: [Uses Tyrosinase to Produce **Melanin**]--\>worn by [Basal Keratinocytes] to block out UV
29
A: *Function* of these cells B: Pathogenesis of **Albinism**
A: [Uses Tyrosinase to Produce **Melanin**]--\>worn by [Basal Keratinocytes] to block out UV B: They Lack Tyrosinase
30
A: Most common *Skin lesion of Childhood* B: Description (2) and Pathogenesis C: Location
A: [Freckle Ephelis] B: [Small & (Red - Brown macules)] from INC melanin pigment within basal keratinocytes. Comes from [Enlarged but normal density Melanocytes] C: Sun exposed areas
31
**Lentigo** A: Clinical Description (2) B: Location & Demographic C: Histology
A: Small & [Tan-Brown] B: Mucus membranes / any age C: Melanocyte Hyperplasia along basal layer
32
A: *Describe Histology* B: Dz C: Locations (3) D: Clinical Description
A: image B: [**I**ntra**D**ermal Melanocytic **N**evus] C: **Common** Type = [IntraDermal vs. Junctional vs. Compound] D: [Tan - brown] Macules vs. Papules
33
A: *Describe Histology* (3) B: Dz
A: image B: Dysplastic Nevi
34
A: Clinical Description of [Dysplastic Nevi] (2) B: Locations (2) C: Pgn
A: 1. [Tan - brown] slightly raised Macules 2. [\>5 mm] B: Sun exposed AND Protected Areas C: Are Clinically stable, which --\> Melanoma Risk from DEC early detection
35
A: Describe [Dysplastic Nevus Syndrome] B: Genetic Causes (2) C: Mode of Inheritance D: Pgn
A: Tendency to develop [Multiple Dysplastic Nevi AND MELANOMA] B: [**CDK-N2A Chromo 9 mutation**] vs. [CDK4 Chromo 12 mutation] C: Auto Dom D: 50% develop Melanoma by 60!
36
A: *Describe Histology* (5) B: Dz C: List the Prognostic Factors (4)
A: image B: Melanoma C: "Use **MUDS** to assess Melanoma PGN!" 1. [**D**epth *B**reslow* - good indicator especially when**GRTR** than 1 MM thickness] 2. [# of **M**itotic Figures - only can be used with \<1 MM thickness] = **always poor pgn if positive** 3. **U**lceration 4. [**S**entinel Lymph Node Biopsy if \> 0.8 MM]: if positive = Stage 3 = POOR PGN
37
A: What test is used if [**Melanoma** is \> 0.8 MM] B: Pgn for Melanoma in general
A: [Sentinel Lymph Node Biopsy]: ***if positive = Stage 3 = POOR PGN*** B: FATAL (*early recognition and surgical excision is IMP*) "Use **MUDS** to assess Melanoma PGN!"
38
A: *Describe Histology* B: Dz
A: image B: Melanoma
39
A: *Describe Histology* B: Dz
A: image B: [Melanoma *In Situ*] (No dermal infiltration) *Melanophages are seen in dermal level and have pigment covering their nucleus*
40
A: Melanoma Risk Factors (4) B: Which Risk Factor has a tx and what is the tx
"**Bl**acks **C**ircumvent **S**un **C**A" 1. **S**un Exposure (*not straight forward*) 2. [**C**DK-N2A Chromo 9 mutations] 3. **B**RAF mutations --\> [Tx = Vemurfenib] 4. [**C**KIT mutation in non-sun exposed]
41
Describe the 2 Growth Phases of the Dz showin in the *Image*
1st: [Radial Growth Phase] = Lentigo Maligna (*lentigenous*) **superficial** spreading 2nd: [Vertical Growth Phase] = Nodular or [Progression of Radial Growth phase]--\> **Metastatic potential** into Dermis with lil epidermal involvement
42
Describe the 4 **Stages** of Melanoma
Stage 0 = [Melanoma *In Situ*] Stage 1/2 = Confined to Skin = 5 year Survivial Stage 3 = [Sentinal Lymph node] = 5 year Survival Stage 4 = [Distant Skin vs. Visceral Metastasis] = 5 year Survival
43
A: *Identify Histology* (2) B: Dz (2) C: Composition D: Which Dz **makes keratin** --\> appears as [keratin filled cyst structure]
A: image B: L arrow = [**F**ibroepithelial **P**olyp] R arrow = [Epi**D****ermal**Inclusion Cyst Wen] - [**DERMAL BASED**nodule made of [Infundibular hair follicle tht has**loss its rete pegs**]. Also makes Keratin--\> Appears as [Keratin filled cyst structure] lined with epidermis. *Does NOT communicate with epidermis*
44
A: *Describe Histology* (2) B: Dz C: Composition
A: image B: [Epi**Dermal** Inclusion Cyst Wen] C: [**DERMAL** BASED nodule made of [Infundibular hair follicle but tht has **loss its rete pegs**]. Also makes Keratin--\> Appears as [Keratin filled cyst structure] lined with epidermis. Does **NOT** communicate with epidermis
45
A: *Describe Histology* B: Dz **and** composition C: Explain the Precipitating Dz of this, its [mode of inheritance], and pathogenesis
A: image B: Trichilemmoma - [outer root sheath proliferation] with epidermal vertical growth C: Cowden's Dz (Auto DOM): [**PTEN mutation**] --\> [Multiple Trichilemmoma] / [Breast-Endometrial-Thyroid CA] / Fibromas
46
A: *Describe Histology* B: Dz C: Location
A: image B: **D**ermato**F**ibroma C: LE
47
A: *Describe Histology* (2) B: Dz C: Location
A: image B: **D**ermato**F**ibroma C: LE
48
A: *Describe Histology* (2) B: Dz C: Location D: Pgn
A: image B: [**DFSP** - **D**ermato**f**ibro**S**arcoma **P**rotuberans] C: image D: Aggressive _local_ invasiveness --\> morbidity * CD34 Positive* * [**D**ense Dermal Proliferation] / [**F**ayo/Morbidity from local invasiveness] / [**S**toriform Cartwheel] / [**P**rotuberans on a large nodule]*
49
A: *Describe Histology* (2) B: Dz C: Location D: Pgn
A: image B: [**DFSP** - **D**ermato**f**ibro**S**arcoma **P**rotuberans] C: image D: Aggressive _local_ invasiveness --\> morbidity * CD34 Positive* * [**D**ense Dermal Proliferation] / [**F**ayo/Morbidity from local invasiveness] / [**S**toriform Cartwheel] / [**P**rotuberans on a large nodule]*
50
A: *Describe Histology* B: Dz C: Cause
A: image B: Keloid C: Hyperrxn after Trauma
51
A: *Identify Dz* B: What syndrome is this associated with? Describe the Syndrome *(Mode of Inheritance,Pathogenesis)*
A: Sebaceous Adenoma B: [Auto DOM- **Muir Torre Syndrome]** = [**MLH1** vs. **MSH2** DNA mismatch repair gene mutation]--\> microsatellite instability --\> - Sebaceous Adenoma - GI CA - GU CA
52
A: *Describe Histology* (3) B: Dz
A: image B: Leiomyoma
53
A: *Describe Image (Clinical vs. Histo)* B: Dz C: Which vessels are affected (2)
A: - Clinical: [Palpable Purpura +/- LE Ulceration] - Histo: Inflammation of arteries **in subcutis** with fibrin deposition B: [**PNEI** - **P**olyarteritis **N**odosum **E**rythema **I**nduratum] C: Small and [Medium Muscular] arteries
54
A: *Describe Image (Clinical vs. Histo)* B: Dz C: Location D: Causes (3)
"[Erythema **N**o**D**osum **GIFTS**]" ## Footnote A: image B: Erythema Nodosum C: Front Of Legs D: 1. Drugs (*Sulfa vs. NSAID vs. BCP*) 2. TB Infection 3. Idiopathic "**N**o **D**osum **GIFTS**​" [**N**eeds space = Macule _more spread out_ Papules] / [**D**rug-induced] / [**G**iant cells + Histiocytes]/[**I**diopathic]/[**F**ront Legs]/[**T**B]/[**S**eptal fibrosis & Inflammation]
55
A: *Describe image* (5) B: Dz C: How does this manifest in the **mouth**
"The Lichens had *sawteeth* and always had a *plan*" ## Footnote A: image B: Lichen *Plan*us (*subtype of Lichenoid Dermatitis*) C: image
56
A: *Describe Histology* (3) B: Dz C: How does this manifest in the **mouth**
"The Lichens had *sawteeth* and always had a *plan*" ## Footnote A: image B: Lichen *Plan*us (*subtype of Lichenoid Dermatitis*) C: image
57
A: *Describe Histology* (2) B: Dz
A: image B: Lichenoid **Dermatitis**
58
A: *Identify Dz* (2) B: Describe its corresponding Histology (3) C: Cause and onset
A: [**S**teven **J**ohnsons **S**yndrome] vs. [**T**oxic **E**pidermal **N**ecrolysis (will cover \>30% body surface)] B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with - [**Civatte** necrotic keratinocytes] in epidermis and/or - [confluent full thickness necrosis] C: [Drug (**Allopurinol**) induced ( \<8 weeks post exposure)]
59
A: Dz B: Describe its corresponding Histology (3) C: Cause (2)
A: [Erythema Multiforme (minor vs. Major)] B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with - [**Civatte** necrotic keratinocytes] in epidermis and/or - [confluent full thickness necrosis] D: HSV vs. [Mycoplasma or HSV if Major] - *self resolving*
60
A: *Identify Dz* (3) B: Describe the Histology (3)
A: [**S**teven **J**ohnsons **S**yndrome] vs. [**T**oxic **E**pidermal **N**ecrolysis (will cover \>30% body surface)] vs. [Erythema Multiforme(minor vs. Major)] B: Lichenoid Dermatitis (sparse lichenoid infiltrate) with - [**Civatte** necrotic keratinocytes] in epidermis and/or - [confluent full thickness necrosis]
61
A: *Describe Histology* (3) B: Dz
A: Epidermal atrophy w/[superficial / interface / deep] perivascular & periadnexal infiltrate of lymphocytes w/plasma cells - Dermal mucin (*highlight w/Alcian blue or colloidal FE*) - Basal Layer thickening B: **D**iscoid **L**upus **E**rythematosus **DLE**: [**D**ermal Mucin]/[**L**ower level (BL) thickening]/[**E**pidermal Atrophy w/Lymphocytic infiltrate]
62
A: *Describe Histology* (3) B: Dz
A: Epidermal atrophy w/[superficial / interface / deep] perivascular & periadnexal infiltrate of lymphocytes w/plasma cells - Dermal mucin (*highlight w/Alcian blue or colloidal FE*) - Basal Layer thickening B: **D**iscoid **L**upus **E**rythematosus **DLE**: [**D**ermal Mucin]/[**L**ower level (BL) thickening]/[**E**pidermal Atrophy w/Lymphocytic infiltrate]
63
A: *Describe Histology* (3) B: Dz
A: [Similar to SLE] but **MORE epidermal atrophy** and [no deep or periadnexal infiltrates]. Will have lab markers. B: Dermatomyositis
64
A: *Describe Histology* (3) B: Dz
A: **LSA**: [**L**oss of Rete Pegs]/[**S**clerosis of Dermis with Follicular Plugging]/[**A**bove lichen infiltrate is _pink_ hyalinized material] B: [**L**ichen **S**clerosus & **A**trophicus]
65
A: *Describe Image* (4) B: Dz C: What is this Dz associated with? (5) D: Genetic Cause
A: image B: Psoriasis C: [**SAAME: A**rthritis / **M**yopathy / **E**nteropathy / **S**pondylitic Joint Dz / **A**cquired Immuno] D: [2/3 have **HLA-C** but only 10% of those people actually have Psoriasis] **PSORIASIS**: **P**laque/**S**ilver scales/**O**nycholysis/[**R**igid border=Well Demarcated]/[**I**nappropriate Nail Discoloration]/[**A**uspich sign]/[**S**cales tht are WAFTER like]/[D**i**lated blood vessel]/[**S**kinny Suprapapillary plates]
66
A: *Describe Histology* (5) B: Dz C: Genetic Cause
A: image B: Psoriasis C: [2/3 have **HLA-C** but only 10% of those people actually have Psoriasis] *Psoriasis will also be accompanied with Auspich sign = peeling off scab --\>bleeding since suprapapillary plates are now so thin* **PSORIASIS**: **P**laque/**S**ilver scales/**O**nycholysis/[**R**igid border=Well Demarcated]/[**I**nappropriate Nail Discoloration]/[**A**uspich sign]/[**S**cales tht are WAFTER like]/[D**i**lated papillary blood vessel]/[**S**kinny Suprapapillary plates]
67
A: *Describe Histology* ( 1 per slide) B: Dz
A: image B: Spongiotic Dermatitis
68
A: Dz B: *Describe Image* ( 3) C: When does this typically onset
A: [Allergic Contact Dermatitis] (*Suptype of Spongiotic Dermatitis*) B: "[Allergic Contact Dermatitis] is a **PES**!" 1. [**E**rythematous papules] 2. [**S**mall vesicles vs. weeping plaques] 3. **Pruritic** C: 12-48 Hrs post exposure = Delayed Hypersensitivity rxn
69
A: Dz and description B: What's used for Dx? How is PGN assessed (3)?
A: **Bullous Dermatitis** (*3 Types*) = [Bullae vs. vesicle] anywhere in Epidermis B: Direct Immunofluorescence (since Ab are the ones attacking Hemidesmosomes --\> Subepidermal Blisters) 1. **WHAT**: What's Causing/Underlying MOD for the split 2. **WHERE**: Epidermal Anatomic level of split (*Where's the Split located within the Epidermis?*) 3. **HOW**: Nature of inflammatory infiltrate
70
A: *Describe Image* (1 for each) B: Dz C: Which Ab causes this D: Location (5)
A: image B: Bullous Pemphigoid (*subtype of Bullous Dermatitis*) C: IgG Ab attaching hemidesmosomes D: image = **FAGAT** = [**F**orearm / **A**xillae / **G**roin / **A**bd / **T**high-inner]
71
A: *Describe Image* (1 for each) B: Dz C: Which Ab causes this
"[Easily ruptured bullae are Vulgar] / [Tombstones are Vulgar] / [Nets are Vulgar]" ## Footnote A: - Gross: Superficial bullae that **ruptured easily** - Micro: Acantholysis --\> [Tombstoning Suprabasalar Clefting] B: Pemphigus Vulgaris (***MOST COMMON*** *subtype of Bullous Dermatitis*) C: [IgG Ab & C3] attacking *Desmogleins*
72
A: *Describe Image* (Gross vs. IF) B: Dz C: What Other Dz is this _associated_ with
A: - Gross: **EXTREMELY PRURITIC** Papules vs. Vesicles on erythematous base (usually forearm) - IF: [Ig**A** despoits against gliadin] B: Dermatitis Herpetiformis (*subtype of Bullous Dermatitis*) C: Celiac Dz
73
A: *Describe Histology* B: Dz
A: image B: Sarcoidosis *Naked = No lymphocytes on surrounding outside layer (rules out infection*)
74
A: *Describe Image* B: Dz C: Describe Histology
A: small purpura on LE B: [**Vasculo**pathic Neutrophilic Dermatitis] C: image
75
A: Clinical Course for **Henoch Schonlein Purpura** B: Histology C: What is this accompanied with? (4)
A:[URI vs. ingestion of certain things] --\> [Leukocytoclastic vasculitits] from [Anticardiolipin IgA] and [Neutrophil cytoplasmic IgA] B: IgA Deposition in vessel wall C: **HSP** - **H**inge pain (Arthritis) - **S**tomach pain - [**P**ee with blood! (Hematuria)] & [Palpable Purpura]
76
Dz
"My Pa was a DEJ Soldier" = [Mycosis Fungoides/Pautrier's microabscess/lymphocytes along DEJ like Soldiers] Mycosis Fungoides [***MOST COMMON*** *Subtype of Cutaneous T Cell Lymphoma*]
77
A: *Describe Histology* B: Dz
"*My Pa* was a *DEJ* *Soldier*" = [*Mycosis Fungoides/Pautrier's microabscess*/lymphocytes *along DEJ* like *Soldiers*] ## Footnote A: image B: Mycosis Fungoides [**MOST COMMON** Subtype of Cutaneous T Cell Lymphoma]
78
A: *Describe Histology* B: Dz
"My Pa was a DEJ Soldier" = [Mycosis Fungoides/Pautrier's microabscess/lymphocytes along DEJ like Soldiers] ## Footnote A: image B: Mycosis Fungoides [**MOST COMMON** Subtype of Cutaneous T Cell Lymphoma]
79
A: *Describe Histology* B: Dz C: What is different about these cells
"My Pa was a DEJ Soldier" = [Mycosis Fungoides/Pautrier's microabscess/lymphocytes along DEJ like Soldiers] ## Footnote A: image B: Mycosis Fungoides [**MOST COMMON** Subtype of Cutaneous T Cell Lymphoma] C: NO Expression of CD7 (like normal lymphocytes)
80
A: *Describe Histology* (4) B: Dz C: Cause
A: image B: Verruca **Vulgaris** (*Other Types: [plana = face/hands] vs. plantaris vs. palmaris vs. Condyloma Acuminatum*) C: HPV
81
A: *Describe Histology Image Only* B: Dz C: Mode of Transmission
A: image B: Molluscum Contagiosum (*skin infection*) C: Sexually transmitted (especially to breast & genitalia of immunocompromised)
82
A: *Describe Histology* (3) B: Dz (2)
A: image B: [Oral HSV1] vs. [Genital HSV2]
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A: *Describe Image* (3) B: Dz C: Mode of Transmission (2)
A: image B: [1° Varicella Zoster Chicken **POX**] [**P**apules/ (**O**crusty Erosions) /**X**esicles] C: image
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A: Dz B: Location and Demographic
A: [Varicella Zoster SHINGLES] B: image
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A: *What sign is this?* B: Dz C: Why does this sign warrant **hasty** evaluation?
A: image B: [Herpes Zoster] C: could indicate potential ocular involvement as well --\> Blindness
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A: *Describe Histology* (1 for each) B: Dz C: Causes (2) D: Tx E: Demographic
A: image B: Bullous Impetigo C: [**Staph** vs. (Group A Strep Pyogenes)] D: Mupirocin Topical E: Kids
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A: *Identify* (4) B1: Dz B2: Most common Genera (3) C: Dx (2)
A: image B1: [Dermatophytes (fungus living on keratin)] B2: [Microsporum vs. Trichophyton vs. Epidermophyton] C: Hyphae seen on [KOH prep] or [Corneal layer using tissue PAS stain]
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What is [Dermatophyte Infection of the Nail] called?
**Onychomycosis**
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A: *Describe Histology* B: Dz
A: image B: Tinea Versicolor
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A: *Describe Image* B: Dz
A: image B: Tinea Versicolor
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A: *Describe Histology* B: Dz C: Clinical manifestation (2)
A: image B: Scabies C: - [Papulovesicular Persistent Nodules] - [Norwegian Crusted Forms]
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A: *Describe Histology* (4) B: Dz C: What can this Dz mimic and why?
"**BLAST**: [**B**road Base Budding yeast forms]/[**L**akes (Great Lakes) & Mississippi River]/[**A**canthosis in Epidermis]/[**S**QC mimicking]/[**T**issue Death in Dermis] ## Footnote A: image B: Blastomycosis C: [**S**quamous **C**ell **C**arcinoma] (since it's so acanthotic as well)
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Dz
Coccidiomycosis
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A: *Describe Histology* (3) B: Dz
A: image B: Cryptococcus Neoformans (*capsule looks like halo*)
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A: *Describe Histology* (4) B: Dz C: What type of cells are these found inside
A: image B: Histoplasma Capsulatum C: Giant Cells
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A: *Describe Histology* (3) B: Dz
A: image B: Pyogenic Granuloma (*type of Capillary Hemangioma*)
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A: **Dermatomyositis** and **Acute Lupus** have similar cutaneous histology other than what? B: Which ab is most indicated in **Dermatomyositis** C: What 3 things are associated with **Dermatomyositis** D: Etiology
A: [Dermatomyositis has More Epidermal Atrophy] B: [**p155**/p140 Ab] positive = INC risk of malignancy C: [Pulm Dz] / [Elevated Creatine Kinase] / [Underlying CA in Adult form] D: Autoimmune
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A: Dz B: Location (4) C: What will these pts *serology* show
A: [Discoid Lupus Erythematosus] (*Dis*includes Systemic involvement!) B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia] C: NEGATIVE SEROLOGY (since this *Dis*includes Systemic involvement)
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Dz
Dermatomyositis
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A: Dz B: What distinguishes this from **Dermatomyositis** C: What is this Dz associated with? (2)
A: [Acute _Cutaneous_ Lupus] B: **Spares Nasolabial Folds!** C: [Kidney Dz] & [**Systemic** Lupus Erythematosus]
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A: Dz B: What distinguishes this from **Dermatomyositis** C: What is this Dz associated with? (2)
A: [Acute _Cutaneous_ Lupus] B: **Spares Nasolabial Folds!** C: [Kidney Dz] & [**Systemic** Lupus Erythematosus]
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Dz
Dermatomyositis ## Footnote *Rash is **OVER** the knucles (not in between)*
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A: Dz B: Location (4) C: What will these pts *serology* show
A: [Discoid Lupus Erythematosus] (*Dis*includes Systemic involvement!) B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia] C: NEGATIVE SEROLOGY (since this *Dis*includes Systemic involvement)
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A: Identify each image. What Dz B: Location (4) C: What will these pts *serology* show
A: Image. [Discoid Lupus Erythematosus] (*Dis*includes Systemic involvement!) B: Head / Neck / [Ear = Conchal Bowls] / [Scarring Alopecia] C: NEGATIVE SEROLOGY (since this *Dis*includes Systemic involvement)
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Dz
Lupus
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A: Dz B: Demographic
A: Sclerodactyly seen in [**Systemic/Limited Sclerosis**] B: Female
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A: Clinical Presentation for [**Limited** Scleroderma] (5) B: Cause C: Pgn compared to [Systemic Scleroderma]
A: **CREST** [**C**alcinosis cutis & Cuticular Hypertrophy] **R**aynaud's Phenomenon *(Connective tissue Dz​)* **E**sophageal Dysmotility **S**clerodactyly **T**elangiectasia B: [Anti-Centromere Ab] C: Better Pgn than Systemic
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Dz
Limited Sclerosis ## Footnote **CREST** [**C**alcinosis cutis & Cuticular Hypertrophy] **R**aynaud's Phenomenon (*Connective tissue Dz*) **E**sophageal Dysmotility **S**clerodactyly **T**elangiectasia
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A: Describe image B: What is this associated with? (5) C: Tx (2) D: What is this *worsened* by (3) E: Demographic
A: Raynaud's Phenomenon B: "Raynaud worked for the **NDC S**&**S**" - **S**cleroderma - **S**LE - **C**onnective Tissue Dz - [**D**rugs (clonidine / bleomycin)] - **N**euro Disorders (Carpal Tunnel) C: [Ca+ channel blockers] / [Warm up Body] D: [Caffeine] / Smoking / [Beta Blockers] E: Female
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Dz
Calcinosis Cutis in Limited Sclerosis ## Footnote **CREST** [**C**alcinosis cutis & Cuticular Hypertrophy] **R**aynaud's Phenomenon (*Connective tissue Dz*) **E**sophageal Dysmotility **S**clerodactyly **T**elangiectasia
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A: Dz B: Demographic C: What is this often associated with
[Lichen Sclerosus Dermatitis] B: Women C: Localized Scleroderma
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A: Dz B: Location C: Lab
A: Sarcoidosis B: Scar vs. [trauma sites] (tattoos) C: INC ACE levels
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A: Dz B: Location C: Lab
A: Sarcoidosis B: Scar vs. [trauma sites] (tattoos) C: INC ACE levels
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A: Dz B: What is this associated with C: Location
A: [Necrobiosis Lipoidica] B: DM C: Pretibia
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A: Dz B: What is this associated with? (3)
A: Pyoderma Gangrenosum B: IBD / [Inflammatory Arthritis] / Hematologic DO
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A: Describe image (2) B: Dz C: Associated with? D: Tx
A: - [Retiform Stellate Purpura w/Ca+] on fatty areas - Central Black Eschar B: Calciphylaxis C: ESRD (PGN = HIGH MORTALITY) D: Na+ Thiosulfate
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A: Dz B: Type of Hypersensitivity C: Causes (4)
A: **Leukocytoclastic Vasculitis (Palpable Purpura)** B: Type 3 Hypersensitivity!!! C: 1. MOSTLY IDIOPATHIC 2. Drugs (**DAN** - **D**iuretics / **A**bx / **N**SAIDs) 3. Infections 4. Foods
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Dz
[Venous Stasis Dermatitis] ## Footnote *Will be **Bilateral***
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Dz
[Acute Stasis Dermatitis]
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Dz
Varicose Veins
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Dz
[Stasis Dermatitis + Lymphedema]
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A: Dz B: Location
Atrophie Blanche ## Footnote *White areas = ischemic areas from atrophy* B: Medial Ankle
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A: Dz B: Location
A: Venous Ulcer B: Medial LE
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A: Dz B: Course of Dz
A: [**CCM**- Capillary Congenital Malformation] B: Grows in proportion to the child
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A: Dz B: Onset C: Dx
A: [**ACM- A**rterioVenous **C**ongenital **M**alformation] (*many are apparent at birth*) B: Puberty C: US
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A: Dz B: What seasons is this seen in (2) C: Pgn
A: [Viral Exanthem] B: Summer & Fall C: Self-Resolving
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A: Dz B: What *type* of skin lesions are seen C: Pgn
A: [Coxsackie Hand Foot Mouth Dz] B: Vesicles C: Benign
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A: Dz B: Accompanied sx C: Seasons this occurs in (2) D: Pgn
A: Parvovirus B19 (LOOKS LIKE SLAPPED CHEEKS) B: Arthralgia (Mimics RA in Adults) C: Winter & Spring D: Fetal infection may --\> [**FAAD**- **A**nemia / **F**etal Hydrops / (**A**cral Purpura) / **D**eath]
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A: Name Skin condition B: What type of Hypersensitivity C: Describe the Skin condition D: How do you differentiate this from Angioedema
A: Urticaria B: Type **1** Hypersensitivity C: image D: Angioedema has swelling deeper in **Dermis** + More Painful (vs. Urticaria is fluid collection in Epidermis)
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A: Dz B: What type of cells will *Histology* show B: How long do the lesions last
A: Urticaria Pigmentosa B: Mast Cells C: LONGER (**NOT** Transient)
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A: Dz B: What type of cells will *Histology* show B: How long do the lesions last
A: Urticaria Pigmentosa B: Mast Cells C: LONGER (**NOT** Transient)
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A: Dz B: Causes (4) C: What should you look for in these pts
A: [Allergic Contact Dermatitis] B: "**N**ever **T**ouch or **C**arry **P**oisonIvy" 1. [**T**opical Abx vs. Cleansers] 2. **C**hlorhexadine 3. **N**ickel 4. **P**oison Ivy C: "Outside In" Pattern
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A: Dz B: Causes (2) C: Risk Factors (3)
A: [**MEDE- M**orbilliform **E**xanthematous **D**rug **E**ruption] (*looks like viral exanthem*) B: Bug vs. [Drug rxn (7-10 days post intake)] C: - HIV - Connective tissue Dz - Hepatitis
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A: Dz B: Location (2)
A: [**MEDE- M**orbilliform **E**xanthematous **D**rug **E**ruption] (*looks like viral exanthem*) B: Intertriginous & Dependent Areas *No Blister or Mucus Membrane involvement*
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A: Dz B: Describe the Syndrome (5)
A: **DRESS** Syndrome B: [**D**rug-induced and Delayed onset (2-6 wks post intake)] **R**ash: (Morbiliform vs. Infiltrated vs. Exfoliative Dermatitis) **E**osinophilia [**S**ystemic and Severe] = [Liver--\>Failure--\>Death] / Heart / Kidney / Lung **S**ymptoms = Facial Swelling & LAD
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A: Dz B: Causes (5)
A: **DRESS** Syndrome B: *DRESS* **SAAAM** 1. [**A**romatic AntiConvulsants] 2. **M**inocylcine Abx 3. **S**ulfasalazine 4. **A**llopurinol 5. [**A**bacavir antiretroviral]
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A: Dz B: Explain the unique onset C: Cause (4)
A: Fixed Drug Rxn B: [1-2 weeks post exposure] but with subsequent exposure will reappear within 24 hours in same "fixed' location C: [Sulfa vs. NSAIDS vs. Barbiturates vs. Tetracyclines]
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A: Dz B: What can this Dz progress to? C: Accompanying Sx (2)
A: [Severe Mucus membrane involvement] in [**Steven Johnson Syndrome**] B: **TENS** C: [Stinging Eyes] + Dysphagia
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A: SPF (*Sunburn Protection Factor*) measures what? B: Recommended Dose C: How long does [Water Resistant vs. VERY Water Resistant] last?
A: UV**B** protection B: [SPF 30+ q 2 Hours] C: [Water Resistant=40 min.] vs. [**VERY** Water Resistant=80 min.]

Dermatopathology (1 decks)

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