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Clin Med MSKII > high yield Skin path > Flashcards

high yield Skin path Flashcards

1
Q

a melanocytic nevus (typical mole) has activating mutation in what?

A

RAS or BRAF

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2
Q

Dysplastic nevus syndrome what mutation

A

LOF of CDKN2A (encoding p16/INK4a)

-or CDK4

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3
Q

where are lesions in dysplastic nevus syndrome

A

sun exposed AND protected areas

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4
Q

highlights for Acrol lentiginous melanoma

A
  • Flat
  • DARK SKINNED individuals
  • soles, palms, under nails
  • C-Kit mutations
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5
Q

what melanoma is worst type

A

nodular due to vertical growth

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6
Q

Dermal neurotization is helpful in distinguishing this entity from melanoma

A

benign nevi

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7
Q

Melanoma cell stain

A

HMB 45

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8
Q

mutation for Seborrheic keratosis

A

Gof in FGFR3

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9
Q

SCC of skin is usually related to sun exposure but what is 2nd most common

A

immunosuppression so transplant or HIV

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10
Q

Morphology for SCC of skin

A
  • hyperkeratosis
  • Enlarged nuclei
  • Keratin pearls
  • Intercellular bridges
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11
Q

what is needed to confirm a diagnosis of SCC of skin

A

immunohistochemical stains for keratins

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12
Q

pearly nodules with tealangiectasias

A

BCC

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13
Q

BCC have mutations that lead to what

A

hedgehog signaling

-PTCH (SHH receptor) common

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14
Q

morphology for BCC

A
  • ulceration of lesions
  • palisading
  • resemble the basal cell layer of epidermis
  • multifocal
  • nodular
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15
Q

inflammatory infiltrates in Acute inflammatory dermatoses

A

lymphocytes and macrophages rather than neutrophils

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16
Q

what are the 3 acute inflammatory dermatoses

A
  • Urticaria (Hives)
  • Acute Eczematous Dermatitis
  • Erythema Multiforme
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17
Q

Which acute inflammatory dermatoses?

  • edema of deeper dermis and subcutaceous fat
  • mast cells
  • NOO changes in epidermis
A

Urticaria

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18
Q

morphology of Urticaria

A
  • circular plaques
  • spaces between collagen bundles wider than normal
  • dermal edema
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19
Q

Mast cell dependent, IgE independent Urticaria is from what

A
  • opiates
  • certain antibiotics
  • curare
  • radiographic contrast media
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20
Q

what are the 2 mast cell independent, IgE independent Urticaria talked about

A
  • Aspirin

- Hereditary angioneurotic edema . caused by deficiency of C1 inhibitor

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21
Q

Eczematous dermatitis typically results from what type of reaction

A

-T cell mediated inflammatory reaction (type IV) hypersensitivity

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22
Q

what cells in the epidermis play a role in Eczema

A

Langerhans cells . .present haptens to CD4 cells

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23
Q

this is characterized by red, papulovesicular, oozing, and crusted lesions that if persistent, develop reactive acanthosis and hyperkeratosis that produce raised scaling plaques

A

Eczema

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24
Q

this is characterized by keratinocyte injury mediated by skin homing CD8+ cytotoxic T lymphocytes

A

Erythemia multiforme

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25
Q

what is the characteristic lesion in Erythma multiform

A

target like lesions

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26
Q

febrile form of erythema multiform associated with extensive involvement of skin (<10%).
-tends to involve lips, oral mucosa, conjunctiva, urethra, and genital and perianal areas

A

Stevens Johnson syndrome

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27
Q

This variant of Erythema multiform is characterized by diffuse necrosis and sloughing of cutaneous mucosal epithelial surfaces
-Widespread epidermal damage produces clinical picture similar to that seen in pts with extensive burns

A

Toxic epidermal necrolysis (>30% detached epidermis)

28
Q

what are the chronic inflammatory Deratoses?

A
  • Psoriasis
  • Seborrheic Dermatitis
  • Lichen Planus
29
Q

well-demarcated, pink to salmon colored plaque covered by loosely adherent silver white scale

A

Psoriasis

30
Q

what is the general basis of Psoriasis

A

autoimmune

31
Q

Auspitz sign: minute bleeding points when scale is lifted from plaque

A

Psoriasis

32
Q

morphology for psoriasis

A
  • Nail changes
  • the stratum granulosum is thinned or absent and extensive overlying parakeratotic scale is seen
  • Neutrophilc in spongiotic foci of superficial epidermis (spongiform pustules)
  • Munro microabscesses
33
Q

where is Seborrheic dermatitis found

A

sebaceous glands but is still due to inflammation of epidermis

  • scalp
  • external auditory canal
  • retroauricular
  • nasolabial folds
  • presternal
34
Q

what other conditions are associated with Seborrheic dermatitis?

A
  • Parkinson Disease
  • Fungal species of Malassezia
  • HIV with low CD4 counts
35
Q

follicular lipping

A

Seborrheic Dermatitis

36
Q

6 P’s for Lichen Planus

A
  • Pruritic
  • purple
  • polygonal
  • planar
  • papules
  • plaques
37
Q

Koebner phenomenon is found in what conditions

A
  • Lichen Planus
  • psoriasis
  • means induced by local trauma
38
Q

Wickham striae: papules highlighted by white dots or lines

A

Lichen planus

39
Q

Lichen planus is a prototype example of what

A

interface dermatitis

40
Q

Colloid or Civatte bodies

A

Lichen planus

41
Q

Honey colored crust

A

impetigo

42
Q

characteristic microscopic feature of impetigo

A

accumulation of neutrophils beneath the stratum corneum

43
Q

a blistering disorder caused by autoantibodies that result in the dissolution of intercellular attachments within the epidermis and mucosal epithelium

A

Pemphigus

44
Q

pemphigus are what antibodies?

against what

A
  • IgG

- Desmogleins

45
Q

what is the characteristic finding by immunofluorescence of Pemphigus

A

net like pattern of intercellular IgG deposits

46
Q

what is the common histologic denominator in all forms of pemphigus

A

-Acantholysis: the dissolution or lysis of the intercellular bridges that connect squamous epithelial cells

47
Q

what type of blister is pemphigus VULGARIS

A

suprabasal acontholytic

48
Q

highlights for Bullous Pemphigoid

A
  • elderly
  • inner thighs, flexor surfaces of forearms,axillae, groin, lower abdomen
  • autoantibodies that bind to proteins that are required for adherence of basal keratinocytes to basement membrane
49
Q

what type of blister is bullous pemphigoid

A
  • Subepidermal nonacantholytic

- does not rupture easily

50
Q

highlights for Dermatitis herpetiformis

A
  • urticarial and grouped vsicles
  • predominantly males
  • third or fourth decade
  • some cases associated with intestinal celiac disease and responds to gluten free diet
  • Granular IgA deposits at tips of dermal papillae
51
Q

Epidermolysis Bullosa highlights

A
  • inherited structural protein defects

- blisters at sites of pressure, rubbing, or trauma at or soon after birth

52
Q

What are the cutaneous lesions found in Tuberous sclerosis complex

A
  • angiofibromas
  • localized leathery thickenings (shagreen patches)
  • Hypopigmented areas (ash-leaf patches),
  • Subungual fibromas
53
Q

Eccrine poroma

A

-palms and soles where sweat glands are numerous

54
Q

multiple small tan papules in vicinity of lower eyelids

A

syringomas

55
Q

appendage tumor on forehead and scalp, hat like growth

A

cylindroma

56
Q

composed of factor XIIIa-positive dermal dendritic cells

A

benign fibrous histiocytomas (Dermatofibroma)

57
Q

molecular hallmark for dermatofibrosarcoma protuberans

A

-translocation of COL1A1 and PDGFB

58
Q

Morphology for Benign fibrous histeocytome (dermatofibroma)

A

psuedoepitheliomatous hyperplasia

59
Q

Morphology for Deratofibrosarcoma protuberans

A
  • blades of pinwheel fibroblasts (storiform)

- honeycomb patten

60
Q
  • Sezary Lutzner cells

- Pautrier microabscesses

A

Mycosis Fungoides (Cutaneous T cell lymphoma)

61
Q

spectrum of rare disorders characterized by increased numbers of mast cells in the skin

A

Mastocytosis

62
Q

Darier sign: localized area of dermal edema and erythema (wheal) that occurs when lesional skin is rubbed

A

Mastocytosis

63
Q

Dermatographism: area of dermal edema resembling a hive that occurs as a result of localized stroking of apparently normal skin with a pointed instrument

A

Mastocytosis

64
Q

osteoporosis in premenopausal women or men can be a clue for diagnosis of what

A

mastocytosis

65
Q

Gene involved in acanthosis nigricans

A

FGFR3

66
Q

Gene involved in Seborrheic Keratoses

A

FGFR3

Clin Med MSKII (16 decks)

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