Histopath - skin

Question 1

normal structures seen in the dermis?

Answer 1

• Sebaceous glands
• Small nerves + vessels
• collagen + elastic fibres
• Hair follicles

Question 2

How does normal skin on the soles of feet compare to normal skin on the face?

Answer 2

Feet: v thick epidermis
Face: bare sebaceous glands

Question 3

Name 4 vesicobullous diseases

Answer 3

PemphigoiD (deep)
PemphiguS (superficial)
Pemphigus Foliaceous (vv superficial)
Dermatitis herpetiformis

Question 4

Pathophysiology of pemphigoid?

Answer 4

Deep bullae

IgG binds to hemidesmosomes in BM –> sub epidermal bullae form

Question 5

Histology of pemphigoid?

Answer 5

Sub epidermal bullae + LINEAR IgG DEPOSITION

Question 6

Which vesicobullous disease is associated with IgA deposition?

Answer 6

Dermatitis herpetiformis

Question 7

Differences between bullous pemphigoid vs dermatitis herpetiformis?

Answer 7

Both are deep bullae BUT

• Pemphigoid = IgG. DH = IgA
• Pemphigoid = elderly flexures.
• DH = Coeliac + extensors.

Question 8

Which vesicobullous diseases is superficial?

Answer 8

Pemphigus vulgaris + foliaceous

Question 9

Pathophysiology + histology of pemphigus vulgaris?

Answer 9

Pemphigus Vulgaris

• IgG binds to desmosomal proteins in epidermis –> intraepidermal bullae form
• IgG deposits between cells in a netlike pattern

Question 10

What is the most superficial of vesicobullous diseases? where are the bullae?

Answer 10

Pemphigus follaecous

Bullae are SUBCORNEAL

Question 11

3 histological features in acute eczema?

Answer 11

1) Spongiosis
2) Inflammatory cell infiltration
3) Dilated dermal CAPILLARIES

Question 12

Type of hypersensitivity in contact dermatitis?

Answer 12

IV

Question 13

Auspitz’ sign

Answer 13

PSORIASIS

- pin point bleeding on rubbing

Question 14

Koebner phenomenon

Answer 14

PSORIASIS

- psoriatic esions form at sites of trauma

Question 15

Histological findings in psoriasis

Answer 15

TEST TUBES IN A RACK appearance (micro abscesses)

Question 16

Characteristic pathological finding in Lichen Planus

Answer 16

BAND OF T-CELLS beneath the epidermis

Question 17

the 5 Ps of clinical features in lichen planus

Answer 17

Pruritic
Purple
Polygonal
Papules
Plaques

Question 18

define a granuloma

Answer 18

Collection of activated macrophages w secretory activity

Question 19

Painful ulcer + rolled edge

- IBD, malignancy, sarcoidosis

Answer 19

Pyoderma gangrenosum

Question 20

What kinda cysts are seen in seborrheic keratosis

Answer 20

Keratin cyst

Question 21

“stuck on” appearance + benign

Answer 21

Seborrheic keratoses

Question 22

Name a disease which is a pre-malignant skin neoplasm?

Answer 22

Bowen’s disease

Question 23

Key histological feature of basal cell carcinoma

Answer 23

Palisading nuclei

Question 24

When bowen’s disease spreads and invades the dermis, what is this?

Answer 24

Squamous cell carcinoma

Question 25

Posh term for moles

Answer 25

Melanocytic nevi

Question 26

Most important prognostic factor for malignant melanoma?

Answer 26

Breslow thickness