acrochondrons
(aka skins tags): pedunculated outgrowths of normal skin that are commonly present on regions affected by acanthosis nigricans
Asboe-Hansen sign
bullae spread laterally when pressure is applied on the top (pemphigus vulgaris)
Stewart Treves syndrome
cutaneous angiosarcoma 2ry to chronic lymphedema
Connexin defects do underilie some specific forms of
palmoplantar keratoderma or deafness associated ichthyosis
Autoantibodies against cutaneous basement membrane protein
epidermolysis bulosa acquisita (forms tesne acral bullae) and cicatricial pehugoid (causes chronic conjunctiva + scarring)
cafe au lait spotes - histology
increased melanosomes aggregates within melatocytes
postinflammatory hypopigmentation
redistribution of existing melanin within the skin (associated with reduced transfer of melanin in keratinocytes)
Toblestone cells
along basal layer in pemphigus vulgaris
gluten enteropathy - age of rash
40-50
most important prognostic factor for melanoma
Depth of invasion (Breslow thickness: distance from epidermal granular cell layer to the deepest visible melanoma cell)
aggressive and destructive arthritis of psoriasis
arthritis mutilants
melanoma in situ (and special characteristics in histology)
lentigno maligna (contain mulinucleated giant melanocytes)
type of melanocytic nevi - according to location
- junctional: along dermoepidermal junction (flat)
- Compound nevi: nevus cells exnted into dermis - epidermal + dermal involvement (raised papiles)
- Intradermal: nevi in the dermis + raised (lose of tyrosinase activity –> little or no pigmented)
aggressive and destructive arthritis of psoriasis
arthritis mutilants
categories of xanthomas
- eruptive xamthomas (yellow papules that abruptly appear wen plasma TG and lipids increase)
- tuberous and tendinous xanthomas
- plane xanthomas (lienar lesions in skin folds, associated with primary biliary cirrhosis)
- xanthalesma (soft eyelid or perioribital, not associated with lipid abnormalities)
Marjolin’s ulcer?
it is an aggressive, ulcerating squamous cell carinoma that presents in an areia of previously traumatised, chronically inlamef, or scarred skin (more than 10 years after initial trauma)
spider angiomas - presentation
bright red central papule surrounded by several outwardly radiating vessels that blanch with pressure and refill centrifugally uppon release
(associated with increased estrogen states)
Ecchymoses frequently indicate
a deep hemorrhage (hematoma due to bony fracture, ligamentous rupture, or mucular injury –> they do not blanch under pressure as the RBCs are not contained within the vasculature
petechiae vs purpura vs ecchymoses according to size
- less than 5 mm
- 5mm - 1 cm
- more than 1 cm
molloscum bodies?
eosinophilic cytoplasmic inclusions due to molluscum contagiosum infection
mutated BRAF in melanoma - action (vs normal)
activation of BRAF (independent to NRAS) –> nuclear replication –> increased cellular growth, differentiation, survival –> metastasis
in normal melanocutes –> NRAS –> BRAF –> …..
intertigo?
well defined erythematous plaques with satellite vesiclees or pustules in warm, moist skin areas - due to Candida after antibiotic use or immunocompromised (esp uncontrolled diabetes)
skin dyskeratosis
premature keratinization of indicudual keratinozutes below the stratum granulosum
chronic exposure of an type 4 hypresensitivity induced antigen
acantosis + hyperkeratosis
primay of HIV - area of maculopopular rash
everywhere (and palm + sole)
cutaneous small vessel vasculitis?
affects only skin, arises due to drug (eps penicillins) or pathogen exposure
biopsy: neutrophils (in first day) + mononuclear cells (in older lesions
Seborrheic dermatitis
common inflammatory condition characterised by accumulation of scaly, greasy skin on the scalp, face, ears, eyelids + eyebrows
severe in HIV + Parkinson
intergluteal piloidal disease
it is an azquired skin infection invovling the upper natal cleft od the buttocks - it may present with drainage sinus tract
local cutaneous adcverse effect of chronic topical corticosteroid administration
atrophy/thinning of the dermis (loss of dermal collagen, drying, tightening of the skin, telangiectasias, ecchymoses)
Dress syndrome - presenation/due to
presentation: fever, generalized lymphadenopahty, facial edema,, diffuse morbilliform skin rash, eosinophylia, atypical lymphocytes, increasd lier enzymes
due to: antiepileptics, ALLOPURINOL, sulfonamides, antibiotics
SLE vs drug induces lupus according to manifestation
drug induced lacks tha usual cutaneous manifestation (eg. malar rash and is rarely associated with neuroogic or renal complications
ephelides?
aka freckles –> at sun exposed areas –> by increased melanin production
skin manifestation of Reactive arthritis
keratoderma blennorrhagicum
Clostiridum perfinges effect on skin
toxin –> binds claudin –> interferes tight junctions –> water loss from tissue to the intestitial lumen –> watery diarrhea
HPV infection - according to type
1-4 –> skin warts
6, 11 –> genital warts (condylomata acuminatum)
16, 18 cervical, vaginal, vulvar, anal neoplasia
koilocyte histology
immature squamous cell with dense, irregularly staining cystoplasm + perinuclear clearing, resulting in HALO
also enlarged pyknotic nucleus –> aidinoid appearance
skin - lucidum - location
present only in PALMOPLANTAR SKIN (palms and soles) - GLABROUS