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Flashcards in Pathology, skin 1 Deck (125):
1

What are the 5 layers of the epidermis?

stratum basale,
stratum spinosum,
stratum granulosum,
stratum lucidum,
stratum corneum

2

What are the 4 thing in the dermis?

Dermal papillae,
hair follicle,
basaL. Cell,
sebaceous gland,
desmosome

3

Name 4 disorders of pigmentation

vitiligo,
Melasma,
Freckles (ephelides,
Benign lentigo.

4

Name the three non-malignant melanocytic tumors.

Congenital melanocytic tumor (birthmark),
Nevocellular Nevus (mole),
Dysplastic Nevi,

5

Name 4 malignant melanomas.

lentigo Maligna melanoma,
Superficial spreading melanoma,
acral lentiginous melanoma,
nodular melanoma

6

What is the prognosis for malignant melanoma?

Level 1 - 100%,
Level 2 - 93%,
Level 3 - 71%,
Level 4 - 59%,
Level 5- 36%

7

How is malignant melanoma treated? Three ways

wide surgical excision, or
chemo if systemic,
may resolve spontaneously

8

What melanoma has the worst prognosis?

Nodular Melanoma,

9

What are used to help ID nodular melanoma?

Elevation,
Firm and
Growing, EFG

10

Most common melanoma in darker skinned people?

Acral lentiginous Melanoma

11

Where does acral lentiginous melanoma affect?

Palms,
under nails,
soles, and
sublingual

12

What is the most common melanoma over all?

superficial spreading melanoma

13

Pattern for growth of spreading malignant melanoma?

Horizontal growth, not deep.

14

What malignant melanoma has best prognosis?

Lentigo maligna melano, ususally found on face and neck

15

What is the danger of a giant gongenital nevi?

They have an increased risk of developing melanoma

16

What disorders of pigmentation has a loss of melanocytes?

vitiligo

17

What disorder of pigmentation has proliferation of melanocytes on the face?

melasma

18

What pigment disorder is caused by hormones?

melasma

19

What pigment order doesn't change or get better?

vitilago, once melanocytes are gone you won't have pigment

20

What causes freckles?

Same number of Melanocytes are making more pigment, melanin

21

What is the other name for freckles?

ephelides

22

what pigmentation disorder has melanocytic hyperplasia?

benign lentigo, it?s the local proliferation of melanocytes that you are not born with.

23

what is a benign tumor of melanocytes?

Mole, Nevocellular Nevus

24

What are the three types of Nevi?

Junctional,
compound,
intradermal

25

gross appearance of a mole or nevocellular nevus

uniform color,
defined borders,
stable size and shape,

26

What can look like a dysplastic Nevi?

cutaneous melanoma

27

What is dysplastic nevus syndrome?

specific gene causes one to have multaple dysplastic nevi and an increased risk of melanoma

28

What is a dysplastic nevi?

Large, irregular shape and color.

29

What does dysplastic nevi show microscopically?

cytological and archeticular atypia

30

Risk factors for Malignant melanoma?

sunburns,
chronic uv exposure,
fair skin,
dysplastic nevus syndrome,
familia mutation of tumor supressor gene.

31

what location generally gets the least malignant melanoma?

head

32

where do men get malignant melanoma most?

trunk, upper back

33

Woman, malignant melanom most oftern?

back and legs.

34

what melanoma is often found in the face or neck of older individuals and has the best prognosis?

lentigo Maligna melanoma,

35

what melanoma has a horizontal growth pattern?

superficial spreading melanoma

36

what melanoma is most common in darker skinned people and sublingually?

acral-lentiginous melanoma

37

what is the melanoma that you don?t want the most?

Nodular Melanoma,

38

describe nodular melanoma

nodular tumor, vertical growth patter that allows it to spread fast.

39

List epidermal - dermal lesions

Acanthrosis nigricans - seborrheic Keratosis - Psoriasis - pempigus - Bullous emhigoid - Ichthyosis vulgaris - xerosis - Eczema - polymouphus light eruption - Chronic cutaneous lupus erythematous - erythema multiforme - Pityriasis Rosea - Granuloma Annulare - erythema Nodosum - Epidermal inclusion cyst -

40

What should hold adjacent epidermal cells together?

Desmosomes

41

Acanthosis Nigricans looks like what?

thickened hyperpigmented skin at neck, armpit and groin
Ring around the collar

42

what skin conditon is assciated with obesity and hyperisnulinism?

acanthosis nigricans.

43

What more dangerous pathology could be associatate with acanthosis nigricans?

stomach and gastrointestinal malignancies.

44

what is the key feature of Seborrheic Keratosis?

stuck on appearance.

45

How would Seborrheic keratosis look microscopically?

basaloid epidermal hyperplasia - horn cysts.

46

what could sudden development of suborrheic keratosis accompany?

underlying malignancy

47

where would the middle aged and elderly develop suborrheic keratosis?

trunk,
head,
neck
extreamities.

48

Seborrheic keratosis

benign squamoproliferative neoplasm -
stuck on -
old/middle aged -
Leser trelat, underlying malignancy

49

What % of population is affected by Psoriasis?

One %

50

most common form of Psoriasis?

Psorisis vulgaris

51

What can psorisis also be associated with?

arthritis,
enteropathy,
myopathy

52

Psoriasis

autoimmune disorder accompanied by increased proliferation and turnover of epidermal keratinocytes

53

Common Psoriasis sites?

knees,
elbows,
scalp

54

What would psoriasis look like?

well demarcated erythematous plaque with silvery scale

55

What is auspitz sign?

scraping off scales and the layer below causing pinpoint bleeding

56

Under microscope what would elongation of the dermal ridges indicate?

psoriasis

57

What pathology has hyperkeratinization with parakeratosis?

psoriasis

58

How is psoriasis treated?

steroids,
UV radiation
methotrexate

59

What skin pathologies cause blisters?

- Pemphigus both vulgaris and foliaceus,
- bullous Pemphigoid
- dermatitis herpetiformis

60

What sign can indicate pemphigus?

Nikolski's sign, blister border expands and its easily torn

61

What type of disorder is pemphigus?

autoimmune, pemphigus vulgaris is the most common,

62

What type of Antibodies that attack desmosomes in pemphigus?

IgG

63

acantholysis is what?

loss of intercellular adhesions

64

What is pemphigus?

rare autoimmune disorder, potentially fatal, blisters, acantholysis,

65

Is pemphigus or bullous pemphigoid more common?

Bullous pemphigoid

66

What is bullous pemphigoid?

autoimmune disorder of older people, Separation of the epidermis from dermis causing subepidermal blister formation, so they are hard to pop

67

What could indicate the difference betweem pemphigus and bullous pemphigoid?

Pemphigus blisters tear easily and the edges spread, bullous pempigoid blisters do not tear easily

68

What is the antibody that attacks epidermal junction in buuous pemphigus?

IgG

69

what is dermatitis herpetiformis often associated with?

-celiac sprue
-subepidermal blisters often in a line that form at tips of dermal papille

70

what antibodies attack gliadin and other antigens that deposit in tips of papillae?

IgA

71

what skin disorder can be treated with gluten free diet?

dermatitis herpetiformis

72

what conditon looks like aligator?

ichthyosis vulgaris

73

how does one get ichthyosis vulgaris?

common inherited disorder

74

what is ichthyosis vulgaris?

characterized by thickened stratum corneum and nearly absent granulosum.
Hyperkeratotic fry skin
-palm
-soles and
-extensor areas

75

what is Xerosis?

Abnormal dryness of the skin or musus membranes

76

eczema

group of inflammatory skin disoriders characterized by pruitus (iching)

77

what is puritus?

Another word for iching

78

types of Eczema?

acute,
chronic,
atopic dermitius,
contact dermitiis

79

What does acute eczema cause?

vesicular erythematous (red) rash

80

What does erythematous mean?

Red, so a red rash

81

what does chronic eczema look like?

chronic scratching followed by dry, thickened hyperkeratonic skin.

82

What mediates atopic dermititus hypersensitivity?

IgE mediated, causes dry skin and eczema

83

what is the most common form of photodermatosis?

polymorphous light eruption

84

polymouphous light eruption,

erythematous(red) macules,
papules,
plaques, or
vesicles on exposure to sun

85

macule

change in surface color w/o elevation or depression.

86

Papule

solid elevation of skin with no visible fluid

87

Plaque

solid raised flat topped leison greater than 1 cm

88

vesicule

small fluid filled sacks that form on skin

89

What does chronic cutaneous lupus erythematous cause?

epidermal atrophy, DNA anti DNA complexes in basment membrane of epideris.

90

How does lupus often appear?

butterfly rash on face - red, erythematous maculopapular eruption

91

Erythema multiforme?

hypersensitivity skin reaction to infection that gives bullseye rask

92

How is erythema multiforme characterized?

bullae (blisters),
targetoid red lesions, and
vesicles.

93

Bullae

blister bigger than 1 cm.

94

pityriasis Rosea

Christmas tree,
puritic rash,
herald patch,
following upper respiratory infection

95

Granuloma annulare

rare,
autoimmune reddish bumps in
form of ring

96

Granuloma is caused by an overproductive what?

WBC - leukocyttosis - they can flow freely the clump.

97

who is more likely to have granuloma annulare?

women

98

Erythema nodosum?

raised erythematous (red) painful nodules of subcutaneous fat, anteror shins.

99

How is erythema nodosum treated?

pain killers and it ususally resolves spontaneously in 3-6 weeks

100

On what age is erythema nodosum found mostly

12 -20 years

101

What is filled with keratin debries?

epidermal inclusion cyst

102

What are the types of malingant tumors?

- squamous carcinoma -
- basal cell carcinoma -

103

What can be a precursor or basal cell carcinoma?

actinic keratosis - old people hands

104

actinic keratosis characteristics?

-rough, red papules on face, arms and hands,
-induced by sun

105

What is happenning cellularly in actinic keratosis?

sun induced dysplasia of keratinocytes

106

Characteristic of squamous cell carcinoma?

tan nodular mass which commonly ulcerates

107

Microscopic squamous cell carcinoma?

nests of atypical keratinocytes that invade dermis, keratin pearls,

108

Keratoacanthoma

horn, rapidly growing domeshaped nodules with a central keratin filled crater

109

what is the normal prognosis for squamous cell carcinoma?

rarly metastazie, cut out will cure

110

What is the most common tumor in adults in the western world

basal cell carcinoma

111

where does basal cell carcinoma arise from?

basal cells of hair follicles

112

what does basal cell carcinoma look like?

sun exposed surfaces,
pearly papules,
nodules with translucent borders,
telangiectasia,
ulceration

113

what does basal cell carcinoma look like microscopically?

invasive nests of basoloid cells with palisading groth pattern

114

Prognossis for basal cell carcinoma?

slow growing, rarly metastasize

115

treatment for basal cell carcinoma?

complete excision

116

What is histocytosis X?

proliferation of langerhans cells, which are normally in epidermis.

117

variants of histocytosis X?

unifocal, multifocal, acute diseminated.

118

What are 4 main points about Psorisis?

Autoimmune with increased proliferation and turnover of epidermal keratinocytes
- effects 1% of pop
-genetic component
-associated with arthritis, enteropath and myopathy

119

Main characteristics of Actinic keratosis (old lady hands)

- SUn induced dysplasia of keratinocytes
- possible precursor to SCC
-rough red papules on face arms and hands

120

Vitilago characteristics

- irregular patches of depigmentation
- possible genetic component
-missing melanocytes

121

Pemphigus character

- rare but possibly fatal
-pemphigus vulgaris is most common
- autoantibodies: acantholysis
-attack desmoglein 3 of desmosime

122

Acantosis Nigricans

-thickened hyperpigmented skin at neck and pits
-hyperinsulenism
-obesity
-malignancy , (digestive tract)

123

Dysplastic nevi

- increased risk of melanoma
-cmm1 gene, chromosome 1, autosomal dominant
-may have more than one

124

Malignant melanoma

- increasing in US
- fair skinned more common
- familial form, loss of function in p16 tumor suppressor gene on chromosome 9

125

Nevocellular Nevi

- sharp well defined borders
- stable shape and size
- malignant transformation uncommon
-uniform color