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Flashcards in Skin Pathology Deck (101):
1

Hypersensitivity reaction characterized by targetoid rash and bullae

Erthema multiforme

*Targetoid appearance is due to central epidermal necrosis surrounded by erythema

2

Indomethacin acts as a nonselective NSAIDs. What are it's additional modes of action?

•It inhibits motility of polymorphonuclear leukocytes, similar to colchicine.

•It uncouples oxidative phosphorylation in cartilaginous (and hepatic) mitochondria, like salicylates.

3

Classic location for basal cell carcinoma

Upper lip

4

NSAIDs have an increased risk of  hepatotoxicity when given with __________.

 

alcohol, barbiturates, anticonvulsants, rifampin

5

Risk factors for cellulitis

Recent surgery

Trauma

Insect bite

6

Immunofluorescence highlights IgG surrounding keratinocytes in a "fish net" pattern

Pemphigus vulgaris

7

Additional functions of celcoxib.

Reduce the numbr of colorectal polyps in people who suffer from FAP

8

Cellulitis can progress to _________.

Necrotizing fascitis with necrosis of subcutaneous tissues due to infection with anaerobic "flesh-eating" bacteria

9

Malignant proliferation of squamous cells characterized by formation of keratin pearls

Basal cell carcinoma

10

  • Well-circumscribed, salmon colored plaques with silvery scale, usually on extensor surfaces and the scalp

Psoriasis

11

treatment for psoriasis

Corticosteroids

UV light with psoralen (destroy keritonocytes)

Immune modulating therapy

12

Tniea Versicolor

  • Caused by Malassezia
  • Inhibition of tyrosinase
    • Hypopigmentation
  • Hyperpigmentation associated with inflammatory response

13

What effects can be seen if indomethacin is used with vasopressin?

Edema

Hyperkalcemia

Hypernatremia

Hypertension

14

pemphigus vulgaris is due to _______ antibodies against desmoglein.

IgG

15

Epidermal hyperplasia with darkening of the skin

Acanthosis nigricans

16

Regenerative stem cell layer of epidermis

Stratum basalis

17

Why doesn't celecoxib affect platelet aggregation?

COX2 selective NSAIDs

18

malignant proliferation of squamous cells characterized by formation of keratin pearls

Squamous cell carcinoma

19

Celebrex increases the risk of ________ and _______.

Heart attack and stroke

20

_________- is the sudden onset of multiple suborrheic ketoses and suggests underlyinf carcinoma of the GI tract.

Leser- Trelat sign

21

Locations of lichen planus

Wrists, elbow, and oral mucosa

22

___________ is a precursor leasion of squamous cell carcinoma and presents as a hyperkeratotic scaly plaque, often on the face, back or neck.

Actinic keratosis

23

  • Pruitic, erythematous, oozing rash with vesicles and edema
  • Exposure to allergens
  • Type IV hypersensitivity

Contact dermatitis

24

Melanoma risk factors

UVB-induced DNA damage

Prolonged exposure to sunlight

Albinism

Xeroderma pigmentosum

Dysplastic nevus syndrome

25

__________ is associated with HLA-C.

Psoriasis

26

Cuase of comedone formation in acne vulgaris

  • Due to chronic inflammation of hair follicles and associated sebaceous glands
    • Hormone-associated increase in sebum production and excess keratin production block follicles, forming comedones

27

Autoimmune destruction of desmosomes between keratinocytes

pemphigus vulgaris

28

most common mole inadults

Intradermal nevus

29

What are adnexal structures?

Hair shafts

Sweat glands

Sebaceous glands

30

Presentation for basal cell carcinoma

Elevated nodule with a central, ulcerated crater surrounded by dilated (telangiectatic) vessels

31

Flesh colored papule with central umbilication

Mollucuscum contagiosum

*Associated with poxvirus

32

Indomethacin treats....

Gout, RA, and OA

33

How is SSSS distinguised histologically from toxic epidermal necrolysis?

Separation in toxic epidermal necrolysis occurs ar the dermal-epidermal junction

34

Histology: inflammation of the dermal-epidermal junction with a 'saw-tooth' appearance

lichen planus

35

most common mole in children

Acquired nevus that begins as nests of melanocytes at the dermal-epidermal juntion (junctional nevus)

36

Vitiligo

  • localized loss of skin pigmentation
  • Due to autoimmune destruction of keratinocytes

37

  • Begign squamous proliferation; common in the elderly
  • Presents as raisied discoled plaque on the extremities or face
  • Often has a coin-like, "stuck on" appearance.

Seborrheic keratosis

38

Children and teenagers with viral infections, who take NSAIDs, are at risk for __________.

Reyes syndrome

39

Epidermal layer characterized by keratin in anucleate cells

Stratum corneum

40

Dysplastic nevus syndrome is __________ (autosomal dominant/autosomal recessive)

Autosomaldominant

41

How does pemphigus vulgaris present?

  • Acantholysis of stratum spinosum keratinocytes, results in suprabasal blisters
  • Basal layer cells remain attached to basement membrane membrane via hemidesmosomes
  • Nikosky sign

42

Treatment for acne vulgaris

Benzoly peroxide (antimicrobial)

Vitamin A derivatives (reduce keratin production)

43

Wickham striae

Reticular while lines on the surface

*Associated with Lichen planus

44

Pemphigus vulgaris is a type ______ hypersensitivity.

II

45

___________ is a severe form of SJS characterized by diffuse sloughing of skin, resembling a large burn.

Toxic epidermal necrolysis

*most often due to an adverse drug reaction

46

Ingestion of large doses of acetaminophen can produce _____________.

N-acetyl-benzoquinoneimine (NABQNE)

*highly reactive intermediate is formed in amounts sufficient to deplete hepatic glutathione

47

Firm, pink, umbilicated papules due to poxvirus

Molluscum contagiosum

*Affected keratinocytes show cytoplasmic inclusions

48

Classic location for squamous cell carcinoma

Lower lip

49

Furunculosis

A furuncle (abscess) forms when a hair follicle and the skin surrounding it become infected. 

50

Autoimmune destruction of hemidesmosomes between basal cells and the underlying basement membrane

Bullous pemphigoid

*IgG antibodies specifically against BP180 component of hemidesmosome

51

Acetaminophen toxicity

Hepatic necrosis

*Treated with sulfhydryl compounds, which replenish stores of glutathione

52

Compund nevus

Grows by extension into the dermis

53

Lentigo maligna melanoma

Radial growth; good prognosis

54

Epidermal layer characterized by granules in keratinocytes

Stratum granulosum

55

Patients with high GI and low CV risks should receive a ____________.

cyclooxygenase-2 inhibitor plus a proton-pump inhibitor

56

In cellulitis, production of ______ leads to crepitus.

CO2

57

Acral lentiginous

Arises on the palms or soles; often on dark-skinned individuals; not related to UV light exposure

58

Dermatophytes

Microsporum

Trichophyton

Epidermophyton

59

Dermatitis herpetiformis has a strong association with __________ disease.

Celiac

60

Mutation in dysplastic nevi syndrome

CMM1 on chromosome 1

61

Celecoxib relieves pain and inflammation in what conditions?

OA and RA

62

Nikolsky sign

Thin-walled bullae rupture easily

63

Patients with low GI and high CV risks should receive _________.

naproxen

64

Carbunculosis

A carbuncle is made up of multiple furuncles, and goes much deeper into the skin.

65

___________ infection produces lipases that break down sebum, releasing proinflammatory fatty acids; results in pustule or nodule formation.

Propionibacterium acnes

66

Munro microabscesses

Collection of neutrophils in the stratum corneum

*Seen in psoriasis

67

Components of dermis

Connective tissue

Nerve endings

Blood and lymphatic vessels

Adnexal structures

68

Pruritic, planar, polygonal, purple papules

Lichen planus

69

  • Pruritic, erthematous, oozing rash with vesicles and edema
  • Type I hypersensitivity
  • Associated with asthma and allergic rhinitis

Atopic (eczematous) dermatitis

70

Cause of psoriasis

Excessive keratinocyte proliferation

71

How does squamous cell carcinoma present?

An ulcerated, nodular mass, usually on the face

72

Risk factors for basal cell carcinoma

UVB-induced DNA damage

Prolonged exposure to sunlight

Albinism

Xeroderma pigmentosum

73

Erythematous macules that progress to pustules, usaully on the face; rupture of pustules results in erosions and dry, crusted, honey-colered serum

Impetigo

*Most commonly caused by S. Aureus or S. pyrogenes

74

Squamous cell carcinoma has the same risk factors as basal cell carcinoma. What are some additional risk factors?

Immunosuppresive therapy

Arsenic exposure

Chronic inflammation

75

Albinism increases risk for..

Squamous cel carcinoma, basal cell carcinoma, and melanoma due to reduced protectin against UVB

76

Erythema multiforme with oral mucosa/lip involvement and fever is termed _________.

Stevens-Johnson syndrome

77

Histology of seborrheic keratosis

Keratin pseudocysts 

78

Histology of basal cell carcinoma

Nodules of basal cells with peripheral palisading

79

Histology of psoriasis

  • Acanthosis (epidermal hyperplasia)
  • Parakeratosis
  • Munro microabscesses
  • Thinning of the epidermis above elongated dermal papillae

80

Bugs associated with condyloma acuminata

HPV 6 and 11

*Warts, koilocyte

81

Autoimmune deposition of IgA at the tips of dermal papillae

Dematitis herpetiformis

*presents as pruritic vesicles and bullae that are grouped 

82

Malignancy associated with acanthosis

Gastric carcinoma

*Also associated with insulin resistance

83

  • Gingivostomatitis
  • Keratoconjunctivitis
  • Herpes labiallis
  • herpetic whitlow on finger
  • temporal lobe enchephalitis
  • esophagitis
  • erythema multiform

HSV1

84

Breslow thickness

The most important prognostic fact in predicting metastasis, depth of extension

85

Patients with low GI and low CV risks should receive a __________.

traditional NSAID

86

In SSSS, exfoliative A and B toxins result in epidermolysis of the _________.

Stratum granulosum

87

What is the most common complication of shingles?

Herpetic neuralgia

88

How do you test for HSV?

  • Viral culture for skin/genitalia
  • CSF PCR for herpes encephalitis
  • Tsanck test

89

__________ is a mask-like hyperpigmentation of the cheeks, associated with pregnancy or oral contraceptives. 

Melasma

90

What inflammatory dermatoses is associated with chronic hep C infection?

Lichen planus

91

Erythema multiforme is most commonly associated with __________ infection. 

HSV

*Also associated with Mycoplasma infection, drugs (penicillin and sulfonamides), autoimmune disease and malignancy

92

Diameter must be greater than _________, to be a melanoma.

6mm

93

Verruca (wart) is due to _____ infection of keratinocytes.

HPV

*Characterized by koilocytic change

94

Celebrex contains a sulfonamide derivative as one of its components, which are well known to cause ___________.

Stevens-Johnson syndrome

95

___________ is a well-differentiated squamous cell carcinoma that develops rapidly and regresses spontaneously.

Keratoacanthoma

96

Epidermal layer characterized by desmosomes between keratinocytes

Stratum spinosum

97

Common location for acanthosis nigricans

Axilla; groin

98

How does keratoacanthoma present?

Cup-saped tumor filled with keratin debris

99

Due to an increased # of melanosomes

Freckle (Ephelis)

*melanocytes are NOT increased

100

Treatment for basal cell carcinoma

Surgical excision

*metastasis is rare

101

Nodular melanoma

Early vertical growth; poor prognosis