Sweep 1.6

Question 1

• Macule:

Answer 1

flat, circumscribed area <5 mm

Question 2

• Patch:

Answer 2

flat, circumscribed area >5mm

Question 3

• Papule:

Answer 3

elevated lesion <5 mm

Question 4

• Plaque:

Answer 4

elevated lesion > 5 mm

Question 5

• Pustule:

Answer 5

discrete pus-filled lesion

Question 6

• Vesicle:

Answer 6

fluid-filled lesion <5 mm

Question 7

• Bulla:

Answer 7

fluid-filled lesion >5 mm

Question 8

Acute Urticaria

Answer 8

PATHOGENESIS
• Mast cell degranulation increased dermal vascular permeability dermal edema
• Immediate Type I (IgE) hypersensitivity rxn • Inciting factor: medications (opiates, abx)
TREATMENT
• Antihistamines

Question 9

Erythema Multiforme

CLINICAL FEATURES

Answer 9

• “targetoid” lesions
• Multiple features with macules, papules, vesicles with central pallor
• Can lead to epidermal desquamation if progresses

Question 10

Chronic Inflammatory Dermatosis: PSORIASIS

Answer 10

Psoriasis CLINICAL FEATURES
• erythematous salmon-pink colored plaques with silvery scale
– extensor elbows, knees, scalp, gluteal cleft
– nail thickening and dystrophy
• Koebner: induce lesion by local trauma
• Auspitz sign: punctate bleeding when overlying scale is removed

Question 11

Psoriasis

– ———- scale

Answer 11

Parakeratotic

Question 12

Lichen Planus

Answer 12

• Pruritic
• Purple
• Polygonal
• Planar papules and plaques
• Covered in Oral Pathology

Question 13

Impetigo

Answer 13

– Staph Aureus, can be Strep pyogenes
– Contagious, more commonly in kids, spread through direct contact
– Starts as small macule often perioral/perinasal
– Enlarges with honey-colored crust (dried serum)
– Treat with antibiotics with good Staph coverage

Question 14

Acantholysis: lysis of

Answer 14

intercellular junctions between squamous cells
• Subcorneal (superficial epidermis at stratum granulosum): pemphigus foliaceus
• Suprabasal (above basal cell): pemphigus vulgaris

Question 15

Nonacantholysis

Answer 15

• Subepidermal (below DEJ): bullous pemphigoid with intact intercellular junctions

Question 16

Pemphigus • Type —- hypersensitivity reaction

• IgG autoantibodies bind to ———

Answer 16

II

desmoglein type I and type 3 intercellular desmosomal proteins

Question 17

Pemphigus

– Disrupted intercellular adhesion causes ———-

Answer 17

blistering

Question 18

Pemphigus

• DIF: intercellular IgG deposition along ---------
cell membranes (fish-net)

Answer 18

keratinocyte

Question 19

– Pemphigus vulgaris: —– deposits throughout epidermis –

Answer 19

IgG

Question 20

Pemphigus foliaceus: IgG deposits in ——- layers of

epidermis

Answer 20

superficial

Question 21

Actinic Keratosis/Cheilitis

• Red, rough patches on ———- (mainly head/neck, lips, dorsal hands)
• More common in ———–•

Answer 21

chronically sun exposed skin

fair-skinned and blond/red heads

Question 22

Actinic Keratosis/Cheilitis

Histo: cytologic atypia with ——– of basal cells with overall epidermal ———

Answer 22

hyperplasia

thinning

Question 23

Actinic Keratosis/Cheilitis

• Can rarely evolve into ———–, particularly with ——- mutation from UV DNA damage

Answer 23

squamous cell carcinoma

TP53

Question 24

Actinic Keratosis/Cheilitis

• Treatment: ——- (liquid nitrogen), ————

Answer 24

cryotherapy

topical chemotherapy agents

Question 25

Squamous Cell Carcinoma | forms in

Answer 25

basal layer

Question 26

SCC mutations

Answer 26

TP53 mutation | • HRAS and Notch receptor mutations

Question 27

SCC metastasis

Answer 27

* Mucosal>cutaneous * Thickness of lesion and depth of invasion into dermis * Size >2 cm * Ulceration * High risk locations such as head/neck, particularly lips, ears, around eyes

Question 28

Basal Cell Carcinoma • Most common type of skin cancer

Answer 28

• Pearly pink, translucent papules with telangiectasias; can become nodular and ulcerate • Superficial: multifocal growth in epidermis • Nodular: downward invasion to dermis – Can be locally aggressive but rarely metastasizes

Question 29

Basal Cell Carcinoma Histopathology • Arise in -------- of epidermis • Palisading nests of --------- cells with -------- nuclei surrounded by ---------

Answer 29

basal layer basaloid hyperchromatic fibrotic stroma

Question 30

Genetic disorder: Basal Cell Nevus Syndrome (Gorlin Syndrome) with

Answer 30

PTCH gene mutation in Hedgehog tumor suppressor pathway

Question 31

Melanocytic Nevi (Moles) • benign neoplasm of melanocytes • Congenital or acquired • ----- mutation as common factor in nevi • Cellular senescence: migration of nevi from --------– Superficial nevi: produce melanin, grow in nests – Deeper nevi: minimal to no pigment, grow in -------- or single cells

Answer 31

BRAF DEJ into dermis cords