Sweep 1.6 Flashcards Preview

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Flashcards in Sweep 1.6 Deck (31):
1

• Macule:

flat, circumscribed area <5 mm

2

• Patch:

flat, circumscribed area >5mm

3

• Papule:

elevated lesion <5 mm

4

• Plaque:

elevated lesion > 5 mm

5

• Pustule:

discrete pus-filled lesion

6

• Vesicle:

fluid-filled lesion <5 mm

7

• Bulla:

fluid-filled lesion >5 mm

8

Acute Urticaria

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

9

Erythema Multiforme
CLINICAL FEATURES

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

10

Chronic Inflammatory Dermatosis: PSORIASIS

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

11

Psoriasis
– ---------- scale

Parakeratotic

12

Lichen Planus

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

13

Impetigo

– 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

14

Acantholysis: lysis of

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

15

Nonacantholysis

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

16

Pemphigus • Type ---- hypersensitivity reaction
• IgG autoantibodies bind to ---------

II

desmoglein type I and type 3 intercellular desmosomal proteins

17

Pemphigus

– Disrupted intercellular adhesion causes ----------

blistering

18

Pemphigus

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

keratinocyte

19

– Pemphigus vulgaris: ----- deposits throughout epidermis –

IgG

20

Pemphigus foliaceus: IgG deposits in ------- layers of
epidermis

superficial

21

Actinic Keratosis/Cheilitis


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

chronically sun exposed skin

fair-skinned and blond/red heads

22

Actinic Keratosis/Cheilitis

Histo: cytologic atypia with -------- of basal cells with overall epidermal ---------

hyperplasia

thinning

23

Actinic Keratosis/Cheilitis

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

squamous cell carcinoma

TP53

24

Actinic Keratosis/Cheilitis

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

cryotherapy

topical chemotherapy agents

25

Squamous Cell Carcinoma
forms in

basal layer

26

SCC mutations

TP53 mutation
• HRAS and Notch receptor mutations

27

SCC metastasis

• 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

28

Basal Cell Carcinoma • Most common type of skin cancer

• 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

29

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

basal layer

basaloid

hyperchromatic

fibrotic stroma

30

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

PTCH gene mutation in Hedgehog tumor suppressor pathway


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

BRAF

DEJ into dermis

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