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Flashcards in Week 19 - Skin 1+2 Deck (17)
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how are Lichenoid reactions characterised

- epidermal basal layer damage
- Basal vacuolar change or cell death
- Accompanying inflammatory infiltrate – lymphocytes, histiocytes, eosinophils


what is an example of a Lichenoid reaction

Lichen planus, Lupus


how are psoriasiform reactions characterised

- regular epidermal hyperplasia with elongation of the rete ridges
- increase mitotic activity
- associated inflammatory infiltrate – lymphocytes, polymorphs, histiocytes


what is an example of a psoriasiform reaction



how are spongiotic reactions characterised

- intraepidermal and intercellular edema
- eczematous reaction
- associated inflammatory infiltrate
- intercellular oedema within epidermis (spongiosis)
- lymphocytic exocytosis
- intra-epidermal colections of Langerhans cells
- superficial perivascular lymphocytic infiltrate with some eosinophils


what is an example of a spongiotic reaction

atopic dermatitis (eczema), allergic contact dermatitis, insect bite reaction etc


how are vesiculobullous reactions characterised

- the presence of vesicles or bullae at any levels within the epidermis or at the derma-epidermal junction


what are they types of vesiculobullous reaction

- intra corneal and sub corneal
- intraepidermal
- suprabasilar
- sub epidermal
- miscellaneous


what is an example of a vesiculobullous reaction

pemphigus vulgaris, bullous pemphigoid


how are granulomatous reactions characterised

- Chronic dermal inflammation with infiltration of histiocytes or epithelioid histiocytes


what is a granuloma

A granuloma is an aggregate of epithelioid histiocytes – many types and associated diseases


what is an example of a granulomatous reaction

granuloma annulare, necrobiosis lipoidica, sarcoidosis


how are vasculopathic reactions characterised (hint there are 6 groups)

- Diseases of the blood vessels comprising the following groups
- 1. Non-inflammatory purpure
- 2. vascular occlusive diseases
- 3. Urticarias (leakage of plasma and or cells)
- 4. Vasculitides (inflammation of vessel walls)
- 5. Neutrophilic dermatoses (Dermal infiltration by neutrophils without vasculitis)
- 6. Miscellaneous


what is an example of a vasculopathic reaction

leukocytoclastic vasculitis (aka hypersensitivity vasculitis)


pemphigus vulgaris and bullous pemphigoid are examples of __ type of reaction.
pemphigus vulgaris involves the autoimmune destruction of __ junctions whereas bullous pemphigoid involves the destruction of __ junctions

- vesiculobullous reactions
- desmosomes (epithelial adhesion protein desmoglein 3)
- hemidesmosomes


what is granuloma annular and what type of reaction is it an example of

- Ring shaped inflammatory disease affecting young people, usually starts of with multiple little papules that are separate – fuse to form a ring that gets bigger
- Dermal necrobiotic (degeneration of dermal collagen)
- Well circumscribed foci of necrobiosis completely surrounded by a palisade of epithelioid histiocytes and multinucleated histiocytes and a patchy lymphocytic infiltrate

- granulomatous reaction


what type of reaction is leukocytoclastic vasculitis (aka hypersensitivity vasculitis) an example of, what type of vessels does it affect and what does it involve?

- vasculopathic reaction
- small vessels in the superficial dermis
- fibrinoid necrosis
- swollen endothelium
- perivascular lymphocytic infiltrate, nuclear dust and red cell extravasation

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