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Flashcards in XXII - The Skin Deck (77)
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31

This cancer of the skin may develop from a dysplastic nevus, and results from excessive sun exposure. Malignant cells have large nuclei with irregular contours having chromatin characteristically clumped at the periphery of the nuclear membrane and prominent eosinophilic nucleoli often described as "cherry red". Has both radial and vertical growth phases.

Melanoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 855

32

This determines the biologic behavior of melanomas.

Nature and extent of the vertical growth phase (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 857

33

What is the most common type of all autoimmune blistering disordering of the skin (pemphigus)?

Pemphigus Vulgaris(TOPNOTCH)

34

Histologically, what is the most common denominator in all forms of pemphigus?

Acantholysis (TOPNOTCH)

35

Morphology: Subepidermal nonacantholytic blisters

Bullous Pemphigoid (TOPNOTCH)

36

Morphology: Suprabasal acantholytic blister

Pemphigus Vulgaris (TOPNOTCH)

37

Morphology: Characteristically, fibrin and neutrophils accumulate selectively at the tips of the dermal papillae forming small microabscesses

Dermatitis Herpetiformis (Seen in Celiac Disease) (TOPNOTCH)

38

Morphology: accumulation of neutrophils beneath the stratum corneum

Impetigo (TOPNOTCH)

39

Munro microabscesses is classically seen in?

Psoriasis (TOPNOTCH)

40

Auspitz sign is associated with what condition?

Psoriasis (TOPNOTCH)

41

Pearly papules often containing prominent, dilated subepidermal blood vessels (telangiectasias)

Basal Cell Carcinoma (TOPNOTCH)

42

What is the most commonly accepted exogenous cause of squamous cel carcinoma of the skin?

Exposure to UV light (TOPNOTCH)

43

Cutaneous horns are seen in what condition?

Actinic Keratosis (TOPNOTCH)

44

Morphology: characterized by loss of melanocytes

Albinism (TOPNOTCH)

45

In albinism, melanocytes are present but melanin pigment is not produced due to what enzyme deficiency or defect?

Tyrosinase (TOPNOTCH)

46

Q: + for melanocyte-associated proteins such as tyrosinase or Melan-A or S

Vitiligo (TOPNOTCH)

47

The early developmental stage in melanocytic nevi is called?

Junctional nevi (TOPNOTCH)

48

Most junctional nevi grow into the underlying dermis as nests or cords of cells and are calle

Compound nevi (TOPNOTCH)

49

When all the epidermal nests of compound nevi are lost entirely they form what

intradermal nevi (TOPNOTCH)

50

Appears to play an important role in the development of skin malignant melanoma

Sunlight (TOPNOTCH)

51

What are the 5 clinical warning signs of melanoma?

1. enlargement of a pre-existing mle2. itching or pain in pre-existing mole3. development of a new pigment lesion during adult life4. irregularity of the borders of a pigment lesion5. variegation of color within a pigmented lesion (TOPNOTCH)

52

Appears clinically as flesh-colored, dome shaped nodules with central, keratin filled plug, imparting a crater like topography

Keratoacanthoma (TOPNOTCH)

53

Morphology: Central, keratin filled crater surrounded by proliferating epitheal cells that extend upward in a lip-like fashion over the sides of the crater and downward into the dermis as irregular tongues

keratoacanthoma (TOPNOTCH)

54

The most important clinical sign of malignant melanoma

change in color, size, or shape in a pigmented lesion (TOPNOTCH)

55

In Malignant Melanoma, what type of growth indicated the tendency of a melanoma to grow horizontally within the epidermal and superficial dermal layers, often for a prolonged period of time?

Radial growth (TOPNOTCH)

56

In Malignant Melanoma, what are the determinants of a more favorable prognosis?

1. Tumor depth of less than 1.7 mm2. Absence or low numbers of mitoses3. Presence of a brisk TIL response (Tumor Infiltrating Leukocytes)4. Absence of regression 5. Female gender6. Location on extremity skin (TOPNOTCH)

57

A 20 y/o male, previously known case of peanut allergy inadvertently took biscuits containing peanuts. Within a short time, he developed pink wheals on his extremities and trunk that are pruritic. Histologic findings in his lesion will include:

Sparse superficial perivenular infiltrate of mononuclear cells and eosinophils. (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 1162

58

Most important cause of cutaneous squamous cell carcoma

DNA damage induced by UV light exposure(TOPNOTCH)Robbins Basic Pathology 9th ed., 122

59

Usually present as pearly papules contaning prominent dilated subepidermal blood vessles(telangiectasia), which may ulcerate and locally invade bone or facial sinuses; cells at the periphery of tumor cell islands tend to be arranged radially with long axes in parallel alignment(palisading)

Basal cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1157

60

Actinic keratosis may lead to what type of skin cancer?

Cutaneous squamous cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1157