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Path Skin
KYCOM Block 12
129
Pathology
Graduate
12/16/2013

Additional Pathology Flashcards

 


 

Cards

Term
what are the acute inflammaory dermatitis (3)
Definition
hives/uricaria
eczema
erythema multiform
Term
what do hives look like, where are they
Definition
wheel: edema, puritic

trunk, distal extremities, ears
Term
what are the two causes of hives
Definition
IgE activate mast cells in response to antigen and cause vasodilation

hereditary angioedema: activation of complement excites mast cells causing vasodilation
Term
what causes activation of mast cells in hereditary angioedema
Definition
uncontrolled activation of complement due to opiates, antibiotics, NSAIDS, cold
Term
describe histology of hives
Definition
wide spaces between collagen bundles
eosinophils
Term
who gets hives, how long do they last
Definition
all ages
lasts hours
Term
what are 7 types of eczema
Definition
contact
atopic
primary irritant
drug induced
excematous
photoexcematous
pithodermatitis
Term
what does contact eczema look like
Definition
filled clear vesicles
itching burning
Term
what causes contact eczema from plants
Definition
urushiol
Term
what causes atopic eczema
Definition
defect in keratin layer
family hx
Term
what does atopic eczema look like
Definition
red plaques in flexors
Term
what causes primary irritant eczema
Definition
trauma or irritation (non-immunologic)
Term
what causes drug induced eczema
Definition
hypersensitivity
Term
what causes excematouos eczema
Definition
insect bite
Term
what causes photoexcematous eczema
Definition
UV light
Term
what causes pithodermatitis
Definition
fucocumarin and psoralens from plant and UV light
Term
what does pithodermatitis look like
Definition
red, oozing, crusting
Term
what is the atopic triangle
Definition
atopic dermatitis
asthma
allergic rhinitis
Term
what does erythema multiform look like
Definition
macular, papular, pustule, etc

characteristic: red macularpapular pale, vesicular, eroded center
Term
what causes erythema multiform
Definition
hypersensitivity to drug/infection activates CD8 which eats keratinocytes (and basal cells if serious)
Term
what are two complications of erythema multiform, their appearance, and cause
Definition
SJS: CD8 attacks deeper cells on mucosa (conjunctiva, urethra, genital)

toxic epidermal necrolutis: necrosis and sloughing of cutaneous and mucosa due to full epidermal thickness erosion
Term
what are the 4 chronic inflammatory dermatitis
Definition
psoriasis
seborrhetic dermatitis
lichen planus
lupus erythematous
Term
where is psoriasis located
Definition
elbow
knww
scalp
lumbosacral
gluteal fold
glans penis
Term
what does psoriasis look like
Definition
dermacrated, pink silver, loose scales

nails: pitting, yellow brown, anceylysis (seperates from skin)

psoriatic arthritis
Term
what is the cause of psoriasis
Definition
keritnocytes have nuclei and can still divide

increased epidermal turn over on rete causes acanthosis (increased thickness)

thinning of epidermis over papillae into stratum granulosum
Term
what is a clinical way to diagnose psoriasis
Definition
auzpitz sign: pick the lesion and you will get microbleeds
Term
what are the signs of psoriasis histologically
Definition
thinning of papillar
thickening of rete

munro microabscess: PMN in stratum corneum

Parakaratonic scale: keratinocyte with nuclei allow for division

superificial dermal infiltrate: dermis seen in epidermis
Term
seborrhetic dermaitits: where is it located, what does it look like
Definition
sebaceous glands on scalp, forehead, EAM, nasolabial, pre-sternal

dandruff: cradle cap

eczema like to psoriasis like
Term
what is a histological sign of dermatitis
Definition
parakytosis: PMN and serum at ostea of hair follicles
Term
lichen planus: location
Definition
wrist, elbow, glans penis, oral mucosa
Term
lichen planus: appearance
Definition
puritic, purple, polygonal, papular
Term
lichen planus: cause
Definition
response to antigens in dermal epidermal junction
Term
lichen planus: histological
Definition
ciyatte (colloid) bodies
lymphocyte infiltrate
hypergranulosis
zigzag/sawtooth at epidermal dermal jucntion
Term
what causes ciyatte bodies, what disease is it in
Definition
lichen planus

kerinocytes look like stratum spinosum and cause necrosis
Term
what conditiosn is erythema multiforme associated with
Definition
any age
infection: HSV, histoplasmosis, coccidiomycosis, thyphoid, leprosy

drug: sulfa, penicillin, barbituates, antimalarials

malignancy: carcinomas, lymphomas

vascular disease: lupus erythematosus, polyarteritis nodosa
Term
what are the three types of blisters
Definition
phemphigus vulgaris
bullous phemigod
dermatitis herpatiformis
Term
what does phemigus vulgaris look like
Definition
superficial vesicles
bulle that rupture easy and dry and crust
Term
where is phemigus vulgaris located
Definition
mucosa and skin
scalp, face, axilla, groin
Term
what cause phemigus vulgaris
Definition
igG atttach desmogleins (cement)
Term
phemigus vulgaris histologu
Definition
acanthosis: cells that look like row of tombstomes

IgG in fish net pattern
Term
who gets phemigus vulgaris
Definition
rare
>40yo
Term
where is bullous phemigod located
Definition
mucosa and skin
inner thigh, flexors, forearm, axillae, groin
30% oral
Term
what does bullous phemigod look like
Definition
bullae with clear fluid
dont rupture easy
dont scar if they dont rupture
Term
what causes bullous phemigod
Definition
IgG attacks hemidesmosomes so basal cells detech from BM
Term
histology of bullous phemigod
Definition
IgG in linear pattern

spans entire epidermis (subepidermal non-acanthotic blister

eosinophils
Term
who gets bullous phemigod
Definition
elderly
Term
what does dermatitis herpatiformis look like
Definition
blister
uticaria in grouped vesicles
Term
what causes dermatitis herpatiformis
Definition
auto IgA associated with celiac disease
Term
histology of dermatiti herpatiformis
Definition
igA in granule pattern
Term
what are the 5 benign neoplasma
Definition
nevocellular/melanocytic nevi
acanthosi nigrans
keritocanthoma
seborrhetic keratitis
actintic keratois
Term
what do nevoceullular/melanocytic nevi look like
Definition
tan turns to brown
uniform pigment papule
well defined border
Term
what caue nevocellular/melanocytic nevi
Definition
highly dendeitic ingle cell melanocytes turn to aggregate round nest cell melanocytes
found on rete ridges

congenital or acquired
Term
what are the three types of nevocellular nevi
Definition
junctional
dysplastic
compound
Term
describe a junctional nevi
Definition
flat
grows into dermis
turns into compound
Term
describe compound nevi
Definition
in dermis
raised dome
matures into melanin containing cords of nevus cells
Term
what are the two types of dysplastic nevi, describe each
Definition
sporatic: rarley malignant

familial: malignant/heratiable melanona

both have 100% risk of melanoma
Term
descrive dysplastic nevi
Definition
large >5mm
hundreds of lesions in non-sun areas
Term
describe acanthosis nigrans
Definition
velvet thick pigmented
could have skin tags
Term
where is acanthosis nigrans
Definition
flexors: neck, groin, anogenital, axillae
Term
what are the two types of acanthosis nigrans and the causes
Definition
benign: obesity and insulin resistance, endocrine abnormalities, drugs (steroids)

malignant: middle aged, tumor makes epidermal GF
Term
what does keritocanthoma look like
Definition
crater with keratin mass in center over epidermal hyperplasia
can cause squamous cell carcinoma
Term
where is keritocanthoma located
Definition
in sun exposed places
Term
what is the timeline of keritocanthoma
Definition
3-4 wk grows to 3cm
3-4 mo resolves
Term
what does seborrhetic keratosis look like
Definition
light yellow tan
increased thickness
greasy crust
black dermatocration (stuck on)
verrucous: wart like surface
hyperpigmented
Term
seborrhetic keratosis histology
Definition
horn cyst cells with heratin

normal cells
Term
what is lesser trelat
Definition
sudden development of many srborrhatic keratosis that turned malignant due to previous malignancy (like renal cell carcinoma)
Term
what does actinic keratosis look like
Definition
cutaneous horns
ill defined acule or papule
hyperkeritosis
Term
who gets actinic keratosis, where, complications
Definition
elderly
sun exposed areas
premalignant squamous cell carcinoma
Term
histology actinic keratosis
Definition
parakeratosis
dysplasia in lower epidermis
Term
what is lineres
Definition
seborrhetic dermatitis with dandruff, diarrhea, and failure to thirve
Term
what are the three malignant neoplasms
Definition
squamous cell carcinoma
basal cell carcinoma
malignant melanoma
Term
appearance squamous cell carcinoma
Definition
red, scaline, plaque turns to
nodular, hyperkeritotic, red

may ulcerate, cutaneous horns, leukoplakia
Term
histology squamous cell carcinoma
Definition
atypical epithelium extends into dermis
dysplasia in ALL layers
keratin pearls
intracellular bridges
mitotic figures
Term
prognisis SCC
Definition
<5% metastasize before found
Term
risks SCC
Definition
sun, fair skin, carcinogens, burns, arsenic, chronic ulcer, osteomyelitic, chew, xeroderma pigmentosum
Term
appearance basal cell carcinoma
Definition
sun exposed area
slow growing
locally agressive
rodent ulcer: distinct border, grows at skin
pealry papule with telengectasis
Term
histology BCC
Definition
ulcer
nest of blastoid cells
palaside border
Term
prognosis BCC
Definition
excision cures 50%
rarley metastasis
Term
risk BCC
Definition
sun, fair skin, immune deficiency, xeroderma pigmentosum
Term
malignant melanoma appearance
Definition
asymptomatic or puritic
>1cm
ABCDE
Term
two types malignant melanoma and their prognosis
Definition
vertical - worse, stage by depth (breslow, clark)
horizontal - better
Term
histology and appearance of vertical malignant melanoma
Definition
nodular aggregate of celanoma cells spread from lesion
Term
histology of horizontal melanoma
Definition
irregular nest of melanoma cells
inflammed dermis
Term
three types of horizontal melanoma
Definition
lentigo maligma "hutchinsons freckle"
superificial spreading
acral-lentiginous
Term
lentigo maligma: who gets, prognosis, location
Definition
face and neck
elderly
in situ for years
Term
sperificial spreading MM: who gets, prognosis
Definition
caucasian
in situ for months
Term
acral lentiginous: who gets, location
Definition
dark skin
hands, feet, sublingual
Term
what disease is from epidermal malnutrition
Definition
ichthyosis
Term
cause of ichthyosis
Definition
hyperkeratosis in stratum corneum due to epidermal malnutrition
Term
histology icthyosis
Definition
little to no inflammation
loss of basket weave of stratum corneum
Term
types of icthyosis, which is most common
Definition
icthyosis vulgaris - common
x linked
congenital ichthyosiform erythroderma
lamellar ichthyosis
Term
icthyosis vulgaris: cause
Definition
dominant or acquired from sarcoidosis, HIV infection, hypothyroid
Term
x-linked icthyosis cause
Definition
deficiency in sulfatase
Term
congenital erytheoderma cause, appearance
Definition
homozygous recessive
colloidan baby
Term
cause lamellar icthyosis
Definition
homozygous recessive
Term
signs of icthyosis
Definition
hyperlinear palms
fish like scales from hyperkeratosis
Term
causes of acne vilgaris
Definition
disorder of sebaceous follicles

adrenergic homrones: cause abnormal kertinization of follicles which block sebaceous ducts causing microcomedo and comedone

hereditary: less in asian and dark skin

peopinibacterium acnes: bacterial lipases convert lipids in serum to proinflammatory FA
Term
types of acne vilgaris
Definition
mold
moderate
cystic
sequale
Term
signs of mild acne vulgaris
Definition
comedones
occasional papule or pustule
Term
signs of moderate acne vulgaris
Definition
more inflammation
lesions heal with scars
Term
signs of cystic acne vulgaris
Definition
large deep many papules or pustules
often on trunk (not really a cyst)
Term
signs of sequale acne vulgaris
Definition
trunk involvement
prone to heal with atrophy or pitted scars on face
hypertonic keloids on back
post inflammation hyperpigmentation
Term
signs of acne vulgaris
Definition
begins in adolescence
open comdeones
closed comedones
papules
pustules
Term
what is an open comdeone, what is in it
Definition
black head
sebum, keratin, oxidized melanin causes blockage
Term
what is a closed comdeone
Definition
white head
Term
what are the two epidermal appendage disorders
Definition
acne vulgaris
rosaeca
Term
cause of rosacea
Definition
idiopathic, no inheritence
Term
what percipitates rosacea
Definition
sun, face washing, cosmetics
NOT alcohol, stress, food, smoking, cafiene
Term
types of rosacea
Definition
rhinophyma
perosacea
Term
descripe rhinophyma, who gets it
Definition
middle aged men
disfiguring sebaceous hyperplasia
Term
appearance of perosacea
Definition
facial erythema and telangiectasis (rosy cheeks)

usually do not develop inflammatory lesions typical of rosacea
Term
signs of rosacea
Definition
lesions on flush areas (cheeks, nose, forehead, chin)
blepharoconjunctivitis
Term
who gets verrucae, what is the prognosis
Definition
common in school aged kids
resolve alone except in adults and compormised
Term
cause of warts/verrucae
Definition
infection of keratinocytes confined to epidermis
HPV usually 12, 18
skin to skin transmission
Term
what predisposes to verrucae
Definition
HIV, transplants, chemo, pregnancy, handling raw meat
Term
signs of verrucae
Definition
black dots: not in all types but used to distinguish from callus
absent fingerprint lines
Term
types of warts and their description
Definition
filiform: thread like
plannar: flat
plantar: foot surface
condyloma acuminatum: genital
Term
cause of melasma
Definition
enhanced pigment transfer from melanocytes
accentuated by sun
idiopathic
Term
prognosis of melasma
Definition
resolves on own or with DC or hormones
Term
melasma is associated with
Definition
pregnancy, contraceptives, hydantions
Term
types of melasma
Definition
epidermal
dermal
mixed
Term
cause of epidermal melasma
Definition
increased melanin deposition in lower epidermal layers
Term
cause of dermal melasma
Definition
melanin pigment incontience
macrophages in papillar dermis phagocytes melanin from epidermal cells
Term
cause of lentigines
Definition
local hyperplasia of melanocytes
does not darker in sun
Term
who gets lentigines
Definition
infants and kids
Term
signs of lentigines
Definition
cafe au liat spots: oval tan brown macules or patches
rete ridges elongated and thin
Term
sign of neurofibromatosis type I
Definition
too many cafe au lait spots (in lentigines)
Term
what are other names for solar lentigines
Definition
actinic or liver spots
Term
cause of solar lengitines
Definition
age
sun exposure
increased melanocytes and melanophages
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