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Exam 2 Skin block > Dermatopathology part 6 > Flashcards

Dermatopathology part 6 Flashcards

1
Q

Panniculitis

A

inflammation of fat lobules or the connective tissue septa separating fat lobules

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2
Q

Erythema nodosum: Etiology, SX

A

inflammatory reaction of hte connective tissue septa separating fat lobules

most common in females 20-30

not a disease but a reaction to various etiologies

self limited resolution in 6 weeks

fever malaise and joint pain may precede the rash

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3
Q

ERythema nodosum: gross

A

painful, red, subcutaneous, elevated nodules

nodules are indurated and poorly circumscribed

usually located on the anterior aspect of the tibia

bilateral but not symmeteric

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4
Q

Erythema nodosum causes

A

idiopathic

strep infection

sarcoidosis

inflammatory bowel disease

fungal infection

pregnancy

meds: OCP, sulfa, amiodarone, antibiotics

syphillis

TB

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5
Q

Erythema nodosum: TX

A

bed rest, lega elevation, NSAIDS, and heat for SX. Steroids only when infection excluded

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6
Q

Erythema nodosum histo

A

septal panniculitis (little to no necrosis of lobule)

Early: widening of septa from fibrin edema and neutrophilic infiltrate

chronic: mononuclear cells and granulomatous inflammation of septum with fibrosis

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7
Q

Warts

A

benign growths caused by infection of epidermal cells with human papilloma virus

generally occur in children and yougn adults

transmitted by skin to skin contact

lesions disrupt skin lines

intralesional brown black dots are pathogenomic and reprsent thrombosed vesels

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8
Q

Wart gross: the common wart (verruca vulgaris)

A

the common wart (verruca vulgaris)

flesh colored papule with hyperkeratotic surface

most common on elbows, knees, fingers, palms

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9
Q

Wart gross; Flat wart (verruca plana)

A

flesh colored, slightly raised papules and flat surface

usually on chin, dorsum of hands, and legs

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10
Q

Wart gross: Plantar wart (verruca plantaris)

A

HPV 1

fleshed colored papule with hyperkeratotic surface

warts found on underside of foot. may cause pain if on pressure areas.

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11
Q

Warts: Anogenital wart (condyloma acuminatum)

A

Most common STD, types HPV 6 and 11

HPV 16 and 18 can lead to cervical cancer

appearnce: soft, fleshy pink papillomas on the genitalia, perineum , and anus.

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12
Q

Verruca vulgaris histo

A

exophytic

chruch spire of verrucous acanthosis

koilocytes (cells with vacuolated cytoplasm- clearing around the nucleus)

infected cells may show prominent keratohyline granules

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13
Q

Warts sx

A

most warts are asymptomatic

may bleed

most disappear in 1-2 years but may mutiply or recur despite treatment

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14
Q

Warts TX

A

cryotherapy may need > 1 treatment, 60-75%

duct tape: more effective than cryo in some studies

salicyclic acid

5 fu

imiquimod

pdophyllin for genital warts

pare lesion down or soak to allow better penetration of topical medication

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15
Q

Molluscum contagiosum

A

common, self limited viral infection in kids and sexually active adults

caused by poxvirus

transmitted via skin to skin contact and is highly contagious

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16
Q

Molluscum contagiosum: SX

A

asymptomatci smooth, dome shaped papules with central umbilication

lesions are flesh colored and translucent

papules ahve a cheesy core that can be expressed

may occur singly or in groups

occur anywhere on kids and genitals of sexually active adults

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17
Q

Molluscum contagiosum TX

A

spontaneously remit in a few months

In HIV patients, lesions can be extesnive, grow very large and be refaractory to treatment

TX: cryotherapy, curettage, salicyclic acid

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18
Q

Molluscum contagiosum: Histo

A

cup shaped lesion with scallped border

verrucous acanthosis (epidermal hyperplasia)

molluscum bodies in cells of stratum corneum and stratum granulosum (ovid, homogeneous, cytoplasmic inclusion bodies)

19
Q

Impetigo

A

Common, highly contagious superficial bacterial infection of the skin

children, adults

painful lesions distinguishes from contact dermatitis

two forms nonbullous and bullous

Staph a. is most common cause of either kind

20
Q

Impetigo: Nonbullous

A

most common

face and extremities

papules progress to vesicles on erythematous base

when vescicles rupture causes typically “hone colored rust”

21
Q

Impetigo: Bullous

A

young children

vesicles enlarge to form flaccid bullae with clear yellow fluid contents, later becomes darker and more turbid; ruptured bullae leave a thin brown crust

trunk is more frequently affected

22
Q

Impetigo Histo

A

accumulation of neutrophils beneath stratum corneum

23
Q

Impetigo TX

A

topical: Mupirocin or hydrogen peroxide cream for limited number of lesions

oral antibiotics for bullous type

24
Q

Scabies

A

infection with sarcoptes scabiei

common in school age children, nursing home patients, and less developed countries

patients present with the worst itch they;ve ever had

incubation time is about 1 month so contacts may not be symptomatic

25
Q

Scabies sx

A

predilection for finger webs, wrists, and penis

spares head, neck, palms, and soles

linear burrows with a drak dot at one end representing apth of female mite in skin

small inflammatory papules and excoriations predominate

26
Q

Scabies (sarcoptes scabiei)

A

highly contagious: skin contact, towels, linens

mites tunnel in epidermis, lay eggs, and deposit feces. Very few mites present

eggs and feces cause delayed type IV hypersensitivity reaction causing intense itching usually at night

27
Q

Scabies diagnosis

A

look for burrows on hands, wrists, etc

suspect in anyone with persistent generalized, severe pruritis

confirm diagnosis by scraping burrow with a scalpel. Look under microscope to detect mites, ova, or feces

28
Q

Scabies oil preparation

A

put a few drops of mineral oil on glass slide

put mineral oil on scalpel blade

scrape burrow with blade

put scrapings on slide

look under microscope

29
Q

Sccabies TX

A

topical: 5% permethrin cream, 1% lindande lotion

oral ivermectin

treat all close contact and wash all linens and underwear

not contagious after 1 treatment. itching may alst for weeks as mites are shed. use topical steroids and oral antihistamines

30
Q

Xanthelasma (xanthoma

A

collection of macrophages containing lipid droplets

assocaited with familial hyperlipidemias, nephrotic syndrome, myeloma, pnacreatitis, thryoid disease, primary biliary cirrhosis

may be isolated findings. Always check lipids

31
Q

mongolian spot

A

single gray-blue lesion over lumbosacral area

more common in asian and native americans pts

melanocytes lcoated in the dermis instead of epidermis that may be neural crests cells interrupted in migration

most disappear during childhood.

no melanomas occur in this lesion

32
Q

cherry angioma

A

bright red , domed, vascular lesions on trunk

benign and increase with age

TX not indicated

33
Q

Hemangioma of infancy

A

most common tumor of infancy

most common in premature, caucasian girls

benign tumor of hyperplastic blood vessels

blachable bright red to deep purple lesions

arise in the first few weeks of life and grows for the first year then regresses normally by 10.

34
Q

Hemangioma of infancy

A

do not treat unless it ulcerates or blocks ears, eyes, larynx

can use propranolol, steroids, or laser

parents need a lot of reassurance

35
Q

Alopecia

A

3 phases of hair development: anagen (grwoing) catagen (involution), telogen (resting and hair shed at end)

36
Q

Alopecia androgentic alopecia

A

polygenic inheritance

involves scalp 5 alpha reductase activity and androgenic effects of dihydrotestosterone produced

men and women equally affected

men: loss at temporal areas and mid scalp
women: diffuse loss, rarely complete, front hairline maintained

37
Q

Alopecia: tinea capitis (ringworm)

A

isolated pruritic lesion on scalp with central clearing

38
Q

Alopecia Telogen effluvium

A

diffuse decrease in ahir density due to rapid conversion of anagen to telogen hair

precipitate by stressful events, illness, fever, pregnancy

39
Q

Aloipecia areata

A

autoimmune disorder causing patchy or diffuse hair loss

40
Q

alopecia TX

A

alopecia areata: high potency topical steroids

androgentic alopcia: minoxidil and finasteride (inhibits syntehsis of dihydrotesterone.)

spirnolactone in women.

41
Q

Xeroderma pigmentosum

A

autosomal recessive condition

decreased ability to repair DNA followed damage by UV light due to defects in excision of abnormal nucleotides or defects in replacement of nucleotides following excision

first year of life with erythema, scaling, subsequent hyperpigmentation and lentigo on lgiht exposed area

skin later shows atrophy, teleangiectasia and intermingling areas of hypo and hyperpigmentation

squamous cell cancer, basal cell cancer and melanoma develop as early as 50-60 years of life

42
Q

Chediak higash syndrome

A

autosomal recessive

immunodeficiency due to defect in neutrophil phagosome lysosome fusion causing abnormal giant lysosomal inclusions visible on peripheral blood smear. Pyogenic infection due to staph and strep.

Albinism: abnormal melanin sotrage in melanocytes causes aprtial oculocutaneous albinism

nystagmus, peripheral and cranial neuropathies

most commonly diagnosied in childhood.

43
Q

Wiskott aldrich syndrome

A

x linked disorder

immunodeficiency

eczema

thrombocytopenia

combined B and t lymphcyte disorder

44
Q

albinism

A

melanocytes normal in number and location but production of melanin defective due to complete absence of tyrosinase

complete albinism manifest by white hair, blue eyes and pink or white skin.

Exam 2 Skin block (22 decks)

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