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62 Cards in this Set

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actinic keratosis
rough, scaling, reddish, ill-defined patch or plaque
UV radiation induced, can spontaneously regress or progress to SCC
may form horn-like excrescences (need to biopsy).
inflammatory infiltrate and solar elastosis (sun damage) common
full thickness dysplasia = SCC in situ
actinic keratosis
variable atypia (less than full thickness), solar elastosis, chronic dermal inflammation
UV radiation induced, can spontaneously regress or progress to SCC
may form horn-like excrescences (need to biopsy).
inflammatory infiltrate and solar elastosis (sun damage) common
full thickness dysplasia = SCC in situ
actinic keratosis
variable atypia (less than full thickness), solar elastosis, chronic dermal inflammation
UV radiation induced, can spontaneously regress or progress to SCC
may form horn-like excrescences (need to biopsy).
inflammatory infiltrate and solar elastosis (sun damage) common
full thickness dysplasia = SCC in situ
angiocentric
associated w/ urticaria and necrotizing vasculitis
angiocentric
associated w/ urticaria and necrotizing vasculitis
atrophy
dermal/subcutaneous
BCC
erythematous patch w/ central erosion/ulceration and rolled pearly border w/ telangiectasia
or
pearly papule or nodule w/ telangiectasias
sun exposed skin, most common skin cancer (most common human malignancy)
rarely metastasizes, locally aggressive
BCC
enlarged basaloid keratinocytes
mitosis, individual cell necrosis, peripheral palisading, separation artifact
sun exposed skin, most common skin cancer (most common human malignancy)
rarely metastasizes, locally aggressive
BCC
superficial type
sun exposed skin, most common skin cancer (most common human malignancy)
rarely metastasizes, locally aggressive
dermatitis herpetiformis (celiac dz)
microabcesses and neutrophils
IgA-TeG (antiendomysial Ab) deposition from gluten sensitivity causes blistering and herpetiform
Tx: Dapsone (skin symptoms), gluten free diet (systemic symptoms)
compound melanocytic nevus
melanocytes in dermis and epidermis
discoid lupus
localized to skin (5-10% have SLE), pigment change, telangiectasia, alopecia, follicular plugging
autoimune interface dermatitis
may be entirely localized to skin
chronic
atrophy of skin, pigment change due to damage to basal layer
discoid lupus
epidermal atrophy, hyperkeratosis, lymphocytes attacking DEJ, follicular destruction, dilated vessels, positive "lupus band"
autoimune interface dermatitis
may be entirely localized to skin
chronic
atrophy of skin, pigment change due to damage to basal layer
dysplastic nevus
irregular nests, bridging, shoulder, cytologic atypia, lamellar fibroplasia
melanoma precursor
dysplastic nevus
irregular nests, bridging, shoulder, cytologic atypia, lamellar fibroplasia
melanoma precursor
Erythema Nodosum
panniculitis
chronic inflammation (lymphocytes, histiocytes, eos, granulomas) septal firborsis
often provoked by infection, drug ingestion, or associated systemic inflammatory disorder (most common cause is idiopathic)
tender subc nodules
Erythema Nodosum
panniculitis
chronic inflammation (lymphocytes, histiocytes, eos, granulomas) septal firborsis
often provoked by infection, drug ingestion, or associated systemic inflammatory disorder (most common cause is idiopathic)
tender subc nodules
inflammation
angiocentric/spongiotic/interface
inflammation
vesiculobullous/panniculitic
interface infiltrated
Discoid Lupus Erythematosis
Lichen Planus
pink purple pruritic polygonal papules or plaques
often on wrists/ancles
interface dermatoses
most cases idiopathic, koebner phenom, lymphocytes attacking keratinocytes
Lichen Planus
Interface dermatoses w/ lymphocytes obscuring keratinocytes
interface dermatoses
most cases idiopathic, koebner phenom, lymphocytes attacking keratinocytes
melanocytes
melanocytic nevus
most acquired btwn 6 and 35
variable but uniform appearance
brown to flesh colored, <5mm diameter
melanocytic nevus
most acquired btwn 6 and 35
variable but uniform appearance
brown to flesh colored, <5mm diameter
melanocytic nevus
most acquired btwn 6 and 35
variable but uniform appearance
brown to flesh colored, <5mm diameter
melanoma in situ
melanoma cells confined to the epidermal layer
acral melanoma
most common type of melanoma in dark skinned pts
nail beds and soles of feet
necrotizing vasculitis
palpable purpura
can be limited to skin or systemic, non blanching (extravasated RBCs)
Drugs, infection, connective tissue Dz, underlying malignancy may cause
Typically IgG
Henoch-Schonlein Purpura an IgA variant more common in peds requiring serial UAs
normal skin
normal skin
normal skin
Hyperplasia (Acanthosis)/Dysplasia
Psoriatic Arthritis
gross
psoriasis
erythematous plaques w/ silvery scales
Koebner Phenom, Auspitz sign
HLA types (genetic factor)
neutrophils
arthritic lesions may present
autoreactive T Cells?
psoriasis
"regular" acanthosis
parakeratosis
neutrophils
loss of granular layer
suprapapillary dermal plate
prominent dilated capillaries
Koebner Phenom, Auspitz sign
HLA types (genetic factor)
neutrophils
arthritic lesions may present
autoreactive T Cells?
psoriasis
"regular" acanthosis
parakeratosis
neutrophils
loss of granular layer
suprapapillary dermal plate
prominent dilated capillaries
Koebner Phenom, Auspitz sign
HLA types (genetic factor)
neutrophils
arthritic lesions may present
autoreactive T Cells?
Pemphigus Vulgaris
flacid easily ruptured blisters
Nikolsky sign
genetic predisposition, 40s-50s
autoimmune attack of IgG against desmoglein 3
uniformly fatal before steroid therapy available
Pemphigus Vulgaris
tombstone pattern, basal layer still attached
genetic predisposition, 40s-50s
autoimmune attack of IgG against desmoglein 3
uniformly fatal before steroid therapy available
Pemphigus Vulgaris
immunofluorescence for IgG against Desmoglein 3
Lace of fish scale pattern differentiates from lupus or dermatitis herpetiformis
genetic predisposition, 40s-50s
autoimmune attack of IgG against desmoglein 3
uniformly fatal before steroid therapy available
Squamous Cell Carcinoma
scaling erythematous plaque or nodule
occurs often on sun-exposed skin or mucous membrane or sites of chronic injury
locally invasive
small potential to metastasize
Squamous Cell Carcinoma
atypical keratinocytes, growth into underlying dermis, keratin pearls, hyperkeratosis, parakeratosis
occurs often on sun-exposed skin or mucous membrane or sites of chronic injury
locally invasive
small potential to metastasize
Squamous Cell Carcinoma
atypical keratinocytes, growth into underlying dermis, keratin pearls, hyperkeratosis, parakeratosis
occurs often on sun-exposed skin or mucous membrane or sites of chronic injury
locally invasive
small potential to metastasize
seborrheic keratosis
"stuck on" plaque or papule
rough surface
middle age and older
Sign of Leser-Trelat = many SKs in short time a result of internal malignancy
possible environmental cause
seborrheic keratosis
no melanocytic incr
horn cytsts of onion like laminated whorls
middle age and older
Sign of Leser-Trelat = many SKs in short time a result of internal malignancy
possible environmental cause
seborrheic keratosis
no melanocytic incr
horn cytsts of onion like laminated whorls
middle age and older
Sign of Leser-Trelat = many SKs in short time a result of internal malignancy
possible environmental cause
seborrheic keratosis
no melanocytic incr
horn cytsts of onion like laminated whorls
seborrheic keratosis
no melanocytic incr
horn cytsts of onion like laminated whorls
Allergic contact dermatitis
pruritic well demarcated erythematous edematous papules and plaques with vesicle formation
often linear
blister in 1-2 days
scaly w/ chronicity
type IV hypersensitivity reaction (cell-mediated, delayed) (Langerhans present to naive T cells --> itchy)
initial type I reaction may also be present initially
Allergic contact dermatitis
spongiotic reaction
intercellular edema, vesicles may form btwn keratinocytes
perivascular infiltrate of lymphocytes, histiocytes, and eos
blister in 1-2 days
scaly w/ chronicity
type IV hypersensitivity reaction (cell-mediated, delayed) (Langerhans present to naive T cells --> itchy)
initial type I reaction may also be present initially
Allergic contact dermatitis
spongiotic reaction
intercellular edema, vesicles may form btwn keratinocytes
perivascular infiltrate of lymphocytes, histiocytes, and eos
blister in 1-2 days
scaly w/ chronicity
type IV hypersensitivity reaction (cell-mediated, delayed) (Langerhans present to naive T cells --> itchy)
initial type I reaction may also be present initially
Storage deposition
solar elastosis/amyloid
Allergic contact dermatitis
spongiotic reaction
intercellular edema, vesicles may form btwn keratinocytes
perivascular infiltrate of lymphocytes, histiocytes, and eos
blister in 1-2 days
scaly w/ chronicity
type IV hypersensitivity reaction (cell-mediated, delayed) (Langerhans present to naive T cells --> itchy)
initial type I reaction may also be present initially
urticaria
angiocentric inflammation
dermatographism, tempurature sensitive
vascular dilation, dermal edema
often in young adults
<24 hrs, intensly pruritic, angioedema
chronic forms: urticarial vasculitis, underlying dz
IgE/mast cell/PG reaction
angioedema in airways a immediate life threat
urticaria
angiocentric inflammation
dermatographism, tempurature sensitive
vascular dilation, dermal edema
often in young adults
<24 hrs, intensly pruritic, angioedema
chronic forms: urticarial vasculitis, underlying dz
IgE/mast cell/PG reaction
angioedema in airways a immediate life threat
urticaria
angiocentric inflammation
dermatographism, tempurature sensitive
vascular dilation, dermal edema
often in young adults
<24 hrs, intensly pruritic, angioedema
chronic forms: urticarial vasculitis, underlying dz
IgE/mast cell/PG reaction
angioedema in airways a immediate life threat
urticaria
angiocentric inflammation
dermatographism, tempurature sensitive
vascular dilation, dermal edema
often in young adults
<24 hrs, intensly pruritic, angioedema
chronic forms: urticarial vasculitis, underlying dz
IgE/mast cell/PG reaction
angioedema in airways a immediate life threat
urticaria
angiocentric inflammation
dermatographism, tempurature sensitive
vascular dilation, dermal edema
often in young adults
<24 hrs, intensly pruritic, angioedema
chronic forms: urticarial vasculitis, underlying dz
IgE/mast cell/PG reaction
angioedema in airways a immediate life threat
Verruca Vulgaris
HPV
benign squamoid proliferation, koilocytosis
verruca vulgaris
HPV
benign squamoid proliferation, koilocytosis
verruca vulgaris
HPV
benign squamoid proliferation, koilocytosis
seborrheic keratosis
"stuck on" plaque or papule
rough surface
middle age and older
Sign of Leser-Trelat = many SKs in short time a result of internal malignancy
possible environmental cause
seborrheic keratosis
"stuck on" plaque or papule
rough surface
middle age and older
Sign of Leser-Trelat = many SKs in short time a result of internal malignancy
possible environmental cause