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21 Cards in this Set
- Front
- Back
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What types of lesions are good to biopsy with a shave biopsy?
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Exophytic or epidermal lesions
BCC SCC Seborrheic keratoses Warts |
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Seborrheic keratosis: attributes
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most common benign epidermal tumor
well circumscribed tan or brown papule or plaque waxy or verrucous surface "stuck-on" appearance Pseudohorn cysts often present |
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Punch biopsy: allows visualization of what tissues?
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epidermis, dermis, subcutaneous fat
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Leukocytoclasic vasculitis: pathogenesis
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Immune complex deposition --> inflamm response --> complement activation
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Leukocytoclasic vasculitis: presentation
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Palpable purpura on extremities
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Leukocytoclasic vasculitis: causes
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medications, infections, malignancy, collagen vascular disease, idiopathic
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Leukocytoclasic vasculitis: histo
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- fibrinoid necrosis of the vessel walls
- neutrophils arond blood vessels - fragmented neutrophils (leukocytoclasia) |
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Leukocytoclasic vasculitis: things to look for
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Usually seen in lower ext
Look for involvement of other organs: - GI: ab pain, blood in stools - Kidneys: hematuria, protein, cellular casts, elevated BUN, creatinine |
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Leukocytoclasic vasculitis: tx
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symptomatic
steroids |
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What allows for the immediate dx of herpetic infection? Describe the test
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Tzank smear
Use 15 blade scalpel to open vesicle, scrape base for keratinocytes, spread the adherent cells and material onto a glass slide. Stain with Giemsa stain (or Wright's stain) Multinucleated giant cells are diagnostic for infections with herpes simplex or varicella zoster CANNOT distinguish between herpes simplex and herpes zoster. CANNOT distinguish between HSV-1 and HSV-2 CAN see 1. margination 2. multinucleation 3. molding (nuclei pushed together) this is dx for a herpes infection |
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what testing method do you use if you suspect a fungal infection?
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KOH prep.
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What is a dermatophyte?
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A fungus that lives on keratin (hair, nails, skin)
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How do you do a KOH prep?
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Swab site with alcohol
15 scalpel blade to gently scrape scale Moist keratinocytes transferred from blade to slide add 1-2 drops of KOH Apply cover slip Gently warm with a bunsen burner examine under microscope |
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How do you do a scabies prep?
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- Apply mineral oil to a 15 blade scalpel
- scrape a burrow vigorously (make it bleed) - transfer material to a glass slide - Examine for mites, eggs, and scybala (skih-bah-lah, fecal pellets) |
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What causes the inflamm reaction with scabies?
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Inflamm reaction to the scybala, the fecal pellets
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Scabies: clinical features
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- Spread by direct contact
- Severe pruritus, esp at night - Linear burrows and pink papules in the interdigital web spaces of hands, flexor wrists, axillae, abdomen, genitalia, buttocks, thighs |
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Scabies: tx
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5% permethrin cream
Treat close contacts launder clothes and bed linens |
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"Spaghetti and meatball" histo appearance
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yeast forms and short hyphae
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Tinea versicolor: clinical appearance
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mulitple round hypopigmented macules coalescing to a patch. see scales. worse in summer. chest abdomen, back
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Tinea versicolor: cause
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immune reaction to pityrosporum orbiculare (malassezia furfur)
occurs when temp and humidity are high |
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Tinea versicolor: tx
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topical or oral antifungals
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