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40 Cards in this Set

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dominated by perivascular infiltration by lymphocytes in the upper dermis
ACUTE DERMATITIS
Common, usually temporary, pruritic lesion.
Local mast cell, antigen mediated IgE dependent, degranulation
Urticaria
deficiency of C1-inactivator
precipitating vascular dilatation and increased permeability
hereditary angioedema
distinctive urticarial eruption of the last trimester of pregnancy.
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
dominated by intraepidermal vesicles or bullae with associated spongiosis
Acute Eczematous Dermatitis
types of eczema: Occurring at points of contact with specific allergens. E.g., Poison ivy
Contact
types of eczema: coin-shaped lesions
Nummular
types of eczema: Marked acanthosis(thickening), spongiosis, hyperkeratosis and parakeratosis yielding disfiguring scaling lesions. A predilection for involvement of the face in infants and flexural areas. Observed frequently in children with milk allergies. Serum IgE is elevated.
Atopic
types of eczema: Associated with systemically administered antigens or haptens (e.g. penicillin).
Drug-related
acute self-limited inflammatory (hypersensitivity cytotoxic [CD8+]) disorder characterized by symmetrically distributed nodular, papular, vesicular and bullous lesions of variable distribution but frequently involving the extremities including the palms and soles. "Iris lesions" showing central ulceration with surrounding halo.
Erythema Multiforme
chronic idiopathic disease in which the rate of epidermal cell replication is accelerated. It is characterized by red-brown scaling silvery plaques with predilection for extensor surfaces of extremities which involute in summer and exacerbate in winter months
Histologic characteristics:
Munro abscesses-localized PMN accumulation in stratum corneum
Psoriasis
inflammatory dermatosis even more common than psoriasis. It classically involves the regions with a high density of sebaceous glands, such as the scalp, forehead (especially the glabella), external auditory canal, retroauricular area, nasolabial folds, and the presternal area. Dandruff is the common clinical expression on the scalp.
Seborrheic dermatitis:
An idiopathic subacute inflammatory disorder of skin characterized by pruritic shiny violaceous papules and plaques (often as Wickham striae) with predilection for flexor surfaces of extremities, genital areas and buccal mucosa. • T-cell mediated immune response at DE jct with hyperplasia of Langerhans cells
Lichen planus
Malar erythema which worsens with sun exposure
Infiltrate of lymphocytes at DE jct, periappendageal and perivascular regions.
Atrophic epidermis with loss of rete ridges
Diffuse vacuolization of the basal layer
Atrophic dilated keratin-filled follicles
Characteristic GRANULAR immunofluorescence
Humoral and cell-mediated mechanisms collaborate in its pathogenesis.
Serologic diagnosis: ANA (>95%), DS-DNA, and ENA (Sm and RNP)
Lupus erythematosus (LE) (discoid, or local variant)
A chronic inflammatory dermatosis affecting hair follicles of teens.
A physiologic hormonal alteration in hair follicle maturation, exacerbated by drugs, chemical exposure, occlusive conditions, heritable factors, etc. Histology: comedones (follicle expansion with lipid and keratin) with variable acute and chronic inflammatory changes.
Acne vulgaris
dermititis due to vascular insufficiency
Stasis dermatitis
Panniculitis of subcutaneous tissue
self-limited disorder. It often involves the legs as poorly defined, exquisitely TENDER, erythematous nodules accompanied by fever and malaise. The lesions flatten and become bruise-like over the course of weeks. The panniculus shows capillary and perivascular inflammatory infiltrates including eosinophils, giant cells, and histiocytes leading to inflamed CONNECTIVE TISSUE SEPTA.
Erythema Nodosum
Panniculitis of subcutaneous tissue. A vascular hypersensitivity. An uncommon disorder affecting primarily adolescents and menopausal women. The cause is unknown with no associated underlying disease. It is more chronic than erythema nodosum, is less tender, and is characterized by a granulomatous, tuberculoid infiltrate, vasculitis, and caseation necrosis leading to inflamed FAT LOBULE.
Erythema Induratum
This autoimmune disorder is a diffuse vesicular and bullous disorder of skin and mucous membranes characterized by epidermal acantholysis with vesiculation Inflammatory reaction is scant, nonspecific, and confined to the superficial dermis. It is usually fatal. Histology: IgG deposits with the fixation of complement directed against surface antigens of the squamous cells (fishnet-like pattern).
Pemphigus
A chronic but self-limited inflammatory disorder of skin characterized by blister-like lesions having predilection for intertriginous areas but frequently widespread. Involvement of mucosa is unusual and mild. Most common in the elderly. Lesions are characterized by subepidermal clefts and bullae distended by fluid and inflammatory exudate rich in eosinophils which elevates the basically unaltered overlying epidermis. Linear immunoglobulin deposits with complement are demonstrable at the base of the bullae.
Bullous Pemphigoid:
a rare disorder characterized by urticarial wheals and vesicles on the flexural surfaces occurring in the 4th and 5th decades and associated with celiac disease responding to gluten-free diet. It is characterized by microabscesses at tips of dermal papillae. Immunofluorescence shows granular deposits of IgA. IgA Ab to gluten protein of flour (esp. wheat) at these tips. There is association with certain HLA types.
Dermatitis Herpetiformis
a group of uncommon inborn or acquired disturbances of porphyrin metabolism. Porphyrins are pigments present in hemoglobin, myoglobin and cytochromes. Skin manifestations consist of urticaria and vesicles that heal with scarring and that are exacerbated by exposure to sunlight. The primary microscopic alterations are subepidermal vesicle with marked thickening of superficial dermal vessels
Porphyria
An autosomal dominant genodermatosis, probably due to abnormalities in desmosomes. The lesions usually first appear in childhood, but may arise later. The lesions are small keratotic papules usually on face, chest, back, and extremities. Histologically, there is suprabasal clefts in which acantholytic cells called grains are found. The dermal papillae covered by a layer of basal cells form small villi at the base of the lesion. In addition, within the epidermis large individually dyskeratotic cells called CORPS ROUND are found.
Darier's disease (keratosis follicularis):
A group of hereditary disorders unified by the common link of blisters that develop at sites of pressure, rubbing, or trauma at or soon after birth.
Epidermolysis bullosa
loss of pigment-producing melanocytes
Vitiligo
tyrosinase deficiency
Albinism
benign disorders of pigment.
Nevi
heritable melanoma syndrome
Dysplastic Nevi
probability of metastasis of Malignant melanoma can be predicted by simply measuring ____ of invasion
depth
regional lymph node involvement of Malignant melanoma becomes likely at _____
~ 0.76 mm.
Clarks Level 1 – Confined to epidermis. "Malignant melanoma in situ". Five-year survival ?
100%.
Clarks Level 2 – Confined to papillary dermis. Five-year survival?
90%
Clarks Level 3 – Infiltration penetrating to but not beyond junction between papillary and reticular dermis. Five-year survival?
50-65%
Clarks Level 4 – Infiltration into reticular dermis. Five-year survival?
30-50%.
Clarks Level 5 – Infiltration into subcutaneous panniculus. Five-year survival?
10-30%.
Seborrheic Keratosis in large numbers as part of a paraneoplastic syndrome, sign of _______
Leser-Trélat)
Elderly individual presents with flesh-colored, usually solitary nodules on head, neck, and extremities of elderly individual. Metastasizes to regional lymph nodes (>50%) widespread mets and death in about 1/5. Microscopically resembles small cell carcinoma of the lung: sheets and cords of small cells, pale nuclei, and many mitotic figures. EM: cytoplasmic dense core granules
Merkel Cell Carcinoma (neuroendocrine or trabecular ca)
Benign adnexal tumor of hair differentiation
pilomatrixoma
Benign adnexal tumor of apocrine differentiation
cylindroma
AIDS patient presents with bluish-red plaques and nodules often associated with lymphedema which frequently ulcerates. Herpes implicated (HHV-8).
Kaposi's Sarcoma