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30 Cards in this Set

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SKIN DISORDERS

Impetigo
Superficial skin infection. Honey crusting. Highly contagious.
SKIN DISORDERS

Dermatitis
A group of inflammatory pruritic skin disorders. Etiology: allergy (usually type IV hypersensitivity), chemical injury, or infection.
SKIN DISORDERS

Atopic dermatitis
Pruritic eruption, commonly on flexor surfaces. Often assoc'd with other atopic disseases (asthma, allergic rhinitis).
SKIN DISORDERS

Allergic contact dermatitis
Type IV hypersensitivity reaction that follows exposure to allergen (poison ive, poison oak, nickel, rubber, chemicals). Lesions occur at site of contact.
SKIN DISORDERS

Psoriasis
Epidermal hyperplasia (acanthosis) with parakeratotic scaling (nuclei still in stratum corneum) especially on knees and elbows. Increased stratum spinosum, decreased stratum granulosum (see Color Image 65). Auspitz sign.
SKIN DISORDERS

Dermititis herpetiformis
Pruritic papules and vesicles. Deposits of IgA at the tips of dermal papillae. Assoc'd with celiac disease.
SKIN DISORDERS

Lichen planus
Pruritic, purple polygonal papules; infiltrate of lymphocytes at dermoepidermal junction.
SKIN DISORDERS

Erythema multiforme
Assoc'd with infections, drugs, cancers, and autoimmune dissease. Presents with multiple types of lesions, including macules, papules, vesicles, and tartet lesions (red papules with a pale central area).
Stevens-Johnson syndrome (sulfa and anticonvulsant drugs) is the major form of erythema multiforme. Characterized by high fever, bulla formation and necrosis, ulceration of skin, and a high mortality rate.
SKIN DISORDERS

Seborrheic keratosis
Flat, pigmented squamous spithelial proliferation with keratin-filled cysts (horn cysts). Benign.
SKIN DISORDERS

Actinic keratosis
Caused by sun exposure. Small, rough erythematous or brownish papules, Premalignant lesion. Risk of carcinoma is proportional to epithelial dysplasia.
SKIN DISORDERS

Keloid
Tumore of connective tissue elements of dermis that cuases raised, thickened scars. Follows trauma to skin, especially in African-Americans.
SKIN DISORDERS

Bullous pemphigoid
Autoimmune disorder with IgG antibody against epidermal basement membrane hemidesmosomes (linear immunofluorescence). Similar to but less severe than pemphigus vulgaris - affects skin but spares oral mucosa (see Color Image 64).
SKIN DISORDERS

Pemphigus vulgaris
Potentially fatal autoimmune skin disorder. Intraepidermal bullae involving the oral mucosa and skin. Findings: acantholysis (breakdown of epithelial cell-to-cell junctions), IgG antibody against epidermal cell surface desmosomes (immunofluorescence throughtout epidermis) (see Color Image 63).
SKIN DISORDERS

Verrucae (warts)
Soft, tan-colored, cauliflowerlike lesions. Epidermal hyperplasia, hyperkeratosis, koilocytoses. Verruca vulgaris on hands, condyloma acuminatum on genitals.
SKIN CANCER

Squamous cell carcinoma
Very common. Accoc'd with excessive exposure to sunlight & arsenic exposure. Commonly appear on hands & face. Locally invasive, but rarely metastasizes. Histopathology: keratin "pears" (see Color Image 60)
SKIN CANCER

Basal cell carcinoma
Most common in sun-exposed areas of body. Locally invasive, but almost never metastasizes. Gross pathology: pearly papules (see Color Image 62).
Basal cell tumors have "palisading" nuclei.
SKIN CANCER

Melanoma
Common tumore with significant risk of metastasis. Assoc'd with sunlight exposure; fair-skinned persons are at increased risk. Incidence increased. Depth of tumor correlates with risk of metastasis (see Color Image 61).
SKIN CANCER

What is the precursor to squamous cell carcinoma?
Antinic keratosis is a precursor to Squamouse cell carcinoma.
SKIN CANCER

What is a precursor to Melanoma?
Dysplastic nevus is a precursor to melanoma.
SKIN CANCER

Primary Bone Tumors-Benign

What are the five benign primary bone tumors?
1. Osteoid osteoma
2. Osteoblastoma
3. Giant cell tumor
4. Osteochondroma (exostosis)
5. Enchondroma
SKIN CANCER

Primary Bone Tumors - Benign

Osteoid osteoma?
Interlacing trabeculae of woven bone surronded by osteoblasts. <2 cm and found in proximal tibia and femur
SKIN CANCER

Primary Bone Tumors - Benign

Osteoblastoma?
Same morphologically as osteoid osteoma, but larger and found in vertebral column
SKIN CANCER

Primary Bone Tumors - Benign

Giant cell tumor?
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often around the distal femur, proximal tibial region. Characteristic "double bubble" or "soap bubble" appearance on x-ray. Spindle-shaped cells with multinucleated giant cells.
SKIN CANCER

Primary Bone Tumors - Benign

Osteochondroma (exostosis)
Most common benign bone tumor. Mature bone with cartilaginous cap. Usually in men <25 years of age. Commonly originates from long metaphysis. Malignant transformation to chondrosarcoma is rare.
SKIN CANCER

Primary Bone Tumors - Benign

Enchondroma
Benign cartilaginous neoplasm found in intramedullary bone. Usually distal extremities (vs. chondrosarcoma).
SKIN CANCER

Primary Bone Tumors- Malignant

What are the 3 malignant primary bone tumors?
1. Osteosarcoma (osteogenic carcinoma)
2. Ewing's sarcoma
3. Chondrosarcoma
SKIN CANCER

Primary Bone Tumors- Malignant

Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone. Peak incidence in men 10-20 years old. Commonly found in the metaphysis of long bones. Predisposing factors include Paget's disease of bone, bone enfarcts, radiation, and familial retinoblastoma. Codman's triangle (from elevation of periosteum) on x-ray.
SKIN CANCER

Primary Bone Tumors- Malignant

Ewing's sasrcoma
Anaplastic small blue cell malignant tumor. Most common in boys <15. Extremely aggressive with early mets, but responisive to chemotherapy. Characteristic "onion-skin" appearance in bone ("going out for Ewings and onion rings") Commonly appears in diaphysis of long bones, pelvis, scapula, and ribs. 11;22 translocation
SKIN CANCER

Primary Bone Tumors- Malignant

Chondrosarcoma
Malignant cartilaginous tumor. Most common in men agend 30-60. Usually located in pelvis, spine, scapula, humerus, tibia, or femur. May be of primary origin or from osteochondroma. Expansile glistening mass within the medullary cavity. See drawing page 332)
SKIN CANCER

Buerger's disease
Also known as thromboangiitis obliterans; idiopathic, segmental, thrombosing vasculitis of intermediate and small peripheral arteries and veins. Seen in heavy smokers.
Findings: Intermittent claudication, superficial nodular phlebitis, cold sensitivity (Raynaud's phenomenon), severe pain in affected part; may lead to gangrene.
Treatment: Quit smoking