Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
101 Cards in this Set
- Front
- Back
|
What is a macule?
|
Circumscribed flat area of discoloration
|
|
|
What is a papule?
|
Elevated area of 5mm or less
|
|
|
What is a nodule?
|
Elevated dome shaped area of >5mm
|
|
|
What is a plaque?
|
Elevated flat topped area usually >5mm
|
|
|
What is a vesicle?
|
Fluid-filled raised lesion <5mm
|
|
|
What is a bulla?
|
Fluid-filled raised lesion >5mm
|
|
|
What is a pustule?
|
Discrete, pus-filled, raised lesion
|
|
|
What is a lichenification?
|
Thickening of skin with accentuation of skin markings
|
|
|
What is hyperkeratosis?
|
Increased thickness of stratum corneum
|
|
|
What is parakeratosis?
|
Retention of nuclei in stratum corneum
|
|
|
What is spongiosis?
|
Intercellular edema of the epidermis
|
|
|
What is acanthosis?
|
Epidermal hyperplasia
|
|
|
What is acantholysis?
|
Loss of intercellular connections between keratinocytes
|
|
|
What is pagetoid spread?
|
Extension of melanocytes with pale cytoplasm into the upper layers of epidermis
|
|
|
What is the difference between lentigo and freckles?
|
Freckles appear after sun exposure so fade in winter darken in summer - lentigines do not react to sun
Freckles have increased melanin pigment in freckles without increase in density of melanocytes |
|
|
What is the histologic feature of junctional nevus?
|
Nests as dermoepidermal junction
|
|
|
What is the histologic feature of compound nevus?
|
Nests at dermoepidermal junction and in the dermis
|
|
|
What is the histologic feature of intradermal nevus?
|
Nests in the dermis
|
|
|
Which melanocytic nevi carry an increased risk of melanoma?
|
Large & giant variants of congenital nevi
Dysplastic nevi |
|
|
What is a malignant melanoma?
|
Malignant neoplasm of melanocytes mostly in skin
Sometimes found in oral, anogenital mucosa, esophagus, meninges, eye |
|
|
What are the risk factors for malignant melanoma?
|
Excessive sun exposure
Hereditary factors Fair skin Dysplastic nevus syndrome Large/giant congenital nevi |
|
|
What are the clinical features of malignant melanoma?
|
Asymmetry
Border - Irregular Color - Variegated Diameter - Large Elevation New pigmented lesion in adult life, change in color, size, or shape of pre-existing mole, itching, pain, or erosion in pigmented lesion |
|
|
What are clinical variants of malignant melanoma?
|
Lentigo maligna melanoma
Superficial spreading melanoma Acral/mucosal lentiginous melanoma Nodular |
|
|
What are the prognostic factors for malignant melanoma?
|
Clark's anatomic levels of invasion: 1-5 from melanoma in-situ to extension into subcutaneous fat
|
|
|
Presence of ulceration in a malignant melanoma is indicative of what?
|
Evidence of regression
|
|
|
What are some factors that may influence metastases of a malignant melanoma?
|
Number of mitoses
Tumor infiltrating lymphocytes Gender Location |
|
|
What is the most common benign epidermal tumor?
|
Seborrheic keratosis (occurs in middle-aged and elderly)
|
|
|
What is sign of Leser-Trelat?
|
When seborrheic keratosis occurs explosively in large numbers as part of a paraneoplastic syndrome
|
|
|
Where do seborrheic keratosis usually occur?
|
Most often on trunk; occasionally on extremities and head and neck
|
|
|
Acanthosis nigricans of the malignant type is usually associated with what?
|
Underlying cancer, mostly GI adenocarcinoma
|
|
|
What are epithelial cysts?
|
Common lesions formed by downward growth & cystic expansion of epidermis or epithelium of the follicle
|
|
|
What is a steatocystoma?
|
An epithelial cyst with lining epithelium resembles sebaceous gland duct
|
|
|
What is a dermoid cyst?
|
An epithelial cyst which is similar to epidermal inclusion cyst but also contains adnexal structures in the wall
|
|
|
What is a trichilemmal (pilar) cyst?
|
An epithelial cyst lined by epithelium that resembles follicular epithelium
|
|
|
What is an epidermal inclusion cyst?
|
An epithelial cyst lined by epithelium that is identical to epidermis & filled w/ laminated keratin
|
|
|
What is the clinical significance of adnexal tumors?
|
Majority are benign but may be mistaken for cancer
When malignant may be confused for metastasis Association with mendelian patterns of inheritance - markers for internal malignancy |
|
|
What are some hair follicle tumors?
|
Trichoepithelioma
Trichilemmoma Pilomatrixoma |
|
|
What are 2 types of sebaceous tumors?
|
Sebaceous adenoma
Sebaceous carcinoma (when of the eyelid known as meibomian carcinoma and follows aggressive course w/ systemic metastasis) |
|
|
What is a meibomian carcinoma?
|
Sebaceous carcinom of the eyelid with aggressive course and systemic metastasis
|
|
|
What are some apocrine tumors?
|
Cylindroma (turban tumor)
Apocrine carcinoma |
|
|
What are some eccrine tumors?
|
Syringoma
Poroma Eccrine carcinoma |
|
|
What is Cowden syndrome?
|
Multiple trichilemmomas and breast carcinoma
|
|
|
What is Muir-Torre syndrome?
|
Multiple sebaceous neoplasms & visceral carcinomas
|
|
|
What is actinic keratosis?
|
Dysplasia of the epidermis as a result of chronic exposure to sun
Exposure to ionizing radiation, hydrocarbons, and arsenicals can induce similar lesions High incidence in fair-skinned persons |
|
|
What is the second most common skin tumor?
|
Squamous cell carcinoma
Higher incidence in men than women, arises later in life |
|
|
What are predisposing factors for squamous cell carcinoma?
|
Excessive exposure to sun, carcinogens, arsenical ingestion, chronic ulcers & draining osteomyelitis, old burn scars
Chronic immunosuppression Viruses HPV 5 & 8 Xeroderma pigmentosum |
|
|
How does sun exposure lead to squamous cell carcinoma pathogenesis?
|
DNA damage
Direct immunosuppressive effect on skin by affecting normal function of antigen-presenting Langerhans cells |
|
|
What is keratoacanthoma?
|
Rapidly growing neoplasm that regresses spontaneously
Variant of well-differentiated squamous cell carcinoma |
|
|
What is the most common invasive cancer?
|
Basal cell carcinoma
|
|
|
What are basal cell carcinomas?
|
Slow growing tumors that rarely metastasize
|
|
|
What are risk factors for basal cell carcinoma?
|
Sun exposure
Immunosuppression Inherited defects in DNA repair mechanisms |
|
|
What is nevoid basal cell carcinoma syndrome?
|
Autosomal dominant disorder
Numerous basal cell carcinomas before the age of 20 & abnormalities of bone, CNS, eyes, & reproductive organs Aka basal cell nevus or gorlin syndrome |
|
|
What is benign fibrous histiocytoma (dermatofibroma)?
|
Benign dermal proliferation of fibroblasts & histiocytes
|
|
|
What is dermatofibrosarcoma protuberans?
|
Slow growing, locally aggressive fibroblastic tumor of skin (well differentiated primary fibrosarcoma of the skin)
Recur locally but rarely metastasize |
|
|
What is mycosis fungoides (CTCL)?
|
T cell lymphoproliferative disorders that arise primarily in skin & may evolve into generalized lymphoma
|
|
|
What is sezary syndrome?
|
Seen with mycosis fungoides when there is seeding of blood by malignant T cells accompanied by erythroderma
|
|
|
What is the treatment for mycosis fungoides?
|
Topical therapy with steroids or UV light for early lesions & aggressive systemic chemotherapy for advanced disease
|
|
|
What is mastocytosis?
|
Increased #s of mast cells in skin & occassionally in other organs
Signs & symptoms due to effects of histamine, heparin released from mast cells |
|
|
What is the pathogenesis of mastocytosis?
|
Activating point mutations in c-KIT receptor tyrosine kinase which increases signaling and drives mast cell growth & survival
|
|
|
What are the 2 forms of mastocytosis?
|
Urticara pigmentosa and systemic macrocytosis
|
|
|
What is the darier sign?
|
Localized area of dermal edema and erythema that occurs in mastocytosis when lesion is rubbed
|
|
|
What is ichthyosis?
|
Disorder of epidermal maturation characterized by fishlike scales
|
|
|
What are the autosomal dominant and autosomal recessive forms of ichthyosis?
|
Autosomal dominant or acquired: ichthyosis vulgaris
Autosomal recessive: congenital ichthyosiform erythroderma |
|
|
What is the pathogenesis of ichthyosis?
|
Defective mechanisms of desquamation leading to retention of abnormally formed scale
|
|
|
What is urticaria characterized by?
|
Localized mast cell degranulation & resultant dermal microvascular hyperpermeability - wheals
|
|
|
What is angioedema?
|
Deeper edema of dermis and subcutaneous tissue
|
|
|
What are possible pathogenetic mechanisms of urticaria?
|
Antigen-induced release of mediators via IgE sensitization
IgE-independent degranulation (opiates, antibiotics, chemicals) Hereditary angioneurotic edema (complement mediated) |
|
|
What is the classification of the major types of eczematous dermatitis?
|
Allergic contact
Atopic Drug related Photoeczematous Primary irritant |
|
|
What is erythema multiforme?
|
Acute cytotoxic T-cell mediated hypersensitivity rxn to infections (HSV) and drugs (sulfonamides)
May also be assoc. with malignancy & collagen vascular disease |
|
|
What is Stevens-Johnson syndrome?
|
Febrile form of erythema multiforme typically occurring in children
Mucosal involvement is characteristic: erosions & hemorrhagic crusting of lips, oral mucosa, conjunctiva, urethra, and anogenital lesions |
|
|
What are the differences in presentation between HSV assoc. & drug assoc. erythema mulitforme?
|
HSV: extremities involved, typical target-like lesions
Drugs: truncal involvement & purpuric type of macular eruption |
|
|
What is toxic epidermal necrolysis?
|
Severe form of erythema multiforme w/ widespread blotchy erythema that is soon followed by large flaccid bullae with detachment of epidermis
Caused by drugs (sulfonamides, Beta-lactams, NSAIDs) & high mortality |
|
|
What is psoriasis?
|
Chronic dermatosis of unknown etiology
Individuals of all ages affected |
|
|
What are different manifestations of psoriasis?
|
Localized or generalized pustular psoriasis
Eruptive or guttate psoriasis Erythrodermic psoriasis Involvement of nails in 30% of cases |
|
|
What is Auspitz sign?
|
Occurrence of bleeding points when the scale is lifted from a psoriatic plaque
|
|
|
What is the etiology of psoriasis?
|
Unknown
|
|
|
What is lichen planus?
|
Self-limiting disorder of unknown etiology involving skin, mucous membranes, hair follicles, and nails
|
|
|
What is the relationship between squamous cell carcinoma and lichen planus?
|
Uncertain pathogenic relationship but squamous cell carcinoma may be present in cases of lichen planus
|
|
|
What is pemphigus?
|
Autoimmune blistering disorder affecting pts in 4th -6th decade of life
|
|
|
What is the pathogenesis of pemphigus?
|
IgG autoantibodies against desmogleins
|
|
|
What are the different forms of pemphigus?
|
Pemphigus vulgaris
Pemphigus vegetans Pemphigus foliaceus Pemphigus erythematosus Paraneoplastic pemphigus |
|
|
What is bullous pemphigoid?
|
Autoimmune vesiculobullous disease affecting elderly pts
Presents as large tense bullae involving trunk, extremities, & intertriginous areas - do not rupture easily, heal w/o scarring Oral lesions present in 10-15% |
|
|
What is dermatitis herpetiformis?
|
Affects males in 3rd & 4th generation
Symmetric pruritic grouped papulovesicles Associated w/ intestinal celiac disease & response to gluten-free diet |
|
|
What are nodulocystic acne and acne conglobata?
|
Severe expressions of acne vulgaris
|
|
|
What is impetigo?
|
Superficial bacterial infection of skin caused by Staph aureus & less often by Strep
|
|
|
What are the 2 forms of impetigo?
|
Impetigo contagiosa
Impetigo bullosa |
|
|
What is furuncle/carbuncle?
|
Caused by Staph
Suppurative inflammation of skin & subcutaneous tissue |
|
|
What is staph scalded skin syndrome?
|
Toxin mediated exfoliative dermatitis that occurs most frequently in children w/ staph infection of nasopharynx or skin
|
|
|
How do tuberculoid leprosy & lepromatous leprosy differ along the immunopathologic spectrum?
|
Tuberculoid leprosy has maximum host response present
Lepromatous leprosy has minimal host response (anergic leprosy) |
|
|
What are clinical differences between tuberculoid leprosy and lepromatous leprosy?
|
Tuberculoid has scant, dry, scaly hypopigmented papules, plaques & neuronal involvement dominates so assoc. with anesthesia
Lepromatous leprosy has multiple symmetric macules, papules, and nodules w/ involvement of the face and nearby nerves |
|
|
How is leprosy transmitted?
|
Aerosols
|
|
|
What is Ramsay-Hunt syndrome?
|
Facial paralysis due to involvement of geniculate nucleus in VZV infections
|
|
|
What is a verruca?
|
Benign epidermal proliferations due to infection with varying strains of HPV, classification based largely on location and appearance
|
|
|
What are the different classifications of verruca?
|
Verruca vulgaris
Plantar warts Verruca plana |
|
|
What is molluscum contagiosum?
|
Common, self-limited viral infection caused by pox-virus causing lesions on skin & mucous membranes
Usually involving trunk & anogenital regions Spreads by direct contact |
|
|
What is superficial dermatophytosis?
|
Superficial infections involving keratinized tissues (cornified layer of epidermis, hair, nails)
Caused by 3 genera of imperfect fungi: Epidermophyton, Trichophyton, & Microsporum |
|
|
What are the different classifications of superficial dermatophytosis based on anatomic site?
|
Tinea capitis: scalp
Tinea barbae: beard area Tinea faciei: face Tinea corporis: trunk Tinea cruris: intertriginous areas Tinea pedis et manus: feet and hands Tinea unguium: nails |
|
|
What is tinea versicolor?
|
Type of superficial dermatophytosis caused by the yeast Malassezia furfur
Affects upper trunk with brownish discoloration that may become hypopigmented |
|
|
What is deep mycosis?
|
Can be primarily a cutaneous fungal infection or be part of a systemic infection such as those involving respiratory system or reticuloendothelial system (esp in immunocompromised)
|
|
|
What are the cutaneous & subcutaneous mycoses often caused by?
|
Saprophytic organisms including:
Sporotrichosis Chromoblastomycosis Histoplasmosis Coccidiomycosis Blastomycosis Cryptococcus |
|
|
What is leishmaniasis?
|
Chronic inflammatory disease of skin, mucous membrane, or viscera caused by intracellular protozoan parasites transmitted via sandfly bite
Endemic in Middle East, South Asia, Africa, & Latin America |
