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142 Cards in this Set

  • Front
  • Back
What are some functions of the skin?
protect internal environment from external world, tactile interaction, body temp regulation, antigen recognition, sexual attractiveness/apocrine secretions
What does the adnexa refer to?
hair, eccrine units and apocrine units that begin in the reticular dermis and extend outward and exit the epidermis
What is in the horny layer?
What is in the granular layer and what is its function?
keratinhylaine fibers that act as glue for keratin fibers
Where do the keratinocytes accumulate?
basal layer of the epidermis
What are some characteristics of the papillary dermis?
very fine fibers, superficial vascular plexus, expansile
What are Langerhans cells?
macrophages and Ag presenting cells in the skin
What are melanocytes?
make melansomes to be transferred to keratinocytes where dopa converts them to melanin
What is the purpose of melanin?
absorb UV radiation
What are 2 properties of squamous cells?
make keratin and contain intracellular bridges (desmosomes) which makes for a good barrier so no absorption takes place in those areas
What are some cells located in the stratum basale?
melanocytes and keratinocytes; keratin more present in apical region; also contains Merkel cells
What are the dermal papillae?
highly vascularized areas in the dermis
What are rete pegs?
protect against shear stress in the papillary dermis; thin out in older people and allow skin to be more easily moved
What are Meissner's corpuscles?
touch receptor in glaborous skin
What is the function of the reticular dermis?
serves as a cushion and stable platform for the epidermis and papillary dermis
What is subcutaneous tissue?
loose and dense connective tissue consisting of adipocytes and fibroconnective tissue, body temp regulator, fat storage
What layer of the skin is aging most evident?
subcutaneous layer
What is a pilosebasceous unit?
structure consisting of hair, hair follicle and sebaceous gland
Why are sebaceous glands important?
lubrication of hair shaft
What is a eccrine gland?
sweat gland located in mid to lower reticular dermis
Where are apocrine glands located?
deep dermis and at junction of reticular dermis and subcutaneous tissue
What are the primary skin lesions?
macule, patch, papule, nodule, plaque, wheal, vesicle, bulla and pustule
What is a macule?
flat area of coloring; freckle
What is a patch?
larger flat area of coloring
What is a papule?
solid, raised lesion
What is a nodule?
larger discrete, rounded, raised solid lesion
What is a plaque?
raised, flat-topped lesion >1 cm in diameter
What is a wheal?
transient edematous erythematous plaque; hives
What is a vesicle?
fluid-filled lesion with a clear top; HSV
What is a bulla?
larger fluid-filled lesion; blister
What is a pustule?
vesicle-like lesion filled with purulent exudate (pus)
What are the secondary lesions?
erosion, ulcer, fissure, scale, crust, lichenification, atrophy, verrucous
What is an erosion?
Partial or complete loss of epidermis; scratching
What is an ulcer?
loss of epidermis and part of dermis
What is a fissure?
thin, linear erosion; chapped lips
What is a scale?
hyperkeratosis; dry skin
What is crust?
dried serous and serosanguinous exudate; impetigo
What is lichenification?
accentuation skin markings with thickening of the skin caused by prolonged rubbing
What is atrophy?
decrease in the amount of epidermis, dermis or subcutaneous fat
What is verrucous?
wart like surface
What is Lentigo Senilis?
benign, discrete hyperpigmented macule occuring on chronically exposed skin in adults
What is the cause of Lentigo Senilis?
increased melanin pigment in keratinocytes; NO increase in the number of melanocytes
What does lentigo mean?
proliferation of melanocytes
What is the lay termn for Lentigo Senilis?
age spot or liver spot
What causes vitiligo?
1. pigmented skin sloughing off
2. depletion of melanocytes
What is melasma?
hypermelanosis caused by development of demarcated blotchy, brown macules over cheeks and forehead
Where do we see melasma?
pregnant women, women taking oral contraceptives and women in menopause
What is acathosis nigricans?
hyperpigmentation in flexural regions (axilla, groin)
What percent of acantosis nigricans is benign?
80%; mostly occuring in children; associated with obesity and endocrine abnormalities
What percent of acantosis nigricans is malignant?
20%; middle-aged and older people; associated with underlying adenocarcinoma
Where do tatoo particles lie?
What is nevocellular nevi?
benign neoplasm of melanocytes
What is a nevocellular nevus, junctional?
melanocytes that move into dermis in children; commonly called a mole
How is a compound nevus different than a junctional?
compound is more raised and dome shaped
What is an intradermal nevus?
end stage of the nevus where it is not actually growing anymore and there is no more proliferation at the junction
Are nevi associated with melanoma?
What nevus is associated with an increase risk for melanoma?
congential nevus
What is the definition of malignant melanoma?
neoplasm derived from cells capable of forming melanin
Where does malignant melanoma mainly occur?
adults, any part of the body
How does malignant melanoma originate?
de novo as isolated lesions
What is melanoma in situ?
melanoma that remains confined to the epidermis; noninvasive
Where is the most common site for melanoma in females?
Where is the most common site for melanoma in males?
Who is most at risk for malignant melanoma?
white males
How is a malignant melanoma characterized?
1. assymetrical
2. irregular, vague borders
3. variation in pigment hues
4. maculopapular "chaos"
What is the confirmatory test for malignant melanoma?
What are fibroepithelial polyps (FEP)
"skin tags" on neck and groin in older people, associated with areas of rubbing by clothing
What causes an epithelial inclustion cyst?
obstruction of hair follicle; filled with keratinous debris and extremely common around the face and upper trunk
What is benign fibrous histiocytoma?
soft tissue neoplasm seen in adults; tan-brown papule
Where does benign fibrous histiocytomas normally occur?
legs of women
What is seborrheic keratosis?
round, flat elevated papule that is a benign proliferation of keratinocytes
Where on the body is seborrheic keratosis found?
trunk, proximal extremeties, face and neck
Are adnexal tumors benign or malignant?
99% benign
How do benign adnexal tumors present?
symmetrical, small, superficial and vertical in orientation
What are the types of malignant adnexal tumors?
1. sebaceous carcinoma
2. eccrine carcinoma
3. apocrine carcinoma
What is actinic keratosis?
precancerous skin condition present on sun exposed surface of the skin
What places an individual at risk for actinic keratosis?
fair complexioned skin, old scars, organ transplant, albinism, certain genetic syndromes
What is solar elastosis and in what disease state is it seen?
degeneration of the dermal collagen; actinic keratosis
Who does actinic keratosis affect?
middle aged and elderly with increased sun exposure
Where does actinic keratosis affect?
face, neck and dorsum of hands
How does actinic keratosis present?
erythematous, reddish brown macule or minimally elevated papule
What is an eponym for squamous cell carcinoma in situ?
Bowen disease
What is squamous cell carcinoma?
malignant proliferation of epidermal keratinocytes which has the potential for metastasis
What are some causes of SCC?
HPV, arsenic, sunlight, organic hydrocarbons, genetic syndromes
What is the second most common cutaneous malignancy?
Where is a common area of SCC in situe?
below eyelid
How does SCC present?
elevated and central ulceration
What is a keratoacanthoma?
rapidly growing neoplasm on sun exposed areas (hand and face) in older people
What is the treatment for keratoacanthoma?
usually involute and clear sponataneously
What is basal cell carcinoma?
malignant skin neoplasm that seldom metastasizes but has the potential for local invasion and destruction
Where do most basal cell carcinomas appear?
85% head and neck, predilection for hair-bearing skin
What is the clinical appearance of nodular BCC?
dome shaped papule with telangiectasia; translucent border
What is the clinical appearance of sclerosing or morpheaform BCC?
yellowish-white, indurated plaque with poorly defined margins
Where does superficial BCC present?
occurs on non-sun exposed areas such as proximal limbs or trunk
How does superficial BCC present?
erythematous, scaly plaque with slightly elevated rolling edges
Where is the most common site for nodular BCC?
lower eyelid, medial canthus
What is another clinical term for sclerosing BCC?
rodent ulcer because it is difficult to excise
What is seen in Langerhans cell histiocytosis?
lesions that appear as papules or nodules; may be erythematous and scaling
Is langerhans cell histiocytosis malignant?
yes it can be
What is the clinical histiological structure of langerhans cell histiocytosis?
"tennis racket" shape of langerhans
What is mycosis fungoides?
cutaneous peripheral T cell lymphoma which specifically arises in the dermis of the skin
What are the malignant T cells called in the leukemic phase of mycosis fungoides?
sczary cells
What is Sczary syndrome?
diffuse erythema and scaling of the entire body surface; affect of myscosis fungoides
What are some clinical features of mycosis fungoides?
2x more common in males, lethal, affects trunk and extremities; nothing to do with sun exposure
What are the 3 phases of mycosis fungoides?
1. chronic dermatitis
2. patch stage
3. plaque stage
What is epidermaltrophism?
when lymphocytes inflitrate to the epidermis causing it to swell
What is a rare clonal neoplasm in skin?
What is urticaria pigmentosa?
localized cutaneous form of mastocytosis that affects children; multiple oval, red-brown scaling papules
Where does solitary mastocytoma occur?
S/S of mastocytosis
flushing reaction, pruritis, nosebleeds
What is a histological structure seen in mastocytosis?
metachromatic granules within the cytoplasm
What is ichthyosis?
hyperkeratosis giving a fish scale appearance
What is the AD form of ichthyosis?
ichthyosis vulgaris; most common
What is the AR form of ichthyosis?
lamellar ichthyosis
What is urticaria?
hives; caused by an acute allergic reaction
Onset of urticaria?
20-40 yrs
Common location of urticaria?
trunk and extremities
What is the clinical presentation of urticariia?
erythematous, edematous and circular plaques; wheals
What is acute eczematous dermatitis?
acute onset of red, papulovesicular lesions that may ooze or crust
Where is eczema found?
How is eczema treated?
topical corticosteroids
What is the end stage of eczema?
edema, hyperkeratosis, dilated vessels, lymphocytes in the papillary dermis
What is erythema mulitforme?
hypersensitivity reaction to drugs, infections, malignancy and collagen vascular diseases
What is the severe, systemic febrile form of erythema mulitforme?
Stevens-Johnson syndrome
What is histological characteristic of erythema multiforme?
macular erythema that looks target-like; also has an expanded papillary dermis
What are the chronic inflammatory dermatoses?
lichen planus
discoid lupus erythematosus
What does the lesion in psoriasis look like?
well-demarcated, pink plaque
What are of the body does psoriasis affect?
elbows, knees, scalp, lumbosacral area, intergluteal cleft and glans penis
What are the acute lesions of psoraisis?
eruptive lesions dominated by signs of inflammation and erythema
What do chronic lesions in psoriasis look like?
erythema surmounted by silver-white scale
What is another term for epidermal hyperplasia?
psoriasiform hyperplasia
What is a lichen planus?
self limiting chronic condition of skin and mucous membranes
Where are lichen planus plaques distributed?
extremities, glans penis and oral cavitity
How is discoid lupus erythematosus different than SLE?
SLE is systemic while discoid only affects the skin
What are the 3 blistering diseases?
bullous pemphigoid
dermatitis herpetiformis
Where would you see a subcorneal blister?
impetigo or pemphigus foliaceus
What is a subcorneal blister?
just the stratum corneum forms the roof of the bulla
What is a suprabasal blister and in what disease would it be found?
portion of the epidermis forms the roof and it is above the basal layer; pemphigus vulgaris
What is a subepidermal blister and in what diseases?
epidermis seperates from dermis; bullous pemphigoid and dermatitits herpetiformis
What is the most common type of blister formation?
What is pemphigus?
autoimmune disease with Ab directed against the desmosomes of the squamous epithelial cells
What does pemphigus vulgaris involve?
mucosa and scalp, face, axilla and groin; pressure points