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27 Cards in this Set

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29 yo male, waxing and waning of skin lesions over past decade, with scalp, lubosacral, and glans of penis regions affected. chronci arthritis of hip and knees...expected physical finding
Damage to nails...he has psoriasis..marked epithelial hyperplasia and parakeratotic scaling. nail changes seen in 1/3 of pts.
part of the world with most increase of maligant melanoma of skin in past 25 yrs..
Brisbane, Australia...light skinned population
64 yo male, devlpmt thickened, darkly pigmented skin in axilae and flexural areas of neck and groin in past 3 months. no pain or puritic. punch biopsy of axillary skin = undulated epidermal acanthosis with hyperkeratosis and basal layer hyperpigmentation...what is underlying dz
Colonic adenocarcinoma...presentation is typical of acanthosis nigricns, a cutaneous marker for benign and malignant neoplasms
51 yo male, skin lesion on upper, outer arm, recently increased in size what is his occupation
lifeguard..malignant melanoma with irregular borders and variablity of pigmentation...any change in pitmented lesion suggests the possiblity of melanoma
35 yo man, out break of pruritic, 0.4-0.7cm vesicles over extensor surfaces of elbows and knees. hx of malabsorption with celiac dz but been before. punch biopsy of elbow lesion = neutrophils at tips of dermal papillae and formation of small blisters b/c of separation oat dermoepidermal jxn. immunofluorescence = granualr deposits of IgA localized to tip of dermal papillae...condition
Dermatitis herpetiformis...
6 yo boy, devlps 1-2cm erythmatous macules and 0.5-1.0cm pustules on face over 1 wk ime. next 2 days m= pustule break, shallow erosions covered by a honey-colored crust and new lesions form around the curst...uncle recieves same lesions after visit...condition
Impetigo..superficial infection of skin tht produces shallow erosions.
biopsy of 0.8cm red rough-surfaced lesion on forhead of 50yo fml = actinic keratosis. what advice would u give..
Where hat outdoors...AK is premalignant lesion related to sun exposure
10yo child, mutple exoriations of skin of hands. itchy. PE = 0.2 - 0.6cm linear streaks in interditital regions tx with lindane lotion resloves condtion...what organism is is cause
sarcoptes scabiei
solitary 0.4cm flshe-colored nodule been presetn on trunk of 35yo male for past 6 wks, dome shaped lesion is umblicated, and curdlike mterial expressed. material on giemsa stain = pink homogeneous cytoplasmic inclusions...what is the infxous agent...
Histoplasma contgiosum
Subepidermal bulla. Bullus pimphigoid results in antibody-mediated damage to the basal cell bm attachement plaques.
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2.1cm pigmented lesion is excised form the bck of a 39yo female, which had become noduler in past 2 months, micro exam = epitheloid cells extending 2 mm down the reticular dermis...appropriate statement for pt
Prognosis is poor..extension into the reticular dermis is indication of bertical/nodular growth...aka aggressive
oral exam = scattered white, 0.2 to 1.5 cm reticulaed areas of on buccal mucosa. lesion yr old. some 0.3cm pruritic, purple papules on elbows. bipopsy of skkin lesions =bandlike inflitate of lymphcytes at dermal-epidermal jxn and basal keratinocytes...advice
These lesions will resolve over time...he's got pruritc, purple polygonal papules or lichen planus, w/ distinctive bandlike infiltrate of lympocytes at dermal-epidermal jxn.
"atheletic foot", diffuse, erythmatous, scaling skin lesions b/w the toes, has afflicted a 22 yo male..agent
Dermatophytic fungus...common and cuaseb y a variety of fungal speices, incuding trichophyton, epidermophyton, and microsporum
variable sized 0.2-1.2cm macules in upper trunk of 32yo female. malcules are lighter than sourrounding skin fin peripheral scales
Malassezia furfur, tinea versicolor is common caused by M. furfur
30 yo male, large appetite. cant eat nuts b/d develp blotchy erythmatous, slightly edematous plaques on the skin that are pruritic; will fade in couple of hrs...which is snesitized cells mediate response
Mast cells..he's got hivss or urticaria, from tan allergy to an antigen in nuts...type 1 hypersensitivity rxn
macular slightly raised, plague-like, 0.4-1.7cm dark brown pitmnted lesion on sun exposed and non sun epxposed areas of skin of a 17yo female. irregular contours, variability in pigmentation. has 100's of lesions on body. brother has similar...significance of lesions
suggests dysplastic nevus syndrome..inherited lesions that have a high risk of develping melanoma
flesh-colored, dome shaped, 1.2cm nodule appeared on right ear lob of 60yo man in past mo. central keratin-filled crater surrouned by proliferating squamous epithelium. regresses over next mo and then disappears. diagnosis...
Keratoacanthoma..self limtid lesions that offten regress on theri own, if not, suspect squamous cell carcinomas.
pearly,0.3-cm nodule on upper eyelid, nuclear lateral limbus of fith eye of 68yo male. forzen sections to minimize etent of lesion resection. diagnosis...
Basal cell carcinoma..arise as pearly papules on the sun exposed parts of the skin ie face, slowly inflitrate surrounding tissues, gradully enlarging, doesnt normally metastesized but can cause serious complicatins in region of eye.
5yo girl scattered, 1-3cm light brown macules on face, trunk, and extremties. numerous in summer months, each macule is described best as...
Freckles..
19yo male has facial elsions, 0.2-0.9cm comedones, erythmatous papules, nodules, and pustules. waxed and waned for several years. family member expressed simalr at same age. lesions become worse on caribbean cruises. caussitive organism...
Prprionibacterium acnes..causes vulgaris seen often in teens and young adults and males more
5yrs after orthtopic heart t-plant, 53yo male, multpile skin lesions, some larger lesionsa re ulcerated. biopsy of lesion most like shows..
Squamous cell carcinoma...risked by UV light, scarring form burning injury, irradiation, and immunosupression..this pt ws immuno supressed by graft rejection.
39 yo female dvld 0.2 to 1cm vesicles and bullae on her skin ovr past wk. located on scalp, axillae, groin, and knees. ruptured lesions left shallow erosioin with dried rust of serum. epidermal acantholyis, with formation of an intraepidermal blister seen in biopsy. basal cell layer intact. wat additional test good for pathogensis expalnation
Immunofluorescent staining of skin with anti-IgG...lesions are probably pemphigus vulgaris (type II hypersenstivity rxn)
25 yo male, acute resp failure, bronchoalveolar lavage that yields pneumocystits carinii. devlops target lesions after intitiation of therapy, of red macules with aple, vesiclar center. 2-5cm in diatmeer, symmetrically over upper arms and chest. drug implicated in lesions...
Trimethoprim-sulfamethoxazole...erythema multiforme, hypersensitivty resonse to certain infections and drugs, ie sulfonamides and pcns. also hsv, mycoplasmal and fungal infxns.
lesion on hand of 28yold male slowly enlarging for past 3 yrs, no change in color and no pain suggest...
Verruca vulgaris, a papilloma virus...he's got "warts"
biopos of skin lesion on trunk of 75yo male shows sheets of slightly pigmented basaloid celsl that surround keratin filled cysts. sharply demarcated from the surrounding epidermis suggests...
Seborrheic Keratosis...benign tumors called that are flat, round, pigmented, and sharply demarctated. common in elderly
after week in hosptial for URI by pneumonia, 43you female, dvlps skin lesion that are 2-4 mm in diameter. red, papulovesicular, oozing, and crusted and are located on her trunk and extremeties. begin to disappear after discharge week later..pathogenissis..
Drug rxn...producing an acute erythmatous dermatitis.
enalarging conical "cutaneous horn" that has been presented for more than year 0.5cm from 0.7cm base on the left lateral cheek of face of 58yo farmer. excised and microscopic examination shows basal cell hyperplasia. som show nuclear stypicalities associtd with marked hyperkertosis and parakeratosis. lesion...
Actinic Keratosis..on sun exposed areas and considered precursor of squamous cell carcinoma when the atypical basal cells occupy the entire thickness of the epidermis.