Skin Pathology

Front 1

Which intraepidermal cells take up and process antigens presenting them to immunocompetent T-cells?

Back 1

Langerhans Cells

Front 2

Which dermal cell is associated with the assembly of macromolecular complexes involved in early stages of healing in deep wounds?

Back 2

Dermal dendrocyte

Front 3

Which epithelial structures harbor epithelial stem cells capable of regenerating superficial epithelial skin structures?

Back 3

Hair follicles (manufacture hair shafts)

Front 4

Which integumentary glands are responsible for thermoregulation?

Back 4

Eccrine glands

Front 5

What type of modified glands comprise the breast?

Back 5

Apocrine

Front 6

What histological finding will be observed in the lumen of an apocrine gland?

Back 6

Cytoplasmic blebbing

Front 7

What slow adapting mechanoreceptors located in the papillary dermis, are associated with pain, itch, and detecting temperature?

Back 7

Free-Nerve endings

Front 8

What rapidly adapting mechanoreceptor for touch is prominent in the papillary dermis of hands and feet?

Back 8

Meissner's corpuscles

Front 9

What integumentary structure detects deep pressure and vibration?

Back 9

Pacinian corpuscle (onion skinning appearance histologically)

Front 10

What term describes a small flat primary lesion of the skin?

Back 10

Macule (<.5cm)

Front 11

What term describes a large flat primary lesion of the skin?

Back 11

Patch (>.5cm)

Front 12

What term describes a small, elevated solid primary skin lesion?

Back 12

Papule (<.5cm)

Front 13

What term describes a large, solid, well-circumscribed primary skin lesion?

Back 13

Plaque (>.5cm) - Psoriasis

Front 14

What term describes a palpable solid lesion found in the dermis or subcutaneous tissue?

Back 14

Nodule (>.5cm but < 2cm) - Dermatofibroma

Front 15

What term describes a solid, firm lesion typically > 2 cm?

Back 15

Tumor

Front 16

What term describes a small, superficial circumscribed elevation that contains serous fluid?

Back 16

Vesicle - Herpes Zoster

Front 17

What term describes a large raised circumscribed lesion that contains serous fluid?

Back 17

Bulla (blister) - Bullous pemphigoid

Front 18

What term describes an itchy, transient, circumscribed, elevated papule or plaque that is the result of dermal edema?

Back 18

Wheel - Urticaria

Front 19

What term describes a small circumscribed superficial elevation of the skin that contains purulent material?

Back 19

Pustule (<1cm)

Front 20

What term describes a secondary skin lesion with visible fragments of the stratum corneum as it is shed from the skin?

Back 20

Scale

Front 21

What term describes varying colors liquid debris that dried on the surface of the skin?

Back 21

Crust (Impetigo)

Front 22

What term describes the loss of superficial layer of upper epidermis by wearing away as from friction or pressure?

Back 22

Erosion (Pemphigus vulgaris)

Front 23

What term describes a sharply-defined, linear or wedge-shaped tears in the epidermis with abrupt wall?

Back 23

Fissure

Front 24

What term describes a secondary skin lesion with loss of epidermis and dermis?

Back 24

Ulceration (Stasis ulcer or pyoderma gangrenosum)

Front 25

What term describes superficial skin abrasions, that are usually due to scratching of the skin?

Back 25

Excoriation

Front 26

What term describes diffuse thickening of the epidermis as a result of chronic rubbing (Hint: Looks like it grows on a tree)?

Back 26

Lichenification (Lichen simplex chronicus)

Front 27

What microscopic finding is the result of autoimmune loss of intercellular cohesion between keratinocytes?

Back 27

Acantholysis

Front 28

What microscopic term refers to diffuse epidermal hyperplasia which is often due to chronic irritation?

Back 28

Acanthosis

Front 29

What microscopic term refers to abnormal, premature keratinization below the stratum granulosum?

Back 29

Dyskeratosis

Front 30

What microscopic term refers to the infiltration of the epidermis with inflammatory cells?

Back 30

Exocytosis

Front 31

What microscopic term refers to intracellular edema of keratinocytes, which is often seen in viral infections?

Back 31

Hydropic swelling (ballooning) - seen in HSV infections

Front 32

What microscopic term refers to thickening of the stratum granulosum which is often due to intense rubbing?

Back 32

Hypergranulosis (Lichen Simplex Chronicus)

Front 33

What microscopic term refers to thickening of stratum corneum?

Back 33

Hyperkeratosis (Ichthyosis)

Front 34

What microscopic term refers to linear pattern of melanocyte proliferation within the epidermal basal cell layer?

Back 34

Lentiginous

Front 35

What microscopic term refer to surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae?

Back 35

Papillomatosis

Front 36

Where is parakeratosis normal?

Back 36

Mucous membranes

Front 37

What microscopic term refers to keratinization with retained nuclei in the stratum corneum?

Back 37

Parakeratosis (Actinic Keratosis)

Front 38

Which microscopic term refers to intercellular edema of the epidermis?

Back 38

Spongiosis

Front 39

What microscopic term refers to discontinuity of the skin showing complete loss of the epidermis?

Back 39

Erosion

Front 40

What microscopic term refers to discontinuity of the skin showing complete loss of the epidermis revealing dermis or subcutis?

Back 40

Ulceration

Front 41

What autoimmune disease is associated with basal vacuolization?

Back 41

GVHD

Front 42

What disease is characterized by autoimmune depigmentation; with partial or complete loss of pigment?

Back 42

Vitiligo (autoimmune destruction of melanocytes)

Front 43

What disease is characterized by melanocytes that do not produce melanin due to a lack or defect in tyrosinase?

Back 43

Albinism

Front 44

What skin lesion associated with NF is histologically indistinguishable from freckles?

Back 44

Cafe-au-lait spots

Front 45

What pigmented lesions common in childhood are due to increased pigmentation not an increase number of melanocytes?

Back 45

Freckles

Front 46

What causes the permanent growth arrest that is observed in normal nevi?

Back 46

Accumulation of p16/INK4a (inhibitor of cyclin-dependent kinases)

Front 47

What mutations are associated with normal nevi (which are neoplasms)?

Back 47

Mutations in BRAF or NRAS (RAS/BRAF)

Front 48

What type of nevus is very large and associated with an increased risk of developing melanoma?

Back 48

Congenital nevus

Front 49

What type of nevus is often clinically confused with melanoma?

Back 49

Blue nevus

Front 50

What type of nevus is often clinically confused with hemangioma but histologically confused with melanoma?

Back 50

Spitz nevus (spindle and epitheliod cell nevus)

Front 51

What type of nevus is clinically and histologically confused with melanoma due to its characteristic halo?

Back 51

Halo nevus

Front 52

What type of nevus is considered to be a precursor to melanoma?

Back 52

Dysplastic nevus

Front 53

What type of nevus is characterized by minimal pagetoid spread, lentiginous hyperplasia, sideway nesting and briding, and fibrosis

Back 53

Dysplastic/Atypical nevus

Front 54

What are the most important autosomal dominant mutations associated with dysplastic nevus syndrome?

Back 54

CDNK2A and CDK4 mutations

Front 55

What are the ABCDEs associated with melanoma?

Back 55

- Asymmetry
- Border (Irregularity)
- Color (Regression)
- Diameter (>6 cm)
- Elevation

Front 56

Which phase of malignant melanoma is usually without metastasis?

Back 56

Radial Growth Phase ONLY (Lentigo maligna, superficial spreading melanoma)

Front 57

Which phase of malignant melanoma is metastasis most likely?

Back 57

Vertical Growth Phase ONLY (Nodular melanoma)

Front 58

The risk of metastasis depends on Breslow and Clark's level in which phases of malignant melanoma?

Back 58

Radial + Vertical Growth Phase

Front 59

What prognostic factors are associated with a favorable outcome?

Back 59

- Ulceration absent
- Depth <1.7mm
- Mitosis absent or low
- Regression absent
- TIL brisk
- Female
- Extremity

Front 60

What prognostic factors are associated with poor outcome?

Back 60

- Ulceration present
- Depth > 1.7mm
- High number of mitoses
- Regression present
- TIL non-brisk
- Male
- Head

Front 61

What are the most important predisposing factors for malignant melanoma?

Back 61

- Inherited genes
- Sun exposure (severe sunburns early in life)

Front 62

What should you consider if you patient begins acquiring lots of seborrheic keratoses?

Back 62

GI tract malignancy (Paraneoplastic syndrome, Leser-Trelat sing)

Front 63

What histological finding is associated with a seborrheic keratosis?

Back 63

Horn cysts (Keratin horn cysts)

Front 64

What skin conditions presents as thickend, hyperpigmented skin with a "velvet-like texture?"

Back 64

Acanthosis nigricans (typically found in flexural areas, axillae, & skin folds)

Front 65

What skin lesion is a well-circumscribed, firm and movable and is filled with keratin and lipid- containing debris?

Back 65

Epithelial cyst

Front 66

What type of cysts are commonly found around the eye?

Back 66

Dermoid cyst

Front 67

What adnexal tumor present on the forehead and scalp sometimes being referred to as Turban tumor (coalescence of nodules)?

Back 67

Cylindroma (associated with AD mutations in CYLD)

Front 68

Multiple trichilemmomas are asociated with?

Back 68

- Cowden syndrome (PTEN mutations)
- Breast carcinomas

Front 69

What tumor is associated with internal malignancy (Muir-Torre syndrome)?

Back 69

Sebaceous adenomas

Front 70

What is the most common site of sebaceous carcinoma?

Back 70

Meibomian glands of the eyelid (must differentiate from BCC)

Front 71

What hyperkeratotic and parakeratotic skin lesion is considered to be a precursor lesion?

Back 71

Actinic keratosis (sun-damaged skin on the face, arms, dorsum of hands)

Front 72

What type of skin cancer present as a sharply defined lesion with red, scaling plaques?

Back 72

Squamous cell carcinoma (2nd most common tumor arising on sun-exposed skin)

Front 73

What is the most common mutation associated with squamous cell carcinoma?

Back 73

p53 mutations

Front 74

What skin cancer rarely metastasizes but is associated with extensive local invasion?

Back 74

Basal cell carcinoma

Front 75

What type of skin cancer presents as pearly papules with telangiectasias grossly and with basaloid cells and peripheral pallisading histologically?

Back 75

Basal cell carcinoma

Front 76

What autosomal dominant mutation is associated with nevoid basal cell carcinoma syndrome (Gorlin syndrome)?

Back 76

Mutations of PTCH gene (aka "PATCH" gene)

Front 77

What syndrome presents with multiple basal cell carcinomas and jaw cysts?

Back 77

Nevoid basal cell carcinoma (AD PTCH mutation)

Front 78

What syndrome presents with trichilemmomas and breast carcinomas?

Back 78

Cowden syndrome (AD mutation in PTEN)

Front 79

What autosomal recessive disease is the results of deficient nucelotide excision repair?

Back 79

Xeroderma pigmentosum (prevents repair of thymidine dimers)

Front 80

What tumor contains neurosecretory granules positive for chromogranin and synaptophysisn?

Back 80

Merkel Cell carcinoma (small round blue cell tumor like neuroblastoma and pheochromocytoma)

Front 81

What is the result of a defect in the PTCH gene?

Back 81

Uninhibited activation of SMO leading to Basal Cell Carcinoma associated with Gorlin syndrome.