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265 Cards in this Set
- Front
- Back
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Stratum Basale |
Flat cells |
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Stratum Spinosum |
Elongated cells |
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Stratum Granulosum |
Flat nuclei |
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Stratum Corneum |
No nuclei |
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Macule |
Flat, <5mm, different color |
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Patch |
Flat, >5mm, different color |
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Papule |
Elevated dome or flat <5mm |
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Nodule |
Elevated, spherical contour, >5mm |
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Vesicle |
Fluid filled, <5mm |
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Bulla |
Fluid filled, >5mm |
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Pustule |
Pus filled |
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Scale |
Dry, horny, platelike |
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Wheal |
Itchy, transient, elevated due to dermal edema |
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Excoriation |
Traumatic linear break on epidermis |
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Lichenification |
Thickened rough skin |
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Hyperkeratosis |
Thickening of stratum corneum |
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Dyskeratosis |
Abnormal, premature keratinocytes |
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Erosion |
Incomplete loss of epidermis |
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Exocytosis |
Infiltration of inflammatory cells |
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Hydropic Swelling |
Intracellular edema of keratinocytes |
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Parakeratosis |
Retention of nuclei in stratum corneum |
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Hypergranulosis |
Hyperplasia of stratum granulosum |
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Acanthosis |
Diffuse epidermal hyperplasia |
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Papillomatosis |
Surface elevation due to hyperplasia and enlargement of contiguous dermal papillae |
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Acantholysis |
Loss of intracellular connection |
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Spongiosis |
Intercellular edema of epidermis |
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Lentiginous |
Linear pattern of melanocyte proliferation in basal layer |
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Vitiligo |
Partial or complete loss of pigment producing melanocytes |
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Vitiligo |
Macules devoid of pigmentation |
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Vitiligo |
Frequent in darkly pigmented individual |
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Vitiligo |
Often hands, wrists, axillae, perioral, periorbital, and anogenital skin |
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Koebnerization |
Lesions developed in site of repeated trauma |
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Freckles |
Most common pigmented lesion of childhood |
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Freckles |
Lightly pigmented individuals |
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Freckles |
Small, tan red to brown macules occuring after sun exposure, fading and recurring |
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Freckles |
Normal melanocyte number but increased amount of melanin within basal keratinocytes |
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Freckles |
Disappears when there is no sun exposure |
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Melasma |
Mask-like facial hyperpigmentation in hyperestrogenic states |
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Melasma |
Mask of pregnancy |
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Melasma |
Blotchy, tan brown, irregular, ill defined macules and patches |
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Melasma |
Accentuated by sunlight |
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Melasma |
Caused by functional alterations in melanocytes causing enhanced melanin transfer from melanocytes or dermal macrophages |
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Epidermal Melasma |
Increased melanin deposition in basal layer |
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Dermal Melasma |
Macrophage in dermis phagocytized melanin from the epidermis |
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Wood's Lamp (Black Light) |
Can distinguish between the different types of Melasma |
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Lentigo |
Benign, localized linear, non-nested hyperplasia of melanocytes occuring at all ages |
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Lentigo |
Hyperpigmented, oval tan brown macules or patches in skin qnd mucuous membranes |
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Lentigo |
Occurs in infancy and childhood and do not darken with sun exposure |
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Lentigo |
Linear basal hyperpigmentation resulting from melanocytes hyperplasia with elongation and thinning of rete ridges |
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Melanocyte Nevus |
Congenital or acquired neoplasm of melanocytes |
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Melanocytes Nevus |
Small, tan to brown, uniformly pigmented, solid relatively flat to elevated, well defined borders |
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Melanocyte Nevus |
Acquired mutations that leads to activation of NRAS or BRAF |
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Congenital Nevus |
Deep dermal and SQ around adnexa, neovascular bodies and blood vessel walls |
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Congenital Nevus |
Identical to ordinary acquired nevi |
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Congenital Nevus |
Presrnt at birth, large variants have incresed melanoma risk |
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Blue Nevus |
Non-nested dermal infiltration often associated with fibrosis |
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Blue Nevus |
Highly dendritic heavily pigmented nevus cells |
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Blue Nevus |
Black-blue nodule often confused with melanoma clinically |
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Spitz Nevus |
Fascicular growth |
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Spitz Nevus |
Large, plump cells with pink-blue cytoplasm, fusiform cells |
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Spitz Nevus |
Common in children, red pink nodule often confused with Hemangioma |
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Halo Nevus |
Lymphocytic infiltration surrounding nevus cells |
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Halo Nevus |
Identical to ordinary acquired nevi |
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Halo Nevus |
Host immune response against nevus cells and surrounding normal melanocytes |
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Dysplastic Nevus |
Coalescent intraepidermal nests |
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Dysplastic Nevus |
Cytologic atypia |
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Dysplastic Nevus |
Potential marker or precursor of melanoma |
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Dysplastic Melanoma |
Indicator or marker of increased melanoma risk |
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Dysplastic Melanoma |
Occurs in both sun-exposed and protected body surfaces |
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Dysplastic Melanoma |
Flat macules, slightly raised plaques, with plebby surface or target-like lesions with raised center |
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Dysplastic Melanoma |
Irregular borders, variegated color/pigmentation, >5mm |
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Dysplastic Melanoma |
Cytologic atypia, enlarged nuclei, irregular nuclear contour and hyperchromasia |
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Malignant Melanoma |
No order of maturation |
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Malignant Melanoma |
Sun exposure and hereditary factors are very important |
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Malignant Melanoma |
Pruritic, variegated, irregular maculopapular lesions |
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Malignant Melanoma |
Men: Back; Women: Back and legs |
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Malignant Melanoma |
Enlargement of pre-existing mole |
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Malignant Melanoma |
Itching or pain in pre existing mole |
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Malignant Melanoma |
Development of new pigmented lesion in adult |
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Malignant Melanoma |
Irregular, notched borders with variegation in color |
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Lentigo maligna |
Indolent lesion in face of older men and remain such for decades |
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Radial Growth Pattern |
Initial, extends horizontally within the epidermis and superficial dermis, does not metastasize |
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Vertical Growth Pattern |
With extension to the deep dermis, can metastasize |
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Breslow Thickness |
Measured from the superficial granular layer to the deepest intradermal tumor cells |
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Breslow Thickness |
Assesses the skin involvement in melanoma |
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Clark's Level |
Not an absolute measurement, description of the involved structure (epidermis, dermis) |
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Clark's Level I |
Confined to the epidermis, called in situ melanoma, 100% cure rate |
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Clark's Level II |
Invasion of papillary dermis |
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Clark's Level III |
Filling of the papillary dermis, but no extension in to thr reticular |
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Clark's Level IV |
Invasion of the reticular dermis |
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Clark's Level V |
Invasion of the deep, subcutaneous tissue |
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Seborrheic Keratosis |
Spontaneous lesions in the middle-aged and older individuals |
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Seborrheic Keratosis |
Most numerous on the trunks aka Senile Keratosis |
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Seborrheic Keratosis |
Uniform, tan brown, velvety or granular round plaques, keratin-filled plugs may be evident |
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Seborrheic Keratosis |
Hyperkeratosis with horn cysts |
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Seborrheic Keratosis |
Lesser Trelat Sign |
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Seborrheic Keratosis |
Round, flat, coin-like, waxy plaques |
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Seborrheic Keratosis |
Tan to dark brown, velvety to granular, "Stuck On" |
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Acanthosis Nigricans |
"Peaks and Valleys" |
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Acanthosis Nigricans |
Thickened hyperpigmented zones in Flexural areas with velvet-like texture |
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Acanthosis Nigricans |
Associated with benign and malignant conditions elsewhere in the body |
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Acanthosis Nigricans |
Hyperkeratosis with prominent rete ridges and basal hyperpigmentation without melanocyte hyperplasia |
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Fibroepithelial Polyp |
Achrocordon, squamous papilloma, skin tag |
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Fibroepithelial Polyp |
Neck, trunk, face and intriginous areas |
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Fibroepithelial Polyp |
Soft, flesh-coloured, bag-like tumor attached by a slender stalk with fibrovascular core covered by a benign epidermis |
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Fibroepithelial Polyp |
(+) Fibrovascular core covered by benign squamous epithelium |
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Fibroepithelial Polyp |
Associated with diabetes, obesity, and intestinal polyposis |
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Epithelial Cysts (Wen) |
Invagination and cystic expansion of the epidermis |
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Epithelial Cysts (Wen) |
Well-circumscribed, firm, SQ nodules formed by downgrowth and cystic expansion of epithelial or follicular epithelium |
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Epithelial Cysts (Wen) |
Classified on the basis of the cyst wall characteristics |
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Epithelial Cysts (Wen) |
All are filled with keratin and variable amounts of lipid and debris from sebaceous secretions |
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Keratoacanthoma |
Self limited, spontaneously resolving, rapidly growing lesion, typically in sun-exposed areas |
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Keratoacanthoma |
Flesh-colored, dome-shaped nodules, central keratin- filled craters |
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Keratoacanthoma |
Cup-shaped epithelial proliferations enclosing a central keratin- filled plug |
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Eccrine poroma |
Occurs predominantly on palms and soles |
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Cylindroma |
With ductal differentiation, occurs in head and scalp, coalescent of nodules may produce |
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Cylindroma |
Hat-like growth (Turban tumor) |
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Cylindroma |
Islands of cells resembling epidermal or adnexal basal cell appearing like Jigsaw puzzle |
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Syringomas |
Eccrine differentiation, small, tan papules in eyelids |
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Sebaceous Adenoma |
Associated with Muir-Torre syndrome |
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Sebaceous Adenoma |
Lobular proliferation of sebocytes appearing with frothy or bubbly cytoplasm |
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Pilomatricomas |
Follicular difderentiation, trichilemmal or hairlike differentiation |
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Trichoepithelioma |
Proliferation of basaloid cells forming primitive structure appearing as hair follicles |
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Apocrine CA |
Ductal differentiation, infiltrative growth pattern |
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Actinic Keratosis |
Premalignant dysplastic lesion associated with chronic sun exposure especially in light-skinned individuals |
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Actinic Keratosis |
Usually <1cm, tan brown, red, or flesh-colored with rough Sandpaper consitency |
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Actinic Keratosis |
May have cutaneous horns due to hyperkeratosis |
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Actinic Keratosis |
Cytologic atypia ij the lower epidermis with basal cell hyperplasia and dyskeratosis |
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Actinic Keratosis |
Intercellular bridges are present and no acantholysis |
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Actinic Keratosis |
There us elastosis, thickened, blue-gray elastic fibers |
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Actinic Keratosis |
Treated with gentle curettage, freezing, or topical chemotherapeutic agent |
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Squamous Cell Carcinoma |
Second most common tumor of sun-exposed skin of older individuals |
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Squamous Cell Carcinoma |
Well-demarcated, red, scaling, plaques, invasive lesions, ulcerated nodules, leukoplakia may be present |
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Squamous Cell Carcinoma |
Well-differentiated to poorly dofferentiated, polygonal, large zones of keratinization arranged in orderly lobules |
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Squamous Cell Carcinoma |
Large zones of keratinization, rounded cells with dyskeratosis, no intercellular bridges and loss of maturation |
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Basal Cell Carcinoma |
Most common tumor in sun-exposed skin |
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Basal Cell Carcinoma |
Immunosuppressed and inherited defects in DNA repair |
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Basal Cell Tumor |
Slow-growing tumors in sun-exposed skin, rarely metastasize |
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Basal Cell Carcinoma |
Activating mutation of Hedgehog pathway |
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Basal Cell Carcinoma |
Pearly papules or expanding plaques with prominent dilated subepidermal blood vessels |
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Basal Cell Carcinoma |
Rodent Ulcer |
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Basal Cell Carcinoma |
Uniform, monotonous basal cell proliferation extending deeply into the dermis |
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Basal Cell Carcinoma |
Cords and islands of basophilic cells with peripheral palisading and surrounded by thin clefts |
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Basal Cell Carcinoma |
Mucinous matrix, lymphocytes and fibroblasts |
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Basal Cell Carcinoma |
Retraction artifact |
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Benign Fibrous Histiocytomas |
Usually in adults, on the legs of young to mid-aged woman |
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Benign Fibrous Histiocytomas |
Cholesterol-laden macrophages that forms a mass |
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Benign Fibrous Histiocytomas |
Indolent course, firm, tan to brown papules |
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Benign Fibrous Histiocytomas |
Dimple inward on lateral compression, no borders |
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Benign Fibrous Histiocytomas |
Benign, spindle-shaped fibroblasts, unencapsulated |
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Benign Fibrous Histiocytomas |
Dirty Fingers epidermis |
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Benign Fibrous Histiocytomas |
Pseudoepitheliomatous hyperplasia of the overlying skin |
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Dermatofibrosarcoma Protuberans |
Primary fibrosarcoma of skin |
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Dermatofibrosarcoma Protuberans |
Well-differentiated, slow growing, locally invasive, rarely metastasize, fibroblast arranged radially |
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Dermatofibrosarcoma Protuberans |
Compact fibroblasts arranged radially reminiscent of blades of pinwheel |
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Dermatofibrosarcoma Protuberans |
In the SQ fat, may appear as "Swiss cheese" or "Honeycomb" pattern |
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Xanthomas |
Tumor-like collections of Foamy Histiocytes within the dermis |
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Xanthomas |
Associated with familial or acquired causes of hyperlipidemia |
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Mycosis Fungoides |
Cutaneous T-cell lymphoma in the skin |
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Mycosis Fungoides |
Commonly affects >40 y/o, but may occur at any age, usually involves the trunk |
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Mycosis Fungoides |
T-cell lymphoproliferative disorder primarily in the skin (generalized lymphoma) |
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Mycosis Fungoides |
Scaly, red, brown patches, raised, scaling plaques |
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Mycosis Fungoides |
Sezary Syndrome |
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Mycosis Fungoides |
May be confused with psoriasis and fungating nodules |
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Sezary Syndrome |
Blood seeding with diffuse erythema and scaling of entire body surface |
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Mycosis Fungoides |
Markedly infolded nuclear membranes |
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Mycosis Fungoides |
hyperconvoluted or ceribriform contour |
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Mycosis Fungoides |
Sezary-Lutzner cells |
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Mycosis Fungoides |
Bandlike aggregates in upper dermis |
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Mycosis Fungoides |
Pautier microabscesses |
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Mastocytosis |
Characterized by increased number of mast cells in the skin and other organs |
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Mastocytosis |
Associated with allergies |
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Mastocytosis |
Symptoms are due to effects of histamine and heparin |
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Mastocytosis |
Darier Sign |
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Darier Sign |
Localized are of dermal edema and erythema when skin is rubbed |
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Mastocytosis |
Dermatographism |
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Dermatographism |
Dermal edema due to localized stroking with pointed instrument |
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Mastocytosis |
Pruritus and flushing, watery nasal discharge, GIT or nasal bleeding, bone pain |
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Mastocytosis |
Clonal proliferation of mast cells containing point mutation of c-KIT protooncogene |
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Mastocytosis |
Spindle-shaped, stellate mast cells, mastocytoma, metachromatic staining |
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Ichthyosis |
Group of inherited diseases associated defective desquamation resulting to chronic, excessive keratin build up |
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Ichthyosis |
Fishlike scale appearance |
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Ichthyosis |
Defective desquamous, build up of compacted stratum corneum with loss of normal Basket Weave Pattern |
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Urticaria |
Localized mast cell degranulation with microvascular hyperpermeability |
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Urticaria |
Small, pruritic papules/plaques (wheals) develop and fade and may persist for months |
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Urticaria |
Antigen-induced release of vasoactive mediators through sensitizatiob with IgE antibodies |
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Acute Eczematous Dermatitis |
Red, papulovesicular oozing, crusted lesion to raised scaling plaques |
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Erythema Multiforme |
Autoimmune disease usually secondary to drugs |
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Erythema Multiforme |
Targetoid lesions |
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Erythema Multiforme |
Perivascular lymphocytic infiltrates, edema, lymphocytes along dermoepidermoid junction, necrotic keratinocytes |
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Erythema Multiforme |
Steven-Johnson Syndrome |
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Steven-Johnson Syndrome |
Symptomatic febrile form often seen in children, erosions and histologic crusts lips/oral mucosa |
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Toxic Epidermal Necrolysis |
Variant which results from diffuse necrosis and sloughing of cutaneous and mucosal surface similar to extensivd burn |
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Erythema Multiforme |
CD8+ cytotoxic T-lymphocytes kill epithelial cells |
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Erythema Multiforme |
Toxic epidermal necrolysis |
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Psoriasis |
Well-demarcated pink to salmon colored plaque covered by loose silver white scale |
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Psoriasis |
Usually affects elbows, knees, scalp, lumbosacral, intergluteal |
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Psoriasis |
Erythoderma |
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Psoriasis |
Nail discoloration and onycholysis |
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Psoriasis |
Increased epidermal cell turnover |
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Psoriasis |
Acanthosis with regular downward elongation of rete ridges |
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Psoriasis |
Stratum granulosum is thinned or absent with extensive parakeratotic scaling |
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Psoriasis |
Excessive parakeratotic scale |
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Psoriasis |
T-cell mediated disease with TNF is a major mediator in pathogenesis |
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Psoriasis |
Koebner phenomenon |
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Psoriasis |
Auspitz Sign |
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Auspitz Sign |
Multiple, minute bleeding points when scale is lifted from the plaques |
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Spongiform Pustules |
Aggregates of neutrophils in spongiotic epidermis |
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Psoriasis |
Spongiform Pustules |
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Psoriasis |
Munro Microabscesses |
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Munro Abscesses |
Aggregates of neutrophils within parakeratotic stratum corneum |
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Seborrheic Dermatitis |
More common than psoriasis |
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Seborrheic Dermatitis |
Regions with high density of sebaceous glands |
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Seborrheic Dermatitis |
Macules and papules on erythematous yellow, greasy base |
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Seborrheic Dermatitis |
Dandruff (Cradle Cap) |
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Seborrheic Dermatitis |
Spongiosis and acanthosis |
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Seborrheic Dermatitis |
Follicular lipping |
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Folicular lipping |
Mounds of parakeratosis + neutrophils at the ostia of hair follicle |
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Seborrheic Dermatitis |
Etiology: Malssezia furfur |
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Lichen Planus |
Pruritic, purple, polygonal, planar, papules and plaques |
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Lichen Planus |
Itchy, violaceous,flat topped papules that coalesce forming plaques |
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Lichen Planus |
Papules are highlighted by white dots or lines called Wickham Striae |
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Lichen Planus |
T-lymphocyte infiltrates and hyperplasia of Langerhans cells |
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Lichen Planus |
Anucleate necrotic basal cells incorporated into inflamed papillary dermis |
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Lichen Planus |
Colloid or civatte bodies |
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Lichen Planus |
Dense continuous infiltrate of lymphocytes along dermoepidernal junction |
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Lichen Planus |
Basal keratinocytes show degeneration and necrosis |
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Pemphigus |
Autoimmune blistering |
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Pemphigus |
Dissolution of intercellular attachments within the epidermis and mucosal epithelium |
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Pemphigus |
All forms are caused by IgG autoantibodies against desmogleins |
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Pemphigus vulgaris |
Suprabasilar acantholytic blister |
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Pemphigus foliaceus |
Subcorneal blister |
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Pemphigus vulgaris |
Predilection: scalp, face, axilla, groim, trunk |
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Pemphigus vulgaris |
Superficial vesicles and bullae rupture erosions |
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Pemphigus vulgaris |
(+) subepidermal, nonacantholytic blister |
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Pemphigus vegetans |
Moist, verrucous, vegetating plaques with pustules |
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Pemphigus foliaceus |
Bullae are superficial; subcorneal blister |
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Pemphigus erythematosus |
Malar area; severe form of foliaceus |
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Bullous Pemphigoid |
Elderly, autoantibodies against BP antigens, subepidermal, nonacantholytic |
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Dermatitis Herpetiformis |
Uticaria and grouped vesicles |
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Dermatitis Herpetiformis |
Associated with Intestinal Celiac Disease |
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Dermatitis Herpetiformis |
Fibrin and neutrophilic accumulate in dermal papilla formjng microabscess |
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Dermatitis Herpetiformis |
Direct immunofluorescence: (+) granular IgA deposits |
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Dermatitis Herpetiformis |
Sites of involvement: Extensor surface, elbows, knees, upper back, and buttocks |
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Epidermolysis Bullosa |
Defects in structural proteins |
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Simplex Type Epidermolysis Bullosa |
Affects basal layer, mutationsij genes encoding keratin 14 and 15 |
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Junctional Type Epidermolysis Bullosa |
AR defects in one of the subunits of laminin, mutations in BPAG2 |
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Dystrophic Type Epidermolysis Bullosa |
Mutations in COL7A1, AD/AR |
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Porphyria |
Inborn or acquired disturbances in porphyrin metabolism |
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Porphyria |
Urticaria and vesicles lesding to scarring and exacerbated by exposure to sunlight |
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Acne Vulgaris |
Physiologic hormonal variations and alteration in hair follicle maturation |
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Acne Vulgaris |
Non inflammatory, open, central black keratin plug and closed comedones |
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Rosacea |
Flushing episode, persistent erythema and telangiectasia, pustules amd papules, rhinophyma |
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Rosacea |
Increased cathelicidin |
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Rosacea |
Non specific perifollicular infiltrate composed of lymphocytes predominantly, neutrophils may colonize follicles, follicular rupture then granuloma |
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Rhinophyma |
Permanent thickening of nasal skin |
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Panniculitis |
Inflammatory reaction in SQ fat |
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Erythema Nodosum |
Poorly differentiated tender, erythematous plaques and nodules |
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Erythema Nodosum |
Edema, fibrin exudation, neutrophilic infiltration, lymphocytes and histiocytes |
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Erythema Induratum |
Granulomatous inflammation and zones of caseous necrosis |
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Cylindromas |
Multiple coalescing nodules of basaloid cells with apocrine differentiaion on the scalp or forehead |
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Syringomas |
Mutliple, small, tan papules near lower eyelids composed of Tadpole-shaped islands of basaloid epithelium |
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Trichoepitheliomas |
Mutliple flesh colored papules on the face, scalp, neck, upper trunk, composed of proliferations of basaloid forming Hair-follicle like structure |
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Trichilemmomas |
Proliferations of cells resembling the uppermost portion of hair follicles |
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Hidradenoma Papilliferum |
Occurs on the face and scalp composed of ducts and papillae lined by Apocrine-type cells |
