S&S Lecture 13&14 Flash Cards

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Title:	S&S Lecture 13&14
Description:	Skin 1 and 2
Number of Cards:	88
Save Count:	4
Author:	saba.saadat9
Created:	2010-11-02
Tags:	m2
Private	No

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- Question
- Answer
- Side 3

- What is dermatopathology?
- Study of skin diseases by laboratory techniques: light microscopy, histochemistry, immunohistochemistry and immunofluorescense.
- What are parts of skin superficial to deep?
- 5 epidermal layes
  basement membrane
  2 dermal layers
  skin appendages
  subcutaneous tissue or fat
- What are the cells in epidermis?
- keratinocytes
  melanocytes
  langerhans cells
  merkel cells
- What is seen in reticular dermis?
- Elastin fibers and collagen
- Where are melanocytes located?
- basal layer of epidermis
- What are skin appendages?
- hair
  sebaceous glands
  Eccrine sweat glands
  Apocrine sweat glands
- What embryonic layer gives rise to epidermis, skin appendages and melanocytes?
- Ectoderm
- What layer of skin is mad by Mesoderm?
- Dermis (both layers)
- Where is keratin formed?
- It is formed by keratinocytes in the granular layer
- How do keratinocytes look like in stratum corneum?
- flat, no nucleus
- What is produced by keratinocytes? 2 things..
- keratin
  cytokines for regulation of epidermal and dermal cells
- What is the stain used to look at melanin?
- Fontana/Masson
- What is S100?
- stain for melanocytes and langerhans cells
- What is the role of hair follicle?
- generates hairshaft
  its a reserve for epidermal regeneration in case of damage
- What gland helps regulate body temperature?
- Eccrine sweat glands
- where are apocrine sweat glands located?
- associated with the hair bearing parts of the skin:
  axilla
  inguinal regions
- How does subcutaneous tissue regulate body temperature?
- in cold --> superficial plexus contracts, less blood circulation --> retention of heat
  
  in cold they open up --> cooling of body
- What is solar elastosis?
- denaturation of reticular dermal elastic fibers due to su exposure
  
  shows amount of life-long UV exposure (radiation badge of body)
- what is a flat circumscribe lesion <5mm called?
- macule
- what is a patch?
- flat circumscribed lesion >5mm
- Elevated dome-shaped flat-topped lesion of <5mm?
  
  How about >5mm?
- <5mm: Papule
  >5mm: Nodule
- Difference between bulla and vesicle?
- both are blister
  Vesicle is <5mm
  Bulla is >5mm
- what is a pustule?
- discrete, pus-filled raised lesion
- What is acantholysis?
- loss of intercellular cohesion between keratinocytes
- Diffused epidermal hyperplasia?
- Acanthosis
- Dyskeratosis?
- abnormal premature keratinization within cells below the stratum granulosum
- Intercellular edema in epidermis is called ____?
- spongiosis
- List 6 disorders of melanocytes
- Freckle (Ephelis)
  Lentigo
  Nevi
  Unusual nevi
  Dysplastic nevi
  Melanoma
- What are the two pigmentation disorders and how do they differ?
- Albinism: genetic disorder. its absence or decreased of skin pigment due to lack of tyrosinase. normal # of melanocytes
  
  Vitiligo: autoimmune. decreased number of melanocytes
- Patient presents with small macules showing increased amount of melanin pigmentation. She complains about change in number and intensity of her macules ina cyclic fashion.
  what is the disease?
- Freckle
- What is freckle?
- increased melanin pigmentation.
  same number of melanocytes
- What is lentigo?
- benign linear hyperplasia of melanocytes in basal layer
  not darkened due to sun exposure
  Precursor of melanoma
- what is the histology seen in lentigo?
- elongation and hyperpigmentation of rete ridges
- What is melanocytic nevus?
- tan to brown uniformly pigmented mole. <6mm and well defined rounded borders
- what changes are seen in Nevi by age?
- they begin at dermoepidermal junction, progress into dermis and become compound nevi, progress into dermal layer completely and if lose color becomes neural
- What are the stages of acquired nevi?
- junctional
  compound
  intradermal
  neural
- What is a junctional nevi?
- nest of melanocytes in epidermis
  flat
- if the nevi is elevated and pigmented, what stage is it in?
- compound
- what is the appearance of intradermal nevi?
- elevated with loss of pigment.
  nest of melanocytes in dermis ONLY (usually papillary dermis)
- what are neural nevi?
- maturation of intradermal nevus cells stimulating partial of complete neurofibroma
- How is Halo nevi formed?
- acquired with lymphocytic infiltration and depigmentation
- What are congenital nevi?
- present at birth with deep dermal component
- What kind of nevi is more common in children with minimal pigmentation
- Spitz nevi
  spindle and epitheloid cell nevus
- which type of nevi is associated with melanoma
- Congenital
- if histology shows darkly pigmented spindled melanocytes in dermis, what type of nevi are we looking at?
- blue nevi
- What type of nevi is present if there is a chronic inflammation?
- Halo nevi... dense lymphocytic infiltrate
- What is a dysplastic nevi?
- abnormal nevi --> increased risk for melanoma
  larger than common nevi and high number
  variable pigmentation (darker in center) with irregular borders.
  developed as acquired nevi in both sun exposed and non-sun exposed areas
- Dysplastic nevus syndrome?
- B-K mole
  autosomal dominant
  mambers have >50% risk of developing one or more melanomas by age 60
- what is term "shoulder"?
- extension of rete ridges in dysplastic nevi is called shoulder
- What are the 5 different phases in melanoma?
- Melanocytic hyperplasia
  Melanocytic dysplasia
  Melanoma-in-situ
  Invasive melanoma
  metastatic melanoma
- What types of melanoma has access to vasculature?
- Mucosal and ocular melanoma
- What types of melanoma have radial growth?
- Lentigo maligna
  Superficial spreading
  Nodular
  Acral lentiginous
- What is in-situ-melanoma called?
- Lentigo maligna
- What is the most favorable type of melanoma?
- lentigo maligna: it is slow growing, has radial growth and commonly on face.
- What is the most common type of melanoma?
- superficial spreading melanoma
- Define ABCDE
- A: Asymmetry
  B: Border irregularity
  C: Color variation
  D: Diameter > 6 mm
  E: Progressive enlargement, evolution, ulceration and pruritis
- Whats the prognosis of melanoma if there is a vertical growth?
- poor prognosis because of access to vasculature and nerves.
- What type of melanoma has vertical growth phase ONLY?
- nodular melanoma
- what are characteristics of nodular melanoma?
- Vertical growth only
  rapid growth
  worse prognosis due to depth and invasion
- Which melanoma targets skin of sole of feet and palms?
- Acral lentigious
  rare
- What gender has better prognosis in melanoma?
- Women
- What is Breslow thickness?
- tumor thickness in mm from granular layer to deepest invasion
- What are prognostic factors in melanoma?
- Breslow thickness
  epidermal ulceration
  mitotic rate
  tumor regression
  Host response by tumor infiltrating lymphocytes
  Gender (women better)
  location
  stage
- What are favorable prognosis?
- Breslow thickness less than 1.7mm
  Absence of ulceration
  no or few mitosis
  absence of regression
  Brist TIL (tumor infiltrating lymphocyte) response
  female
  extremities
  radial growth phase
- How do you treat melanoma?
- surgical excision
  lymph node excision
  chemotherapy
  immunotherapy
- Name 5 benign epithelial tumors
- Seborrheic keratosis
  Acanthosis Nigricans
  Fibroepithelial polyp
  Epithelial Cyst
  Adnexal tumors
- Whats Seborrheic keratosis?
- benign lesion
  no internal invasion
  can be removed by freezing or shaving
- Acanthosis Nigricans?
- thickened hyperpigmented skin
  flexural areas
  80% benign, childhood or puberty
  20% associated with a cancer (GI tract)
- What are other names for Fibroepithelial polyp?
- acrochordon
  Squamous papilloma
  skin tag
- Whats the common site for epidermal inclusion cyst?
- trunk
  its soft keratin
- Whats the common site for Pilar or Trichilemmal cyst?
- Scalp
  its hard keratin
- What are the two epithelial cysts?
- Epidermal inclusion cyst
  Pilar or Trichilemmal cyst
- Clyndroma is a .... tumor?
- Skin appendage or adnexal tumor
- Trichoepithelioma?
- Skin adnexal tumor
  resemble primitive hair follicles
  usually in face
  immature hairshafts and stromal cells but looks like basal cell carcinoma under microscope
- Where is the common site of Clyndroma?
  whats the histology?
- Skin of scalp and forehead
  Nest of epithelial cells that are surrounded by thickened basement membrane