Path
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| thick rough skin w prominent markings d/t repeated rubbing | Lichenification
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| circumscribed, flat, colored | Macule = 5 or less mm, Patch = >5mm
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| elevated, dome or flat topped | Papule = 5 or less mm, Nodule = >5mm
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| elevated, flat topped, caused by coalescent papules, >5mm | Plaque
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| pus filled, raised lesion | Pustule
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| dry, horny, platelike excrescence d/t imperfect cornification | Scale
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| fluid filled, raised | Vesicle = 5 or less mm, Bulla = >5mm
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| itchy, transient, elevated w variable blanching and erythema, result of dermal edema | Wheal
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| Loss of intercell cohesion b/w keratinocytes | Acantholysis
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| diffuse epidermal hyperplasia | Acanthosis
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| premature keratinization w/in cells below stratum granulosum | Dyskeratosis
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| Discontinuity of skin w Incomplete loss of epidermis | Erosion
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| Infiltration of epiderm by inflamm cells | Exocytosis
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| Intracell Edema of keratinocytes (viral infx) | Hydropic swelling (ballooning)
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| Hyperplasia of stratum granulosum d/t intense rubbing | Hypergranulosis
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| Thickening of stratum corneum | Hyperkeratosis
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| Linear pattern of melanocyte prolif w/in epiderm basal layer | Lentiginous
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| surface elevation d/t hyperplasia and enlargement of contiguous Dermal Papillae | Papillomatosis
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| Keratinization w Retained Nuclei in stratum corneum. Seen with Psoriasis. Normal on mucus membranes | Parakeratosis
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| intercell Edema of Epiderm | Spongiosis
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| Discontinuity of skin showing Complete loss of epiderm, reveal derm or subQ | Ulceration
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| Formation of vacuoles w/in or adjacent to cells | Vacuolization
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| common benign localized hyperplasia of melanocytes occurring at all ages, starting w infants. small, oval, tan-brown, macules or patches, don't darken in sun | Lentigo
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| precursors of melanoma, larger than most acquired nevi. flat macules/slightly raised plaques w pebbly surface, or target-like lesion w darker raised center and irreg flat periph | Dysplastic Nevi
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| >10mm and changes and color, size, shape of pigmented lesion, irreg/notched borders. Loss of func RB muts, and activating BRAF, and loss of p16/INK4a. resist chemo and radiation | Melanoma
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| round, flat, coin-like, waxy plaques, tan/brown w velvety granular surface. small round, porelike ostia impacted w keratin. FGFR3 mut. Explosive appearance in large # = Leser-Trelat sign | Seborrheic keratoses
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| thick, hyperpigmented skin w velvet like texture most commonly in the axillae, neck folds, groin and anogenital regions. Benign type = most cases, gradual starts during puberty. Malignant type = older people, w GI adnenocarcinomas | Acanthosis Nigricans
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| skin tag, soft, flesh-color, bag-like tumor attached to surrounding skin by slender stalk. | Fibroepithelial polyp
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| invagination and cystic expansion of epidermis or hair follicle. filled w keratin and lipid containing debris derived from sebaceous secretions. Moveable. | Epithelial cyst (Wen)
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| nondescript flesh-colored solitary or multi papules and nodules on palms and soles | Eccrine Poroma
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| nondescript flesh-colored solitary or multi papules and nodules on forehead and scalp. CYLD mut | Cylindroma
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| multi, small, tan papules around lower eyelids | Syringoma
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| <1cm, tan/brown/red/skin colored, rough/sandpaper. Cutaneous Horn. sun-exposed sites. | Actinic Keratosis
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| deeply invasive and involve subQ, not through basement memb = in situ (sharply defined, red, scaling plaques); more advanced invasion = (nodular, hyperkeratotic scale, may ulcerate. | Squamous cell carcinoma
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| most common invasive cancer. slow growing, rarely metastasize. sun exposed sites of lightly pigmented people. pearly papuples containing prominent, dilated subepidermal blood vessels(telangectasias). | Basal cell carcinoma
- Gorlin synd (Nevoid basal cell carcinoma)= multiple basal cell carcinomas. PTCH gene.
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| on legs of young women, firm, tan/brown papules, <1cm, tendency to Dimple inward on lateral compression | Dermatofibroma
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| firm, solid nodules, most freq on the trunk. fibroblasts arranged radially (pin wheel, storiform). Deep extension from dermis into subQ fat->"honeycomb" pattern. translocation b/w COL1A1 and PDGFB. | Dermatofibrosarcoma Protuberans
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| >40 y/o, on the trunk- scaly, red/brown patches; raised, scaly plaques; fungating nodules. can -> Sezary synd (diffuse erythema/scaling of entire body surface). Sezary-Lutzner cells=CD4+ that form bandlike aggregates w/in superfic derm and invade epiderm | Mycosis Fungoides (Cutaneous T-Cell lymphoma)
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| increased mast cells in skin of kids. accounts for most urticaria pigmentosa (lesions multiple and widely distributed, round/oval, red/brown, nonscaling papules and small plaques. Darier sign=dermal edema and erythema(wheal) when skin is rubbed. | Mastocytosis
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| hyperkeratosis->fish-like scales. loss of normal basket weave pattern | Ichthyosis
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| localized mast cell degranulation->dermal microvasc hyperpermeability->pruritic edematous plaques (wheals). angioedema w dilation of superficial lymph channels. | Urticaria (Hives)
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| red, papulovesicular, oozing, and crusted lesions->raised, scaling plaques d/t reactive acanthosis and hyperkeratosis. can be d/t poison ivy. | Acute Eczematous Dermatitis
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| hypersensitivity rxn to infx (herpes, mycoplasma, histoplasmosis, typhoid, leprosy), drugs (sufonamides, penicillin, antimalarials), malignancies, collagen diseases (SLE, PAN). present w red macule/papule w pale center. symm extremeties. | Erythema Multiforme
- Stevens-Johnson synd=extensive, symptomatic febrile form often in kids
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| chronic inflamm dermatosis sometimes ass w arthritis, AIDS, trauma (Koebner). on skin of elbows, knees, scalp, lumbosacral, interglut, glans penis. well demarcated, pink plaque, silver scale. thin/absent strat gran w overlying parakeratotic scale. HLA-C | Psoriasis
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| chronic inflamm dermatosis of scalp, forehead (glabella), ext auditory canal, nasolabial folds, presternal, but NOT a sebaceous gland disease. macules/papules on yellow, greasy base, scaly and crusty. | Seborrheic Dermatitis (Dandruff)
- cradle cap for infants
- + diarrhea and failure to thrive = Leiner disease
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| Pruritic, purple, polygonal, planar papules/plaques. resolves 1-2 yrs leaving postinflamm hyperpigment. highlighted by white dots or lines (Wickham striae). symm extremities (wrist/elbow and penis) | Lichen Planus
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| d/t IgG autoantibods against desmogleins->dissolution of intercell attachments w/in epiderm and mucosal epithel. scalp, face, axilla, groin, trunk, points of pressure. superfic vesicles/bullae rupture (acantholytic)->shallow erosions covered by crust. | Pemphigus
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| elderly. tense bullae (dont rupture easy) filled w clear fluid on normal or erythematous skin. inner thigh, flexor forearms, axillae, groin, lower ab. subepiderm, nonacantholytic. linear deposits of IgG/complement in base memb d/t BPAG2 antibods. | Bullous Pemphigoid
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| urticaria and grouped vesicles. ass w celiac. IgA antibods to gluten cross-react w reticulin->subepidermal blister. very itchy elbows, knees, upper back, butt. | Dermatitis Herpetiformis
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| Open comedones=small follicular papules w a central black keratin plug. Closed comedones= follicular papules w/o visible central plug. d/t keratin plug blocking sebum outflow, puberty->hypertroph sebaceous glands, bacteria, inflamm follicle. | Acne Vulgaris
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| flushing episodes, persistent erythema and telangectasia, pustules and papules, permanent thick nasal skin (rhinophyma). high cutaneous lvl of antimicrobial peptide cathelicidin | Rosacea
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| ass w Strep B/tuberculosis. poorly defined, very tender, red plaques/nodules, better palpated than visualized. become bruiselike | Erythema Nodosum
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| primary vasculitis affecting deep vessels supplying lobules of subQ w caseous necrosis and inflamm w/in the fat. red, slightly tender nodule that ulcerates | Erythema Induratum
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| relapsing febrile nodular panniculitis. crops of red plaques/nodules on LEs d/t deep foci of inflamm w foamy histiocytes, lymphocytes, neutrophils, giant cells | Weber-Christian disease
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| d/t HPV. dorsal hands. gray/white/tan, flat/convex, rough (pebble) surface. HPV 6 and 11->anogenital warts. HPV 16->in situ squamous cell CA of genitals and bowenoid papulosis. | Verrucae (Warts)
- vulgaris is most common
- plana are flat and smaller
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| d/t poxvirus (brick shaped w dumbbell DNA). multi lesions on skin and mucous mems (trunk and anogenitals). firm, itchy, pink, umbilicated papules w curdlike matter expressed from central umbilication. | Molluscum Contagiosum
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