Cysts
Steatocystoma path features (2)
sebaceous glands near lining, red/pink shark tooth lining
most common porokeratosis subtype? one with highest SCC risk?
common - disseminated superficial actinic porokeratosis DSAP
SCC - linear
role of regulatory T cells
suppress auto-immunity
2 proteins altered in epidermolysis bullosa simplex
keratin 5/14
most important cell for wound healing
macrophage
path for epidermal inclusion cyst vs pilar cyst
EIC - stratified squamous epithelium, granular layer
pilar - stratified squamous epithelium, no granular layer
percent of SCC in situ or invasive SCC at base of cutaneous horn? 5%, 20%, 40%
20%
role of Langerhans cells
antigen presenting cell in epidermis
which basement membrane level and protein affected in junctional epidermolysis bullosa
lamina densa, laminin 332
name 3 patient factors that affect wound healing
Older age patient
Smoker, nutrition
Poorly controlled obesity, diabetes, vascular disease
On systemic steroids
Systemic autoimmune disease
epidermal inclusion cyst vs pilar cyst - analogous to which layers of hair
pilar - isthmus
organ systems affected by epidermal nevus syndromes (name 2)
neuro, eye, MSK
name 4 immunotherapies and target
ipilimumab CTLA-4
nivolumab, pembrolizumab, cepilimumab PD-1
2 components of lamina densa
collagen type IV and laminin 332/5
scar strength at 2 weeks (% of original strength)
max strength of scar at 1 year (% of original strength)
10%; 80%
typical location on body for - thyroglossal duct cyst, bronchogenic cyst, brachial cleft cyst
thyroglossal - midline neck, moves with swallowing
bronchogenic - suprasternal notch
branchial cleft - preauricular, mandibular, SCM
what is acantholytic dyskeratosis
acantholytic - separation of epidermal cells
dyskeratosis - abnormal keratinocyte differentiation corp roads and grains
Waardenburg syndrome is due to defect in what
neural crest (migration/development)
3 diseases with collagen VII issues
bullous lupus, epidermolysis bullosa acquisita, dystrophic epidermolysis bullosa (dominant and recessive)
healing by primary intent? secondary intent? tertiary intent?
primary - surgeon closes it
secondary - heal on its own
tertiary - primary then dehiscence, then let heal by secondary
path for thyroglossal duct cyst, bronchogenic cyst, branchial cleft cyst
thyroglossal - look for pink thyroid globules
bronchogenic - pseudo stratified, cilia, goblet cells, smooth muscle
branchial cleft - lymphoid germinal centers
what do squamous eddies look like and what two benign lesions can look like SCC on path with squamous eddies
pink whorls; irritated SK, inverted follicular keratosis
where do melanocyte stem cells reside in the skin (be specific). and why is this clinically relevant
hair follicle bulge; vitiligo treatment works better in areas with many hair follicles (face, not acral areas)
3 altered proteins in cicatricial pemphigoid/mucous membrane pemphigoid
BPAG2 (carboxy terminus), integrin beta4, laminin 332 (anti-epiligrin)
name of topical for diabetic neuropathic ulcers of lower extremity and mechanism?
Regranex (becaplermin gel); mimics platelet derived growth factor
bonus fact - used to have black box warning for increased risk cancer death but warning was removed in 2018