6662218 Skin Pathology

8/9/2019 6662218 Skin Pathology

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SKIN DISEASES

CASE ANALYSIS

Objectives:

To identify and explain basic morphologic skin lesions.

Discuss the basic pathophysiology (mechanism) of the above lesions

Explain the etiopathogenesis.

To differentiate benign and malignant tumors.Make clinical and pathologic correlation.

Explain the possible outcome and complications.


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SKIN DISEASES07

CASE ANALYSIS

P. B. Casuela, Jr.,MD


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Case 1 :

A 22 year old female medical student came in because of right

malar skin lesions of few days duration after camping in Los

Banos, Laguna.

A B C D

0.5 cm

1. Describe/characterize each lesion which could be present and

indicate the proper nomenclature.

Which of the above is most likely present in the patient? Explain.


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2. Describe the gross lesion.

3. State conditions or diseases

which could clinically

present in this manner. B

3. Pictures A & B are biopsies

of common diseases which

could represent the above

disease. Classify the morphologic type

of inflammation illustrated and

characterize the inflammatory

response in each.

4. State the etiopathogenesis.

Patient A(4x;10x ): Early and full-blown lesions


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Case 2: Two patients presented with chronic skin diseases.

Characterize the gross clinical presentation.

A (forearm) B (elbow)


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1. Describe the salient microscopic features of the following. Which

of these correlate with the previous gross clinical presentation?

State your diagnosis.

A B

2. Discuss the etioathogenesis of each.


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Case 3

A 45 year old female

came in because ofmultiple skin lesions

(up to 7 cm in diam.).

1. Describe and classify

the lesions.

State commoncomplication of

these lesions.

2. State readily available

diagnostic

procedure/s whichcould be under-

taken in this case.

State principles.


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3. Localize (layer of skin)and

characterize the following

skin lesions

andwhich lesion is compatible

with the clinical

presentation.

State your basis.A

B


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4. Match and describe the microscopic

features of three diseases one

of which could be present in this

patient and relate it to com- A

mon clinical presentation. 4x

!. Herpes simplex infection

2. Bullous pemphigoid

3. Pemphigus vulgaris

B4x 40x C 4x


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4.

1. Herpes simplex

-Intraepidermal vesicle with multinucleated giant cells echibiting the

Moulding phenomenon=nuclei deform each other and never ovarlapone another.

2. Pepmphigus vulgaris

- intraepidermal, suprabasal cleft or blister containing acantholytic cells (inset)

3. Bullous pemphigoid

-non-acantholytic, subepidermal blister with prominent eosinophilic cell infiltrates

5. Immunofluorescence microscopy: Direct Immunofluorescence

A-Pemphigus vulgaris

-lace-like squamous intercellular space deposition of Ig G in the lower

epidermis.

B. Bullous pemphigoid linear deposition of Ig G in the basement membrane

zone.


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5. This diagnostic procedure is useful in the diagnosis of

two of the previous conditions. Discuss the main features

and state the significance of each.A B


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Case 4: A 45 year old laundry woman presented with lesions

on the face of several months duration.

19. Describe and classify the clinical/gross skin lesions.


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20x: A B

2. Describe the salient dermal histopathologic abnormalities.Classify the lesion according to the morphologic pattern.

3. State your diagnosis and differential diagnosis.

4. Discuss briefly Lepromin test state principle and significance

of results.

5. Discuss the etiopathogenesis and outcome of this disease.

BIOPSY dshows::

Scanner View:


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Case 5

A 35 year old patient complains of pigmented lesions of the

chest.

1. Describe the lesions.

2. State whether the lesion is benign or malignant.State your basis.

1cm


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3. Match and describe common

pigmented lesions which could A

be present in this patient. 4x I. Seborrheic keratosis

II. Intradermal nevus

III. Junctional nevus

IV. Lentigo senilis

4. Discuss age predilection & malignant potential.

.

B 10x C 10x D4x


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After five years the patient developed chest lesion

which presented as shown :

1cm

5. Characterize the lesion. Is this benign or malignant?

State your bases.

6. Discus the etiopathogenesis & outcome of this tumor.

7. State the basic principles of biopsy and microstaging in this case.


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END

THANK YOU

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6662218 Skin Pathology