Dr. Magro: Cutaneous vasculitis is a form of sm...

    Multiple choice question

    Question provided by Dr. Cynthia Magro, M.D.

    Cutaneous vasculitis is a form of small vessel vasculitis that can be categorized according to the dominant cell type infiltrating the vessel wall. In this regard the main categories of cutaneous vasculitis are leukocytoclastic vasculitis, lymphocytic vasculitis and granulomatous vasculitis.  

    The cell type that defines the subtype of vasculitis may be a critical clue regarding etiology. For example lymphocytic vasculitis unaccompanied by eosinophils can be seen in the setting of collagen vascular disease and viral syndromes.

     

     

    Images below show a protoypic morphologic depiction of  leukocytoclastic vasculitis. Please note the angiocentric neutrophilic infiltrates with leukocytoclasia and fibrin deposition accompanied by vascular injury resulting in red cell extravasation.

     

     
     

     

    Only one of the statements regarding vascultis below is CORRECT. Which one is it?

     

    Dr. Magro:Which of the following statements r...

    Multiple choice question

    Question provided by Dr. Cynthia Magro, M.D.

    Which of the following statements regarding de novo intraepidermal epithelioid cell dysplasia is CORRECT ?

     

    Which of the following statements regarding the entity de novo intraepidermal epithelioid melanocytic dysplasia illustrated in the slides above is correct ? 

    Dr. Magro: Soluble adenyly cyclase antibody imm...

    Multiple choice question

     

     

    Question provided by Dr. Cynthia Magro, M.D.

    Dr. Magro: Soluble adenyly cyclase antibody immunostaining produces distinctive patterns which parallel melanomagenesis. The hallmark of a high grade melanocytic lesion/malignant melanoma is revealed by a diagnostic SAC staining pattern.  Various patterns are illustrated in the next slides.

     

     

     

     

    1. In benign nevi, the sAC antibody  pattern was characterized by a discrete dot-likeperinuclear Golgi staining in the majority of melanocytes within the epidermis and dermis; weak nucleolar staining could be seen.  

     

     

    2. In contrast the slides shown below illustrate sAC staining in a severely atypical  compound melanocytic tumor associated with an immunogenic host response.

     

     

     

     

    The question is what SAC pattern associated with a high-grade melanocytic lesions and lentigo maligna?


     

     

    Dr. Lyle: A biopsy below is from a 9 year ...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    A biopsy below is from a 9 year old girl. Her parents provided history that she was "born with deep scalp ulcer"


    The biopsy shows an areas of scarring with no cutaneous appandages. The features are consistent with aplasia cutis which usually presents as one of the following:

     

    Dr. Lyle: The biopsy below is from a 15 year ol...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The biopsy below is from a 15 year-old male with a verrucous area of alopecia on the scalp. It shows feature of prepubertal nevus sebaceous which is associated with epidermal hyperplasia reminiscent of epidermal nevus and abnormal hamartomatous sebaceous glands. Prominent sebaceous gland hyperplasia usually develops after puberty in response to hormonal influences at that time.


    Nevus sebaceus is excised for cosmetic reasons and to prevent development of tumors which include include all EXCEPT:

     

    Dr Lyle: The biopsy illustrated below is from a...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The biopsy illustrated below is from a 57 y.o female with clinically scarring alopecia. The sections show mild interface inflammatory infiltate at the follicular isthmus. This is a rare but characteristic finding in Pseudopalalde of Broque.


    Which of the following is the most typical clinical pattern of alopecia in this condition (select one)?

     

    Dr. Lyle: Traumatic alopecia

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    13 year old female



    Trichotillosis caused by pulling of hairs results in which one histologic feature?

     

    Dr. Lyle. This biopsy is from a 3 year old boy ...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    This biopsy is from a 3 year old boy with several boggy lesions on scalp with hair loss. A clinician suspected kerion.

    Kerion represents infection with what agent?

     

    Dr. Lyle: Rare alopecias: Triangular alopecia

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The biopsy below is from a 4 year old boy with congenital triangular patch of alopecia on temporal side of scalp. The characteristic abnormality in this condition is present in the helf half of the biopsy. The features are consistent with temporal/triangular alopecia. Which of the following is not a feature.


     

    Dr. Lyle: Rare genetic alopecias: Lipase H mutation

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    Family with 1 of 4 children showing hypotrichosis


     

    Dr. Lyle: The biopsy shown below is from a 62 y...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The biopsy shown below is from a 62 year-old African American female. The biopsy was performed to ro scarring alopecia vs alopecia areata. Which one of the following histological features can be found in alopecia areata?


     

    Dr. Lyle:The image below shows a biopsy from a...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The image below shows a biopsy from a 68 year old women with a recent diffuse hair loss. You observe essentially a normal findings. This biopsy is consistent with telogen effluvium. Which statement regarding telogen effluvium is INCORRECT .


     

    Dr. Lyle: The biopsy below is from a 26 year-ol...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The biopsy below is from a 26 year-old female with history of hair loss on crown. It was submitted with clinical differential diagnosis listing traction vs. CCCA vs AGA vs normal scalp.

    The biopsy show features consistent wiht androgenetic alopecia.


    Which of the following statements regarding androgenetic alopcia is incorrect?

     

    Dr. Lyle: The image below is from a normal skin...

    Multiple choice question

     

    Question provided by Dr. Stephen Lyle, M.D., Ph.D.

    The image below is from a normal skin biopsy. The stem cells responsible for follicular regeneration and cycling reside in the area of the hair follicle between the attachment of the sebaceous duct and pilar muscle is referred to as? 


     

    Dr. Ioffreda: Follicular mycosis fungoides

    Multiple choice question

     

     

     

    Question provided by Dr. Michael D. Ioffreda, M.D.

     

    Which of the following is NOT a feature of follicular mycosis fungoides?


     

    Dr. Ioffreda: Rosacea

    Multiple choice question

     

     

     

    Question provided by Dr. Michael D. Ioffreda, M.D.

     

    All of the following are histologic features of rosacea EXCEPT?

     

    Dr. Ioffrda: Which of the following may be use...

    Multiple choice question

    Question provided by Dr. Michael D. Ioffreda, M.D.

    Which of the following may be used to distinguish psoriatic alopecia from psoriatic alopecia/alopecia areata like reaction to TNF inhibitor?

     

     

    Dr. Ioffreda: Psoriasic alopecia

    Multiple choice question

     

     

     

    Question provided by Dr. Michael D. Ioffreda, M.D.

     

    All of the following are seen in psoriatic alopecia EXCEPT?

     

    Dr. Ioffreda: Discoid lupus erythematosus

    Multiple choice question

     

     

    Question provided by Dr. Michael D. Ioffreda, M.D.

    Which of the following histologic features favors lupus alopecia over lichen planopilaris?


     

    Dr. Ioffreda: Frontal fibrosis alopecia

    Multiple choice question

     

     

     

    Question provided by Dr. Michael D. Ioffreda, M.D.

     

    Which of the following statements regarding frontal fibrosing alopecia is FALSE?


     

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