Skin

Exam 10

Freckle
are the most common pigmented lesions of childhood in
lightly pigmented individuals
Lentigo
consist of small (5–10 mm across), oval, tan-brown macules or
patches.
• Unlike freckles, lentigines do not darken when exposed to sunlight.
 Compound Nevus
Combines the features of the junctional
and the intradermal types
Junctional Nevus
defined as nevus in which the melanocytic proliferation is
restricted to the basal portion of the epidermis
• mostly found in the palms and soles
 < - DYSPLASTIC NEVUS
Nevus cell nests within the epidermis
Atypical cells - nuclear enlargement,
irregular, often angulated, nuclear
contours, and hyperchromasia
mutated genes - CDKN2Aon
chromosome 9p21
- CDK4 (cyclin-dependent kinase 4)
on chromosome 12q14

HALO NEVUS CONGENITAL NEVUS ↓ BLUE NEVUS

SPITZ NEVUS
Two most important predisposing
factors are:
• Inherited genes
– affect cell cycle control, pro-
growth pathways, and telomerase.
• Sun exposure
– severe sunburns early in life are
the most important risk factor
Lichen Planus. A. Flat topped pink-purple, polygonal papule has a
white lacelike pattern of lines that are referred to as Wickham stria.
B. There is a bandlike infiltrate of lymphocytes at the dermoepidermal
junction, hyperkeratosis, and pointed rete ridges (sawtoothing) the
latter as a result of chronic basal cell layer injury
Pemphigus Vulgaris. A. Eroded plaques are formed following the rupture of content, thin-
roofed bullae, here affecting aillary skin. B. Suprabasal acantholysis results in an
intraepidermal blister in which dyscohesive (acantholytic) epidermal cells are present (inset).
C. Ulcerated blisters in the oral mucosa are also common, as seen here on the lip.
Bullous Pemphigoid. A. Bullae consist of tense subepidermal blisters that usually fail to rupture,
as their roof consists of the full epidermal thickness. Ulcers form when the blisters are rupture.
B An intact sub-basilar blister associated with eosinophils, lymphocytes and occasional
neutrophils.
Pemphigus Foliaceus. A. The delicate superficial (subcorneal) blisters are
much less erosive than those seen in pemphigus vulgaris. B. Subcorneal
separation of the epithelium is seen.
Verruce Vulgaris. A. Multiple papules with rough pebble-like surface. B.(low power) and
C. (high power) showing papillomatous epidermal hyperplasia an cytophatic alterations
that included nuclear pallor and prominent keratohyaline granules. D. In situ
hybridization demonstrating viral DNA within epidermal cells.