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Rim Halaby (talk | contribs) (Created page with "{{WBRQuestion |QuestionAuthor={{Rim}} |ExamType=USMLE Step 1 |MainCategory=Pathology |SubCategory=Dermatology |MainCategory=Pathology |SubCategory=Dermatology |MainCategory=Pa...") |
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|Prompt=A 21 year old woman presents to the dermatology clinic for a lesion on her right arm. The patient explains that the lesion has been expanding slowly. She describes it as scaly but neither itchy nor painful. She notices that the lesion bleeds when she scratches it or tries to lift off the overlying scale. The patient reports she has never had any similar lesions, but her grandma used to complain of similar scales on her arms and legs. On physical exam, you notice a well demarcated erythematous plaque covered by a fine, and loosely adherent, silvery-white scale. If you were to biopsy the lesion, what would you most likely find on microscopic examination? | |Prompt=A 21-year-old woman presents to the dermatology clinic for a lesion on her right arm. The patient explains that the lesion has been expanding slowly. She describes it as scaly but neither itchy nor painful. She notices that the lesion bleeds when she scratches it or tries to lift off the overlying scale. The patient reports she has never had any similar lesions, but her grandma used to complain of similar scales on her arms and legs. On physical exam, you notice a well demarcated erythematous plaque covered by a fine, and loosely adherent, silvery-white scale. If you were to biopsy the lesion, what would you most likely find on microscopic examination? | ||
|Explanation=Psoriasis is an inflammatory skin disorder characterized by silvery white scales usually seen on the scalp, knees, and elbows. It is a T-lymphocyte associated auto-immune disease. Prevalence is estimated at 2% of the general population. Nail involvement and psoriatic arthritis can be seen in up to 25% of patients. Classically the plaques exhibit punctate bleeding when the scale is peeled off. This is known as the Auspitz sign. | |Explanation=Psoriasis is an inflammatory skin disorder characterized by silvery white scales usually seen on the scalp, knees, and elbows. It is a T-lymphocyte associated auto-immune disease. Prevalence is estimated at 2% of the general population. Nail involvement and psoriatic arthritis can be seen in up to 25% of patients. Classically the plaques exhibit punctate bleeding when the scale is peeled off. This is known as the Auspitz sign. Features on pathological examination of a psoriatic lesion include keratinocyte hyperproliferation and hyperkeratosis, as well as leukocytic infiltration and angiogenesis. The stratum spinosum is usually thickened while the stratum granulosum becomes thinner. Neutrophils migrate to the epidermis then form Munro microabscesses which are characteristic of psoriasis. | ||
|AnswerA=Civatte bodies | |AnswerA=Civatte bodies | ||
|AnswerAExp=Civatte bodies are typically seen in lichen planus. | |AnswerAExp=Civatte bodies are typically seen in lichen planus. | ||
|AnswerB=Munro microabscesses | |AnswerB=Munro microabscesses | ||
|AnswerBExp=Munro microabscesses are neutrophilic accumulations in the stratum corneum characteristic of psoriasis. | |AnswerBExp=Munro microabscesses are neutrophilic accumulations in the stratum corneum characteristic of psoriasis. | ||
|AnswerC=Psammoma bodies | |AnswerC=Psammoma bodies | ||
|AnswerCExp=Psammoma bodies are calcified whorls seen in meningioma, serous cystadenocarcinoma of the ovary, papillary thyroid carcinoma, and mesothelioma. | |AnswerCExp=Psammoma bodies are calcified whorls seen in meningioma, serous cystadenocarcinoma of the ovary, papillary thyroid carcinoma, and mesothelioma. | ||
|AnswerD=Paget’s cells | |AnswerD=Paget’s cells | ||
|AnswerDExp=Paget cells are typically found in Paget's disease. | |AnswerDExp=Paget cells are typically found in Paget's disease. | ||
|AnswerE=Horn cysts | |AnswerE=Horn cysts | ||
|AnswerEExp=Horn cysts are characteristic of seborrheic keratosis. | |AnswerEExp=Horn cysts are characteristic of seborrheic keratosis. | ||
|EducationalObjectives=Psoriasis is an inflammatory skin disorder characterized on pathology by hyperkeratosis, angiogenesis, thickening of the stratum spinosum and munro microabscesses. | |||
|References=Schön MP, Boehncke WH. Psoriasis. N Engl J Med. 2005;352(18):1899-912. | |||
|RightAnswer=B | |RightAnswer=B | ||
|WBRKeyword=Psoriasis, Munro microabscesses | |WBRKeyword=Psoriasis, Munro microabscesses, Hyperkeratosis, Auspitz sign, Scale | ||
|Approved= | |Approved=Yes | ||
}} | }} | ||
Revision as of 15:33, 7 October 2014
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Dermatology |
| Prompt | [[Prompt::A 21-year-old woman presents to the dermatology clinic for a lesion on her right arm. The patient explains that the lesion has been expanding slowly. She describes it as scaly but neither itchy nor painful. She notices that the lesion bleeds when she scratches it or tries to lift off the overlying scale. The patient reports she has never had any similar lesions, but her grandma used to complain of similar scales on her arms and legs. On physical exam, you notice a well demarcated erythematous plaque covered by a fine, and loosely adherent, silvery-white scale. If you were to biopsy the lesion, what would you most likely find on microscopic examination?]] |
| Answer A | AnswerA::Civatte bodies |
| Answer A Explanation | AnswerAExp::Civatte bodies are typically seen in lichen planus. |
| Answer B | AnswerB::Munro microabscesses |
| Answer B Explanation | AnswerBExp::Munro microabscesses are neutrophilic accumulations in the stratum corneum characteristic of psoriasis. |
| Answer C | AnswerC::Psammoma bodies |
| Answer C Explanation | AnswerCExp::Psammoma bodies are calcified whorls seen in meningioma, serous cystadenocarcinoma of the ovary, papillary thyroid carcinoma, and mesothelioma. |
| Answer D | AnswerD::Paget’s cells |
| Answer D Explanation | AnswerDExp::Paget cells are typically found in Paget's disease. |
| Answer E | AnswerE::Horn cysts |
| Answer E Explanation | AnswerEExp::Horn cysts are characteristic of seborrheic keratosis. |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::Psoriasis is an inflammatory skin disorder characterized by silvery white scales usually seen on the scalp, knees, and elbows. It is a T-lymphocyte associated auto-immune disease. Prevalence is estimated at 2% of the general population. Nail involvement and psoriatic arthritis can be seen in up to 25% of patients. Classically the plaques exhibit punctate bleeding when the scale is peeled off. This is known as the Auspitz sign. Features on pathological examination of a psoriatic lesion include keratinocyte hyperproliferation and hyperkeratosis, as well as leukocytic infiltration and angiogenesis. The stratum spinosum is usually thickened while the stratum granulosum becomes thinner. Neutrophils migrate to the epidermis then form Munro microabscesses which are characteristic of psoriasis. Educational Objective: Psoriasis is an inflammatory skin disorder characterized on pathology by hyperkeratosis, angiogenesis, thickening of the stratum spinosum and munro microabscesses. |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Psoriasis, WBRKeyword::Munro microabscesses, WBRKeyword::Hyperkeratosis, WBRKeyword::Auspitz sign, WBRKeyword::Scale |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |