PathMD Quizes, Dermatopathology Dermatopathology – 01 October 29, 2017 peferguson Author: Harry Winfield, M.D. Make sure to subscribe to PathMD to stay up to date with new content and features!! 1. A 15 year old male presents to the emergency room obtunded after ingestion of an unknown toxic substance. 12 hours after admission, the patient develops large, peripherally erythematous edematous plaques with central necrosis. The patient is in renal failure. A biopsy of the lesion is performed and examined under polarized light microscopy. Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Gouty emboliThrombosis cutis medicamentosaCalciphylaxisOxalosis 2. Excisional biopsy of a solitary asymptomatic reddish-brown nodule on the cheek of a 3 year old male Dermatopathology Set 1 Dermatopathology Set 1Eruptive xanthomaSpindle and epithelioid nevus (Spitz Nevus)Juvenile xanthogranulomaLangerhans cell histiocytosis 3. A 50 year old male presents with a slowly growing firm nodule on the nape of the neck. He denies any other medical conditions. An incisional biopsy is performed. Your diagnosis is: Dermatopathology Set 1 Dermatopathology Set 1Low-grade fibromyxoid sarcomaNodular fasciitisDermatofibromaDermatofibrosarcoma protuberans 4. A 31 year old African American female presents with a 1 year history of gradually worsening alopecia on the vertex of the scalp. She also complains of painful lesions that wax and wanes in her left ear. Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Discoid lupus erythematosusAlopecia areataCentral centrifugal scarring alopeciaFolliculitis decalvans 5. 79 year old male presents to his clinician with complaint of a persistent slow-growing non-painful nodule on his scalp for 1 year. Primary excision is performed. The preclinical diagnosis is squamous cell carcinoma. Immunohistochemical markers including S100, MART1, AE1/AE3, and SMA, but is positive for Vimentin, CD99 and CD68. Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Spindle Melanoma Malignant peripheral nerve sheath tumorAtypical FibroxanthomaSarcomatoid Carcinoma Angiosarcoma 6. A 68 year old male presents with a 6 month history of whelps with blisters occurring over the chest, back and scalp. Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Polymorphous light eruptionPorphyria cutanea tardaBullous PemphigoidPhoto-allergic dermatitis 7. A 52 year old female with a long-standing history of cutaneous T cell lymphoma presents with a new lesion on the scalp. The lesion consists of a non-scarring well demarcated nummular patch of alopecia. There is slight erythema, but no scaling or induration. A biopsy is performed with a pre-operative diagnosis of mycosis fungoides. Dermatopathology Set 1 Dermatopathology Set 1TrichotillomaniaPseudopelade of Broque (folliculitis decalvans)Tinea capitisFollicular mucinosis Alopecia areata 8. A 35 year old southeast asian female presents to the dermatologist with a complaint of worsening hyperpigmentation bilaterally over the zygomatic arches. She states that the patches have been worsening over the last 5 years. She states that she has been utilizing an over-the-counter bleaching cream purchased in India for the last 4 years, but the lesions have only worsened. Your diagnosis is: Dermatopathology Set 1 Dermatopathology Set 1OnchocerciasisChromoblastomycosisExogenous ochronosisMal de MeledaHenna tattoo 9. A 26 year old female presents with an asymptomatic firm well demarcated nodule on the lower extremity. The lesion is 1 cm in diameter, hyperpigmented without scale. An excisional biopsy is performed. The diagnosis is: Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Pleomorphic fibromaNecrobiotic xanthogranulomaNeurothekomaDermatofibrosarcomaSclerotic fibroma 10. A 47 year old male presents to clinic with complain of a slowly progressive scaling rash over his right chest and back. The lesion consists of a sharply demarcated, scaling, erythematous and hyperpigmented plaque with distinct dermal induration. Routine H & E sections reveal the following: Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Cutaneous mastocytosisSegmental lamellar ichthyosisInflammatory breast carcinomaMycosis fungoides with large cell transformationLeukemia cutis 11. A 65 year old female with a history of multiple myeloma presents with nodular, verruciform plaques on the face and extremities. Her history is complicated by renal failure. An excisional biopsy is performed. Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1Necrobiotic xanthogranulomaXanthoma disseminatumRuptured epidermal inclusion cystNecrobiosis lipoidica 12. A 5 year old female presents with a solitary lesion on the right hand. The lesion consists of multiple papules, arranged in a circular pattern over the dorsa of the hand. There is no scaling, erythema, or atrophy. The child is otherwise healthy. Dermatopathology Set 1 Dermatopathology Set 1Granuloma annulareEpithelioid sarcomaRheumatoid noduleNecrobiosis lipoidica 13. An 85 year old male presents to clinic with the complaint of pruritic, blistering lesions over the left buttock and natal cleft. The patient states that the lesions begin as raised “whelps” which then blister then ulcerate. A punch biopsy is performed. Dermatopathology Set 1 Dermatopathology Set 1Bullous pemphigoidHuman herpes virus infectionPemphigus vulgarisHaily-Haily disease (benign familial pemphigus) 14. 32 year old male with a 2 year history of itchy, scaling plaques over the central back and scalp. A PAS stain for fungal organisms is negative. Dermatopathology Set 1 Dermatopathology Set 1Fungal Id reactionPsoriasisChronic eczematoid dermatitisInflammatory Linear Verrucous Epidermal Nevus (ILVEN) 15. A 42 year old male presents with a painful, erythematous to violaceous nodule on the lower extremity. The lesion measures 0.7 cm and blanches with pressure. An excisional biopsy is performed. The diagnosis is: Dermatopathology Set 1 Dermatopathology Set 1 Dermatopathology Set 1GlomangiomaHidredenoma papilliferumKaposi’s sarcomaTargetoid hemosiderotic hemangiomaHemangiopericytoma Loading...