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51 Cards in this Set
- Front
- Back
List the stratified squamous cysts? |
aw girl, DEM TVS! PPPP
Dermoid Epidermoid Milia
Trichilemmal Vellus Steatocystoma
Proliferating epidermoid Proliferating trichilemmal Pits Pigmented follicular Pilonidal |
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List the non stratified squamous cysts? |
Hydrate your throat and genitals!
Hydrocystoma (apocrine and eccrine)
Throat- (ish) bronchogenic, thyroglossal, branchial
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List the non epithelial cysts? |
Mucocele Digital mucous cyst Ganglion cyst Pseudocyst of the auricle |
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Which cysts are derived from the follicular infundibulum? What is the follicular infundibulum? |
Follicular infundibulum is the area between the sebaceous duct and the surface of the hair
Epidermoid, milium, pigmented follicular, vellus hair |
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Most common cutaneous cyst? Where does it come from? |
Epidermoid cyst aka epidermal cyst, epidermal inclusion cyst, infundibular cyst and keratin cyst
Develops from infundibular area |
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Multiple epidermoid cysts are seen in what syndromes? |
GORLIN'S
GARDNER'S
(also seen in scrotal calcinosis and significant acne) |
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Buzz word: multiple lesions of congenital hypertrophy of the retinal pigmented epithelium |
CHRPE! Multiple are associated with Gardner's syndrome aka familial adenomatous polyposis
birds CHRPE in the garden |
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Gene defect in Gardner's syndrome? |
AD defect in APC gene- regulates B catenin |
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See epidermoid cysts, fibromas, osteomas together. What else do you see? |
Gardner's syndrome- will also see GI polyposis --> colorectal cancer
May also see odontomas and supranumerary teeth
This is a defect in the APC gene (dysregulation of B catenin) |
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AD, PTCH1 mutation best decribes.. |
Basal Cell Nevus Syndrome (Gorlins) |
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Multiple BCC, palmoplantar pits, epidermoid cysts, which mutation? |
Gorlin's syndrome- AD mutation of PTCH 1 gene |
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What is seen in Gorlin's syndrome? |
BCC, plamoplantar pits, epidermoid cysts, jaw cysts, frontal bossing, bifid ribs, kyphoscoliosis, calcificatino of the falx cerebri, medulloblastoma |
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Ovarian fibomas, epidermoid cysts, calcification of the falx cerebri? |
Gorlin's syndrome |
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Path of epidermoid cysts? |
Stratified squamous epithelium, +granular layer, cavity filled with keratin |
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HPV infected epidermoid cysts? |
Verrucous cysts- HPV 60 |
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Proliferating epidermoid cysts are most common in what locations? |
PELVIC/ANOGENITAL (36%)
mc in men |
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DDX for this? |
Pilar sheath cyst- which is what this is, MC on upper lip of adults, will see bulbous proliferations pushing into surrounding dermis on path
DDX must include: Dilated pore of Winer: These contain a larger cystic space which is surrounded by radiating thin strands of epithelium as opposed to the lobular arrangement of pilar sheath acanthoma |
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Milia on the hard palate? |
Bohn's nodules
(hard = boner) |
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Milia on the gums? |
Epstein's pearls |
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Milia behind the ear on a red base? What is this associated with? |
Milia en plaque, associated with lupus, or as result of trauma |
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Multiple milia can be associated with? |
Marie-Unna hypotrichosis (hereditary trichodysplasia- AD sparse hair at birth, wirey growth during childhood, loss of hair in adolescence)
Oral-facial-digital syndrome type 1(mutation of OFD1 causes oral, facial, digital malformation in the setting of polycystic kidney disease)
Rombo and Bazex syndrome (BCC) |
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What are the features on path of a Trichilemmal cyst? |
1. abrupt keratinization 2. no granular layer 3. swollen and pale keratinocytes 4. stratified squamous epithelium 5. calcification/cholesterol clefts |
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Where do pilar cysts originate? |
Isthmus |
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Isthmus cysts? |
Pilar/Wen/Isthmus-catagen |
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Proliferating trichilemmal cysts, who grows em and are they bad? |
Usually women in their 60s on their scalp, usually benign, but can grow and become metastatic (variant of SCC?)-- very locally invasive, can grow to 25cm |
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Relationship between proliferating trichilemmal cysts and KID syndrome? Mutation in KID? |
KID syndrome- keratosis, ichthyosis, deafness
malignant proliferating pilar tumors may occur in young adults and be fatal
KID- connexin 26 (kids always played ConnectFour!) |
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'Rolls and scrolls' |
Proliferating trichilemmal cyst |
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Eruptive vellus hair cysts may be associated with... |
Steatocystoma multiplex-
Pachyonychia congenita type 2- |
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Where are steatocystomas typically found? |
chest, axillae, groin |
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Steatocystoma multiplex is a mutation in which gene? |
AD mutation in keratin 17-- identical to mutation found in pachyonychia congenita type 2
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Pachyonychia congenita I vs pachyonychia congenita II, what are the mutations and findings? |
PCI- Jadassohn Lewandowsky, mutation in K6a and 16, associated with subungual hyperkeratosis, leukokeratosis, palmoplantar calluses
PCII- Jackson Lawler, AD mutation in K6b and 17, associated with natal teeth, steatocystona multiplex, eruptive vellus hair cysts, epidermoid cysts |
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Which cysts are associated with Gorlins? |
epidermoid and cutaneous keratocysts |
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What must we be concerned about in dermoid cysts? |
Dermoid cysts are present in infants along embryonic fusion plane (mc eye), if they need to be removed, should get imaging first to r/o neural heterotopias (barbell) |
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Histology of a dermoid cyst?: |
Stratified squamous cyst, + granular layer, can have hair, sebacous lobules, eccrine glands, apocrine glands, smooth muscle |
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How does the ear form embryologically? |
3 tubercles from first two branchial arches |
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How do ear pits arise? What are they associated with? |
Preauricular cyst from defective embryologic fusion with epithelial entrapment, a/w
1. branchio-otic syndrome --> deafness 2. branchil-oto-renal dysplasia --> renal abnormalities |
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What is the follicular occlusion tetrad? |
Acne conglobata, hidradenitis suppurativa, pilonidal disease, dissecting cellulitis |
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Histologic differences between apocrine and eccrine hidrocystomas? |
Apocrine hidrocystomas- adenomas of apocrine sweat glands usually on lower eyelid, unilocular or multilocular, lined by one to several layers; Clinically this lesion will be SOLITARY
Eccrine hidrocystomas- adenomas of eccrine sweat glands, unilocular always, lined by two layers of flattened cuboidal epithelium always; clinically there will be multiple lesions that enlarge in the heat |
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Cysty/pitty lesion at suprasternal notch? |
Bronchogenic cyst- fistulous tract, found at birth, respiratory epithelium (pseudostratified ciliated columnar epithelium with goblet cells) sequestered during development |
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Midline neck cyst , moves with swallowing? |
Thyroglossal duct cyst- arise from remnants of the thyroglossal duct, will see thyroid follicles on path |
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Cyst on anterior border of SCM, noticed age 25? |
Branchial cleft cyst- will see lymphoid tissue on path |
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Cyst can be found either on LE of young women or on labia majora? |
cutaneous ciliated cyst |
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Cyst found on young men, ventral aspect of the penis? |
median raphe cyst |
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This cyst shares same developmental abberation as a Meckels diverticulum? |
Omphalomesenteric duct cyst- developmental defect in the closure of the omphalomesenteric duct |
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Kid leaking urine from umbilicus? |
Urachal cyst |
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contains what material inside? |
Mucocele- mc on lower labial mucosa, mucinous material --> SIALOMUCIN
**superficial mucoceles are mc on retromolar pad, posterior buccal mucosa and soft palate |
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Which genodermatosis is associated with multiple hidrocystomas? |
Schopf-Schulz-Passarge
ectodermal dysplasia, multiple eyelid apocrine hidrocystomas, palmoplantar keratoderma, hypodonia, hypotrichosis, nail dystrophy |
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Multiple types of these cysts may be found in these 2 genodermatoses? |
Gardner syndrome
Gorlin's syndrome |
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2 associated findings? |
Dermoid cyst:
hearing loss (branchio-otic syndrome) renal abnormalities (branchio-oto-renal dysplasia) |
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Histological features of steatocystomas? Where do they come from? |
TRUE SEBACEOUS CYSTS! Arise from sebaceous duct.
see stratified squamous epithelium, no granular layer, siiregular corrugated cuticle ('shark tooth') |
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what age does this present? |
second or third decade of life |