Chapter 1: Inflammatory Diseases of the Epidermis

QUESTIONS

QUESTION 1-1. Which of the following statements regarding this lesion is INCORRECT?

A) It is characterized by intercellular edema that results in impaired cohesion between epidermal keratinocytes. This finding represents a nonspecific inflammatory reaction pattern with little correlation to etiology.

B) The clinical and histological appearances vary depending on the etiology, duration, location, and superimposed secondary changes (ie, excoriation).

C) The eruption always represents a type IV hypersensitivity reaction to an exogenous antigen.

D) It is divided into acute, subacute, and chronic stages.

E) A PAS stain should be considered to exclude dermatophyte infection.

QUESTION 1-2. Which sequence of events CORRECTLY describes the acute phase of allergic contact dermatitis?

1. Extracellular edema

2. Stretching and rupture of desmosomes and keratinocyte membranes

3. Langerhans cells present foreign antigen to presensitized T lymphocytes that become activated and, along with keratinocytes, secrete various cytokines.

4. Reticular degeneration

5. Lymphocytes marginate from the superficial vascular plexus with subsequent papillary dermal edema. Occasional eosinophils may be present.

6. Increased exocytosis of lymphocytes

7. Slight exocytosis of lymphocytes

8. Expansion in volume of the epidermis

9. Intracellular edema

A) 5, 3, 1, 2, 4, 7, 6, 9, 8

B) 3, 5, 7, 9, 1, 2, 6, 4, 8

C) 5, 1, 2, 3, 6, 4, 8, 7, 9

D) 3, 5, 7, 1, 9, 2, 6, 4, 8

QUESTION 1-3. Which of the following is NOT a feature of chronic spongiotic dermatitis?

A) There are intraepidermal Langerhans cell–rich microvesicles and transepidermally eliminated spongiotic vesicles producing serum-imbued parakeratotic scale crusts.

B) Spongiosis gradually decreases in chronic lesions.

C) Irregular psoriasiform epidermal hyperplasia

D) Papillary dermal hyperplasia

E) Hypergranulosis and thick hyperkeratosis (orthokeratosis and parakeratosis)

QUESTION 1-4. Which of the following statements regarding irritant contact dermatitis is INCORRECT?

A) It is caused by the direct noxious effect of substances such as acid, alkali, or organic solvents.

B) It will occur in all persons exposed to an offending agent in sufficient concentration.

C) Phototoxicity is the result of direct tissue and cellular injury following UVR-induced activation of a phototoxic agent.

D)...