ABD Dermatopathology 3

Question 1

A biopsy shows acantholysis with a 'row of tombstones' basal cell appearance and intraepidermal, suprabasal clefting. Which disease is this?

Accepted Answer

Pemphigus vulgaris

Answer

Suprabasal acantholysis leaving a 'row of tombstones' of basal keratinocytes is classic for pemphigus vulgaris.

Question 2

Direct immunofluorescence showing granular IgA deposits in the dermal papillae supports which diagnosis?

Accepted Answer

Dermatitis herpetiformis

Answer

Granular IgA in the dermal papillary tips is the hallmark of dermatitis herpetiformis.

Question 3

A cutaneous tumor shows peripheral palisading of basaloid cells with clefting (retraction) from the surrounding stroma. What is the diagnosis?

Accepted Answer

Basal cell carcinoma

Answer

Peripheral palisading of basaloid nests with stromal retraction artifact is characteristic of basal cell carcinoma.

Question 4

Which histologic finding is most characteristic of a Spitz nevus?

Accepted Answer

Kamino bodies

Answer

Kamino bodies (eosinophilic PAS-positive globules at the junction) are characteristic of a Spitz nevus.

Question 5

Pautrier microabscesses (intraepidermal collections of atypical lymphocytes) are a diagnostic feature of which condition?

Accepted Answer

Mycosis fungoides

Answer

Pautrier microabscesses are clusters of atypical T-cells in the epidermis seen in mycosis fungoides (cutaneous T-cell lymphoma).

American Board of Dermatology (ABD) Practice Test