Test Bank for Weedon's Skin Pathology| 6th
Edition |2026 update |Answers + Rationale | 100%
verified. | All Chapters covered.
By James W. Patterson,
,Table of Contents
SECTION 1: Introduction ...................................................................................................................... 4
Chapter 1. An Approach to the Interpretation of Skin Biopsies ......................................................... 4
Chapter 2. Diagnostic Clues............................................................................................................ 20
SECTION 2: Tissue Reaction Patterns.................................................................................................. 36
Chapter 3:The Lichenoid Reaction Pattern (Interface Dermatitis) ................................................... 36
Chapter 4: The Psoriasiform Reaction Pattern ................................................................................ 52
Chapter 5: The Spongiotic Reaction Pattern ................................................................................... 67
Chapter 6. The Vesiculobullous Reaction Pattern ........................................................................... 82
Chapter 7. The Granulomatous Reaction Pattern ........................................................................... 97
Chapter 8. The Vasculopathic Reaction Pattern ............................................................................ 112
SECTION 3 The epidermis................................................................................................................. 127
Chapter 9. Disorders of Epidermal Maturation and Keratinization ................................................ 127
Chapter 10. Disorders of Pigmentation ........................................................................................ 143
SECTION 4: The Dermis and Subcutis ............................................................................................... 159
Chapter 11. Disorders of Collagen ................................................................................................ 159
Chapter 12. Disorders of Elastic Tissue ......................................................................................... 175
Chapter 13. Cutaneous Mucinoses ............................................................................................... 190
Chapter 14. Cutaneous Deposits .................................................................................................. 206
Chapter 15. Diseases of Cutaneous Appendages .......................................................................... 222
Chapter 16. Cysts, Sinuses, and Pits ............................................................................................. 237
Chapter 17. Panniculitis ............................................................................................................... 252
SECTION 5: The Skin in Systemic and Miscellaneous Diseases .......................................................... 268
Chapter 18. Metabolic and Storage Diseases................................................................................ 268
Chapter 19. Miscellaneous Conditions ......................................................................................... 284
Chapter 20. Cutaneous Drug Reactions ........................................................................................ 300
Chapter 21. Reactions to Physical Agents ..................................................................................... 316
SECTION 6 Infections and infestations ............................................................................................. 332
Chapter 22. Cutaneous Infections and Infestations ...................................................................... 332
Chapter 23. Bacterial and Rickettsial Infections ............................................................................ 348
Chapter 24. Spirochetal Infections ............................................................................................... 364
Chapter 25. Mycoses and Algal Infections .................................................................................... 380
Chapter 26. Viral Diseases............................................................................................................ 396
, Chapter 27. Protozoal Infections .................................................................................................. 412
Chapter 28. Marine Injuries ......................................................................................................... 428
Chapter 29. Helminth Infestations ............................................................................................... 444
Chapter 30. Arthropod-Induced Diseases ..................................................................................... 460
Chapter 31. Tumors of the Epidermis ........................................................................................... 476
Chapter 32. Lentigines, Nevi, and Melanomas.............................................................................. 492
SECTION 7: Tumors .......................................................................................................................... 508
Chapter 33: Tumors of Cutaneous Appendages ............................................................................ 508
Chapter 34. Tumors and Tumor-like Proliferations of Fibrous and Related Tissues ....................... 524
Chapter 35. Tumors of Fat ........................................................................................................... 540
Chapter 36. Tumors of Muscle, Cartilage, and Bone ..................................................................... 556
Chapter 37. Neural and Neuroendocrine Tumors ......................................................................... 572
Chapter 38: Vascular Tumors ....................................................................................................... 588
Chapter 49: Cutaneous Metastases .............................................................................................. 604
Chapter 40: Cutaneous infiltrates nonlymphoid ........................................................................... 620
Chapter 41: Cutaneous infiltrates—lymphomatous and leukemic ................................................ 636
, SECTION 1: Introduction
Chapter 1. An Approach to the Interpretation of Skin Biopsies
1
A 42-year-old woman presents with a 6-month history of pruritic, violaceous papules on the wrists and
oral mucosa. A punch biopsy is performed. On low-power examination, the pathologist notes a band-like
inflammatory infiltrate hugging the dermoepidermal junction with basal vacuolar alteration. What is the
most appropriate initial diagnostic approach according to Weedon?
A. Begin immunohistochemistry to classify lymphocyte subsets
B. Correlate the histologic pattern with the clinical morphology and distribution
C. Diagnose lichen planus based solely on the interface pattern
D. Perform molecular testing to exclude early lymphoma
ANS: B
Rationale: Weedon emphasizes that interpretation of skin biopsies must begin with clinicopathologic
correlation. While the histologic pattern suggests an interface dermatitis, several entities can share this
pattern. Clinical features such as pruritus, violaceous papules, and mucosal involvement are critical
before assigning a specific diagnosis. Immunohistochemistry or molecular studies are not first-line in
routine inflammatory dermatoses.
2
A shave biopsy from a scaly erythematous plaque on the scalp shows parakeratosis, regular acanthosis,
thinning of the suprapapillary plates, and dilated capillaries in dermal papillae. According to Weedon’s
approach, which histologic feature is most useful in placing this lesion into the correct diagnostic
pattern?
A. Presence of neutrophils in the stratum corneum
B. Thickness of the granular layer
C. Pattern of epidermal hyperplasia
D. Degree of dermal fibrosis
ANS: C
Rationale: Weedon advocates pattern recognition as a cornerstone of dermatopathology. Regular
psoriasiform epidermal hyperplasia immediately places the lesion into the psoriasiform dermatitis
category. While neutrophils and granular layer changes are supportive, the architectural growth pattern
is the most decisive initial feature.
3
A 60-year-old man undergoes excision of a pigmented lesion. The specimen arrives fragmented and
Edition |2026 update |Answers + Rationale | 100%
verified. | All Chapters covered.
By James W. Patterson,
,Table of Contents
SECTION 1: Introduction ...................................................................................................................... 4
Chapter 1. An Approach to the Interpretation of Skin Biopsies ......................................................... 4
Chapter 2. Diagnostic Clues............................................................................................................ 20
SECTION 2: Tissue Reaction Patterns.................................................................................................. 36
Chapter 3:The Lichenoid Reaction Pattern (Interface Dermatitis) ................................................... 36
Chapter 4: The Psoriasiform Reaction Pattern ................................................................................ 52
Chapter 5: The Spongiotic Reaction Pattern ................................................................................... 67
Chapter 6. The Vesiculobullous Reaction Pattern ........................................................................... 82
Chapter 7. The Granulomatous Reaction Pattern ........................................................................... 97
Chapter 8. The Vasculopathic Reaction Pattern ............................................................................ 112
SECTION 3 The epidermis................................................................................................................. 127
Chapter 9. Disorders of Epidermal Maturation and Keratinization ................................................ 127
Chapter 10. Disorders of Pigmentation ........................................................................................ 143
SECTION 4: The Dermis and Subcutis ............................................................................................... 159
Chapter 11. Disorders of Collagen ................................................................................................ 159
Chapter 12. Disorders of Elastic Tissue ......................................................................................... 175
Chapter 13. Cutaneous Mucinoses ............................................................................................... 190
Chapter 14. Cutaneous Deposits .................................................................................................. 206
Chapter 15. Diseases of Cutaneous Appendages .......................................................................... 222
Chapter 16. Cysts, Sinuses, and Pits ............................................................................................. 237
Chapter 17. Panniculitis ............................................................................................................... 252
SECTION 5: The Skin in Systemic and Miscellaneous Diseases .......................................................... 268
Chapter 18. Metabolic and Storage Diseases................................................................................ 268
Chapter 19. Miscellaneous Conditions ......................................................................................... 284
Chapter 20. Cutaneous Drug Reactions ........................................................................................ 300
Chapter 21. Reactions to Physical Agents ..................................................................................... 316
SECTION 6 Infections and infestations ............................................................................................. 332
Chapter 22. Cutaneous Infections and Infestations ...................................................................... 332
Chapter 23. Bacterial and Rickettsial Infections ............................................................................ 348
Chapter 24. Spirochetal Infections ............................................................................................... 364
Chapter 25. Mycoses and Algal Infections .................................................................................... 380
Chapter 26. Viral Diseases............................................................................................................ 396
, Chapter 27. Protozoal Infections .................................................................................................. 412
Chapter 28. Marine Injuries ......................................................................................................... 428
Chapter 29. Helminth Infestations ............................................................................................... 444
Chapter 30. Arthropod-Induced Diseases ..................................................................................... 460
Chapter 31. Tumors of the Epidermis ........................................................................................... 476
Chapter 32. Lentigines, Nevi, and Melanomas.............................................................................. 492
SECTION 7: Tumors .......................................................................................................................... 508
Chapter 33: Tumors of Cutaneous Appendages ............................................................................ 508
Chapter 34. Tumors and Tumor-like Proliferations of Fibrous and Related Tissues ....................... 524
Chapter 35. Tumors of Fat ........................................................................................................... 540
Chapter 36. Tumors of Muscle, Cartilage, and Bone ..................................................................... 556
Chapter 37. Neural and Neuroendocrine Tumors ......................................................................... 572
Chapter 38: Vascular Tumors ....................................................................................................... 588
Chapter 49: Cutaneous Metastases .............................................................................................. 604
Chapter 40: Cutaneous infiltrates nonlymphoid ........................................................................... 620
Chapter 41: Cutaneous infiltrates—lymphomatous and leukemic ................................................ 636
, SECTION 1: Introduction
Chapter 1. An Approach to the Interpretation of Skin Biopsies
1
A 42-year-old woman presents with a 6-month history of pruritic, violaceous papules on the wrists and
oral mucosa. A punch biopsy is performed. On low-power examination, the pathologist notes a band-like
inflammatory infiltrate hugging the dermoepidermal junction with basal vacuolar alteration. What is the
most appropriate initial diagnostic approach according to Weedon?
A. Begin immunohistochemistry to classify lymphocyte subsets
B. Correlate the histologic pattern with the clinical morphology and distribution
C. Diagnose lichen planus based solely on the interface pattern
D. Perform molecular testing to exclude early lymphoma
ANS: B
Rationale: Weedon emphasizes that interpretation of skin biopsies must begin with clinicopathologic
correlation. While the histologic pattern suggests an interface dermatitis, several entities can share this
pattern. Clinical features such as pruritus, violaceous papules, and mucosal involvement are critical
before assigning a specific diagnosis. Immunohistochemistry or molecular studies are not first-line in
routine inflammatory dermatoses.
2
A shave biopsy from a scaly erythematous plaque on the scalp shows parakeratosis, regular acanthosis,
thinning of the suprapapillary plates, and dilated capillaries in dermal papillae. According to Weedon’s
approach, which histologic feature is most useful in placing this lesion into the correct diagnostic
pattern?
A. Presence of neutrophils in the stratum corneum
B. Thickness of the granular layer
C. Pattern of epidermal hyperplasia
D. Degree of dermal fibrosis
ANS: C
Rationale: Weedon advocates pattern recognition as a cornerstone of dermatopathology. Regular
psoriasiform epidermal hyperplasia immediately places the lesion into the psoriasiform dermatitis
category. While neutrophils and granular layer changes are supportive, the architectural growth pattern
is the most decisive initial feature.
3
A 60-year-old man undergoes excision of a pigmented lesion. The specimen arrives fragmented and
