13 - Basic Principles of Immunologic Diseases in Skin (Pathophysiology of Immunologic/Inflammatory Skin Diseases)

Question 1

Pellino-1 participates in toll-like receptor 4 (TLR4)– mediated signaling, a pathway known to be involved in what kind of allergy?

Answer 1

Nickel

Question 2

TRUE OR FALSE: CD4+ T cells are the primary mediators of skin inflammation in ACD.

Answer 2

FALSE. CD8+ T cells appear to be the primary mediators of skin inflammation in ACD, but CD4+ T-cell activation may be required for optimal CD8+ T-cell response.

Question 3

Severe cutaneous adverse reactions (SCARs) include what skin diseases?

Answer 3

1. Stevens–Johnson syndrome (SJS)
2. Toxic epidermal necrolysis (TEN)
3. Drug-induced hypersensitivity syndrome (DiHS) (or drug reaction eosinophilia with systemic symptoms [DRESS])
4. Acute generalized exanthematous pustulosis

Question 4

In cohorts of Han-Chinese patients, SJS/TEN that is caused by allopurinol is strongly associated with what haplotype?

Answer 4

HLA B∗58:01

Question 5

In cohorts of Han-Chinese patients, SJS/TEN that is caused by carbamazepine is strongly associated with what haplotype?

Answer 5

HLA B∗15:02

Question 6

DiHS/DRESS patients exhibit immunologic abnormalities long after resolution of the acute phase and may develop autoimmune diseases such as?

Answer 6

Hashimoto thyroiditis
Systemic lupus erythematosus
Type I diabetes

Question 7

What is the biologic agent of choice for AD and its mechanism of action?

Answer 7

Dupilumab - blocks IL-4 and IL-13 signaling by binding to IL-4Rα.

Question 8

The histology of psoriatic lesions is typified by?

Answer 8

1. a thickened, hyperproliferative epidermis
2. markedly reduced basal keratinocyte transit times
3. abnormal keratinocyte differentiation
4. neutrophilic and lymphocytic inflammation
5. prominent capillary loops that extend into the very superficial dermis

Question 9

Cytokines elevated in lesional skin in psoriasis?

Answer 9

TNFα, IL-23, and IL-17

Question 10

Genetic risk loci in psoriasis?

Answer 10

1. SNPs in the MHC Class I locus
2. Gene encoding endoplasmic reticulum aminopeptidase 1
3. Genes encoding components of signaling pathways that are operative in innate immunity
4. Genes that influence the activity of the IL-23/IL-17 axis

Question 11

T or F: Alopecia areata involves preferential association of lesional lymphocytes with the stem cell-containing bulge region of the hair follicle.

Answer 11

FALSE. Preferential association of lesional lymphocytes with ANAGEN hair bulbs.

Question 12

Pathway said to be a possible target of intervention in Alopecia areata?

Answer 12

JAK/STAT pathway

Question 13

Immunosuppressive agent that binds the cell surface protein CD20 that is expressed by B cells leading to the depletion of both normal and autoreactive B cells in patients, and the possibility of prolonged remissions in pemphigus.

Answer 13

Rituximab