Cutaneous Immunology

Question 1

What are the inflammatory mediators of innate immunity response?

Answer 1

mast cells and eosinophils

Question 2

What are the phagocytic cells of the innate immunity response?

Answer 2

neutrophils and macrophages

Question 3

how long does initial stimulation of the adaptive immune response take?

Answer 3

7-14 days

Question 4

what cytokines do TH1 cells release?

Answer 4

IFN-y and TNF

Question 5

What do IFN-y and TNF do?

Answer 5

activate macrophages, dendritic cells, neutrophils and cytotoxic T cells

Question 6

What do TH1 cells direct their attack against?

Answer 6

viruses, tumors, and intracellular pathogens

Question 7

Which cells are responsible for delayed (Type IV) hypersensitivity?

Answer 7

Th1 cells

Question 8

What do Th2 cells release?

Answer 8

IL-4, IL-5 and IL-10

Question 9

What do IL-4, IL-5 and IL-10 do?

Answer 9

activate eospinophils and plasma cells and lead to IgE production

Question 10

What do Th2 cells attack against?

Answer 10

parasites and extracellular microbes

Question 11

What cells stimulate humoral immunity?

Answer 11

Th2

Question 12

Which cells are implicated in the development of autoimmune diseases?

Answer 12

Th17

Question 13

Th1 cells are linked to what 3 pathologies?

Answer 13

Allergic contact dermatitis
Psoriasis
Drug eruptions

Question 14

What 3 pathologies are Th2 cells linked to?

Answer 14

Atopic Dermatitis
Uticaria
Asthma

Question 15

What are 5 common allergens?

Answer 15

Poison Ivy/oak
nickel
fragrances
preservatives
topical antibiotics

Question 16

What is patch testing used for?

Answer 16

To detect common allergens that could be causing allergic contact dermatitis

Question 17

What are haptens?

Answer 17

molecules that are too small to be recognized independently but are capable of stimulating the immune system after binding native proteins

Question 18

Where does atopic dermatitis affect infants?

Answer 18

face, scalp and extensor aspects of the extremities

Question 19

Where does atopic dermatitis affect older children and adults?

Answer 19

flexural regions and face

Question 20

colonization of what bacteria can contribute to atopic dermatitis?

Answer 20

staph aureus

Question 21

what is the genetic defect associated with atopic dermatitis?

Answer 21

filaggrin

Question 22

What is a good treatment for prevention of atopic dermatitis flares?

Answer 22

bleach baths–> kills colonization of staph areus

Question 23

What viral infection are those with atopic dermatitis at risk of contraction?

Answer 23

eczema herpeticum (due to impaired cell-mediated immunity

Question 24

What syndrome is associated with destructive arthritis?

Answer 24

psoriasis

Question 25

What is keobnerization?

Answer 25

trauma to the skin that leads to more inflammation (scratching)

Question 26

What is guttate psoriasis?

Answer 26

presents with small round papules and plaques; often precipitated by strep infection

Question 27

What is the defining histological characteristic of psoriasis?

Answer 27

presence of neutrophils

Question 28

What disease presents with angioedema?

Answer 28

Urticaria

Question 29

What is angioedema?

Answer 29

affects the deep dermis and causes painful swelling often of the lips and face

Question 30

What is the most defining feature of urticaria?

Answer 30

evanesence--> symptoms resolve after 24 hours

Question 31

Urticaria is a ____ type hypersensitivity

Answer 31

type I

Question 32

What is dermatographism?

Answer 32

when light scratching results in itchy linear wheals that can be "read" minutes later

Question 33

What causes Dermatographism?

Answer 33

very excitable mast cells

Question 34

What medications most commonly cause drug eruptions?

Answer 34

antibiotics, anticonvulsants and NSAIDS

Question 35

what is the systemic parallel of allergic contact dermatitis?

Answer 35

Exanthematous drug eruption

Question 36

What is DRESS?

Answer 36

DRug Eruption with Eosinophilia and Systemic Symptoms; characterized by exanthematous eruption with fever, lymphadenopathy, and facial edema

Question 37

When is the onset of DRESS

Answer 37

15-40 days after initial stimuli

Question 38

When does ACE-inhibitor angioedema occur?

Answer 38

days to YEARS after exposure

Question 39

Describe some common features of Steven-Johnson Syndrome/ Toxic Epidermal Necrolysis.

Answer 39

Immune system activates a cascade of apoptosis --> widespread epidermal necrosis characterized by erythematous and dusky macules fever and systemic syndromes PAINFUL