Derm Damage/Signs of Disease

Question 1

• Effects of UVR on skin? (6)
• Damage by UVR? (3) Which UV?
• Induces what mediators? (7)
• Induces immunosuppression or inflamm? How?
• Possible UVR outcomes? (3)
• Defense mechanisms against UVR? (4)
• Family of diseases with defects in DNA repair? What happens?
• Repair enzymes: Excision? Repair replication? Rejoinging? What else play a role?
• Damage to what is beyond reach of defenses?
• Resistant to cell death?

Answer 1

• Damage DNA, RNA, lipids, pro inflamm, immunosuppress, induce innate, apop., vit d syn
• Thymine dimers (B), pyrimidine-6-4-pyrimidone (B), Hydroxyguanisine (A)
• IL1,6,10; PGE2, VEGF, TNFalpha, histamine
• Inflamm = leukocyres; Suppress = Langerhans cells decrease, NK and T regs induce tolerance
• p53 repair, apoptosis, mutation (init., trans., prog)
• repair, apoptosis, reactive O2 enzymes, melanin
• Xeroderma Pigmentosum; Aging UVR skin cancer
• ABC nuclease; DNA polymerase, DNA ligase, XP
• Stratum corneum
• Basal cells

Question 2

• Melanocytes: Stem cells? Except where? Disease related? What is a melansome? Enzymes/cofactors for melanin synthesis? Melansome taken where? Made from? Mutation? Pigmentation based on? (3) Key melanocyte TF? Turned on by? (2)
• Vit D synthesis: UV? Syntesis of? Transported?
• Neutrogena heliopax? Parsol 1789?
• Photodermatoses: 1.) Solar urticaria, PMLE, actinic prurigo? 2.) XP? 3.) Drug, porphria? 4.) Psoriasis, atopic dermatitis?
• UVC, UVB, UVA?

Answer 2

• No, hair follicles, vitiligo; lysozome with melanin; transported in; keratinocytes; tyrosine; albinism; melanin structure, distribution, synthesis; MITF; WNT, Stem Cell Factor (SCF)
• UVB; D2/D3; kidney and liver
• Current gold standard sunscreen ingredient; good for lasting UVA
  1. ) Idiopathic; Repair defect; Chemical; photoaggrevated
• UVC = shortest wave length, least penetration, most damage

Question 3

Signs of Disease: 1.) Nails

a. ) Clubbing related to? (3)
b. ) Terry’s nails? Related to?
c. ) Half and half? Related to?
d. ) Prox subungal? Related to? Due to?
2. ) Kaposis Sarcoma: Triggered by? Type of malignancy? Due to? Often in who?
3. ) Exopthalmas? Pretibial myxderma, vitilligo and allopecia related to? Also related to? (3)
4. ) Eryhtema nodosum? Associated with?
5. ) Pyoderma gangrensom: Lesion to? Related to?

Answer 3

a. ) CVD, pulm disease, malignancies
b. ) All white underneath; liver cirrhosis
c. ) Proximal half is white; renal failure
d. ) Very white prox half; HIV; Immunosupression
2. ) HHV-8; Endothelial; immunosupression; Eastern European men
3. ) Owl eyes; Thyroid disease; anemia, diabetes, addisons
4. ) Inflammatory subcutaneous fat; IBD
5. ) Necrotic ulcer; IBD

Question 4

Signs of Disease:

6. ) Lichens pannus? Associated with?
7. ) Acanthosis nigricans: Looks like? where? Related to? (3)
8. ) Dermatomyositis: Related to? Recommend?
9. ) Urticaria: Hives related to? (3)
10. ) Steven Johnson: Looks like? Related to?
11. ) Toxic epidermal necrolysis? Related to?
    - Related to malignancies? (3)
    - Related to Drug eruptions? (4)

Answer 4

• Annular mouth lesions; Hep C
• Hyperpigmented thick skin; Neck, fat rolls; diabetes, malignancy, obesity
• Malignancy; regular screenings
• Drugs, food, infection
• Eruptions on lips; drug rxn
• Hands also involved; drug rxn
• Clubbing, acanthosis negricans, dermatomylo
• SJS, TEN, uticaria, morbilliform