Dermatology 1 Flashcards
1
Q
What part of the skin is involved in shock absorbance and thermoregulation?
A
subcutaneous layer
2
Q
Where do you find anexal structures (aka hair follicles and sebacous glands)?
A
dermis
3
Q
the epidermis is a layer of (blank) cells that produces keritan.
A
stratified squamos cells
4
Q
What is the lowest layer of the epithelium, this layer is responsible for regenerating keritinocytes.
A
stratus basale
5
Q
What layer of the epidermis produces cytokeratins that form tonofibrils that make desmosomes (intercellular bridges)?
A
stratum spinosum
6
Q
What layer of the epidermis is darker blue because of Keratohyaline granules?
A
stratum granulosum
7
Q
WHen keratohyaine granules and tonofibrils combine they produce (blank) and as they mature they are manifested in the stratum (Blank) where they lose their nuclei and cytoplasm
A
keratin
stratum corneum
8
Q
(blank) function in protecting the skin from UV injury
A
Melanocytes
9
Q
(blank) function in antigen recognition in the immune system
A
Langerhann cells
10
Q
What do you find under the epidermis that connects it to the dermis?
A
the basement membrane
11
Q
The skin is the largest organ and undergoes (blank) forces. To combat these forces the epidermis has (blank).
A
sheering
ridges
12
Q
What are the 2 layers to the dermis?
A
Papillary
Reticular layer
13
Q
the (blank) is partially water-soluble.
A
epidermis
14
Q
What layer is this: loose collagen, capillaries, Meissner’s corpuscles.
A
Papillary dermis
15
Q
What is below the papillary layer of the dermis?
A
reticular dermis
16
Q
What layer is this:
densely packed collagen, elastic fibers
A
reticular dermis
17
Q
What is the function of the reticular dermis?
A
to provide strength and extensibility
18
Q
Which layer of the dermis has the adenexal structures?
A
reticular dermis
19
Q
Where do you find apocrine sweat glands?
A
axilla, groin
20
Q
Where do you find eccrine glands?
A
sweats
21
Q
soles and palms dont have (blank) structures. they have thicker layers of (blank)
A
adnexal
keratin (stratum lucidum)
22
Q
What is this:
circumscribed, flat lesions <5mm distinguished from surrounding skin by color
A
Macule
23
Q
What is this:
circumscribed flat lesion >5mm distinguished from surrounding skin by color
A
patch
24
Q
What is this:
elevated dome-shaped or flat-topped lesion <5mm
A
Papular
25
What is this:
| elevated dome-shaped or flat topped lesion >5mm
Nodule
26
What is this:
| elevated flat-topped lesion >5mm
plaque
27
What is this:
| Discrete, pus-filled, raised lesion
pustule
28
What is this:
| Dry, horny, platelike excrescence; usually the resut of imperfect cornification
Scale
29
What is this:
| fluid filled raised lesions <5mm, also called a blister
Vesicle
30
What is this:
| fluid filled raised lesion > 5mm, also called a blister.
Bulla
31
What is this:
| Itchy, transient, elevated lesion with variable blanching and erythema formed as the result of dermal edema.
wheal
32
Which kind of skin things are sharply demarcated?
macule
| patch
33
If your skin thing is fluid, then what is it?
vesicle/bulla
34
If your skin thing is pus, then what is it?
pustule
35
What do you call diffuse epidermal hyperplasia?
acanthosis
36
What do you call abnormal, premature keratinization within cells below the stratum granuosum?
Dyskeratosis
37
What do you call hyperplasia of the stratum granulosum?
hypergranulosis
38
What do you call a thickening of the stratum corneum?
hyperkeratosis
39
What do you call a linear pattern of maloncyte proliferation within the epidermal basal cell layer?
Lentiginuous
40
What do you call a surface elevation caused by hyperplasia and enlarement of contiguous dermal papillae?
papillomatosis (papilla fragmentation)
41
What do you call keritinization with retained nuclei in the stratum corneum?
parakeratosis
42
What do you call intercellular edema of the epidermis?
spongiosis
43
Thickening of stratum corneum but with retained nuclei is (blank)
parakeratosis
44
What is this:
| surface elevation, caused by hyperplasia and fragmentation of dermal papilla.
papillomatosis
45
What is this:
| edema that pushes apart stratum spinosum; intracellular bridges become very prominant
spongiosis
46
What is this:
| radial growth pattern of pigmentation along the stratum basale.
Lentiginous
47
What is this:
| abnormal keratinization due to malignant change; cells keratinize prematurely below the granulosom.
Dyskeratosis
48
What are the 2 types of inflammatory dermatoses?
acute
| chronic
49
Acute inflammatory dermatoses is characterized by (blank)
lymphocytic and macrophage inflammatory infitrate and edema
50
How long does acute inflammatory dermatoses last?
days to weeks
51
How long does chronic inflammatory dermatoses last?
persist for months to years
52
Chronic inflammatory dermatoses is characterized by (blank)
changes in epidermal growth (atrophy or hyperplasia) or dermal fibrosis
the skn is roughened due to excess or abnormal
53
What is this:
common disorder characterized by localized mast cell degranulation and dermal microvascular hypermeability.
-patients present with pruiritic edamtous plaques (wheals)
-Angioedema is a related condition with edema of the deeper dermis and subcutaneous fat
Urticaria (hives)
54
How long does urticaria (hives) last?
can be acute (less than 6 weeks) or chronic
55
if you have urticaria, what will the histo slide show?
edema in the papillary dermis
56
What are the causes of urticaria?
```
immunologic mechanisms
non-immunologic mechanisms
physical stimuli
skin contact
small vessel vasculitis
```
57
What is the treatment for urticaria?
avoidance of specific allergense
oral H1 antagonists
epinephrine
58
What is the most common acute inflammatory dermatoses?
acute eczematous dermatitis
59
Acute eczematous dermatitis can be subdivided into 5 categories, what are they?
-Allergic contact dermatitis
-Atopic dermatitis
-drug-related eczematous dermatitis
-photoeczematous dermatitis
Primary irridant dermatitis
60
What kind of reaction is atopic dermatitis?
type 1 hypersensitivity reaction
61
Drug related ecematous dermatitis, photoeczematous dermatitis, and primary irritant dermatitis are all types of (blank) dermatitis
contact
62
Acute eczematous dermatitis results from (blank) which is a type IV hypersensitivity reaction
T-cell mediated inflammatory reactions
63
What are the causes of acute eczematous dermatitis?
inside: reaction to an internal circulating antigen
outside: reaction from external application of an antigen
64
What is the treatment of acute eczematous dermatitis?
removal of the offending substance and topical steroids
65
What is this:
self-limited hypersensitivity reaction that is associatd with infections from virus (herpes simplex), bacteria (mycoplasma, leprosy, typhoid), fungus (histoplasma, coccidioides)
Erythema mulitforme
66
Exposure to which drugs can cause erythema multiforme?
sulfonamides, penicillin, barbiturates, salicylate, antimalarias.
67
What are the four causes of erythema multiforme?
Infections
Drugs
Cancer
Collagen vascular disease
68
What are targetoid lesions and where are they found?
Central epidermal necrosis surrounded by erythema
| Erythema Muliforme
69
What are the 2 types of Erythema multiforme?
Stevens Johnson Syndrome
| Toxic Epidermal Necrolysis
70
What is this:
- a febrile form with extensive skin involvement
- also involves oral mucosa, conjunctiva, urethra, genital and perinanal areas,
- may lead to spesis
- often seen in children
Erythema Multiforme-Stevens Johnson Syndrome
71
What is this:
- characterized by diffuse necrosis and sloughing of cutaneous and mucosal epithelial surfaces
- clinical pictures similiar to that of burn atients
Erythema multiforme-toxic epidermal necrosis
72
What is this:
- a common disorder affecting 1-2% of the US population
- results from interaxn's of genetic (HLA-C) and environmental factors (trauma)
- Activated T cells in skin stimulate cytokine and grow
Psoriasis
73
In Psoriasis patients, 15% of them have (blank) associated with it.
arthritis
74
What does psoriasis happen?
activated T cells in the skin stimulating the secretion of cytokines and growth factors that induce keratinocyte proiferation
75
What is the genetic element associated with psoriasis?
HLA-C
76
Where do you typically find psoriasis?
on exterior surfaces and scalp
77
What all can you see in psoriasis?
- acanthosis
- parakeratosis
- Munro microabscesses
- elongated dermal papillae
78
What do you call a collection of neutrophils in the stratum corneum?
munro microabscesses
79
What does elongated dermal papilae result in?
pinopoint bleeding when scale is picked off "Auspitz sign"
80
What are the treatments for psoriasis?
-topical steroids*******
-intralesional steroid injection
-UVB and tar******
-methotrexate
-cyclosporino
-soriatane
(UVB and Psoralen)
81
What is this:
- common chronic inflammatory dermatosis that affects up to 5% of the general pop.
- Involves regions with high density of sebacous glands
Seborrheic dermatitis
82
Where do you often find seborrheic dermatitis?
```
scalp
foreheard
external auditory canal
retroauricular canal
retroauricular area
nasolabial folds
presternal area
```
83
What disease is "cradle cap" associated with?
seborrheic dermatitis
84
What are the causes of sebhorreic dermatitis?
increased sebum production
| colonization of the skin by malassezia
85
When do you see the severe form of sebhorreic dermatitis?
in HIV + patients with low CD4 counts
86
What is increased sebum production due to?
hormones
87
The appearance of sebhorreic dermatitis is seen on skin as (blank)
erythematous plaques
88
What is the treatment of sebhorreic dermatitis?
- frequent washing of the affected area with antisebhoreic soaps
- topical steroids
- anti-yeast medications
- oral antifungals
89
What is this:
self-limitd condition most commonly resolving spontaneously 1-2 years after onset.
Involves the 6 Ps.
Lichen planus.
90
What are the 6 Ps of Lichen planus?
Pruritic, purple, polygonal, planar, papules, and plaques
91
Resolution of lesions of lichen planus results in (blank)
postinflammatory hyperpigmentation
92
In lichen planus, (blank) may develop in oral lesions
squamos cell carcinoma
93
Oral involvement in lichen planus manifests as (blank)
Wickham striae
94
What is wickham striae?
white areas within purple plaques caused by hypergranulosis
95
What type of disease is this:
| inflammation of the dermal-epidermal junction with a saw-tooth appearance.
Lichen planu
96
What is the treatment of lichen planus?
- topical steroids
- intralesional steroids
- systemic steroids
- azathioprine
- cyclosporine
- light therapy (PUVA & UVB)
97
Many conditions exist in which blisters are a feature of the condition.... what are the four?
Herpes virus
Spongiotic dermatitis
Erythema multiforme
thermal burns
98
(blank) disorders are a group of diseases in which blisters are the primary and most distinctive feature.
bullous (bistering)
99
Blistering disorders are due to (inflammatory/non-inflammatory) causes
Both!!
100
Where do you find pemphigus foliaceus? What protein is affected in this case?
submucosal blistering disorders
| Desmoglein I
101
Where do you find pemphigus vulgaris? What protein is affected in this case?
suprabasal
| desmoglein III
102
Where do you find bullous pemphigoid? What protein is affected in this case?
Subepidermal
| Hemidesmosome
103
What will you find within the desmosome of the stratum spinosum?
desmoglein (pemphigus), plakophilin, plakogloblin, desmoplakin, desmocolin
104
What will you find within the hemidesmosome of the basement membrane?
BPAG1, BPAG2 (pemphigoid), intermediate fibers
105
(blank) is an inflammatory blistering disorder caused by autoantibodies that result in the dissolution of intercellular attachments within the epidermis and mucosal epithelium
Pemphigus
106
Why do you get pemphigus?
IgG autoantibodies to desmoglein 1 and 3 disrupt intercellular adhesions of desmosomes
107
What are the varients of pemphigus?
- pemphigus vulgaris
- pemphigus vegetans
- pemphigus foliaceus
- pemphigus erythematosus
- paraneoplastic pemphigus
108
What is the most common pemphigus (80%) and it is found on the oral mucosa?
pemphigus vulgaris
109
What is a rare pemphigus that shows up as plaques around groin?
pemphigus vegetans
110
What type of pemphigus shows up as subcorneal blisters?
pemphigus foliaceus
111
What type of pemphigus is this, it is a form of foliaceus bt less severe?
pemphigus erythematosus
112
What type of pemphigus is this; associated with cancer
paraneoplastic pemphigus
113
If you see a tombstone row, what are you looking at?
pemphigus
114
If you see a swiss cheese partern then what are you looking at?
pemphigus foliaceus
115
How do you treat pemphigus?
immunosuppressive agents to decrease the titers of the pathogenic antibodies
116
(blank) is a blistering disorder caused by autoantibodies directed to the proteins that bind basal keratinocytes to the basement mebrane. Antibody deposition occurs in a (blank) pattern at the dermoepidermal junction.
Bullous pemphigoid
| linear
117
The proteins (blank) are part of the hemidesosomes that link basal keratinocytes to the basement membrane.
BPAGs
118
If you see linear IgG on root of blister on a histo slide, what are you looking at?
bullous pemphigoid
119
What is the treatment for bullous pemphigoid?
topical steroids
systemic steroids
methotrexate
azathioprine
120
What is this:
| rare disorder characterized by urticaria and grouped vesicles. Strong association with HLA-B8, HLA-DR3 and HLA-DQw2
Dermatitis herpetiformis
121
In dermatitis herpetiformis, genetically predisposed individuals develop (blank) antibodies to dietary gluten.
IgA
122
Why do you get subepidermal blisters in dermatitis herpetiformis?
IgA antibodies to dietary gluten, these antibodies cross react with reticulin which is a component of the anchoring fibrils that attaches the epidermal basement membrane to the superifical papillary dermis.
123
If you see a subepidermal blister , what are you looking at?
dermatitis herpetiformis
124
What is the treatment for dermatitis herpetiformis?
dapsone
| sulfapyridine
125
What is this:
inherited defect in structural proteins that cause mechanical instability to the skin. Clinical manifestations soon after birth with blister formation at sites of pressure, rubbing or trauma.
Epidermolysis bullosa
126
What are the 4 types of epidermolysis bullosa?
simplex
junctional
dystrophic
mixed
127
What type of epidermolysis bullosa is this:
autosomal dominant inheritance of defects in keratin 14 or keratin 5 resulting in defects in the basal cell layer of the epidermis.
Simplex type
128
What type of epidermolysis bullosa is this:
autosomal recessive inheritance of defects in laminin, a protein at the lamina lucida. Blisters are seen at the level of the lamina lucida.
Junctional type of epidermolysis bullosa
129
What does the lamina lucida do?
binds to both hemidesmosomes and anchoring filaments
130
What makes up the basement membrane?
lamina lucida +lamina densa
131
What type of epidermolysis bullosa is this:
autosomal dominant or recessive inheritance of defects in type VII collagen (a major component of the basement membrane anchoring fibrils)
Defects causes blisters at the level of lamina densa.
This is a scarring disorder.
Epidermolysis bullosa
132
Why does epidermolysis bullosa cause scarring?
cuz its a collagen defect
133
Dystrophic type of epidermolysis bullosa can be inherited autosomal dominant or recessive due to defects in (blank)
type VII collagen
134
(blank) is a mjor component of the basement membrane anchoring fibrils.
type VII collagen
