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Dermatology > Dermatology Immunology > Flashcards

Dermatology Immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the immune and non immune cells involved in the Epidermis?

A

Non immune: keratinocytes

Immune: Langerhans, T cells

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2
Q

What is the role of the keratinocytes cells in skin immunity?

A
  • Sense pathogens and mediate immune response via cell surface receptors
  • Can be activated by UV light and sensitisers (e.g. allergic contact dermatitis)
  • Produce AMP (antibodies) that directly kill pathogen
  • High AMP in psoriasis patients
  • Produce cytokines and chemokines
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3
Q

In what condition is there a high AMP?

A

Psoriasis

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4
Q

What is the role of the langerhans cells in skin immunity?

A
  • Act as sentinels (first line defence)
  • Help to activate T cells by processing lipid Ag and microbial fragments and presenting them to effector T cells
  • The antigen presenting granules are known as Birbeck Graules
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5
Q

What does TH1 and TH2 protect against?

A

TH1 protects against viral invaders

TH2 against parasitic invaders

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6
Q

Where are T cells produced?

A
  • Produced in bone marrow

- Synthesised in thymus

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7
Q

Which conditions are associated with TH1 and TH2 cells?

A 
TH1= psoriasis
TH2= atopic dermatitis
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8
Q

Which conditions are associated with TH17?

A

Psoriasis and atopic dermatitis

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9
Q

What is the function of TH1 cells?

A

To activate macrophages, destroy micro-organisms

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10
Q

What is the function of TH2 cells?

A

Help B cells make antibodies

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11
Q

Where are CD4 and CD8 cells found in the skin?

A

CD4 and CD8 found in the dermis

CD8 in the epidermis

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12
Q

Why do histamines not always work?

A

There are numerous newly synthesised mediators

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13
Q

What cells are found at the dermis?

A
  • Macrophages and neutrophils (though more abundant at site of infection)
  • APCs (transmit info to B and T cells)
  • Mast cells (effectors of IgE immune response)
  • Dendritic cells- both dermal and plasmacytoid
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14
Q

What is the role of Dermal and Plasmacytoids?

A
  • Both dendritic cells found in dermis
  • Dermal is involved in antigen presentation and secretes chemokines and cytokines
  • Plasmacytoid produces IFNalpha
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15
Q

Name some skin conditions associated with inappropriate immune response

A

-Psoriasis, Atopic Dermatitis, Bullous Pemphigoid, Contact dermaitis, systemic sclerosis, Urticaria, Systemic Lupus Erthyematous, Skin infections and tumours

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16
Q

What is the differences between class I and class II in the major histocompatibility complex?

A

Class I: found on all cells, present antigen to CD8, endogenous antigen

Class II: found on B cells, macrophages, more specific
Present to CD4 cells, exogenous antigen

17
Q

What are the TH2 specialists in lymph nodes?

A

Langerhans cells

18
Q

What is the most common trigger for psoriasis?

A

Psychosocial stress eg bereavement or due to infections

19
Q

What is the hallmark of skin lesions in psoriasis?

A

Inflammation

20
Q

Are psoriasis plaques irreversible?

A

Yes

21
Q

When can psoriasis plaques occur?

A

After surgery as a late phase wound reaction

22
Q

What is psoriasis triggered by?

A

Environmental factors in genetically susceptible individuals (risk factor genes)

23
Q

What other medical conditions should be asked about in psoriasis?

A

-Gastritis, arthritis or may have an underlying infection acting as a trigger

24
Q

What is the pathogenesis of psoriasis?

A

Keratinocytes under stress–>
Release factors that stimulate dendritic cells to produce IFN alpha–>
Release IL-IB/IL-6 and TNF–>
Dendritic cells are activated and migrate to skin draining lymph nodes–>
TH1 and TH17 activated–>
T cells attracted to dermis by cytokines–>
Keratinocytes proliferation stimulated, AMP released–>
Dermalfibroblasts involved, KC released

25
Q

What IL is clinically relevant in psoriasis?

A

IL-17

26
Q

What IL is clinically relevant in atopic eczema?

A

IL-4

27
Q

What kind of reaction occurs in psoriasis?

A

Feed forward

28
Q

What is fillagrin?

A

A protein which is chopped down by enzymes. The left over molecules work hydroscopically to maintain water retention in the skin, working as a natural skin moisturiser

29
Q

What are filligrin mutations associated with?

A

Severe/early onset atopic eczema

30
Q

What should you look at in eczema?

A

Hands, should be lots of lines

Dermatology (14 decks)

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