DLA 38

Question 1

What is hyperkeratosis?

Answer 1

thickening of the stratum corneum

Question 2

What is parakeratosis?

Answer 2

retention of nuclei in the keratinocytes of the stratum

corneum

Question 3

What is acanthosis?

Answer 3

increase in the thickness of the stratum spinosum

Question 4

What is a vesicle?

Answer 4

a small, circumscribed elevation of the skin containing fluid, other liquid or gas

Question 5

What is a bulla?

Answer 5

a large blister appearing as a circumscribed area of separation of the epidermis from underlying structures, or of the epidermal cells

Question 6

What is a pustule?

Answer 6

a small, circumscribed elevation of the skin, containing

purulent material

Question 7

What can lead to basal cell carcinoma?

Answer 7

UV light

Question 8

What does basal cell carcinoma look like microscopically?

Answer 8

1. proliferation of basal stem cells
2. Dark nuclei with poorly defined cytoplasm
3. cells are more randomly arranged
4. can invade dermis and deeper structures

Question 9

explain squamous cell carcinoma?

Answer 9

malignant tumor of the keratinocytes

can be due to p53 inactivation due to UV

common in older people (70ish)

more likely to be seen in fair-skin people

Hyperkeratosis and parakeratosis

loss of orderly cell maturation and variability in cell structure

more common in head and neck

Question 10

What are the predisposing factors for squamous cell carcinoma?

Answer 10

1. sunlight
2. industrial carcinogens
3. chronic ulcers
4. chewing tobacco
5. burns
6. ionizing radiation
7. betel nut chewing

Question 11

explain malignant melanoma?

Answer 11

highest cause of skin cancer deaths

more common in white people

due to sun exposure

increased number of melanocytes with atypical morphology

may spread

Question 12

What are the four characteristics of a malignant melanoma?

Answer 12

1. asymmetry
2. border irregularity
3. color
4. diameter (1/4 inch)

Question 13

explain albinism?

Answer 13

autosomal recessive disease

lose of pigmentation of the eyes, skin, and hair

Question 14

why does albinism occur?

Answer 14

due to the lack of tyrosinase

Question 15

What are the two types of albinism?

Answer 15

Ocular and oculocutaneous

Question 16

what are the long term effects of albinism?

Answer 16

skin cancers

social stigma

macular hypoplasia

Question 17

Explain vitiligo?

Answer 17

depigmentation disorder

autoimmune - destruction of the melanocytes

Question 18

What are the three types of vitiligo?

Answer 18

focal, segmental, and generalized

Question 19

What are treatment options of vitiligo?

Answer 19

1. topical steroid therapy
2. depigmentation
3. psolaren photochemotherapy

Question 20

surgical treatments for vitiligo?

Answer 20

autologous skin graft

micropigmentation

melanocytes transplants

Question 21

What is psoriasis?

Answer 21

This is a chronic inflammatory and hyperproliferative disorder of the skin

Clinically manifested as well-circumscribed, erythematous and itchy plaques covered with silvery scales – knees, elbows, lower back, scalp

characterized by hyperkeratosis and parakeratosis

Question 22

what may predispose someone to psoriasis?

Answer 22

genetic background and inciting factors

Question 23

What is the pathogenesis of psoriasis?

Answer 23

Exogenous/Endogenous antigens

Antigen presentation by APCs

T-lymphocyte- mediated immune response

Cytokine secretion

Inflammation & cellular hyperproliferation

Clinical lesions of psoriasis

Question 24

What is Bullous Pemphigoid?

Answer 24

Damage to the hemidesmosomes- separation of the epidermis from dermis

chronic autoimmune blistering disease- large blisters that will not easily rupture

Question 25

why do those with bullous pemphigoid get blisters?

Answer 25

Antibodies (IgG) specific to hemidesmosomes bind to basement membrane and stimulate leukocytic infiltration

Eosinophils release proteases that degrade hemidesmosomes

Fluid accumulation – blister formation

Question 26

What is pemphigus vulgaris?

Answer 26

This is a rare autoimmune disorder that affects the epidermis and mucosal epithelium

the antibodies target cadherins and desmoplakins

blister formation - easy to rupture

Question 27

Explain acne?

Answer 27

inflammation of the sebaceous gland

Question 28

Epidermal wound healing?

Answer 28

In response to an injury, the basal cells of the epidermis surrounding the wound, break contact with the basement membrane, enlarge and migrate across the wound.

The cells migrate from opposite sides until they meet (in a sheetlike formation).

Epidermal growth factor stimulates basal stem cells to divide and replace the lost cells, that have moved into the wound.

These new cells divide to thicken the new epithelium.

Question 29

Deep wound healing?

Answer 29

penetrates the dermis

healing process is more complex and can lead to scar formation and/or loss of function

four stages:

1. inflammatory
2. migratory
3. proliferative
4. maturation

Question 30

first degree burn?

Answer 30

partial thickness

epidermis only

heals spontaneously

Question 31

second degree burn?

Answer 31

partial thickness

epidermis and dermis impacted

epithelial water barrier disrupted

heals spontaneously

Question 32

third degree burn?

Answer 32

full thickness of the epidermis, dermis, and subcutaneous tissue.

water barrier disrupted; nerves and blood vessels destroyed

does not heal spontaneously

fluid loss is extensive