Epidermis & Keratinization Flashcards

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1
Q

Squamous cell carcinoma characterized by?

A

Redness and scaling

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2
Q

Row of tombstones is indicative of?

A

Pemphigus vulgaris

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3
Q

Desquamation involves? (3 things)

A

1) Proteolysis of intercellular bonds via hydrolases
2) Organized dissolution of intercellular lipids
3) Keratinocytes shed singly without dry skin

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4
Q

Xerosis characterized by? (3 things)

A

Fine, white scale
Hyperkeratosis
May be itchy

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5
Q

Mechanism of xerosis (3 things)

A

1) Dehydration of keratinocytes due to decrease in Natural Moisturizing Factors
2) Decreased intercellular lipids
3) Failure to break intercellular bonds in organized fashion

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6
Q

5 endogenous causes of xerosis

A
Atopy
Ichthyosis vulgaris
Renal insufficiency
Lipid lowering medications
Malnutrition
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7
Q

Acanthosis

A

Hyperplasia of stratum spinosum due to proliferation

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8
Q

Hyperkeratosis

A

Hyperplasia of corneum due to increased production or reduced desquamation

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9
Q

Lichenification

A

Hyperplasia of spinosum and corneum due to scratching / rubbing

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10
Q

Keratosis pilaris

A

Hyperkeratosis (hyperplasia of corneum) due to retention

Tiny pink dots associated w/ hair follicles

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11
Q

Lichen simplex chronicus

A

Lichenification (hyperplasia of spinosum and corneum) due to rubbing and scratching

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12
Q

Ichthyosis vulgaris (cause, inheritance, age, appearance, association)

A
Most common disorder of cornification
Retention hyperkeratosis
Autosomal dominant
Appears in childhood
Fish scale appearance (polygonal)
Associated with atopic triad, hyperkeratosis pilaris, and hyper linear palms
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13
Q

Palmoplantar Keratoderma (cause, inheritance, 3 subtypes, and treatment)

A

Hyperkeratosis of palms and soles
Autosomal dominant and recessive
Due to keratin mutation
Diffuse - thick, yellow plaques; associated w/ hyperhidrosis (excess sweating)
Focal - Hyperkeratosis over pressure points
Punctate - Hyperkeratotic papules w/ warty apperance
Treated w/ paring hyperkeratotic areas, moisturizers, and humectants

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14
Q

Atopic dermatitis (cause, defect, sxs, tx)

A

Inflammation due to aberrant TH2 response
Filaggrin defect –> reduction in AA’s –> dehydration of corneum
Itchy rash that favors flexural surfaces
Treat with topical steroid

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15
Q

Psoriasis (inflammation, sxs, tx)

A

Inflammation due to TH1 and TH17
Hyperplasia of spinosum (acanthosis) due to increased rate of cell turnover and inflammation
Variably itchy rash that favors extensor surfaces
Red plaques, thick adherent scale, and nail changes.
Tx w/ topical steroid

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16
Q

Atopic dermatitis (cause, defect, sxs)

A

Inflammation due to aberrant TH2 response
Filaggrin defect –> reduction in AA’s –> dehydration of corneum
Itchy rash that favors flexural surfaces

17
Q

Psoriasis (inflammation and sxs)

A

Inflammation due to TH1 and TH17
Faster cell turnover
Variably itchy rash that favors extensor surfaces
Red plaques, thick adherent scale, and nail changes.

18
Q

SSSS (cause, sxs, treatment)

A

Due to exotoxin of staph aureus (Exofoliative toxins ET-A / B) attacking desmoglein 1
Toxins are renally excreted
Malaise, irritability, fever, PAIN
Cutaneous erythema starting at head and generalizing
Flacid bullae
Desquamation
Tx includes IV antibiotics

19
Q

5 steps of keratinization

A

1) Enlargement and flattening of keratinocytes
2) Filaggrin-induced keratin assembly and cross-linking to form cornfield envelop
3) Lamellar granule lipids form hydrophobic barrier
4) Degradation of organelles to form anucleate cells
5) Apoptosis
Moving upwards the whole time