Exam 2 Flashcards
Infundibulum
Opening - sebaceous gland opens
Isthumus
Opening of sebaceous gland to erector muscle attachment
Matrix (hair follicle)
Rapidly dividing cells
What are 3 types of the pilosebaceous unit?
- Lanugo - fetal and anorexic
- Vellus - fine, arm hair
- Terminal - head, hirsutism
What do sebaceous glands produce and where are they at the highest density?
- Sebum - oil
2. Face and scalp - everywhere but palms and soles
How do sebaceous glands secrete sebum? When are they active?
Holocrine secretion
At birth, stim by androgen production in puberty
What are the 3 phases of the hair cycle?
- Anagen (growth) ~85%
- Catagen (transition) < 1%
- Telogen (resting) ~15%
Telogen effluvium
Stressor results in greater proportion of hair entering telogen phase –> inc. in amount of hair being shed – seen 3 months after event
Alopecia Areata
Autoimmune
Smooth patches of complete alopecia develop
Nail pits
1st line: Topical corticosteroids
What are the two types of sweat glands?
- Eccrine (sweaty) - palms and soles - Sym fibers via ACh
2. Apocrine (sweaty/smelly) - secrete to infundibulum
Anhidrosis/Hypohidrosis
Occurs when sweat glands are absent/reducted
Acne Vulgaris
P. acnes - GP rod, dependent on glycerol –> inflammation
Androgen stim of sebum secretion & hyperproliferation follicular keratinocyte in comodone
How do retinoids treat acne vulgaris?
Target hyperproliferization of follicular keratinocytes
How does benzoyl peroxide treat inflammatory acne?
Oxidizes p. acnes - inflammatory acne
Open comedones
Black heads
Closed comedo
White heads
How do topical antibiotics target acne?
Cidal p. acnes and anti-inflammatory
What are 3 types of system treatment for acne?
- Antibiotics - tetracycline, doxycycline (pill esophagitis)
- Oral contraceptives - block androgens
- Isotretinoin - teratogenic
Tinea versicolor
Malassezia spp
Oval - round scaly patches with fine overlying scale
Hyperpigmented
Where are melanocytes derived from?
Neural crest (dendritic cells)
What is the ratio of melanocytes:keratinocytes
1:10
What contributes to racial difference in skin color?
Size number and density of melanosomes - not number and density of melanocytes
What can you used to determine “white” from hypopigmented?
Wood’s light
Oculocutaneous Albinism
AD/AR - defect in tyrosinase - impaired melanin production
White - yellow/red hair w/ light/white skin
Ephelides
Freckles
Café au lait macules
Can be associated w/ Neurofibromatosis
Neurofibromatosis
AD - mutations in neurofibromin - 50% spontaneous
Cafe-au-lait macules
Axillary/inguinal freckling
Neurofibromas (adol/young adults)
Solar Lentigo
Age spots, liver spots - sun exposed
Cheek, tops of hands, after sunburn
What are triggers for psoriasis?
- Systemic corticosteroid withdrawal
- Beta blockers
- Lithium
- Anti-malarials
- Interferons
What is the most common joint affected in psoriatic arthritis?
Asymmetric oligoarthritis particularly in knee
What are other symptoms of Psoriatic arthritis?
- Sausage digits
- Flexure deformities
- Pencil-in-cup deformity
- Nail involvement
Koebner phenomenon
Seen in psoriasis - lesions at sites of injury
Auspitz sign
Seen in psoriasis - Pinpoint bleeding points when scale removed
What are 2 topical corticosteroids you can use on the face/groin?
Hydrocortisone or desonide
What are 2 topical corticosteroids you can use on the body?
Triamcinolone and hydrocortisone valerate
What are 2 topical corticosteroids you can use on the hands and feet?
Clobetasol, fluocinonide
What are topical treatments for Psoriasis?
- Topical steroids
- Vitamin D - Calcipotriene
- Topical retinoid - tazarotene
- Salicylic or lactic acid
- Coal tar
- Calcineurin inhibitors - tacrolimus
What are systemic treatments for psoriasis?
- Phototherapy - narrowband UVA and UVB
- MTX
- Cyclosporine
- Acritretin
- TNF-alpha blockers
- IL-12/IL-23
How do you treat Lichen Planus?
- Topical corticosteroids
- Topical calcineurin inhibitors
- NBUVB phototherapy
- Oral steroids
- Acitretin
- Mycophenolate mofetil
- MTX
What are secondary problems associated with atopic dermatitis?
- Secondary staph infection
2. Widespread HSV infection - eczema herpeticum
Management of atopic dermatitis?
- Topical corticosteroids and immunomodulators (tacrolimus)
- Antihistamines
- Bleach baths
- Phototherapy
- Systemics - avoid systemic steroids
- Gentle cleansers
What 3 things contribute to pathogenesis for atopic dermatitis
- Barrier-disrupted skin
- Triggers - allergens, microbes, scratching
- Immune dysreg (Th2 acute, Th1 chronic)
