Exam 2 Flashcards by Mary Potkonjak

Infundibulum

Opening - sebaceous gland opens

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Isthumus

Opening of sebaceous gland to erector muscle attachment

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Matrix (hair follicle)

Rapidly dividing cells

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What are 3 types of the pilosebaceous unit?

Lanugo - fetal and anorexic
Vellus - fine, arm hair
Terminal - head, hirsutism

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What do sebaceous glands produce and where are they at the highest density?

Sebum - oil

2. Face and scalp - everywhere but palms and soles

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How do sebaceous glands secrete sebum? When are they active?

Holocrine secretion

At birth, stim by androgen production in puberty

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What are the 3 phases of the hair cycle?

Anagen (growth) ~85%
Catagen (transition) < 1%
Telogen (resting) ~15%

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Telogen effluvium

Stressor results in greater proportion of hair entering telogen phase –> inc. in amount of hair being shed – seen 3 months after event

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Alopecia Areata

Autoimmune
Smooth patches of complete alopecia develop
Nail pits
1st line: Topical corticosteroids

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What are the two types of sweat glands?

Eccrine (sweaty) - palms and soles - Sym fibers via ACh

2. Apocrine (sweaty/smelly) - secrete to infundibulum

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Anhidrosis/Hypohidrosis

Occurs when sweat glands are absent/reducted

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Acne Vulgaris

P. acnes - GP rod, dependent on glycerol –> inflammation

Androgen stim of sebum secretion & hyperproliferation follicular keratinocyte in comodone

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How do retinoids treat acne vulgaris?

Target hyperproliferization of follicular keratinocytes

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How does benzoyl peroxide treat inflammatory acne?

Oxidizes p. acnes - inflammatory acne

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Open comedones

Black heads

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Closed comedo

White heads

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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?

1. Systemic corticosteroid withdrawal 2. Beta blockers 3. Lithium 4. Anti-malarials 5. Interferons

What is the most common joint affected in psoriatic arthritis?

Asymmetric oligoarthritis particularly in knee

What are other symptoms of Psoriatic arthritis?

1. Sausage digits 2. Flexure deformities 3. Pencil-in-cup deformity 4. 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?

1. Topical steroids 2. Vitamin D - Calcipotriene 3. Topical retinoid - tazarotene 4. Salicylic or lactic acid 5. Coal tar 6. Calcineurin inhibitors - tacrolimus

What are systemic treatments for psoriasis?

1. Phototherapy - narrowband UVA and UVB 2. MTX 3. Cyclosporine 4. Acritretin 5. TNF-alpha blockers 6. IL-12/IL-23

How do you treat Lichen Planus?

1. Topical corticosteroids 2. Topical calcineurin inhibitors 3. NBUVB phototherapy 4. Oral steroids 5. Acitretin 6. Mycophenolate mofetil 7. MTX

What are secondary problems associated with atopic dermatitis?

1. Secondary staph infection | 2. Widespread HSV infection - eczema herpeticum

Management of atopic dermatitis?

1. Topical corticosteroids and immunomodulators (tacrolimus) 2. Antihistamines 3. Bleach baths 4. Phototherapy 5. Systemics - avoid systemic steroids 6. Gentle cleansers

What 3 things contribute to pathogenesis for atopic dermatitis

1. Barrier-disrupted skin 2. Triggers - allergens, microbes, scratching 3. Immune dysreg (Th2 acute, Th1 chronic)