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MCD Y2: Immunology > Immunology 5: Inflammatory dematoses > Flashcards

Immunology 5: Inflammatory dematoses Flashcards

1
Q

What is the role of melanin in the skin?

A

Protect keratinocyte nuclei from damage

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2
Q

Recall the life cycle of a keratinocyte

A

Originates in BM
Migrates supradermally, producing keratin
Dead and anucleated by the time they reach stratum corneum
Form “bricks” in barrier of skin (“cement” = lipids)

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3
Q

Recall the general pathophysiology of eczema

A

Defect in barrier function of skin

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4
Q

Recall the types of sweat gland, and the type of secretion they produce

A

Eccrine - watery

Apocrine - viscous

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5
Q

What are the 2 main components of the matrix in the dermis?

A

Collagens

GAGs

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6
Q

Which part of the skin is affected by acne?

A

Pilosebaceous unit

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7
Q

Summarise the pathogensis of acne

A
  1. Androgenic stimulation
  2. Sebaceous gland hypertrophy
  3. Accumulation of sebum and keratin
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8
Q

What are black and white heads and what is the proper term given to them?

A

Black head = buildup of sebum + keratin at the infundibulum = open comedone
White head = black head with skin on top = closed comedone

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9
Q

What are the main areas affected by acne?

A

Face
Neck
Upper back
Upper chest

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10
Q

By what other name is eczema known?

A

Dermatitis

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11
Q

Which of the common skin conditions are classed as atopic?

A

Eczema

Acne

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12
Q

Recall how eczema tends to affect individuals over their lifetime

A

Tends to start young and go away by adulthood

Fist step in atopic march

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13
Q

Why doe seczema predispose to other atopic diseases?

A

Defective barrier function of the skin allows infiltration of other allergens

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14
Q

Recall 3 things that may enter the body through the skin due to eczema

A

Allergens
Irritants
Pathogens

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15
Q

What is the main pathogen involved in skin infection?

A

Staphylococcus aureus

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16
Q

What is the function of the filagrin protein?

A

Epidermal protein

Maintains barrier function

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17
Q

What is palmar hyperlinearity a sign of?

A

Filagrin mutation

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18
Q

What are the worst-affected areas by eczema on a baby?

A

Cheeks
Elbows
Knees

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19
Q

What are the worst-affected areas by eczema in adults?

A

Where there is sweat - eg antecubital fossa

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20
Q

Recall 4 types of eczema

A

Eczema herpeticum
Seborrheic
Allergic-contact dematitis
Discoid

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21
Q

What type of skin disease is dandruff?

A

Mild seborrheic eczema

22
Q

Recall the pathogenesis of eczema herpeticum

A

HSV able to penetrate skin due to defective barrier

23
Q

Recall which areas are most commonly affected in severe seborrheic eczema

A

Nasolabial folds
eyebrows
forehead

24
Q

Recall the pathogenesis of seborrheic eczema

A

Overgrowth of naturally-occurring yeast on skin and a secondary dermatitis reaction to this

25
Q

Recall 2 common allergens that can cause ACD

A

Makeup

PPD in black henna

26
Q

Where is the most common site affected by discoid eczema?

A

Legs

27
Q

What is the main treatment for discoid eczema?

A

Emoliant

28
Q

What is the primary form of inflammatory dermatosis?

A

Psoriasis

29
Q

Recall 4 types of psoriasis

A

Chronic plaque
Guttate
Palmoplantar pustulosis
Generalised pustular psoriasis

30
Q

Recall a common comorbidity that presents with psoriasis

A

Psoriatic arthritis

31
Q

Describe the appearance of psoriasis

A

Salmon-pink coloured plaques

32
Q

What triggers are required to cause psoriasis?

A 
Multigenic - but requires genetic susceptibility
Environmental trigger (infection, stress, drugs)
33
Q

Recall the 6 steps of the pathogenesis of psoriasis

A
  1. T cell infiltration of dermis
  2. Cytokine and TNF-a release
  3. Acanthosis
  4. Hyperkeratosis
  5. Parakeratosis
  6. Local vasodilation
34
Q

Describe the distribution of psoriasis over the body

A

Very symmetrical

ofetn affects scalp, face, elbows, groin, axilla

35
Q

What nail signs are produced by psoriasis?

A

Oncolysis

Subungual hyprkeratosis

36
Q

Describe the appearance of guttate psoriasis

A

Like little raindrops

37
Q

Which group is most susceptible to guttate psoriasis?

A

Young people

38
Q

What is the cause of guttate psoriasis?

A

Strepococcus sore throat

39
Q

What is the treatment for guttate psoriasis?

A

Antibiotics

Topical steroids

40
Q

Which form s psoriasis is driven by genetics alone?

A

Palmoplantar pustulosis

41
Q

Which form of psoriasis will require emergency hospital admission?

A

Generalised pustular psoriasis

42
Q

What is bulbous pemphigoid?

A

Autoimmune blistering condition

43
Q

What are the auto-antibodies directed against in bullous pemphigoid?

A

BP180 and BP230 - proteins that bind dermis to epidermis

44
Q

Why does bullous pemphigoid have a high mortality rate?

A

Blisters easily become septic

45
Q

Which group is most susceptible to bullous pemphigoid?

A

Elderly

46
Q

Other than bullous pemphigoid, recall a condition that results from basement membrane breakdown

A

Epidermolysis bullosa

47
Q

What is pemphigus vulgaris?

A

Autopimmune superficial blistering condition

48
Q

Recall the 2 most common autoimmune skin conditions and how they can be differentiated

A 
Bullous pemphigoid (deep)
Pemphigus vulgaris (superficial)
49
Q

Recall the appearance of pemphigus vulgaris

A

Superficial blisters that easily break to produce erosions and crusted lesions

50
Q

In pemphigus vulgaris, what is the auto-Ab directed against?

A

Desmoglein

= Component of epidermal hemidesmosome

51
Q

What is the result of auto-Ab binding to desmoglen in PV?

A

Loss of cell-cell ahesion (ancatholysis)

MCD Y2: Immunology (5 decks)

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