Immunology 5: part 5 Flashcards
What can be the result of lesion healing
Scarring
Where is acne most common
Where the sebaceous glands are present: Face neck upper chest
What is bullous pemphigoud
AI condition… antibody against component of basement membrane… often in elderly
blister forms
Why are special proteins required for the epitdermis and the dermis
BECAUSE the epitdermis is derived from the ectoderm and the dermis is derived from the mesoderm so you need proteins to hold them toegether via the basement membrane
Which proteins are found between the epidermis and the dermis
Tonofilaments from epidermis linking to the basement membrane, anchoring fibrils in the dermis linking to basement membrane too
lots of proteins involved
Which anitgens are involved in bollous pemphigoid
BPAg 1 and BPAg 2 Involved in hemidesmosome B cells produce produce ABs against them
Pathology of bollous pemphigoid
- The BPAg proteins are located on the basement membrane - This AI disease has autoantibodies against these proteins. Causes inflammation at the BM zone, and splitting of the epidermis from the dermis - This is a deep blister, where the deep blister split is at the location of the basement membrane (subepidermal blister)
Treatment for bollous pemphigoid
high dose oral steroids, and other immunosuppressant drugs (methotrexate) Suppresses formation of autoantibodies and allows skin to recover Must be maintained for number of years
Who does bollous pemphigoid often occur in adn what is the effect
In bullous pemphigoid, you get tense blisters. It is usually an elderly patient in their 70s/80s/90s. The condition begins with a rash (looks like eczema), followed by the development of blisters. The blisters progress, and without treatment, they become infected. Patients can then die from sepsis.
What is epidermolysis bullosa
IN BULLOUS PEMPHIGOID AND PEMPHIGUS, THERE IS AN AUTO-ANTIBODY ATTACKING THE BP PROTEIN. IF SOMEONE HAS A MUTATION IN ONE OF THE GENES FOR THESE PROTIENS, THEY GET A GENETIC BLISTERING CONDITION, CALLED EPIDERMOLYSIS BULLOSA.
Differentiate the blisters in bollous pemphigoid and pemphigus
In bullous pemphigoid, the blisters are deep. In pemphigus, the blisters are superficial.
What is the protein affected in pehmphigus vulgaris and what is the consequence
There is an auto-antibody, but this time it is directed at a component of the desmosomes(connections between the keratinocytes) within the epidermis called DESMOGLEINS 1&3 (especially between stratum spinosum.. the spinous processes in the stratum spinosum are desmosomes) It causes blisters, but these are much more superficial. Because of this, they break down and flake off ….erosions of skin.
Differentite where the split occurs in pemphigoi and pemphigus
In pemphigus within the epidermis In pemphigoid it is between epidermis and dermis
What are the causes of pustules on the skin
Infection Psoriasis Drug reaction
How is acne treated
Start off with topicals(include benzyl peroxide,topical antibiotics[like erythromycin and cindamycin-which both work against bacterial acnes and are lipd soluble so that they penetrate into the sebum]), then use systemic agents(like oral antibiotics,which have an anti-inflammatory effect on top of their antibiotic effect, and for females we can use a contraceptive pill ,which are formulated to be good for acne,such as yasmin, and if all of this does not work you can use isotretonoin, whcih has an anti-inflammatory and antiproliferative effects on the acne.
