Immunology and Skin

Question 1

Dermo-epidermal junction structure and conseqeunce of autoimmunity.
Common disease associated
associated event

• ________ anchored by ________.
• weakening = _____
• _____ ______: _____ disease, ___ antibodies against ________ proteins
• associated with ______ event, loss of ____, due to immune response to ____ antigen in ____ tissue

Answer 1

• Keratinocytes anchored by hemidesmosomes.
• weakening = blisters
• Bullous pemphigoid: autoimmune disease, IgG antibodies against hemidesmosomal proteins
• associated with cerebrovascular event, loss of BBB, due to immune response to BP antigen in neural tissue

Question 2

How are keratinocytes connected? autoimmunity consequence?

With ______.
_____ ______, is in the _____.
____ antibodies against ______.
_____ _____ and _____ involvement.

Answer 2

With desmosomes.
Pemphigus vulgaris, is in the epidermis.
IgG antibodies against desmosome.
Superficial erosions and oral involvement.

Question 3

Immunofluorescence, BP and PV

Answer 3

Punch biopsy of skin, anti human antibodies directed against antibodies that cause BP and PB with fluorescent tag.
BP: IgG deposition at dermo-epidermal junction
PV: IgG within epidermis

Question 4

Example of a disease due to broken down epidermis

• _____ ______
• _____ (top) layer of epidermis contains ______, which is converted to _____ which makes _____ ______ ______ (_____ epidermis)
• _____ mutation more likely to have _____ _____

Answer 4

• Atopic eczema
• Granular (top) layer of epidermis contains profilaggrin, which is converted to filagrin which makes natural moisturising factor (cements epidermis)
• Filaggrin mutation more likely to have atopic eczema

Question 5

allergic Contact dermatitis

Answer 5

• An example of type 4 hypersensitivity, can occur with fabric metal ions etc. Can be due to a weakened epidermis?
• patient with atopic dermatitis (eczema) more likely to have allergic contact dermatitis

Question 6

Contact dermatitis types

Answer 6

More likely when have had atopic dermatitis (eczema)
Irritant: wear and tearof substance, substance enters and causes inflammation
Allergic: substance amounts an iimune response

Question 7

Why are patients immunosuppressed

Answer 7

• treat severe disease, e.g BP with prednisone, methotrexate and azathiprine
• because of disease, HIV
• Organ transplantation

Question 8

Neoplasia and immunosuppression

Answer 8

Skin cancer risk increases when immunosuppressed.
SCC more common in immunosuppressed.
Need a competent immune system

Question 9

Psoriasis

Answer 9

Plaques?
TNF-a important in pathogenesis. Drugs to stop, Adalimumb.
Guselkumab really good