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YR2: Immunology > Inflammatory dematoses > Flashcards

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

Describe the life cycle of a keratinocyte

A

Originates in BM
Proliferates
Migrates supradermally, producing keratin
Dead + anucleated by the time they reach stratum corneum

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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 underlying acne

A

Genetic predisposition + Androgenic stimulation
Sebaceous gland hypertrophy
Accumulation of sebum + keratin: colonised by bacteria
Comedone formation

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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 + go away by adulthood

1st step in atopic march, predisposing to food allergies, asthma + rhinitis

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13
Q

Why does eczema 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 pathogen can act as a “super antigen”, thereby worsening eczema?

A

Staphylococcus aureus

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16
Q

What is the function of the filagrin protein?

A

Epidermal protein maintaining barrier function

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17
Q

What is palmar hyperlinearity a sign of?

A

Filagrin gene 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

Areas of sweating + flexure

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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

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22
Q

Recall the pathogenesis of eczema herpeticum

A

HSV able to penetrate skin due to defective barrier

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23
Q

Recall which areas are most commonly affected in severe seborrheic eczema

A

Nasolabial folds
Eyebrows
Forehead

24
Q

Describe the pathogenesis of seborrheic eczema

A

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

25
Q

Recall 3 common allergens that can cause Allergic Contact Dermatitis

A

Cosmetics
Eye drops
PPD in black henna/ hair dye

26
Q

Where is the most common site affected by discoid eczema? What is the main cause of discoid eczema?

A

Legs

Dryness

27
Q

What is the main treatment for discoid eczema?

A

Emoliant

28
Q

Describe 3 characteristics of Psoriasis

A

Erythematous plaques
Well defined
Scaley

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

What triggers are required to cause psoriasis?

A 
Multigenic: but requires genetic susceptibility
Environmental trigger (infection, stress, drugs)
32
Q

Describe the pathogenesis of psoriasis

A

T cell activation; Cytokine + TNF-a release
Stimulate Hyperkeratosis (thickening of keratin layer)
Parakeratosis (Corneocytes don’t lose their nuclei)
Acanthosis (thickening of the epidermis)
Inflammation of epidermis (neutrophils) + dermis (lymphocytes)
Local vasodilation

33
Q

Describe the distribution of psoriasis over the body

A

Very symmetrical

often affects scalp, face, elbows, groin, axilla

34
Q

What nail signs are produced by psoriasis?

A

Oncolysis (nail splitting away from bed)
Subungual hyperkeratosis (buildup of debris under nail)
Cuticle loss
Pitting

35
Q

Describe the appearance of guttate psoriasis

A

Small papules

Like little raindrops

36
Q

Which group is most susceptible to guttate psoriasis? What exacerbates guttate psoriasis?

A

Young people

Streptococcus sore throat

37
Q

What is the treatment for guttate psoriasis?

A

Antibiotics

Topical steroids

38
Q

Which form of psoriasis is driven by genetics alone?

A

Palmoplantar pustulosis

39
Q

Which form of psoriasis will require emergency hospital admission? Describe the presentation of a patient with this

A

Generalised pustular psoriasis

Widespread pustules covering skin, inflammation, increased HR, febrile

40
Q

What is bullous pemphigoid?

A

Autoimmune blistering condition

Split in skin is deep

41
Q

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

A

Proteins that bind dermis to epidermis

42
Q

Which group is most susceptible to bullous pemphigoid? and why is there a high mortality rate?

A

Elderly

Blisters easily become septic

43
Q

Other than bullous pemphigoid, recall a condition that results from basement membrane breakdown. What is this caused by? What does this cause in babies?

A

Epidermolysis bullosa
Genetic defect in proteins holding basement membrane, epidermis + dermis together
Shearing of the skin

44
Q

What is pemphigus vulgaris?

A

Autoimmune superficial blistering condition

45
Q

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

A 
Bullous pemphigoiD (DEEP)
Pemphigus vulgariS (Superficial)
46
Q

Recall the appearance of pemphigus vulgaris

A

Superficial blisters that easily break to produce erosions + crusted lesions

47
Q

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

A

Desmoglein

= Component of epidermal hemidesmosome

48
Q

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

A

Loss of cell-cell adhesion

Split in epidermis

49
Q

Describe the structure of the stratum corneum

A

Corneocytes form “bricks” in barrier of skin
Lipids + surface proteins form”cement”
Creates barrier

50
Q

Describe the nature of atopic eczema

A

Common, relapsing + remitting

51
Q

What change may occur in chronic eczema?

A

Lichenification- thickening of skin with accentuated markings
Poorly defined

52
Q

What is seen when eczema occurs all over the body?

A

Erythroderma

53
Q

List 5 clinical features of acne

A 
Whiteheads
Blackheads
Papules
Pustules
Nodules
54
Q

What treatment is used for acne?

A 
Topical antibiotics (kill bacteria + anti-inflammatory)
Certain contraceptive pills (anti-adrenergic effects)
55
Q

Who is effected more by pemphigus vulgaris and bullous pemphigoid?

A

PV: Adults aged 30-50
BP: Elderly

YR2: Immunology (5 decks)

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