Inflammatory dermatoses

Question 1

describe the process of atopic eczema presentation

Answer 1

1) defect in stratum corneum
2) penetration of exogenous agents - house dust mite, Staph.
3) CD4 lymphocytes activation -> Th2 response -> eosinophils activation
4) mast cell degranulation -> histamine release
5) CD8 lymphocytes activation -> Th1 response -> macrophage activation

Question 2

signs of atopic eczema

Answer 2

itchy - not well-defined area
acute: red, blisters, swollen, sore
chronic: lichenification, less red
palmar hyperlinearity - filaggrin gene mutation
eczema herpeticum (predispose to herpes simplex)

Question 3

where are the common sites of atopic eczema

Answer 3

neck

inside of elbows, knees

Question 4

what other types of eczema are there?

Answer 4

seborrhoeic eczema - greasy scale, red around nose, overgrowth of yeast, not as itchy

allergic contact dermatitis - to eyedrop, PPD(hair dye), nickel, makeup, predisposed by atopic eczema

discoid eczema - disc shape scattered around whole body, in elderly, by overwashing

Question 5

describe the process of psoriasis presentation

Answer 5

1) T cell in dermis
2) cytokines release
3) neutrophils to epidermis
4) overproduction of keratinocytes

Question 6

what are the histological presentation of psoriasis?

Answer 6

thickened epidermis
hyperkeratosis
parakeratosis (nucleus remains in stratum corneum)
acanthosis (thickening and scaling of top layer)
inflammation
dilated blood vessels -> red

Question 7

where are the common sites of psoriasis?

Answer 7

scalp
outside of elbows, knees
buttocks
groin and genitals

Question 8

what the signs of psoriasis?

Answer 8

symmetrical
slightly raised skin - well-defined area
salmon-pink colour
psoriasis soles - plaques, thick yellow scales, desquamation on pressure sites
subungual hyperkeratosis
onycholysis (lifting away of nail from nail bed)
pitting on nail
loss of cuticle

Question 9

how does atopic eczema and psoriasis differ?

Answer 9

not well-defined area vs well-defined area
inside of elbow/knee vs outside of elbow/knee
stratum corneum defect vs keratinocytes overproduction

Question 10

describe the formation of acne

Answer 10

1) hyperkeratinisation of follicle neck
2) overproduction of sebum
3) accumulation of sebum and dead cells
4) overgrowth of propionibacteria
5) inflammation

Question 11

what factors affect acne formation?

Answer 11

comedome formation
genetic predisposition
androgenic stimulation

Question 12

what are the different presentations of acne?

Answer 12

white head (closed comedome)
black head (open comedome)
nodule
pustule
papule

Question 13

what inflammatory dermatoses are autoimmune?

Answer 13

bullous pemphigoid

pemphigus vulgaris

Question 14

what causes bullous pemphigoid?

describe presentation and who it occurs to mostly

Answer 14

autoimmunity against component in basement membrane
splitting between epidermis and dermis
tense blisters = bullae
in elderly

Question 15

what causes pemphigus vulgaris?

describe presentation and who it occurs to mostly

Answer 15

autoimmunity against dermatomes
splitting within epidermis above basement membrane
in middle-aged