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Y3- I & W > inflammatory skin diseases > Flashcards

inflammatory skin diseases Flashcards

1
Q

what does the word eczema mean

A

the greek word for boil over

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2
Q

how common is eczema

A

5% in children

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3
Q

describe eczema

A

it is a reaction pattern rather than a specific disease

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4
Q

what does the acute stage of eczema look like

A

red and weeping

can have serous exudate that can have small vesicles present

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5
Q

what does subacute dermatitis look lik

A

red skin
less exudate
itchy
crusty

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6
Q

what does the chronic stage of eczema look like

A

more scaled and leathery

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7
Q

what does eczema look like histologically

A

oedema in the skin
with fluid filled white spaces
which can cause blisters in the epidermis

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8
Q

what does the subacute chronic eczema look like

A

the epidermis is thickening and the undulation is pronounced
thick keratin layer

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9
Q

describe atopic eczema

A

starts in childhood occasionally adults

family history

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10
Q

what is atopic eczema associated with

A

asthma and hay fever

type 1 HS reaction

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11
Q

define contact irritant dermatitis

A

direct injury to skin by an irritant

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12
Q

define contact allergy dermatitis

A

can occur from metals, rubber etc

delayed type 4 HS reaction

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13
Q

what type of HS reaction is contact allergy dermatitis

A

type IV

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14
Q

describe contact allergic dermatitis

A

act as haptens which combine the epidermal protein to become immunogenic

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15
Q

describe seborrheic dermatitis

A

affects sebaceous gland rich areas eg scalp

no known aetiology

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16
Q

describe nummular dermatitis

A

coin shaped lesions- no known aetiology

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17
Q

how much of the population have psoriasis

A

1-2% of the population

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18
Q

what does psoriasis look like clinically

A 
well defined 
red oval plaques on the extensor surface
fine silvery scale
audpitz signs 
pitted nails 
sero negative arthritis
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19
Q

what is audpitz signs

A

Removal of scale causes small bleeding points

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20
Q

what do we see microscopically in psoriasis

A

Similar elongation of the undulations in the epidermis
Loss of granular layer
Elongation is very regular
Lots of lymphocytes
Little aggregates- often within the corneal layer
Thinned epidermis
Monroe micro abscesses
Postulates- little pustules can form in the epidermis seen in pustular psoriasis

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21
Q

what is the pathogenesis of psoriasis

A

autoimmune
not sure yet
think from a trigger eg trauma

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22
Q

what mutation can be seen in psoriasis

A

PSORS gene- on chromosome 6p2 implicated

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23
Q

comorbidity seen in psoriasis

A

arthritis
CVD
cancer

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24
Q

treatments for psoriasis

A

UV light

but it is a risk for non melanoma skin cancers

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25
Q

what is lupus erythematosus

A

auto immune disorder affecting the CT of the body

26
Q

what happens in systemic lupus erythematosus

A

autoantibodies directed at various tissues

may affect any part of the body but importantly kidneys

27
Q

what do we see on the skin in SLE

A

discoid LE

28
Q

in systemic LE what can we see on the skin

A

visceral disease Red scalp patches on sun exposed skin
scarring
Scalp involvement causes alopecia
Malar rash

29
Q

what is malaria rash

A

which is a butterfly shaped rash on the cheeks and nose

30
Q

what dow e see in systemic LE microscopically

A 
epidermis is thin
basal keratinocytes missing
oedema 
basement membrane thickens 
inflammation underneath- can be around the vessels
plasma cell might be prominent
lymphocytic
31
Q

describe dermatomyositis

A

peri ocular oedema and erythema

erythema in photosensitive distribution

32
Q

why might adults suffer from dermatomyositis

A

25% associated with underlying visceral cancers

33
Q

what do we see histologically in dematomyositis

A

Do not get immunoglobulins at the base of the epidermis therefore no immunofluorescence
Similar to lupus

34
Q

how can we detect SLE

A

immunofluorescence

Created antibody against human antibodies with fluorescent tag:

35
Q

describe lichen planus

A

generally in adults
duration 1-2 years
associated with HIV

36
Q

which HS reaction is lichen planus associated with

A

type IV HS reaction

37
Q

what do we see histologically in lichen planus

A

Missing keratinocytes
Inflammation pronounced
Superficial

38
Q

what is a bullous disease

A

formation of fluid filled blisters

39
Q

what are pemphigus disorders

A

by a loss of cohesion between keratinocytes resulting in a INTRAepidermal blister

40
Q

what are pemphigoid blisters

A

At the bottom of the epidermis
Tense and robust
Can be localised or extensive disease

41
Q

describe pemphigus blisters

A

fragile blisters
formed within the epidermis
antibodies to the components to the intercellular junctions

42
Q

will people have oral manifestations in pemphigus diseases

A

90% yes

43
Q

how can we detect pemphigus blisters

A

immunofluorescence

44
Q

what can we see histologically in pemphigus blisters

A

Deposition of these antibodies that causes the epidermis to fall apart
Tombstoning of the epidermis

45
Q

what is the pathogenesis of pemphigoid blisters

A

Antibodies forming to the basement membrane

46
Q

histologically what do we see in pemphigoid blisters

A

smooth boundary between top and bottom of blisters
a lot of eosinophils
inflammation varies

47
Q

describe dermatitis herpetiformis

A

Small itchy blisters
Often young pts associated with coeliac disease
IgA deposition in dermal papillae

48
Q

what is the histopathology of dermatitis herpetiformis

A

Neutrophil microabscesess in the dermal papillae
Subepidermal bulla
igA located within the bulla
Neutrophil aggregation at the base

49
Q

give examples of skin lesions as a manifestation of a systemic disease

A

acanthuses nigricans- dark warty lesions in armpit
dermatomyositis linked with visceral cancer
dermatitis herpetiformis and coeliac disease

50
Q

what is dermatomyositis associated with

A

visceral cancer

51
Q

what is dermatitis herpetiformis associated with

A

coeliac disease

52
Q

what is erythema nodosum associated with

A

infections elsewhere eg lungs

53
Q

what is erythema nodosum

A

red tender nodules on shins

54
Q

what is pretibial myxoedema seen with

A

thyroid disease

55
Q

what are the two forms of chronic idiopathic inflammatory disease

A

ulcerative colitis

cronhs disease

56
Q

describe UC

A

Disease of the colon

Inflammation begins at the rectum and moves through the large bowel
Inflammation is superficial but leads to the mucous membrane being eroded

57
Q

what are some manifestations seen in UC

A

Skin-
pyoderma ganrenosum

Joints:
Large joint arthritis
Ankylosing spondylitis

Liver:
primary sclerosing cholangitis

58
Q

describe crowns disease

A

May arise form mouth to anus
Inflammation tends to be patchy- skip lesions
Can get fistulas between the Gi tract and the skin or other bits of the organs

59
Q

what is the histological landmark of crohns disease

A

non caseating granulomas

60
Q

what are oral manifestations of crohns disease

A

deep ulcers

Y3- I & W (21 decks)

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