Inmmun 4 : Dermatoses Flashcards

1
Q

Describe the microanatomy of skin

A

Epidermis-4 cells types-then BM
then Dermis
Then subdermis/subcutaneous tissue
epidermis, Startum conrea, papillary dermis, reticular dermis (full of collagen and fibroblasts), hypodermis

In dermis-sweat glands, sebacous glands, hair follicules

cell types: Keratynicytes, merkel cells, melanocytes, dendritic cells
Keratynocytes change (flatten, and at startum granulosum-die but full of keratin. at very top-coreum-no nucleus and dead)
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2
Q

What are the 5 layers of the epidermis and how do keratinocytes change in them? what other cells are present

A

Certain legs get sun burnt
Keratynocytes change (flatten, and at startum granulosum-die but full of keratin. at very top-coreum-no nucleus and dead)
spinisum layer cell- mostly nomral looking cell

Near BM-find melanocytes, merkel cell

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3
Q

What happens to keratinocytes when they reach the stratum conreum

A

Keratynocytes flatte and lose nucleus as reach too
Between them, lipid+protein glue that stick them togethert to from the barrier
Important protein-Filagrin . If mutated, eczema

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4
Q

What is atopic eczema? Some exemples of causes?

A

Atopy-tendency to develop hypersensitivity
Eczema-relapsing skin condition-usually in babies and grow out of it but can stay, or come back later

usually caused by defects in the skin that allow Ag to enter the skin too well
like filagrin gene mutation

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5
Q

What is atopic march?

A

that particular allergies tend to happen at certain point in life and leave later
eczema-start early, peak at 2, then goes down
Food allergt-very similar.
Asthma-peak around 6y/o
Rhinitis-increase adulthood

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6
Q

What is plamar hyperlinearity? What is it a sign of?

A

Many lines on hand-early sign of filagrin gene mutation
If patient comes in itchy-maybe with rashes-look at lines to see if have them-> if with the lines, eczema can cause dry skin and the rashes+itchyness

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7
Q

Where are the common patterns of exczema outbreaks?

A

Very young-around head, but spare mouth and nose
then on elbows, knees-when wlaking

adults change a lot

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8
Q

What are some chronic changes eczema can bring?

A

Lichenification is common-not as red, scartch marks

Severe eczema-on the whole body

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9
Q

What are some things eczema predispose to?

A

Staph aureus-acts like super Ag
And herpes simplex-virus spread amongst dead/open skin
Vesicles appear, then punched out ulcers -> called eczema herpeticum (not usually that severe because not too far)

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10
Q

What is Seborrhoaeicc, allergic contact dermatitis, dicoid eczema?

A

Seborrhoeic-not atopic
Combination of specific yeast+eczema -its dandruff
usually nose, eyebrows (treat with antifungal)-comes back in stress

allergic contact dermititis-atopic eczema predisposes but not always
sensitisation to specific allergies-like cosmetics (rash around eye), hair dye, tattoo

discoid-disc like patches of eczrma-seems realted to dryness (overwashing, older adults, atopic eczema)-moisturise, avoid soap, steroids

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11
Q

What is psioriasis?

A

Plaquy red skin-clear cut off bewteen affected skin and not affected-red, scally plaques
genetic predisposition-many many genes involved (triggers-stress, alcohol, smoking, infection (strep escpecially), some medication)

Causes by overproliferation of keratynocytes-and reach the top before full maturation-shed while immature (have nucleus). Also keratinocyte go down even deeper into dermis
Hyperkeratosis, parakeratosis (nucleus at top) acanthosis (thickening of keratinocyte layer)
Cause inflammation->dilated blood vessels (redness)

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12
Q

What areas of the body does psorioasis affect?

A

Scalp, elbow, trunk, nails (debris under nail and dystrophy of nail) genitals, feet, hands
Onycholisis (more white area at tip of nail) and pitting (into) in nails–

usually quite symetrical (usually means inflammatory rather than infections)

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13
Q

What is guttate psoriasis? And palmoplantar pustulosis? generalised pustular psoriasis?

A

Pattern of psoriasis-affects teenargers and young adults
not big plaques-little papilles (2-3mm)
Each are salmon pink and scaly like plaque
often when strep infection cause it

palmoplantar-often patients only have pustules on hand and feet-not all over psorioasis-smoking, drinking

generalised pustular- need to be sure not infection or drug causes.
If psoriasis-very superficial white tiny pustules-contain nuetrophils but Sterile-no infection
Usually all over the body-and can make people feel very unwell

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14
Q

What is Acne?

A

Disorder of the hair follicule and associated cebacous glands
genetic predisposition-usually at puberty after Ag appearance

pore-build up of debris and keratine in the opening of the pore-> build up of cebum which gets colonised by Perpionibacteria acnes-then inflam, burst, and when the pus goes to skin again-re-infect

features-black heads, white heds, papulles (combination, all at the same time

treatment-lots-ladder-skin sterlisation, topical Abx (lipophilic to dissolve in cebum), contraceptive pills, other oral Abx

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15
Q

What is bullous phemigoid? and epidermolysis bullosa

A

Deeper blisters compared to pempigous

Epidermis-ectoderm, dermis-mesoderm-why basement membrane bewteen them+specialised hemidesmosomes and BPAg1/2 (attache hemidesmosome to cell)

If either proteins genetically affected OR AID targetted
Phemigoid-AID againt BP1/2 ->in targetted area, epidemis seperate from dermis-forms large blister all over body
Steroids to prevent AB formation
Can present with just redareas w/o blistering

If one of the protein actually defective-epidermolysis bullosa-splitting of the skin (ranges from severe to very midl)

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16
Q

What is pempigus vulagis?

A

Pempigus-sligthy suppercicial blistering
Connection at spinosum layer
Ab targets the desmogleins that connects the cells (other prtoeins with similar effects cause same effet)

causes split within the epidermis-flaccid, fragile blisters
rarer than phemigoid
if not treatment veyr high chance of death-with treatment better