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Dermatology > Intro: Skin Structure > Flashcards

Intro: Skin Structure Flashcards

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Dermatology Board Prep flashcards
1
Q

List some causes of skin disease

A

-genetics -irritants -allergens -drugs -sunshine -temperature/humidity -infections

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2
Q

What are the two main layers of the skin?

A
  • epidermis: outer layer: stratified cellular epithelium
  • dermis: under epidermis: connective tissue
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3
Q

What does epidermis derive from?

A

Ectoderm

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4
Q

What does ectoderm become by week 4 ?

A

-periderm -basal layer -dermis

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5
Q

By 16 weeks what layers of skin have developed?

A

-keratin layer -granular layer -prickle cell layer -basal layer -dermis

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6
Q

What are Blaschko’s lines and what does skin disease along these lines mean?

A

-developmental growth pattern of skin -that disease is due to genetic error

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7
Q

What are 5 components of skin?

A

-epdermis -appendages: nails, hair, glands, mucsoae -dermo-epidermal junction -dermis -sub-cutis

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8
Q

What is skin scar defined by?

A

lack of appendages (nails, hair, glands, mucosae)

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9
Q

Pilum

A

hair

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10
Q

pilosebaceous unit

A

relating to gland/hair

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11
Q

Epidermal cell layers

A

-keratin layer -granular layer -prickle cell layer -basal layer

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12
Q

Why called prickle cell?

A

because held together by desmosomes that look like prickles

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13
Q

Label this diagram.

A
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14
Q

What cells make up 95% of the epidermis?

A

Keratinocytes

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15
Q

What are 4 layers of the epidermis?

A
  • keratinous layer
  • granular layer
  • prickle cell layer
  • basal layer
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16
Q

What 3 factors control epidermal turnover?

A
  • growth factors
  • cell death
  • hormones
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17
Q

What 2 skin diseases are a result of loss of control of epidermal turnover?

A
  • psoriasis
  • skin cancer
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18
Q

What are 4 cells in the epidermis?

A
  • keratinocytes
  • Langherhans
  • Merkel cells
  • melanocytes
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19
Q

Where do keratinocytes orginate from and what happens as they migrate to surface?

A
  • Basal layer
  • differentiate as they migrate
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20
Q

What is significance of desmosomes holding together prickle cells?

A

desmosomes allow both stability and some flexibility

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21
Q
A
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22
Q

What are rete ridges in the skin?

A

Downward projections of the epidermis into the dermis

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23
Q

What do keratinocytes synthesise in the basal layer?

A

keratin filaments and desmosomal proteins

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24
Q

What do keratin filaments and desmosomal proteins make up in the cell?

A
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25
Q

What is synthesised in the granular layer and what cells secrete them?

A
  • lipid & lipid hydrolases
  • secreted by lamellar bodies
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26
Q
A
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27
Q

What do lipid and lipid hydrolases form?

A

a water-tight intercellular lipid bilayer

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28
Q
A
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29
Q

What secretes pro-filaggrin and where is it converted to filaggrin?

A
  • lamellar bodies in granular layer
  • in the stratum corneum (AKA keratinous layer)
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30
Q

What are the 2 functions of filaggrin?

A
  • holds moisture within cells (natural moisturising factor)
  • forms part of tough cell envelope i.e. water barrier, binds keratin filaments and lipid filaments
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31
Q

Which layer provides most of the barrier function of the epidermis?

A

outer stratum corneum

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32
Q

What can filaggrin deficiency lead to?

A

Leaky skin that allows entry of allergens causing an immunological response e.g. Ichthyosis vulgari, eczema

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33
Q

Where do melanocytes originate from?

A

Neural crest

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34
Q

Where do melanocytes reside?

A

Basal layer

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35
Q

What amino acid is melanin a product of?

A

tyrosine

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36
Q

What is the function of melanin?

A

Thick brown coloured cap over the nucleus that won’t let UV light penetrate to protect stem cells (basal cells)

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37
Q

Variation in what causes the difference in skin colour?

A

variation in melanin production not the number of melanocytes

38
Q

What are the organelles in melanocytes called and what do they do?

A
  • Melanosomes
  • convert tyrosine to melanin pigament
39
Q
A
40
Q

What is the name of the melanin pigment of brown/black skin?

A

Eumelanin

41
Q

What is the name of the pigment associated with red/yellow skin?

A

phaeomelanin

42
Q

What are Merkel cells, where are they numerous and where exactly in the skin do they sit?

A
  • cells that play a role in sensation
  • numerous in fingertips and oral cavity
  • sit in the basal layer between keratinocytes and nerve fibres
43
Q
A
44
Q

What is the mortality rate of Merkel cell cancer and what is a cause?

A
  • Very high
  • viral infection
45
Q
A
46
Q

How does melanin get into keratinocytes?

A

By travelling in melanosomes across dendrites extended by the melanocytes

47
Q
A
48
Q

What is the pathophysiology behind vitiligo?

A

autoimmune disease with loss of melanocytes

49
Q

What is pathophysiology of albinism?

A

genetic partial loss of pigment production

50
Q

What is Nelson’s syndrome and how does it present in dermatology?

A
  • disorder characterised by abnormal hormone secretion and enlargement of pituitary gland
  • melanin stimulating hormone produced in excess by pituitary and so there is hyperpigmentation
51
Q

Where are Langerhan cells derived from?

A

Bone marrow

52
Q

What type of cell are Langerhan cells and what do they form?

A
  • dendritic cells
  • network across the supra basal layer
53
Q

Where do Langerhan cells sit in the epidermis and where else are they found?

A
  • In the prickle cell layer in epidermis
  • also in dermis and lymph nodes
54
Q
A
55
Q

What is the function of Langerhan cells?

A

-play a role in immunoregulation through picking up antigen and transporting them to lymph nodes via lymphatic system

56
Q

What is the dermo-epidermal junction?

A
57
Q

Describe pathology of bullous pemphigoid and describe blisters.

A

-antibody attack dermo-epidermal junction

BP 20 and PB 240

  • tense blisters
  • generally old people
  • biopsy and stain to diagnose
58
Q
A
59
Q

epidermolysis bullosa

A
  • rare
  • tends to be in babies
  • abnormalities in proteins in dermo-epidermal junction, collagen 7
  • can affect trachea etc
  • chronic scarring
60
Q
A
61
Q

What is dermis made up of?

A
  • ground substance: polysaccharides, water-based, helps with solute transfer
  • cells: fibroblasts(make collagen, elastic fibres), mast cells, lymphocytes, Langerhan cells
  • fibres (collagen, elastin)
  • muscles, blood vessels, lymphatics, nerves
62
Q
A
63
Q

urticaria and nettle rash

A

wheals

mast cells pop

  • release histamine
  • so antihistamines for these
64
Q

Describe collagen arrangement across dermis?

A

more horizontal and condensed further down you go

65
Q

What does it mean to have horizontal plexuses?

A

blood vessels run parallel to skin surface and then branch off

66
Q
A
67
Q

What is angioma?

A

disorganised large arterioles and vessels that grow abnormally in the skin

68
Q

What do lymphatic vessels in the skin drain?

A
  • plasma proteins
  • extravasated cells
  • excess interstital fluid
69
Q

What can cause chronic lymphoedema?

A

damage to lymph vessels so lymph cant drain e.g. from athletes foot (fungal)

70
Q

What are pacinian corpuscle responsible for?

A

sensing pressure on skin

71
Q

What nerves innervate the sweat glands?

A

motor nerve fibres by autonomic nervous system

72
Q

Nerves in the skin

A
73
Q

pilosebaceous unit

A

epidermal component + dermal papilla (papilla is hair root)

-specialised keratins, sebaceous gland with it

-

74
Q

label this imagine

A
75
Q

What are the 3 phases of hair growth?

A

anagen = growing

catagen = involuting

telogen = resting

76
Q

What is the involuting phase?

A

dying phase, hair root shortens, come out naturally, new hair pushes out, embedded but not growing

77
Q

What are hormonal influences on hair

A

thyroxine

androgen

78
Q

what is alopecia areata?

A

autoimmune condition where body attacks alogen hair follicle

79
Q

hirsutism

A

too much hair growing in inappropriate areas

80
Q

What are 3 skin glands

A

sebaceous (present everywhere but mostly in face, chest and upper back, very hormone sensitive, produce sebum (squalene, wax esters, TG and FFA)

apocrine (armpits + groin, feed into hair follicles, linked to pheromones)

eccrine( sweat glands on hands and feet, face also, autonomic nervous system, help with thermoregulation)

81
Q

acute skin failure

A

e.g. toxic epidermal necrolysis

82
Q

functions of the skin

A
  • barrier function
  • metabolism and detoxification
  • thermoregulation
  • communication
  • immune defense

-

83
Q

barrier:

A
  • physical (UV, trauma)
  • chemical
  • pathogens
84
Q

skin metabolic actions examples

A

vitamin D metabolism

-thyroid hormone metabolism

85
Q

wyatbis Hansen’s disease

A

tuberculoid leprosy

86
Q

eczema herpeticum

A

disseminated herpes simplex virus infection

87
Q

What is this autoimmune disease?

A

chronic discoid lupus erythematous

88
Q
A
89
Q

What is this?

A

self harm burns, scratching

90
Q

What is this an example of?

A

neuropathic ulcer e.g. leprosy

Dermatology (10 decks)

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