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Disease and Defense III > Intro to Derm > Flashcards

Intro to Derm Flashcards

1
Q

Skin disorders are the _____ most common reason for visiting the doctor

A

first

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2
Q

Top 3 Global burden skin disease?

A

Dermatitis
Acne
Psoriasis

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3
Q

Weight skin

Size

A

4 kg

2 m^2

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4
Q

Where do hair follicles originate?

A

sub-cu

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5
Q

5 layers of epidermis?

A 
stratum corneum
stratum granulosum
stratum spinosum 
stratum lucidum 
stratum basalis
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6
Q

filaggrin -

A

filament associated protein that binds keratin fibers in epithelial cells - found in the stratum granulosum

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7
Q

desmosomes layer

A

stratum spinosum

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8
Q

stem cell layer

A

stratum basalis

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9
Q

cycle from SB to SC

A

28 days

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10
Q

kertinohyalin granules

A

found in the stratum granulosum - contain pro-filaggrin

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11
Q

Fitzpatrick skin type

hair: blond/red
eye: blue/green
skin: fair
freckles: ++
sunburn: easily
tan: minimally

A

II

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12
Q

Fitzpatrick skin type

hair: blond/red
eyes: blue/grenn
skin: white
freckels: +++
sunburn: always
tan: never

A

I

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13
Q

Fitzpatrick skin type

hair: brown
eyes: dark
skin: moderate brown
freckles: 0
sunburn: minimally
tan: well

A

IV

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14
Q

Fitzpatrick skin type:

hair: brown
eyes: medium to dark
skin: light brown
freckles: +
sunburn: initially
tan: gradually

A

III

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15
Q

Fitzpatrick skin type:

hair: dark
eyes: dark
skin: black
freckels: 0
sunurn: never
tan: always

A

VI

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16
Q

Fitzpatrick skin type

hair: dark
eyes: dark
skin: dark brown
freckels: 0
sunburn: rarely
tan: dark tan

A

V

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17
Q

Skin color variation due to (2)

A

type of melanin

disbtribution of melanosomes

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18
Q

eumelanin

A

black to brown pigment

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19
Q

pheomelanin

A

mutated melanin - yellow to red pigment

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20
Q

light skin melanosome distribution -

A

clusters above nucleus

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21
Q

dark skin melanosome distribution?

A

individually throughout cytoplasm

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22
Q

fx

physical barrier

A

epidermis keritoncytes

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23
Q

fx

light barrier

A

epidermis melanocyte

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24
Q

fx

immunological barrier

A

epidermis

langerhaans cells

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25
Q

fx

vit D synthesis?

A

epidermis

keratinocytes

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26
Q

fx

water homeostasis

A

epidermis
keratinocytes

adnexa
eccrine glands

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27
Q

fx

grasp

A

adnexa

nails

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28
Q

fx

lubrication

A

adnex

sebaceous glands

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29
Q

fx

phermones

A

adnexa

apocrine glands

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30
Q

fx

thermoregulation

A

adnexa
eccrine glands

dermis
blood vessels

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31
Q

fx

strength and elasticity

A

dermis

fibroblasts (produce collagen and elastin)

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32
Q

fx

sensation

A

dermis

nerves

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33
Q

fx

insulation

A

sub-cu

fat

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34
Q

fx

calorie reservoir

A

sub cu

fat

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35
Q

epidermis composition

A

stratified squamous epithelium

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36
Q

dermis composition

A

underlying CT layer
papillary dermis
reticular dermis

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37
Q

papillary dermis

A

loose CT lies immediately under epi

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38
Q

reticular dermis

A

dense CT

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39
Q

Adnexal structures (5)

A 
apocrine
eccrine
hair
nails
sebaceous
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40
Q

sub-cu composition

A

adipocytes

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41
Q

regional variation of skin

thick skin is…

A

hairless and found on the palms and soles

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42
Q

vitD synthesis

skin?

A

7-dehydroholesterol can be converted to vitD3 by UVB… but you can also ingest and absorb

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43
Q

What happens to VitD3 D2?

A

Converted to 25hydroxy D in liver

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44
Q

what happens to 25hydroxy D?

A

converted to 1,25 dihydroxy D in the kideny

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45
Q

keritinocyte fx

A

form barrier layer

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46
Q

kertinocyte synthesize

A

keratin

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47
Q

what is keratin

A

the major intracellular fibrous protein of the skin

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48
Q

keratinocyte cycle?

A

defined cylce of proliferation, differenatiation, and apoptosis (28 days)

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49
Q

melanocyte - fx and derivation

A

pigment producing cells arising from the neural crest

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50
Q

melanocyte location

A

primarily in the basal layer of the epidermis - in hair follicles

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51
Q

melanocyte - ration to keritinocyte -

A

1 : 10

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52
Q

how many kertinocytes does 1 melanocyte supply melanin to? via dendrites

A

30

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53
Q

what is melanin from

A

tyrosine

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54
Q

melanin is packaged into granules called

A

melanosomes

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55
Q

how are melanosome transferred to keratinocytes?

A

via dendritic processes of the melanosome

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56
Q

what does melanin do for us

A

protects basal keratinocytes from UV damage (DNA)

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57
Q

Absence of melanocytes is often due to?

A

autoimmunity causes vitiligo which cinlically consists of depigmented macules and patches

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58
Q

langerhaans cells - location

A

found in all epidermal layers

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59
Q

what are langerhaans cells?

A

dendritic cells in the epidermis derived from a bone marrow cell

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60
Q

What do langerhaans cells do?

A

participate in cell mediated immune reactions by processing and presenting antigens (circulate back and forth between skin and lymph nodes)

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61
Q

Stratum basalis =

A

basal cell layer

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62
Q

Stratum basalis - architecture

A

consists of single cell layer of cuboidal or columnar kertinocytes

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63
Q

_________ are the stem cells of the epidermis

A

basal kertinocytes - thus a site of intense prolifearation

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64
Q

hemidesmosomes

A

attach basal cells firmly to the basal lamina of the dermal epidermal juctnion

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65
Q

antibodies to the protein in the hemidesmosomes may cause autoimmune blistering diseases such as?

A

bullous pemphigoid

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66
Q

genetic defects in collagen VII cause?

A

dystrophic epidermolysis bullosa

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67
Q

Type VII collagen

A

type VII collagen fibril, composed of three identical alpha collagen chains, is restricted to the basement zone beneath stratified squamous epithelia. It functions as an anchoring fibril between the external epithelia and the underlying stroma. Mutations in this gene are associated with all forms of dystrophic epidermolysis bullosa

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68
Q

Laminin-5 genetic defects –>

A

Junctional epidermolysis bullosa

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69
Q

Laminin 5

A

Laminin, alpha 5 has been shown to interact with BCAM,[3][4] FBLN2[5] and Collagen, type VII, alpha 1.[6]

Important in hemidesmasome

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70
Q

Desmosome

A

attach kertinocytes to each other

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71
Q

antibodies to proteins in desmosomes may cause autoimmune blistering diseases such as

A

pemphigus vulgaris

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72
Q

congenital defects in keratin filaments 5 and 14 cause?

A

epidermolysis bullosa simplex

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73
Q

tonofilaments

A

protein structures (kertain filaments) that insert into the dense plaques of desmosomes on the cytoplasmic side of the plasma membrane

74
Q

______________ has a prickly or spiny appearance due to desmosome attachment between cells

A

stratum spinosum

75
Q

intercellular adhesion in the SS depends on _________-____________ interaction in the distribtuion of stress

A

tonofilament - desmosome

76
Q

synthesis of involucrin and membrane coating granules begins in this layer

A

SS

77
Q

Involucrin

A

In binding the protein loricrin, involucrin contributes to the formation of a cell envelope that protects corneocytes in the skin.

78
Q

stratum granulosom

A

the cells of this layer contain different types of granules (below SS and above SL)

79
Q

Keratinohyalin granules contain

A

Profilaggrin - found in SG

80
Q

Filaggrin

A

cross links keratin tonofilaments and is important in the barrier function of the skin.

81
Q

Filaggrin is mutated in dry skin conditions including (2)

A

ichthyosis and atopic dermatitis

82
Q

which protein is mutated in atopic dermatitis

A

filaggrin

83
Q

which protein is mutated in ichthyosis

A

filaggrin

84
Q

stratum lucidum

A

only in thick skin
cells of this layer no longer have nuclei or organelles
above SG below SC

85
Q

Stratum corneum

A

the outermost layer of the epidermis
kertinocytes have lost their nuclei and organelles and the entire cell is filled with keratin
desmosomes still connect tightly packed adjacent cells

86
Q

papillary layer of dermis
site of
contains

A

site of attachment to the epidermis and necessary to its development and differentiation

contains capillary network that is blood supply for dermis

pathway for defense cells

contains meissner corpuscles which sense touch

87
Q

reticular layer of dermis

composition

A

contains extensive collagen and elastin fibers that provide strength and flexibility

88
Q

reticular layer of dermis

houses

A

houses (along with hypodermis) epidermal derivatives such as glands and hairs and plays a major role in their development and functioning

89
Q

which layer of the skin is pathway for major blood vessels arranged specifically to facilitate thermoregulation?

A

reticular layer of dermis

90
Q

which layer of the skin is the site of nerve tracts and major sensory receptors?

A

reticular

91
Q

which layer of the skin are meissner corpuscles located

A

papillary

92
Q

which layer of the skin are pacinian corpuscles located

A

reticular

sense vibration / pressure / touch

93
Q

meissner corpuscles
job
location
composition

A

detect delicate touch
are most commonly found in the dermal papillae of thick skin
consist of Schwann cells and sensory nerve terminals wrapped by fibroblasts and collagen

94
Q

Pacinian corpuscles
job
location
composition

A

rapidly adapting receptors that detect change in deep pressure

found in dermis of both thin and thick skin

large structures resembling onion

the concentric layers are composed of flattened CT like cells interspersed with intercellular fluid and collagen

a single sensory nerve fiber terminates within pacinian corpuscle

95
Q

apocrine sweat glands

fx location

A

fx
specialized sweat glands located in axillary, pubic and perianal regions

produce a milky, viscid, carbohydrate rich secretion that is initally odorless; subsequent bacterial actions lead to a characteristic axillary body odor

96
Q

when do apocrine glands fx

A

puberty

97
Q

apocrine ducts empty where?

A

into hair follicles just above sebaceous glands

98
Q

eccrine sweat glands
local
fx

A

traditional sweat glands distributed over most of the body

not found in lips, under the nails, or the glans penis, glans clitoris, or labia minoa

watery enzyme rich secretion initally isotonic becomes hypotonic as Na is reabsorbed

important for thermoregulation

99
Q

hair

when develop?

A

develops in utero with down growth of the epidermis forming a pilosebaceous unit

100
Q

hair composition

A

central medulla of soft keratin and cortex of hard keratin

101
Q

hair growth

A

growth period is intermittent

2-3 year growth followed by a rest period of several months

102
Q

hair pigment

A

comes from melanocytes at the base of the hair

103
Q

goose bumps?

A

due to contraction of the arrector pilli

104
Q

sebaceous glands

A

oil glands which secrete sebum, a complex mixture of lipids

105
Q

sebaceous glands develop with?

A

with the hair follicles and empty their secretions into the upper 1/3 of the hair follicles

106
Q

sebaceous gland is accelerated at

A

puberty

107
Q

sebum

A

secreted from sebaceous glands (complex mixture of lipids)

108
Q

kertohyalin granules

A

found in SG

Contain profilaggrin

109
Q

Albinism is due to

A

defect in tyrosinase gene involved in melanin production

110
Q

Vitiligo is …

A

an autoimmune disorder against the melanocyte

111
Q

vitiligo is ________ depigmentation

A

acquired

112
Q

vitiligo microscopic finding

A

complete absence of melanocytes

113
Q

vitiligo is commonly seen in

A

periorificial and acral locations

114
Q

attachment point of basal cells to the basal lamina of the dermal - epidermal junction

A

hemidesmosomes

115
Q

Antibodies to hemidesmosomes cause

A

bullous pemphigoid

116
Q

bullous pemphigoid

primary skin lesion?

A

tense bulla

acquired

117
Q

bullous pemphigoid

pathogenesis

A

autoantibodies to bp 180 (collage VII) or BP230

118
Q

Bullous pemphigoid

pathology

A

supepidermal blisters

119
Q

Epidermolysis Bullosa =

A

a goupd of inherited bullous disorders characterized by blister formation in response to mechanical trauma

120
Q

Epidermolysis bullosa simplex

A

defect keratin 5 or 14

121
Q

epidermolysis bullosa junctional

A

defect collagen XVII or laminin 5

122
Q

Epidermolysis bullosa dystrophic

A

defect in collagen VII

123
Q

Junctional EB
Genetic defects in laminin 5
clnical:

A

generalized onset of blisters, improves with age

124
Q

Recessive dystrophic EB
Defects in collagen VII

clinical

A

extensive dystrophic scarring can produce pseudosyndactyly

flexion contractures

increased risk of SCC

Infections

125
Q

thickest layer of epidermis

A

SS

126
Q

Desmosomes

A

specialized structures for cells to cell adhesion

contain intracellular keratin filament 5 and 14

also contain transmembrane proteins, desmogleins and desmocollins

127
Q

acquired antibodies to desmoglein 1 and 3?

A

pemphigus vulgaris

128
Q

pemphigus vulgaris

primary lesions?

A

flaccid bulla

129
Q

pemphigus vulgaris

pathogenesis

A

ab to desmoglein 1 and 3

130
Q

pemphigus vulgaris

pathology

A

intraepidermal blisters

131
Q

EB simplex

pathogeneis

A

genetic defects in keratin 5 and 14

132
Q

EB simplex clinical

A

generalized onset of blisters occur at or shortly after birth - hands, feet, and extremities are the most common sites of involvement

133
Q

Cells in this layer start to lose their nuclei

A

SG

134
Q

Cells in this layer have prominent keratinohyalin granules

A

SG

135
Q

Kertainohyalin granules contain

A

profilaggrin

136
Q

filaggrin –>

A

crosslinks keratin in the formation of the cornified cell envelope

137
Q

lamellar bodies in the SG

A

Excrete lipids (ceramides)

138
Q

this layer is made up of dead and desquamating keratinocytes

A

stratum corneum

139
Q

the breakdown of filaggrin forms _______________ in the stratum corneym

A

NMF

Natural moisturzing factor

140
Q

NMF levels in skin?

A

decline with age

141
Q

_________________ are causd by a defective skin barrier function due to loss-of-funtion filaggrin mutations

A

icthyosis vulgaris

atopic dermatitis

142
Q

Patients with filaggrin mutations have significantly reduced levels of ________________ in the stratum__________ and exhibit increased transepidermal water loss

A

NMF

Corneum

143
Q

Merkel cells

A

small cells in the epidermis that are associated with nerve endings. Their function has long been uncertain, but they seem to be involved in neural development and tactile sensation - recent evidence supports a role in light touch

144
Q

flat lesions =

A

macule or patch

145
Q

raise lesions =

A

papule / plaque / cyst / nodule

146
Q

raised scaly lesions =

A

papule with scale / plaque with scale

147
Q

fluid filled lesion

A

vesicle / bulla / pustule

148
Q

redness =

A

erythema / erythroderma / telangiectasia

149
Q

purpura =

A

ecchymoses / petechiae / palpable purpura

150
Q

thinning or loss =

A

atrophy / erosion / ulcer / fissure

151
Q

flat area of color change

A

macule

152
Q

flat area of color change >1cm

A

patch

153
Q

discrete solid elevated body

A

papule

154
Q

solid, flat-topped elevated area of skin >1cm and broader than thick

A

patch

155
Q

firm and well defined lesion / may be dermal or sub-cu

greater than 1cm

A

nodule

156
Q

excess SC
May appear as flakes or plates
color usually white or grey

A

scale

157
Q

dried blood / serum / purulen exudate
may be thick or thin
color determined by type of dried fluid

A

crust

158
Q

purulent exudate color

A

yellow-green

159
Q

serum color

A

honey

160
Q

blood color

A

red-balck

161
Q

fluid filled cavity or elevation

form below epidermis

A

vesicle

162
Q

fluid filled blister

>1cm

A

bulla

163
Q

circumscribed elevation that contains pus

A

pustule

164
Q

localized blanchable redness

caused by increased blood flow

A

erythema

165
Q

generlized blanchable redness
caused by increased bloodflow
may be associated with desquamation or extensive scaling

A

erythroderma

166
Q

visible persistnet dilation of small superficial cutaneous blood vessels

A

telangiectasia

167
Q

flat discoloration of skin or mucous membranes

due to extravasation of blood

color transitions over time and ranges from blue-black / brown-yellow / or green

A

ecchymoses (bruise)

168
Q

tiny 1-2 mm pinpoint spots
resulting from tiny hemorrhages
color is red or violaceous

A

petechiae

169
Q

raise and palpable discoloration

due to vascular inflammation and extravasation of RBCs (vaculitis)

color is red or violaceous

A

palpable purpura

170
Q

thinning of epidermal / dermal / sub-cu tissue

A

atrophy

171
Q

localized loss of epidermal or mucosal epithelium

causes can include injury or denuding of vesicle or bulla roof (Removal

A

erosion

172
Q

circumscribed loss of epidermis and at leas upper dermis

A

ulcer

173
Q

ulcers are further classified by (3)

A

depth - can extend to sub-cu / muscle / or bone

edge - can be clean / ragged / undermined

tissue at base - necrotic / purulent / or healthy granulation tissue

174
Q

a deep linear crack or cleavage

found in areas of thickened skin

A

fissure

175
Q

scab
adherent thick dry crust
causes can include trauma / infection / or excoriating skin disease
color is black

A

eschar (crust)

176
Q

following lymphatic vessels

A

lymphangitic

177
Q

pertaining to a unilateral area of skin innervated by a single posterior spinal nerve

A

dermatomal

178
Q

pertaining to palms and soles

A

palmoplantar

179
Q

pertaining to sun exposed areas

A

photodistributed

180
Q

regions where opposing skin surfaces come in contact and may cause firction

A

intertriginous

181
Q

skin surface overlaying muscles that flex joints

A

flexural

Disease and Defense III (11 decks)

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