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KEY NOTES WK 2 Flashcards

1
Q

layers of epidermis in order and key features

A

CLGSB

stratum corneum (dead keratin and filaggrin)

stratum lucidum (thick skin- soles, palms)

stratum granulosum (lamellar granules rich in lipids, associate keratin and filaggrin)

stratum spinosum (synthesize keratin and filagrin)

stratum basale (stem cells and melanocytes, sensory receptors, langerhans cells for immune)

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2
Q

dermal layers (2)

A

papillary layer- type I and III collagen (loose CT) with papillae to interlock with epidermis

reticular layer- type I collagen and elastic fiber (dense CT) with nerves, arteries, glands, hair follicles

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3
Q

T cell activation

A

T cell has T cell receptor and CD4 co-receptor that interact with HLA2 on APC

the co-stimulate of CD28 on T cell with CD80 on APC

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4
Q

ILCs

A

type I ILC secretes IFNy and TNFa –> does Th1

type II ILC secretes IL4, IL5, IL9, IL13 –> does Th2

ILC3 secrete IL17, IFNy for extracellular bacteria (Th17 response)

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5
Q

what activates ILC2 cells

A

alarmins

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6
Q

what are alarmins

A

IL25, IL33, TSLP

early release cytokines on skin that push a Th2 response and activate ILC2

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7
Q

promote mast cell survival and migration

A

IgE, IL4, IL22

inhibited by IFNy

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8
Q

how are mast cells activated

A

sensitized by IgE

degranulation in response to an allergen (ie.. atopic dermatitis, allergic rhinitis, asthma) and cause relapse of histamine, serotonin, heparin, proteases, TNFa, IL4

type II inflammation

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9
Q

cytokines to induce proliferation and activation of eosinophils

then what promotes migration from blood to peripheral tissues

A

IL5

eotaxin

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10
Q

when do eosinophils accumulate

A

type 2 inflammation

alarmins (TSLp, IL33, iL25) activate ILC2

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11
Q

granule content of eosinophils

A

major basic proteins; cationic proteins, eosinophil peroxidase, IL4, IL13, TNFa

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12
Q

neutrophil granules

A

defensives and cathelicidins (pore forming –> lysis)

cathepsin

lysosome

lactoferrin (iron)

myeloperoxidase

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13
Q

neutrophil function

A

NET (neutrophil extracellular trap)

sticky chromatin to trap bacteria

histone are toxic to bacteria

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14
Q

classical vs alternative macrophage activation

A

classic= via IFNy –> inflammation - kill microbes

alternative (IL4, IL13)- repair and anti-inflame

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15
Q

NK cells do what

A

apoptosis via fas-fas ligand

secrete perforin (poke holes) and granzyme (apoptosis)

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16
Q

PAMPs

A

PAMPs on bacteria, recognized by PRRs (i.e. TLR, NOD, RIG)

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17
Q

skin cell glands and keratinocytes can secrete

A

AMPs
* Defensins, RNA-ase, dermicidin, cathelicidin, psoriasin

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18
Q

keratinocytes express

A

TLRs and RIGs and respond to alarmines, cytokines, chemokines

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19
Q

types of psoriasis

A

plaque psoriasis (most common): Well-demarcated salmon-pink papules or plaques with a silvery-white scale (on extensors, scalp, soles, palms, nails)

also guttate psoriasis (via strep infection) and pustular psoriasis (pus)

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20
Q

Th type causing psoriasis

A

Th17
–> IL17 from Th17 and ILC3
–> IL23 from dendritic cells

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21
Q

allergic contact dermatitis

A

I.e. nickel, cosmetics, poison ivy

get itching and erythema 48hrs to days after exposure

need sensitization (hapten initial exposure) then elicitation phase and subsequent exposure will cause rxn

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22
Q

what molecule causes allergic contact dermatitis

A

hapten

stick to skin and make it look foreign

activate inflammasome, IL1, TLR4 (nickel)

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23
Q

type of Th response in allergic contact dermatitis

A

Th1

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24
Q

allergic contact dermatitis vs psoriasis Th_

A

ACD= Th1

P= Th17

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25
normal commensal bacteria in skin after birth
Coagulase-negative Staphylococci (Staph epidermidis)
26
staph aureus can cause
MRSA- methicillin resistance staph aureus
27
Staph Soft Tissue Infection (SSTI) toxins
pore forming toxins phenol soluble modulins exfoliative toxins (serine proteases target desmosomal cadherin and cause intraepithelial bullae in skin or staph-scalded skin syndrome if systemic)
28
staph superantigens
Toxic shock syndrome toxin 1 (TSST-1), enterotoxins ..... non specific activation of T cells via HLA2 on APCs (activate CD4+ T cells)
29
TSST-1 (toxic shock syndrome) (staph superantigen) causes
high fever, hypotension, scarlet fever-like rash, desquamation of skin, multiorgan dysfunction
30
staph neutrophil invasion (1st line of defence)
Chemotaxis inhibitory protein (CHIPS) or staphopain A --> block complement Staph-superantigen-like 5 and 11 Staphylococcal nuclease protein A --> block phagocytosis NOT HELPFUL LOL
31
immune response against staph
AMPs (keratinocytes) neutrophil recuited by PRRs (TLR2, NOD2) caspase 1 Th17 - IL-17
32
exfoliative toxins in staph auereus cause
blistering skin disorder ET-A: bulls impetigo (local) ET-B: staph scalded skin syndrome (systemic)
33
exfoliative toxins (serine proteases) in staph aureus bind ___ to cause loss of cell-cell adhesion between stratum ____
bind CAM desmoglein-1 stratum spinous and granulosum
34
group A streptococcus skin infection have 200 subtypes and are identified by _____. types that cause skin infection
M protein type D and E
35
M protein in strep
binds complement binds IgG and inhibits antibody mediated phagocytosis TLR2 bind fibronetin on keratinocytes
36
strep pore forming toxins
streptolsyin O (forms pores --> lysis) steptolysin S (disrupt cell membrane, cytolytic)
37
strep superantigens
streptococcal pyrogenic exotoxin (non specifically activate T cells)
38
strep neutrophil evasion
make antioxidants (glutathione peroxidase and superoxide dismutase) to inhibit ROS mediated killing nuclease A and DNase Sda1 breakdown NETs
39
what type of IFN response to strep
type 1 IFN response --> TLR9 activation
40
strep and staph superantienic toxin dont need to
be processed by APCs; bind outer wall, not HLA2 non specific activation of T cells increase CLA for skin homing cytokine storm; TNFa, IL1, IL6 (i.e. toxic shock)
41
pseudomonas aeruginosa key colour and door
Sweet, grape-like odor and blue-green colour
42
cutaneous infections from pseudomonas aeruginosa
= HOT AND WET Green nail syndrome, toe web infection, folliculitis, hot-foot syndrome, external otitis, perichondritis
43
if get pseudomonas aeruginosa and immunocompromised can get
bacteremia (bacteria in blood stream) ecthyma gangrenosum (necrotic black lesion from invading veins and arteries and then skin)
44
what do pseudomonas aeruginosa need to get into the skin
some type of damage (i.e. burn, trauma, dermatophyte infection)
45
how does pseudomonas aerugiona degrade skin
alkaline protease, protease IV and elastase then use exoenzymes eotoxin A Procyanin LPS
46
key communication of pseudomonas aerugionsa so they can coordinate gene transcription
quorum sensing --> biofilm formation
47
2 things pseudomas aeruginosa produces
alginate (mucoid substance) biofilm
48
antibiotic restistant mechanisms of psuedomonas aeruginosa
multidrug efflux pumps beta-lactamases down regulate porins
49
most common bacteria causing external otitis
pseudomonas aeruginosa
50
dermatophytoses are ____ that attack _____
fungal infection that have spores that adhere to keratin and change gene expression germinating final release proteases and lipases to digest keratin and prevent proliferation
51
what component of dermatophytes activate TLRs in keratinocytes to trigger AMPs, cytokines, proliferation of keratinocytes
mannan
52
type of hypersensitivity rxn to clear fungus in dermatophytes
Th1, Th17 (delayed)
53
what is a dermatophytid reaction
inflammatory dermatitis at distant site from primary infection Criteria to establish ID eruption: (1) dermatophytosis is confirmed on another body part (2) there is no fungal elements within the ID eruption (3) the ID eruption goes away once the primary dermatophyte infection clears
54
onychomycosis
nail fungal infection
55
onychomycosis common causes
Trichophyton rubrum and T. interdigitale, Candida spp
56
tinea barbae caused by
beard final infection T. interdigitale, T. verrucosum
57
tinea corporis and cause
dermatophytosis of labours skin (hairless- i.e bum, top of foot) t. rubrum
58
tinea cruris
dermatophytosis of groin, genital, perineal T. rubric and Epidermophyton floccosum
59
tinea pedis and tinea mannum
dermatophytosis of feet (pedis) and hands (mannum) . rubric, T. interdigitale and Epidermophyton floccosum
60
measles cause transmission sx
ssRNA from paramyxoviridae family contact or airborne morbilliform rash for 3-5 days; kopek spots, fever, cough
61
rubella cause transmission sx
+ strand RNA togaviridae family nasopharynx droplets rash and lymphs
62
Erythema Infectiosum - Parvovirus B19 sx
5th disease/ slapped cheeks poly arthritis papular purpuric glove and sock syndrome
63
what can Erythema Infectiosum - Parvovirus B19 cause if bad
transient aplastic crisis --> suppress eryhtropoesis (RBC production)
64
Human Herpesvirus 6 (HHV-6) sx
6th disease/ roseola infant febrile seizures without rash in kids
65
all herpes virus
chronic; latent stage and reactivate
66
Herpes Simplex Virus 2 types sx
HSV1 oral HSV2 genital mostly asymptomatic effect skin then get into nerves and be latent
67
Varicella-Zoster herpes virus (VZV) presentation
chicken pox (initial) to shingles (reactivate)
68
when Varicella-Zoster virus (VZV) becomes latent and reactivates what does it cause
shingles - effects sensory and autonomic neruons (latent) and causes pain with the rash --> postherpetic neuralgia
69
where is Varicella-Zoster virus (VZV) latent in
trigeminal nerve, spinal sensory ganglia T1-L2
70
how does varicella herpes zoster virus as shingles spread
antidromically (from nerves to skin) --> zoster vesicles
71
Human 
 Papillomavirus (HPV) which types are high risk infects
E6 and E7 (oncogenic) infects keratinocytes
72
HPV common warts butchers warts from (wet meat)
HPV-2, 27, 57 and HPV-4 and HPV-1 HPV7
73
which UV is worst
UVA
74
signature UV mutation
C>T transition in TP53 (tumor suppressor gene)
75
what protect skin cells from UVR scale for burning and tanning and more melanin
melanin Fitzpatrick scale
76
basal cell carcinoma from which UV
UVB
77
basal cell carcinoma mostly on which area
head and neck (rarely metastatic)
78
pathogenesis of basal cell carcinoma
UVB mutates p53 and PTCH1 (tumor suppressors) malfunction in sonic hedgehog singaling (PTCH1) --> SMO not inhibited --> transcription of target genes
79
squamous cell carcinoma more common in
darker skin and immunosuppressed
80
viral carcinogens
HPV (16 and 18) turn off tumor suppressor TP53
81
immunosuppression increases risk of cancer
especially squamous cell carcinoma via medications, HIV
82
chronic inflammation resulting in squamous cell carcinoma
chronic ulcers, burns, inflammatory skin condition (i.e. discoid lupus)
83
malignant melanoma
high mortality risk risks: genes (CDKN2A, CDK4, POT1, TERT), UV exposure, melanocytic nevi/moles (if atypical and large and congenital)
84
hair follicle cycle
ACTEE anagen (growth for 2-8 years) catagen (involution) telogen (rest for 3 months) exogen (shedding)
85
androgenic alopecia
shorten anagen (growth) phase genetics, male, after puberty, androgens (DHT), hormonal dysregulation in female (estrogen), cytokines male pattern: frontal hairline and vertex female pattern: centropariteal thinning and Christmas tree
86
telogen effluvium
diffuse hair loss early termination of anagen (growth) and more % of hairs in telogen (rest) increased shedding of club hairs (i.e. late stage of telogen, lack sac and pigmentation)
87
cause of telogen effluvium
psychophysiologic stressors (remove trigger to resolve)
88
subtypes of telogen effluvium
acute (2-4 months) i.e. rash diet, surgery chronic (>6 months) i.e. thyroid, malnutrition, STI, zinc and iron deficient chronic (4th and 6th decade); age
89
stage changes of hair in telogen effluvium
premature termination of anagen (growth) ie. stress prolong anagen and stop abrupt i.e. post partum short anagen ie. drugs
90
what is elevated in telogen effluvium from stress
elevated interferon levels, heparin
91
alopecia areata
autoimmune hair loss, esp kids, well demarcated patches of hair loss cytotoxic CD8 T cells increase catagen and telogen, inflammatory infiltrate around follicular bulbs
92
oncychomycosis
nail fungi from dermatophytes mostly toes and distal lateral hyperkeratosis and separate nail from bed
93
psoriasis can effet
nails (esp if arthritis) hyperkeratosis, leukonychia, pitting, nail separation (oil or salmon spot)

BMS250 (52 decks)

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