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Management of Infection > Lecture 23B - Skin Damage > Flashcards

Lecture 23B - Skin Damage Flashcards

1
Q

Damage to the skin?

A

adverse drug reactions

allergic reactions, contact with chemicals

wounds and wound healing

sunburn and melanoma

disturbance of the microbiota and infection

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2
Q

What are the 4 stages of wound healing?

A

hemostasis

inflammation

proliferation

remodelling

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3
Q

What can penetrate the external layer of the skin?

A

cuts, penetration of thorns or other sharps and injuries can penetrate through the skin layers right down to vital organs below

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4
Q

Wha does haemostasis involve?

A

stopping the bleeding by clot formation

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5
Q

What is released in haemostasis?

A

histamine from mast cells which causes vasoconstriction as well as changing permeability of the blood vessel wall

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6
Q

What do neutrophils and macrophages do in haemostasis?

A

enter the damaged area to help remove damaged cells and any bacteria/pathogens which have been introduced beneath the surface barrier of the skin

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7
Q

What is the clot?

A

a temporary plug which fills the breach in the skin until it can be repaired

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8
Q

What happens in inflammation?

A

in response to chemotactic factors, monocytes will migrate to the damaged tissue by diapedesis and differentiate into macrophages

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9
Q

What do factors released from macrophages and neutrophils do?

A

cause more cells to be recruited to the site of injury and for specific aspects of immune system to be activated

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10
Q

What does inflammatory factors and cytokines do?

A

cause the site to become hot and throbbing

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11
Q

What is proliferation?

A

alongside the inflammatory response, cell proliferation responses begin to repair the damage

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12
Q

What does a scab (eschar) do?

A

helps protect the underlying repair processes

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13
Q

What do endothelial cells do?

A

proliferate as they repair blood vessels

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14
Q

What do fibroblasts do?

A

help repair the connective tissue matrix as well as repairing the skin layer at the top itself

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15
Q

What does closure of a cut involve?

A

myofibroblasts

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16
Q

What do myofibroblasts do?

A

sit at the edge of an open cut and extend a podium forward as they migrate across the open space in the wound and form a continuous barrier

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17
Q

What do their myofibrils do?

A

contract to pull the normal cells at the edge of the cut along behind them

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18
Q

What does the action of fibroblasts do?

A

helps pull the two separate edges of the cut together till the epidermal layer becomes continuous again

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19
Q

How long does complete remodelling take?

A

a few months for it to be as strong as it was before injury

continues for a long time after the surface has been resealed by the skin

20
Q

What are factors that can directly affect wound healing?

A

body site

infection

vascular supply

mechanical stress

desiccation

edema

21
Q

Factors which can indirectly affect wound healing?

A

age and nutrition, medication, alcoholism, drug abuse, hygiene

diabetes

autoimmune disease

venous stasis

predisposition to keloids

some genetic skin diseases

immunocompromised state

obesity, immobility, vaculitis, neuropathy

22
Q

What can compromise healing in some tissues?

A

medical conditions such as cardiovascular disease

23
Q

What does elasticity of skin change with?

A

age

24
Q

What does tanning involve?

A

p53 activation in keratinocytes in response to UVR-induced DNA damage

25
Q

What does p53 activation lead to?

A

p53 up-mediated regulation of proopiomelanocortin (POMC)

26
Q

What does posttranslational cleavage of POMC produce?

A

beta endorphin and alpha-MSH

27
Q

What does alpha-MSH do?

A

stimulates MC1R on adjacent melanocytes, resulting in melanin synthesis and eventual transfer of melanin-containing vesicles to keratinocytes (pigments) which causes a tan

28
Q

What are melanosomes?

A

melanin containing vesicles

29
Q

What does chronic UVR result in?

A

elevated circulating beta endorphin levels, leading to analgesia and a physical dependence on tanning

30
Q

What is MSH?

A

melanocyte stimulating hormone

31
Q

What ca overexposure to UV radiation induce?

A

skin cancer

tanning does not eliminate the potential damage from overexposure to UV

32
Q

What are darker skin tones?

A

protective as skin cancer is much less common among African-Americans

33
Q

What are lighter skin tones better for?

A

vitamin D production, but more susceptible to DNA damage by strong sunlight

34
Q

What is non-melanoma cancer?

A

most commonly diagnosed cancer in Scotland

it is readily treatable if detected early

35
Q

What does squamous cell carcinoma?

A

arises fro mature keratinocytes and can appear as recurrent open sore (bleeds)

36
Q

What is basal cel carcinoma?

A

arises in the germinal layer of keratinocytes and invades the tissue

37
Q

Where does melanoma occur?

A

in the melanocytes and is a more serious form of cancer which needs to be detected as early as possible to maximise the chance of successful treatment

38
Q

Types of non-melanoma skin cancer?

A

squamous cell carcinoma and basal cell carcinoma

39
Q

How many bacteria are there on our skin?

A

1 million bacteria per cm2

40
Q

What is the microbiota?

A

the microbial biocommunity of bacteria, viruses and fungi

41
Q

What do the bacteria on skin do?

A

protect the skin from colonisation of harmful bacteria and microbes - a sterile skin provides opportunities for pathogens to invade

42
Q

What is healthy skin home to?

A

trillions of bacteria, viruses and fungi

43
Q

What does genetic predisposition mean?

A

can make is easier for microbes to breach the skin barrier or make the skin more sensitive to their presence

some peoples sin can be thinner and the protective barrier is weaker

44
Q

How can metabolic diseases affect the skin?

A

can alter the balance of nutrients on the skin and the vascular supply to the skin, leading to an increase in the density of microbes or a change in the relative proportions of their individual populations

45
Q

What can happen if the skin is breached by a wound?

A

members of the microbiota which are normally harmless on the skin surface could act as pathogens once they get access to the internal tissue

46
Q

What can happen once an infection of the skin takes route?

A

additional skin microbes may contribute to inflammatory processes which can themselves cause tissue damage

47
Q

How can treatments affect the skin?

A

e.g. topical steroids

or environmental changes can change growth conditions for microbes and facilitate overgrowth of potentially harmful bacteria

Management of Infection (36 decks)

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