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FPP MSS > MSS Skin intro > Flashcards

MSS Skin intro Flashcards

1
Q

What are the 4 layers of the epidermis?

A

Basal layer
Spinous layer
Granular layer
Cornified layer

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2
Q

Stratum basale

A

Bottommost layer of the epidermis attached to basement membrane
Contains Stem cells

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3
Q

Stratum Spinosum

A

Contains most of keratinocytes
Held together by desmosomes ( protein complexes that connect keratinocytes and kertain intermediate filament)

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4
Q

Stratum granulosum

A

Composed of flattened keratinocytes that are starting to lose their nucleus and cell organelles.
Keratohyalin granules: filled with proteins for formation of cornified envelope (profilaggrin).
Lamellar granules: (odland bodies): contains lipids (ceramides)

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5
Q

Stratum corneum

A

made up of anucleate cells (corneocytes)
held together by proteins and lipids (filaggrin and ceramides)

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6
Q

Where is the cornified layer the thickest? Thinnest?

A

Thickest: palms and soles
Thinnest: mucosal surfaces

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7
Q

Describe the process of keratinaization and recognize disorders of keratinization

A

Cornification: Process of keratinocyte migration and maturation. Starts with SC differentiation–> separation from basement membrane. Flattens out, forms lamellar and keratohyaline granules. Loses cellular organelles and releases granules.
Eventually becomes anucleate corneocyte in cornified envelope and is eventually shed.

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8
Q

Function of desmosomes

A

Protein complexes that connect keratinocyte and keratin intermediate filament

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9
Q

What layers do UVB and UVA penetrate?

A

UVB: epidermis and superficial dermis
UVA: penetrates into dermis

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10
Q

Interaction of UV and skin

A

UVB –> erythema and sunburn
UVA–> tanning and photoaging

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11
Q

Pharmacology of suncreen

A

Physical blockers: reflect UV radiation (zinc oxide/ titanium dioxide)
Chemical blockers: absorb UV radiation and convert it into heat ( PABA)

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12
Q

What makes up intermediate filaments? How do they assemble?

A

Keratins (alpha helical proteins) that make up IF. Keratin–> heterodimer–> tetramer–> protofilament–> IF

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13
Q

Pemphigus Vulgaris

A

Autoimmune blistering disease
Rare & affects elderly
Etiology: autoantibodies against desmosomes (desmoglein 1 & 3)
Sxs: flaccid blisters that turn into erosions
Sites: mouth, nose, genitalia, cutaneous site
Tx: immunosuppresion

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14
Q

Ichthyosis Vulgaris

A

Autosomal dominant
Etiology: mutations in profillagrin (defective cornified envelope)
Sxs: extremely dry skin, hyperlinear palms, large scales on body
Associated: atopic dermatitis, allergic rhinitis, food allergies, asthma

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15
Q

What is SPF?

A

Sun Protection Factor: measure of protection against UVB exposure and sunburns
Does NOT measure UVA protection
SPF= MED protected/MED unprotected

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16
Q

When is MED?

A

Minimal erythema dose: min. amout of UVB that causes skin redness at 24 hours.

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17
Q

What is the recommendation for sunscreen use?

A

At least SPF 30.
Apply 15 min before sun exposure. Need 1 oz to cover entire body. Reapply every 2 hrs. Avoid sun between 10-4p

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18
Q

Cells of the Dermis

A

Fibroblasts: Produce and secrete ECM
Macrophage
Endothelial cells: vascular network
Nerves
Sensory receptors

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19
Q

What are Meissner’s corpuscles? Where are they located?

A

Sense Light touch.
Located: concentrated in palms and soles in the dermal papillae ( under the epidermis)

20
Q

What are pacinian corpuscles? Where are they located?

A

sense pressure
Located in weight bearing surfaces, lips, nipples, penis, clitoris (deep dermis and subcutaneous tissue)

21
Q

Structural compotenents of dermis

A

Main component is ECM: collagen, elastic fibers and extrafibrillar matrix.

22
Q

Role of Collagen in skin. What type is most abundant?

A

Provides structural integrity. Produced by fibroblasts. Type I collagen is most abudant.

23
Q

When does the proportion of collagen III become more abundant in the skin?

A

Embryogenesis and wound healing

24
Q

Role of Elastic fibers. What is it made up of?

A

Skin elasticity. Made up of fibrillin and elastin

25
Q

What is the extrafibrillar matrix?

A

Ground substance: composed of water, electrolytes, plasma proteins and proteoglycans (protein+GAG)

26
Q

Function of dermis

A

Provides skin with structure and flexibility, vascular support for skin, immunologic protection, nerve sensation

27
Q

Collagen structure and synthesis

A

Triple helix of alpha chains. Gly-X-Y with glycine and proline or hydroxyproline)
RER translation–> modification ( OH, glycosyl), folding–> cleavage of N and C terminals–> assembly and cross-linking with other collagens

28
Q

Ehlers-danlos

A

Etiology: mutation that interferes with structure, production, processing or assembly of collagen
Sxs: fragile skin that is very elastic and prone to scarring. Extremely flexible joints, severe scoliosis
Associations: collagen in blood vessels –> rupture of blood vessels, intestines and uterus

29
Q

Marfan syndrome

A

Etiology: Mutation in fibrillin (autosoma dominant)
Signs: Tall and thin, long limbs, scoliosis, flexible joints, nearsigtedness, ectopia lentis, striae, arotic dilation or aneurysm, mitral valve prolapse

30
Q

Would healing

A

Hemostasis: vasoconstriction
Inflammation: erythema, heat, edema, pain
Proliferation: fibroblasts proliferate and synthesize collagen and MMP
Maturation: inflammatory cells are cleared. Collagen undergoes resorption and deposition to remodel

31
Q

Structural components of subcutaneous fat

A

Below dermis ( derived from mesoderm)
Adipocytes: synthesize and store lipids in cytoplasm

32
Q

Erythema nodosum

A

Acquired disorder
cause is usually idiopathic but infectious cause is common (Strep), Oral contraceptives, sarcoidosis, IBD, maliganacy can also trigger
Sxs: tender, red nodules that arise on shins that starts as crops that involute)

33
Q

Morphea

A

Localized scleroderma: autoimmune acquired disease
Characteristics: sclerosis (thickening of collagen)
Sxs: erythematous; indurated plaques
Associations: more common in females

34
Q

Systemic Sclerosis

A

Acquired autoimmune disease
Characteristic: sclerosis
2 types: limited and diffuse systemic sclerosis
Limited: CREST syndrome (Calcinosis cutis, Raynaud, esophageal dysmotility, sclerodactyly, telangiectasia)
Systemic: widespread sclerosis, w/ pulmonary fibrosis, renal failure, GI disease, cardiac disease

35
Q

Direct Immunofluorescence

A

Helps detects Ig and C3 ON biopsy specimens. Sample from PERI-lesional skin.

36
Q

Indirect Immunofluorescence

A

Detects CIRCULATING antibodies against BMZ in SERUM. Serum is applied to human skin. Antibody complexed to fluorescein conjugated antibody and visualized

37
Q

Structure of BMZ

A

Hemidesmosomes
Lamina Lucida
Lamina densa
Sublamina densa

38
Q

Hemidesmosomes (important proteins)

A

Attach cell to ECM
BP 230 (BP1)
BP 180 (BP2)= Type 17 collagen: connect basal keratinocytes and cytoskeleton to dermal collagen Type 7 (via laminin 332)

39
Q

Lamina Lucida

A

thin, translucent layer

40
Q

Lamina Densa

A

Composed of type 4 collagen and laminins 332 (laminin 5): binds to hemidesmosome (integrin a6b4) and to type 7 collagen (NC-1)

41
Q

Sublamina Densa

A

Type 7 collagen: anchoring fibrils
Necessary to maintain epidermal-dermal cohesion ( binds to both type I and type IV collagen)

42
Q

Bullous Pemphigoid (BP)

A

Autoimmune Bullous dermatosis–> antibodies to BP1 and BP 2 causes subepithelial blisters
Association: primary in eldery
Sxs: TENSE blisters with serous fluid
DIF: linear deposits of IgG and C3 on BMZ
IIF: staining of epidermal side

43
Q

Mucous Membrane Pemphigoid (MMP)

A

Autoimmune–> antibodies to BP180 (BP230, integrin B4, laminin 332)
DIP: linear deposits of IgG and C3 in BMZ
IIF: epidermal/dermal staining, dermal side (anti-laminin 332)

44
Q

Epidermolysis Bullosa Acquisita

A

Autoimmune bullous dermatosis against Type VII collagen
Sight trauma–> blistering and erosion
Characteried by fibrosis of hands and feet
DIF: IgG and C3 along BMZ
IIF: dermal side

45
Q

Epidermolysis Bullosa

A

Mutations in genes of BMZ proteins
Simplex: Keratins 5 and 14
Junctional: laminin 332 and BP180 in BMZ
Dystrophic: Type VII collagen of dermis

FPP MSS (13 decks)

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