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MODULE 7 - Skin and Bones > PATHOLOGY - Skin Disease > Flashcards

PATHOLOGY - Skin Disease Flashcards

1
Q

What is mange?

A

Mange is a skin disease caused by mites

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2
Q

Where on the body is sarcoptic mange more pronounced?

A

Sarcoptic mange is more pronounced on the ventral surface of the body

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3
Q

Where on the body is demodectic mange more pronounced?

A

Demodectic mange is more pronounced on the dorsal surface of the body

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4
Q

What are primary skin lesions?

A

Skin lesions that develop spontaneously as a result of underlying disease

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5
Q

List nine examples of primary skin lesions

A

Macule
Papule
Vesicle
Pustule
Hive
Cyst
Nodule
Plaque
Tumour

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6
Q

What is a macule?

A

Circumscribed, non-palpable spot less than 1cm in diameter and characterised by a change in skin colour

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7
Q

What would be the name of a macule over 1cm in diameter?

A

Patch

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8
Q

What is a papule?

A

Solid elevation of the skin less than 1cm in diameter

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9
Q

What is a vesicle?

A

Circumscribed epidermal elevation less than 1cm in diameter and filled with fluid

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10
Q

What would be the name of a vesicle over 1cm in diameter?

A

Bulla

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11
Q

What is a pustule?

A

Circumscribed intraepidermal, subepidermal or follicular elevation accumulated with fluid or pus

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12
Q

List two common causes of pustules

A

Bacterial infection
Pemphigus foliaceus

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13
Q

What is a hive/wheal?

A

Circumscribed, often transient raised lesion caused by oedema

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14
Q

What is a cyst?

A

An epithelial-lined cavity within the dermis or hypodermis containing fluid or solid material

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15
Q

What is a nodule?

A

Circumscribed solid elevation more than 1cm in diameter, usually caused by cell infiltration into the dermis or hypodermis

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16
Q

List four examples of nodules

A

Abscess
Granuloma
Tumour
Haematoma

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17
Q

What is a tumour?

A

A mass over 2cm in diameter that may or may not be neoplastic

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18
Q

What is plaque?

A

Flat topped, circumscribed elevation more than 1cm in diameter

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19
Q

What is a common cause of plaques?

A

Calcinosis cutis secondary to Cushing’s disease

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20
Q

What are secondary skin lesions?

A

Secondary skin lesions evolve from primary skin lesions or are induced by self-mutilation

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21
Q

List seven examples of secondary skin lesions

A

Collarette
Excoriation
Erosion/abrasion
Fissure
Lichenification
Crust
Cutaneous callus

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22
Q

What is a collarette?

A

Thin, circular rim of scale

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23
Q

Which three primary lesions often evolve to become collarettes?

A

Pustule
Vesicle
Bulla

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24
Q

What is an excoriation?

A

Shallow, linear break in the skin surface

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25
Q

What often causes an excoriation?

A

Self-mutilation

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26
Q

What is an erosion/abrasion?

A

Moist depression in the skin due to partial loss of the epidermis

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27
Q

What is a fissure?

A

Linear crack or break in the epidermis and deep into the dermis

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28
Q

Which disease can often cause pawpad fissures?

A

Pemphigus foliaceus

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29
Q

What is lichenification?

A

Thickening, folding and possible pigmentation of the epidermis

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30
Q

Which disease is commonly associated with lichenification?

A

Chronic dermatitis

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31
Q

What is a crust?

A

Dead keratinocytes, fibrin, serum and neutrophil accumulation

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32
Q

Which disease is commonly associated with the formation of crusts?

A

Chronic staphylococcus infection

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33
Q

What is a cutaneous callus?

A

Thick, firm hyperkeratotic hairless plaque with increased folds and fissures

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34
Q

Where do cutaneous calluses commonly form?

A

Cutaneous calluses commonly form over pressure points

35
Q

What are the three main components of the skin immune system?

A

Physiochemical barrier
Skin microbiome
Immune cells

36
Q

What are the three components of the skin physiochemical barrier?

A

Stratum corneum
Surface lipids
Antimicrobial peptides (AMPs)

37
Q

What percentage of a healthy stratum corneum should be made up of lipids?

A

85%

38
Q

What are the three main lipids found in and around the stratum corneum?

A

Sphingolipids
Cholesterol
Free fatty acids

39
Q

What are the three main functions of the lipid layer of the stratum corneum?

A

Physical barrier
Hydrophobic permeability barrier
Immunological barrier

40
Q

What produces antimicrobial peptides (AMPs)?

A

Keratinocytes and sweat glands

41
Q

What are two of the most common antimicrobial peptides (AMPs)?

A

Defensins
Cathelicidins

42
Q

What are the six main functions of antimicrobial peptides (AMPs) in host defence?

A

Activate and recruit inflammatory cells
Promote angiogenesis
Promote keratinocyte proliferation
Directly kill microbes
Inhibit endotoxins
Induce mast cell degranulation

43
Q

What is the skin microbiome?

A

The skin microbiome is the commensal microbes of the skin

44
Q

Name one of the commensal microbes within the skin microbiome

A

Staphylococcus epidermicus (Staph. epidermicus)

45
Q

What are three of the functions of staphylococcus epidermicus?

A
  • Stimulates IL-1 production which activates T-cells to become more responsive to invading organisms
  • Produces antimicrobial peptides (AMPs)
  • Produce <10K elements which interact with toll-like receptors to enhance defensin expression
46
Q

Which antimicrobial peptide (AMP) is produced by staphylococcus epidermis?

A

Modulin

47
Q

What are the six main factors which can influence the skin microbiome?

A

Host physiology
Environment
Immune system
Host genotype
Lifestyle
Pathobiology (underlying disease)

48
Q

What are the five cellular components of the skin immune system?

A

Endothelial cells
Keratinocytes
Langerhans cells
Mast cells
Lymphocytes

49
Q

How do keratinocytes act as sentinel cells?

A

Keratinocytes express pattern recognition receptors (PRR) which respond to DAMPs and PAMPs. This binding initiates a pro-inflammatory response through the release of antimicrobial peptides (AMPs), cytokines and chemokines

50
Q

How do keratinocytes act as non-professional antigen-presenting cells?

A

Keratinocytes present MHC II however can only interact with antigen-experienced T-cells

51
Q

What is the other name used to describe langerhans cells?

A

Epidermal dendritic cells

52
Q

What is the main function of langerhans cells in response to epithelial cells injury or pathogen invasion?

A

In response to primary cytokines, langerhans cells mature and migrate to local lymph nodes where they carry out antigen presentation to naive and memory T-cells

53
Q

What are the seven epidermal responses to injury?

A

Orthokeratotic hyperkeratosis
Parakeratotic hyperkeratosis
Hypergranulosis
Acanthosis
Hyperplasia
Hyper/hypopigmentation
Lichenification

54
Q

What is orthokeratotic hyperkeratosis?

A

Thickening of the stratum corneum with preserved keratinocyte maturation

55
Q

What is parakeratotic hyperkeratosis?

A

Thickening of the stratum corneum with retained nuclei as a sign of delayed keratinocyte maturation

56
Q

What is hypergranulosis?

A

Prominent keratohyaline granule layer within the stratum granulosum

57
Q

What is hypergranulosis commonly associated with?

A

Hyperkeratosis

58
Q

What is acanthosis?

A

Hyperplasia of the stratum spinosum

59
Q

How does lichenification appear on histology?

A

Hyperkeratosis, hyperplasia and dysplasia of the epidermis

60
Q

Give an example of a self-induced skin lesion

A

Acral lick dermatitis

61
Q

What are two possible causes of acral lick dermatitis?

A

Behavioural
Underlying pyoderma

62
Q

What is a hypersensitivity reaction?

A

An exaggerated or inappropriate immune response to a mild pathogen or innocuous substance (allergen)

63
Q

What is an autoimmune disease?

A

A specific humoral or cell-mediated immune response against the body’s own tissue components

64
Q

What is type I hypersensitivity?

A

Re-exposure of an IgE antibody bound to a mast cell to an allergen, stimulating mast cell degranulation leading to histamine and prostaglandin release

65
Q

What is the name of the systemic response to type I hypersensitivity?

A

Anaphylaxis

66
Q

Which two factors of anaphylaxis lead to death?

A

Hypotension causing tissue hypoperfusion
Direct damage to the respiratory system

67
Q

List two examples of type I hypersensitivity

A

Atopic dermatitis
Insect bite hypersensitivity

Atopic dermatitis
68
Q

(T/F) Atopic dermatitis is multifactorial

A

TRUE. Genetics and the environment both contribute to atopic dermatitis

69
Q

What is the most common allergen that causes atopic dermatitis?

A

Dust mites

70
Q

What are the three classic lesions seen in atopic dermatitis?

A

Pruritic dermatitis (itchy skin)
Otitis
Conjuntivitis

71
Q

Which three anatomical regions are most commonly affected by pruritic dermatitis due to atopic dermatitis?

A

Face
Feet
Ventrum

72
Q

What is the classic histological appearance of insect bite hypersensitivity?

A

Focal necrosis underlying a serocellular crust

73
Q

Which four anatomical regions are most commonly affected by flea allergy dermatitis?

A

Dorsal lumbosacral area
Neck
Inner thighs
Abdomen

74
Q

What is type II hypersensitivity?

A

Antibodies (IgG or IgM) and complement bind to harmless endogenous or exogenous antigens triggering an immune response and phagocytosis

75
Q

Which auto-immune disease of the skin has underlying type II hypersensitivity?

A

Pemphigus foliaceus

76
Q

What is type III hypersensitivity?

A

Free floating antigen-antibody complexes deposit and build up within the capillaries, triggering an inflammatory response and damage to the surrounding blood vessels

77
Q

What is the hallmark lesion of type III hypersensitivity?

A

Vasculitis

78
Q

What is type IV hypersensitivity?

A

T-cells bind to allergens, stimulating a delayed inflammatory response

79
Q

List three examples of type IV hypersensitivity

A

Tuberculin skin test
Contact dermatitis
Granuloma formation

80
Q

What is the purpose of the tuberculin skin test?

A

Tests for the exposure of mycobacterium bovis in cattle

81
Q

Describe how the tuberculin skin test is carried out

A

Mycobacterium bovis and mycobacterium avium are injected subcutaneously into the cow simultaneously. After four days, the difference between the two nodules is measured and compared

82
Q

What causes contact dermatitis?

A

A chemical known as hapten binds to host epidermal proteins, causing it to become an allergen

83
Q

What is the classic lesion seen in contact dermatitis?

A

Pruritic, maculopapular dermatitis

MODULE 7 - Skin and Bones (22 decks)

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