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
What often causes an excoriation?
Self-mutilation
26
What is an erosion/abrasion?
Moist depression in the skin due to partial loss of the epidermis
27
What is a fissure?
Linear crack or break in the epidermis and deep into the dermis
28
Which disease can often cause pawpad fissures?
Pemphigus foliaceus
29
What is lichenification?
Thickening, folding and possible pigmentation of the epidermis
30
Which disease is commonly associated with lichenification?
Chronic dermatitis
31
What is a crust?
Dead keratinocytes, fibrin, serum and neutrophil accumulation
32
Which disease is commonly associated with the formation of crusts?
Chronic staphylococcus infection
33
What is a cutaneous callus?
Thick, firm hyperkeratotic hairless plaque with increased folds and fissures
34
Where do cutaneous calluses commonly form?
Cutaneous calluses commonly form over pressure points
35
What are the three main components of the skin immune system?
Physiochemical barrier Skin microbiome Immune cells
36
What are the three components of the skin physiochemical barrier?
Stratum corneum Surface lipids Antimicrobial peptides (AMPs)
37
What percentage of a healthy stratum corneum should be made up of lipids?
85%
38
What are the three main lipids found in and around the stratum corneum?
Sphingolipids Cholesterol Free fatty acids
39
What are the three main functions of the lipid layer of the stratum corneum?
Physical barrier Hydrophobic permeability barrier Immunological barrier
40
What produces antimicrobial peptides (AMPs)?
Keratinocytes and sweat glands
41
What are two of the most common antimicrobial peptides (AMPs)?
Defensins Cathelicidins
42
What are the six main functions of antimicrobial peptides (AMPs) in host defence?
Activate and recruit inflammatory cells Promote angiogenesis Promote keratinocyte proliferation Directly kill microbes Inhibit endotoxins Induce mast cell degranulation
43
What is the skin microbiome?
The skin microbiome is the commensal microbes of the skin
44
Name one of the commensal microbes within the skin microbiome
Staphylococcus epidermicus (Staph. epidermicus)
45
What are three of the functions of staphylococcus epidermicus?
* 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
Which antimicrobial peptide (AMP) is produced by staphylococcus epidermis?
Modulin
47
What are the six main factors which can influence the skin microbiome?
Host physiology Environment Immune system Host genotype Lifestyle Pathobiology (underlying disease)
48
What are the five cellular components of the skin immune system?
Endothelial cells Keratinocytes Langerhans cells Mast cells Lymphocytes
49
How do keratinocytes act as sentinel cells?
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
How do keratinocytes act as non-professional antigen-presenting cells?
Keratinocytes present MHC II however can only interact with antigen-experienced T-cells
51
What is the other name used to describe langerhans cells?
Epidermal dendritic cells
52
What is the main function of langerhans cells in response to epithelial cells injury or pathogen invasion?
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
What are the seven epidermal responses to injury?
Orthokeratotic hyperkeratosis Parakeratotic hyperkeratosis Hypergranulosis Acanthosis Hyperplasia Hyper/hypopigmentation Lichenification
54
What is orthokeratotic hyperkeratosis?
Thickening of the stratum corneum with preserved keratinocyte maturation
55
What is parakeratotic hyperkeratosis?
Thickening of the stratum corneum with retained nuclei as a sign of delayed keratinocyte maturation
56
What is hypergranulosis?
Prominent keratohyaline granule layer within the stratum granulosum
57
What is hypergranulosis commonly associated with?
Hyperkeratosis
58
What is acanthosis?
Hyperplasia of the stratum spinosum
59
How does lichenification appear on histology?
Hyperkeratosis, hyperplasia and dysplasia of the epidermis
60
Give an example of a self-induced skin lesion
Acral lick dermatitis
61
What are two possible causes of acral lick dermatitis?
Behavioural Underlying pyoderma
62
What is a hypersensitivity reaction?
An exaggerated or inappropriate immune response to a mild pathogen or innocuous substance (allergen)
63
What is an autoimmune disease?
A specific humoral or cell-mediated immune response against the body's own tissue components
64
What is type I hypersensitivity?
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
What is the name of the systemic response to type I hypersensitivity?
Anaphylaxis
66
Which two factors of anaphylaxis lead to death?
Hypotension causing tissue hypoperfusion Direct damage to the respiratory system
67
List two examples of type I hypersensitivity
Atopic dermatitis Insect bite hypersensitivity
68
(T/F) Atopic dermatitis is multifactorial
TRUE. Genetics and the environment both contribute to atopic dermatitis
69
What is the most common allergen that causes atopic dermatitis?
Dust mites
70
What are the three classic lesions seen in atopic dermatitis?
Pruritic dermatitis (itchy skin) Otitis Conjuntivitis
71
Which three anatomical regions are most commonly affected by pruritic dermatitis due to atopic dermatitis?
Face Feet Ventrum
72
What is the classic histological appearance of insect bite hypersensitivity?
Focal necrosis underlying a serocellular crust
73
Which four anatomical regions are most commonly affected by flea allergy dermatitis?
Dorsal lumbosacral area Neck Inner thighs Abdomen
74
What is type II hypersensitivity?
Antibodies (IgG or IgM) and complement bind to harmless endogenous or exogenous antigens triggering an immune response and phagocytosis
75
Which auto-immune disease of the skin has underlying type II hypersensitivity?
Pemphigus foliaceus
76
What is type III hypersensitivity?
Free floating antigen-antibody complexes deposit and build up within the capillaries, triggering an inflammatory response and damage to the surrounding blood vessels
77
What is the hallmark lesion of type III hypersensitivity?
Vasculitis
78
What is type IV hypersensitivity?
T-cells bind to allergens, stimulating a delayed inflammatory response
79
List three examples of type IV hypersensitivity
Tuberculin skin test Contact dermatitis Granuloma formation
80
What is the purpose of the tuberculin skin test?
Tests for the exposure of mycobacterium bovis in cattle
81
Describe how the tuberculin skin test is carried out
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
What causes contact dermatitis?
A chemical known as hapten binds to host epidermal proteins, causing it to become an allergen
83
What is the classic lesion seen in contact dermatitis?
Pruritic, maculopapular dermatitis