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Dermatology Block > Pathophysiology > Flashcards

Pathophysiology Flashcards

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Dermatology Board Prep flashcards
1
Q

Psoriasis pathophysiology?

A

genetic component

1) Keratinocytes under stress (intiated by trauma/drugs/unknown allergen) lead to activation of dermal dendrites
2) Dermal dendrites activate T helper cells
4) T helper cells release growth factors (TNFa), adhesion molecules and other cytokines which propel inflammation and epidermal turnover

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2
Q

Psoriasis presentation?

A

Epidermal cell turnover increased (silvery scales)
Granular layer absent
Affects extensor surfaces
itchy - bleed
thinning epidermal over blood vessels, multiple bleeding pts
Well demarcated papulo-squamous red scaly plaques

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3
Q

Eczema?

A

Impairment of skin barrier function due to mutations in fillagrin gene (fillagrin holds keratin filaments together.)
This leads to stressed keratinocytes, which attract dermal dendritic cells (Ag presenting, chemokine releasers), and therefore T cells. Immune response intiated.
Defective barrier allows access/sensitization to allergens and promotes bacterial colonisation

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4
Q

Eczema presentation?

A

Red inflamed patches
Flexor surfaces
common children

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5
Q

Hyperkeratosis

A

Increased thickness of keratin layer

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6
Q

Parakeratosis

A

Persistence of nuclei in the keratin layer

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7
Q

Acanthosis

A

Increased thickness of prickle cell layer

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8
Q

Basic biochemistry of porphyrias?

A

Porphyrias deposit in skin, energy from sun absorbed.

Porphyria moves deeper into the skin and can intiate a secondary reaction and inflammatory immune response.

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9
Q

Photoallergy is also known as - , it is a form of - - -

A

photodermatitis,

allergic contact dermatitis

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10
Q

Phototoxcitiy does not involve the - -. It is a - induced skin reaction.

A

immune system, chemically

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11
Q

Erythropoetic protophoryia usually presents in - and most cases are -. Clinical presentation involves - - - and - within few mins exposure to sun.

A

childhood
congenital (inborn metabolic defects)
pruritus, erythema, swelling and pain

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12
Q

Porphyria cutanea tarda typical clinical presentation involves - and - as well as -pigmentation, -trichosis and solar -

A 
Blister, fragility
Hyperpigmentation
Hypertrichosis
Solar urticaria 
morphoea which is localised (patches on skin)
scleroderma (hard bits of skin)
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13
Q

Acute intermittent porphyria presents with acute -, as well as peripheral neuropathy syndromes such as – syndrome, and - multiplex.

A

abdomen
gullian barre
mononeuritis
psychosis

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14
Q

Lesion is

A

Lesion is traumatic or pathogic loss of normal tissue continuity, structure or function

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15
Q

Rash is

A

temporary eruption of skin

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16
Q

Flat lesions called?

A

Macule is flat spot <1cm

Patch >1cm

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17
Q

Raised lesions called

A

Nodule if >0.5cm

Papule if <0.5cm

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18
Q

Plaque is

A

ELEVATED edges and flatter surface >1cm

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19
Q

Wheal is

A

localised skin edema, compressible

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20
Q

Lichenification

A

thickened leathery roughening of skin caused by scratching

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21
Q

Blisters are

A

Circumscribed elevations f skin caused by fluid under or within epidermis

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22
Q

Pustules are

A

sircumscribed elevations of skin -pus filled

23
Q

Vesicles are

A

<1cm blister

24
Q

Bullae are

A

> 1cm blister

25
Q

Erosion is

A

loss of superficial epidermis, surface moist but does not bleed

26
Q

Ulcer is

A

Skin defect where there is loss of epidermis and papillary layer of dermis - may extend to subcutaneous tissue

27
Q

Callus is?

A

Hyperkeratotic plaque of skin develops because of pressure or friction

28
Q

Purpura is

A

reddening of skin due to extraversion of blood - doesn’t blanche

29
Q

Petechia

A

small (1-2mm) area of purpura

30
Q

Cyst is?

A

Nodule containg semi-solid material

31
Q

Onycholyisis is?

A

seperation of nail plate from nail bed

32
Q

Alopecia?

A

loss of hair

33
Q

Hypertrichosis

A

general excess growth (hair, nails etc)

34
Q

Hirsutes?

A

excess growth in male pattern (i.e. beard in women)

35
Q

Enzyme deficient in acute intermittent porphyria?

A

PBG Deaminase (high up metabolic pathway)

36
Q

Enzyme deficient in porphyria cutanea tarda?

A

Uroporphyrinogen Decarboxylase (middle metabolic pathway)

37
Q

Enzyme deficient in erythropoietic protoporphyria?

A

Ferrochelatase (bottom of metabolic pathway)

38
Q

Discoid eczema is?

A

well defined, erythematus and scaly “discs” of eczema

Often atopic

39
Q

Diagnostic criteria for eczema?

A 
Itch plus 3+ of:
Visible flexural rash*
History of flexural rash*
Personal history of atopy 					(or first degree relative if under 4 yo)
Generally dry skin 
Onset before age 2 years
40
Q

Immunopathology of contact allergic dermatitis?

A

Langerhans cell in epidermis processes antigen
antigen is then presented to Th cells
Sensitised T cells proliferate epidermis and cause damage = spongiosis

41
Q

Contact allergic dermatitis is inflammation in contact with an?

A

allergen

42
Q

Irritant contact dermatitis is inflammation in response to?

A

non-specific physical irritation rather than a specific allergic reaction
e.g. soap, detergent, nappy
difficult to distinguish from allergic ?

43
Q

Atopic eczema is caused by?

A

Genetic & environmental factors resulting in inflammation
itching,not sleeping, affects whole family w kids

44
Q

Chronic changes of atopic eczema?

A

Lichenification
Excoriation – erosion brought about by scratching
Secondary infection – high carriage Staph A, erosions good carrier bacteria

45
Q

Eczema herpeticum is caused by? Presents as?

A

Herpes simplex virus
monomorphic punched out lesions
fecer

46
Q

Stasis eczema is secondary to?

A

hydrostatic pressure
oedema
red cell extravasation

47
Q

What is “cradle cap”?

A

Seborrhoeic dermatitis

48
Q

Pompholyx eczema is characterised by?

A

Spongiotic vesicles

49
Q

Photosensitive eczema is in response to sun exposure t/f

A

t

50
Q

What is a chronic leg ulcer?

A

open lesion between the knee and ankle joint that remains unhealed for at least 4 weeks.

51
Q

60-80% of leg ulcers are arterial in nature

A

F

60-80% of leg ulcers are VENOUS in nature

52
Q

Features of arterial ulcers? FEED P

A

Full thickness defect
Embolic “showering” on the toes
Extremities
Diabetics

Punched out appearance

53
Q

Features of venous ulcers? VVERD

A 
Varicose veins
Varying depths
Exudative and painful
Recurrent
Distal leg and ankle

Dermatology Block (8 decks)

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