Rashes Flashcards

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1
Q

What is hyperkeratosis?

A

Increased thickness of keratin layer

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2
Q

What is parakeratosis

A

Persistence of nuclei in the keratin layer

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3
Q

What is acanthosis?

A

Increased thickness of epithelium

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4
Q

What is papillomatosis?

A

Irregular epithelial thickening

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5
Q

What is spongiosis?

A

Oedema fluid between squames appears to increase prominence of intercellular prickles

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6
Q

What are the four main reaction patterns and what is an example of each?

A
Spongiotic-intraepidermal oedema
-Eczema
Psoriadiform 
-Elongation of the rete ridges
-Psoriases
Lichenoid-basal layer damage
-Lichen planus
Vesicobullous blistering
-Pemphigoid
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7
Q

What is psoriasis?

A

Common chronic inflammatory dermatosis

Increased epidermal hyperplasia

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8
Q

What is the koebner phenomenon and what exhibits it?

A

New lesions arising from sites of trauma

Psoriasis

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9
Q

What are lichenoid disorders?

A

Conditions characterised by damage to the basal epidermis

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10
Q

What does lichem planus look like?

A

Itchy flat-topped violaceous papules

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11
Q

What is the histology of lichen planus?

A

Irregular sawtooth acanthosis
Hypergranulosis and orthohyperkeratosis
Band-like upper dermal infiltrate of lymphocytes
Basal damage with formation of cytoid bodies

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12
Q

What is the primary feature of immunobullous disorders?

A

Blisters

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13
Q

What is pemphigus?

A

Rare autoimmune bullous disease with loss of epidermal cell adhesion integrity

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14
Q

Can pemphigus be fatal?

A

Yes

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15
Q

Does pemphigus respond to treatment?

A

Yes, Steroids

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16
Q

What is the most common subtype of Pemphigus?

A

Pemphigus vulgaris

17
Q

Is Pemphigus vulgaris autoimmune?

A

Yes

18
Q

What are the IgG auto-antibodies against in Pemphigus vulgaris?

A

Desmoglein 3 (maintains desmosomal attachments)

19
Q

What is the pathogenesis of Pemphigus vulgaris?

A

Immune complexes form on cell surface
Complement activation and protease release
Disruption of desmosomes
End result is acantholysis
Produces fluid filled blisters which rupture to form shallow eroisions

20
Q

What is acantholysis?

A

Lysis of intercellular adhesion sites

21
Q

What is the characteristic of bullous pemphigoid?

A

Subepidermal blister

22
Q

Is there acantholysis in bullous pemphigoid?

A

No

23
Q

What is the pathogenesis of bullous pemphigoid?

A

Circulating antibodies IgG react with a major and/or minor antigen of the hemidesmosomes anchoring basal cells to the basement membrance
This results in local complement activation and tissue damage

24
Q

What does immunoflouresence show in bullous pemphigoid?

A

Linear IgG and complement depositied around the BM

Older lesions show re-epithelialisation of their floor mimicking pemphigus vulgaris

25
Q

What is dermatitis herpetiformis strongly associated with?

A

Coeliac disease

26
Q

What haplotype is associated with dermatitis herpetiformis?

A

HLA-DQ2

27
Q

What are the symptoms of dermatitis herpetiformis?

A

Intensely itchy symmetrical lesions affecting the elbows, knees and buttocks

28
Q

What is the hallmark of dermatitis herpetiformis?

A

Papillary dermal microabscesses

29
Q

What does immunoflourescence show in dermatitis herpetiformis?

A

IgA deposits in dermal papillae

30
Q

What is the pathogenesis of dermatitis herpetiformis?

A

IgA antibodies target gliadin component of gluten but cross react with connective tissue matrix proteins
Immune complexes form in the dermal papillae and activate complement and generate neutrophil chemotaxins

31
Q

Is Acne vulgaris common?

A

Very

32
Q

Where does acne affect?

A

Sebaceous gland sites
Face
Upper back
Anterior chest

33
Q

What is the pathogenesis of acne?

A

Increased androgens at puberty
Increased androgen sensitivity of sebaceous glands
keratin plugging of pilosebaceous units
Infection with anaerobic bacterium corynebacterium acnes

34
Q

Which gender is more commonly affected with rosacea?

A

Females

35
Q

What are the signs of rosacea ?

A
Pustules
Recurrent facial flushing
Visible blood vessels
Vascular ectasia
Thickening of skin - Rhinophyma
patchy inflammation with plasma cells
Perifollicular granulomas
Follicular demodex mites
36
Q

What can trigger rosacea?

A

sunlight
Alcohol
Spicy food
Stress

37
Q

What drugs do some rosacea cases respond to?

A

Tetracyclines