Skin Diseases

Question 1

What are the layers of the skin

Answer 1

epidermis
dermis
hypodermis

Question 2

What cells are in the epidermis

Answer 2

Keratinocytes
merkel cells (pressure receptors)
melanocytes
Langerhans
Tcells

Question 3

Whats found in the dermis layer

Answer 3

connective tissues
collagen elastin and fibrillin
Blood vessels, sweat glands, hair follicles, sebaceous glands, nerves

Question 4

What is the hypodermis for?

Answer 4

subcutaneous tissue
Thermal insulator
Energy store
mechanical protector

Question 5

How does the skin microbial communities prevent disease?

Answer 5

Takes up space and produces AMP
Strengthens epidermal barrier
Primes APCs for adaptive immunity

Question 6

What are the stages of healing?

Answer 6

Bleeding (clot)
Inflammatory (scab formed, fibroblasts and macrophages produced)
Proliferative (fibroblasts proliferate and subcut. heals)
Remodelling (dermis and epidermis heals)

Question 7

What mediators are used for tissue remodelling

Answer 7

Fibroblasts, MMPs TGFb
Lymphocytes also involved

Question 8

What is the role of haemostasis during a skin injury

Answer 8

Injured vessels contract
Coagulation cascade
Platelet aggregation
cytokines which attract fibroblasts and macrophages
Serotonin -> incre. vascular permeability

Question 9

What becomes macrophages in the late inflammatory stage

Answer 9

Blood monocytes

Question 10

What happens during the proliferative phase of a wound

Answer 10

Fibroblast migration
Collagen synthesis
Angiogenesis
Granulation tissue formation
Epithelialisation

Question 11

What happens during the remodelling phase of a wound

Answer 11

Fibronectin and HA (hyaluronic acid) broken down
Collagen bundles strengthen (80% of original)
Collagen synthesis and breakdown by TGFb and MMPs
Scar results

Question 12

What happens during the early inflammation phase of a wound

Answer 12

complement system activated
Neutrophils

Question 13

What is eczema

Answer 13

dry irritated inflamed skin
Itching / burning

Question 14

What are the types of eczema

Answer 14

Atopic
Contact
Seborrhoeic
dyshidrotic

Question 15

What is atopic dermatitis
*symptoms
*Pharmacology
*prevention of flares
*treatments

Answer 15

*symptoms- dry skin, itchy esp. at night usually occurs w asthma or hayfever

*Pharmacology- defect in skin barrier repair mechanism - filaggrin gene
allergen = Th2 cells = IL4 activates Bcells causing IgE-> mediators for inflammation = mast cell stimulation

*prevention of flares- moisturisers, avoid triggers, mild soap

*treatments- emollients, corticosteroids, phototherapy, topical calcineurin inhibitors

Question 16

What is contact dermatitis
*symptoms
*prevention of flares
*treatments

Answer 16

*symptoms - 2 types irritant and allergic

*prevention of flares/ treatments- avoid irritants and allergens, emollients, corticosteroids

Question 17

What is seborrhoeic dermatitis
*symptoms
*Pharmacology
*prevention of flares
*treatments

Answer 17

*symptoms- skin flakes, greasy looking white or yellow scale
Dandruff on scalp

*Pharmacology- overgrowth of yeast

*prevention of flares - stress?

*treatments - children- emollients, topical steroids and antifungals
- adults - ketoconazole, steroid lotions, corticosteroids

Question 18

What is dyshidrotic dermatitis

Answer 18

Usually with atopic
Hands and feet
Itchy blisters
Emollients, steroids, antibiotics, phototherapy

Question 19

What is psoriasis

Answer 19

Autoimmune inflammatory skin disease
Normal skin cells produced faster than shed = itchy plaques- white scales

Question 20

What is plaque psoriasis

Answer 20

Red itchy sore plaques with silvery scales anywhere

Question 21

What is the treatment for psoriasis

Answer 21

Moisturisers and emollients
Vit D derivatives
Steroids topical (eumovate etc)
Calcineurin inhibitors
Phototherapy
Immunosupressants
Vit A derivatives
Biologics

Question 22

What is psoriatic Arthritis and how is it treated

Answer 22

Inflammatory join disease affecting joints and tendons
Worse in morning ease with exercise
Treated with:
Painkillers/ NSAIDs
Corticosteroids
DMARDs- leflunomide
Biologics

Question 23

What are the signs of skin cancer

Answer 23

Asymmetry
Border is irregular
Colour variation
Diameter more than 6mm
Evolving-change

Question 24

What causes warts and verrucas

Answer 24

HPV causes keratin production on epidermis
Can treat with cryosurgery or salicylic acid creams

Question 25

What is impetigo

Answer 25

Sores and blisters- very contagious
Non bullous and bullous
Topical antibiotic

Question 26

What is athletes foot

Answer 26

Ringworm between toes
Itchy flaky red skin

Question 27

What is the treatment for fungal infections

Answer 27

Topical imidazole

Question 28

What is vitiligo

Answer 28

Melanocytes die or stop functioning
Body makes autoantibodies to tyrosine hydroxylase

Question 29

For creams and ointments:
What drugs need water in oil and what drugs need oil in water

Answer 29

Water in oil for ciclosporin and hydrophobic
Oil in water for NSAIDs as hydrophilic

Question 30

Whats an advantage of Transdermal therapeutic systems

Answer 30

Avoids first-pass metabolism of drug in liver
Consistent site of absorption
Constant drug input rate
Easy to stop dosing

Question 31

Difference between intercellular and transcellular mechanisms of drug absorption

Answer 31

Intercellular goes around the cells
Transcellular goes through cells

Question 32

How do glucocorticoids work for skin inflammation

Answer 32

Inhibits release of inflammatory mediators, NFkB, neutrophil activation