Skin DSAs Flashcards

1
Q

Skin Function- Major Types

A

Protective covering – Non-permeable barrier to protect internal systems from external environment.
Water, chemicals, toxic substances, “dirt”, etc.
UV Radiation

Tactile interaction with external world
Touch
Pain
Pressure
Temperature

Body temperature regulation
Vascular dilatation/constriction superficial and deep dermal plexuses
Sweating
Structural for heat retention (adipose tissue; hair, particularly scalp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Skin FunctionsNot commonly mentioned, but Important

A

Sexual attractiveness
Skin Appearance important part of sexual attractiveness

Immune system – production of cytokines and defensins
– antigen presentation via Langerhans Epidermal Dendritic Cells and possibly dermal dendrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Langerhans cells

A

are dendritic cells located in upper spinous layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ThreeBasic Layers of Organization

A
Epidermis
Dermis
- papillary dermis
- reticular dermis
Subcutis (Hypodermis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Adnexae:

A

Three major adnexal structural units and specialized sensory nerve structures
Pilar (hair) units: pilosebaceous units, arrector pili muscles
Eccrine units: eccrine glands and ducts
Apocrine units: apocrine glands and ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

layers of epidermis

A
stratum corneum
lucidum
graulosum
spinosum
basale

dermal-epidermal junction

  • pappillary dermis
  • reticular dermis

Come, Let’s Get Sunburned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Apocrine Glands location

A

deep dermis and often at junction of reticular dermis and subcutaneous tissue (axilla, scalp, perineum, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

melanocytes

A

produce pigment that are is absorbed by the squamous cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

squamous cell connection

A

intercellular bridges = desmosomes

allows for the dx of squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Papillary Dermis

A

Finely woven Type I collagen, parallel to surface

  • some Type III and network of elastic fiber
  • healing by secondary intention
  • capillaries ofsuperficial plexus (blushing, sunburn)

Basement Membrane interface with epidermis
- defines invasion of carcinoma
* contains proteins involved in blistering immune disease
*** bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa
- other inflammatory conditions
discoid lupus erythematosus (thickens BM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

location of the superficial vascular plexus

A

papillary dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

skin sensation-

A

Lamellar/Lamellated/Pacinian corpuscle
Meissner/tactile corpuscles/papillae
General Skin Nerve supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lamellar/Lamellated/Pacinian corpuscle

A

encapsulated nerve ending
pressure receptor
found in deep dermis or hypodermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Meissner/tactile corpuscles/papillae

A

touch receptor
confined to dermal papillae
most numerous on hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

General Skin Nerve supply

A

free nerve endings detect pain and temperature

innervation by sympathetic nervous system controls blood flow and hair movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Subcutis - Hypodermis: structure

A
Loose and dense subcutaneous connective tissue
- Adipocytes arranged in lobules; Fibroconnective tissue arranged in septae
Lobular Panniculitis (e.g. pancreatitis)
Septal Panniculitis (e.g. erythema nodosum)
  • Large number of blood vessels – deep vascular plexus which sends perpendicular small arteries to traverse the reticular dermis and supply arterial blood to the superficial vascular plexus in the dermal papillae of the papillary dermis
    Vasculitis is a pathologic state

Connects reticular dermis with fascia of underlying tissue (muscle, bone, tendon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Subcutis- Hypodermis: purpose

A

Body temperature regulation:
- Both vascular regulation and insulation by adipose tissue.

Primary depot for fat storage
- large energy reserve along with the omentum

Major skin layer where aging is most evident
- With aging there is progressive loss of the adipose component of subcutaneous tissue, particularly in extremities (hands and feet) leading to “gaunt look”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Erosion

A

Superficial partial thickness loss of the epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Excoriation

A

Traumatic abrasion of the skin, often from scratching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ulceration

A

Full thickness loss of the epidermis revealing dermis or subcutis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fissure

A

Linear ulceration

22
Q

Exocytosis

A

Inflammatory cells within the epidermis

23
Q

Lichenification

A

Thickened and rough skin; may be the result of repeated rubbing (lichen simplex chronicus/prurigo nodularis)

24
Q

Scale

A

Dry, horny, platelike excrescence; usually the result of imperfect cornification

25
Q

Macule

A

<5 mm in diameter discolored flat lesion

26
Q

Patch

A

> 5 mm in diameter discolored flat lesion

27
Q

Papule

A

< 5 mm elevated somewhat dome-shaped lesion

28
Q

Nodule

A

> 5 mm elevated or non-elevated rounded mass

29
Q

Plaque

A

Elevated flat-topped lesion, usually > 5 mm across

30
Q

Wheal

A

Itchy elevated lesion with variable blanching and erythema from edema

31
Q

Blister

A

Any clear fluid-filled raised lesion

32
Q

Vesicle

A

<5 mm blister

33
Q

Bulla

A

> 5 mm blister

34
Q

Pustule

A

Elevated area filled with pus, may resemble a blister

35
Q

Onycholysis

A

Separation of nail from the nail bed

36
Q

Hydropic swelling (balooning)

A

Intracellular edema of cells

37
Q

Spongiosis

A

Intercellular edema of the epidermis

(= excema)

38
Q

Acantholysis

A

Loss of intercellular attachment of keratinocytes

39
Q

Vacuolization

A

Formation of vacuoles within or adjacent to cells

40
Q

Acanthosis

A

Thickened stratum spinosum

41
Q

Hyperkeratosis

A

Thickened of the stratum corneum

42
Q

Hypergranulosis

A

Hyperplasia of stratum granulosum

43
Q

Parakeratosis

A

Keratinization with retained nuclei in the stratum corneum

44
Q

Dyskeratosis

A

Premature keratinization of cells below the stratum granulosum

45
Q

Lentiginous

A

Single unit proliferation of melanocytes along basal layer

46
Q

Papillomatosis

A

Finger-like hyperplasia and enlargement of dermal papillae

47
Q

Verrucous

A

Looking like a verruca vulgaris (wart), also used grossly

48
Q

Aging Changes in Skin

A

INTRINSIC AGING: WRINKLES

  • aberrant basal layer proliferation: risk of neoplasm
  • decrease in melanocytes: UV damage, “whitening“
  • decrease in Langerhans cells
  • thinning: decrease in ground substance, cells and adnexae, stiffer collagen and elastic fibers

Decreased hair shaft diameter; by age 70 lose 25 - 50% of cross-sectional diameter present in young people

Decreased # hair follicles; Decreased oil production -“Dry Skin” = xerosis***

Changes in distribution/prominence of hair:

49
Q

Solar Elastosis

A

Telangiectasia - dilated small blood vessels

Actinic (basophilic) degeneration of reticular dermis collagen

50
Q

Sunburn

A

Acute injury caused by mid-UV radiation
Changes in the dermis
- Increased blood flow
- Superficial blood vessels show endothelial swelling, perivenular edema, mixed perivascular inflammatory infiltrate