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AY Dermatology > Skin immunology > Flashcards

Skin immunology Flashcards

1
Q

What are the features of the innate immune system?

A

First line
Non-specific
No memory

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2
Q

What are the features of the adaptive immune system?

A

Highly specific
Memory
Self-limiting

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3
Q

Name 3 important structural proteins in the keratin layer?

A

Filaggrin
Involucrin
Keratin

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4
Q

What is another name for the keratin layer?

A

Stratum Corneum

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5
Q

What are corneocytes?

A

Terminally differentiated keratinocytes which compose most of the stratum corneum

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6
Q

What is the role of keratinocytes in the epidermis?

A

Sense pathogens via cel surface receptors and help mediate an immune response
Produces AMPs that can directly kill pathogen
Produce cytokines & chemokines

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7
Q

AMP levels are found at high levels in the skin of which patients?

A

Psoriasis

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8
Q

What is the main skin resident immune cell?

A

Langerhan cells

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9
Q

What is the characterizing histological finding of langerhans cells?

A

Birbeck granules (tennis racket shaed)

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10
Q

What type of cell are Langerhan cells?

A

Dendritic anitgen presenting cells

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11
Q

Which T cells are mainly found in the epidermis?

A

CD8+ T cells

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12
Q

Which CD4+ cell is associated with psoriasis?

A

TH1

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13
Q

Which CD4+ cell is associated with atopic dermatitis?

A

TH2

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14
Q

What coniditions are TH17 cells associated with?

A

Psoriasis ~& atopic dermatitis

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15
Q

Where are T cells produced?

A

Bone marrow

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16
Q

Where are T cells sensitised?

A

Thymus

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17
Q

What is the function of CD8+ T cells?

A

Direct cell killing

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18
Q

What is the function of CD4+ helper T cells (TH!)?

A

Activate macrophages

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19
Q

What is the function of CD4+ helper T cels (TH2)?

A

Help B cells make antibody

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20
Q

What do denritic cells do in the immune response?

A

Secrete cytokines & chemokines

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21
Q

What attracts neutrophils to damaged tissue?

A

Chemokines

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22
Q

Which cells are the effectors of IgE mediated immune response?

A

Mast cells

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23
Q

What is the role of MHC class I?

A

Present endrogenous Ag

24
Q

What is the role of MHC Class II?

A

Present eogenous Ag

25
Which skin conditions are associated with inappropriate immune response?
``` Psoriasis Atopic dermatitis Bullous pemphigoid Contact dermatitic Systemic sclerosis Urticaria SLE Skin infections Skin tumours ```
26
What is the hallmark of psoriatic skin lesions?
Inflammation
27
What can trigger an exacerbation of psoriasis?
``` Bacterial pharyngitis (usually gram positive) Mild trauma (Koebner phenomenon) HIV infection Psychological stress B blockers or lithium ```
28
Are psoriatic plaques commonly precursors to cancer?
No
29
Who is atopic eczema most common in?
Children
30
Mutations in which gene are associated with severe/early onset eczema?
Fillagrin gene
31
In atopic eczema is there increased or dicreased amp?
Decreased
32
What are the characteristics of Type I (immediate) hypersensitivity reactions?
Excessive mast cell and basophil activation by IgE resulting in an etreme inflammatory response
33
What mediates type II & III hypersensitivity reactions?
IgM | IgG
34
Examples of Type I hypersensitivity?
Allergy (urticaria)
35
Example of type II hypersensitivity?
Pemphgus & pemphigoid
36
Example of Type III hypersensitivity reaction?
SLE | Rheumatoid Arthritis
37
What cells mediate Type IV (delayed) hypersensitivity reactions?
TH1 cells
38
Risk factors for developing drug eruption
``` Infants/elderly Gender (female>male) Genetics Concomitant disease Immune status ```
39
Common presentation of eathematous drug eruption
Widespread symmetrically distributed rash Pruritis What is the most common type of drug eruption?Mild fever Onset 4-21 days after first taking drug
40
What type of rection is an exanthematous drug eruption?
T-cell mediated delayed type hypersensitivy (Type IV) reaction
41
Indicators that an exanthematous drug eruption is potentially severe
``` Involvement of mucous membrane and face Facial oedema & erythema Widespread confluent erythema Fevere Blisters, purpura, necrosis Lymphadenopathy arthralgia Shortness of breath/wheezing ```
42
Drugs associated with exanthematous drug eruptions
``` Penicillins Suphonamide antibiotics Erythomycin Streptomycin Allopurinol Anti-epileptics NSAIDs Phenytoin Chloramphenicol ```
43
What is urticaria?
IgE mediated Type I hypersensitivity after rechallenge with a drug or direct release of inflammatory mediators from mast cells on first eposure
44
What medications can cause acne?
``` Glucocorticoids Androgens Lithium Isoniazide Phenytoin ```
45
What drugs can induce bullous pemphigoid?
ACE inhibitors Penicillin Furosemide
46
What drug can trigger linear IgA disease?
Vancomycin
47
What are fied drug eruptopms?
Well demarcated plaques that occur at the same site every time
48
What drugs are associated with fixed drug eruptions?
Tetracycline/doxycycline Paracetamol NSAIDs Carbamazepine
49
Examples of severe cutaneous adverse reactions
Stevens-Johnson syndrome TEN DRESS Acute generalised eanthematous pustulosis
50
What drugs can cause TEN?
``` sulfonamide antibiotics Cephalosporins Carbamazepine NSAIDs Tramadol ```
51
Acute presentation of phototoxic drug reactions
Skin toxicity Systemic toicity Photodegradation
52
Chronic effects of phototoxic drug reactions
Pigmentatino Photoageing Photocarcinogenesis
53
Drugs that cause immediate prickiling with delayed erythema and pigmentation (cutaneous phototoxicity)
Chlorpromazine | Amiodarone
54
Drugs that cause exaggerated sunburn
Quinine Thiazides DCMT
55
What drug can cause exposed telangiectasia
Calcium channel lockers
56
Clinical manifestations of allergy
Urticaria Angioedema Wheezing/asthma Anaphylaxis

AY Dermatology (11 decks)

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