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AY Dermatology > Skin immunology > Flashcards

Skin immunology Flashcards

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Dermatology Board Prep 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
Q

Which skin conditions are associated with inappropriate immune response?

A 
Psoriasis
Atopic dermatitis 
Bullous pemphigoid 
Contact dermatitic 
Systemic sclerosis 
Urticaria 
SLE
Skin infections 
Skin tumours
26
Q

What is the hallmark of psoriatic skin lesions?

A

Inflammation

27
Q

What can trigger an exacerbation of psoriasis?

A 
Bacterial pharyngitis (usually gram positive) 
Mild trauma (Koebner phenomenon)
HIV infection 
Psychological stress
B blockers or lithium
28
Q

Are psoriatic plaques commonly precursors to cancer?

A

No

29
Q

Who is atopic eczema most common in?

A

Children

30
Q

Mutations in which gene are associated with severe/early onset eczema?

A

Fillagrin gene

31
Q

In atopic eczema is there increased or dicreased amp?

A

Decreased

32
Q

What are the characteristics of Type I (immediate) hypersensitivity reactions?

A

Excessive mast cell and basophil activation by IgE resulting in an etreme inflammatory response

33
Q

What mediates type II & III hypersensitivity reactions?

A

IgM

IgG

34
Q

Examples of Type I hypersensitivity?

A

Allergy (urticaria)

35
Q

Example of type II hypersensitivity?

A

Pemphgus & pemphigoid

36
Q

Example of Type III hypersensitivity reaction?

A

SLE

Rheumatoid Arthritis

37
Q

What cells mediate Type IV (delayed) hypersensitivity reactions?

A

TH1 cells

38
Q

Risk factors for developing drug eruption

A 
Infants/elderly 
Gender (female>male)
Genetics
Concomitant disease 
Immune status
39
Q

Common presentation of eathematous drug eruption

A

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
Q

What type of rection is an exanthematous drug eruption?

A

T-cell mediated delayed type hypersensitivy (Type IV) reaction

41
Q

Indicators that an exanthematous drug eruption is potentially severe

A 
Involvement of mucous membrane and face 
Facial oedema & erythema 
Widespread confluent erythema 
Fevere 
Blisters, purpura, necrosis 
Lymphadenopathy
arthralgia 
Shortness of breath/wheezing
42
Q

Drugs associated with exanthematous drug eruptions

A 
Penicillins 
Suphonamide antibiotics
Erythomycin 
Streptomycin 
Allopurinol 
Anti-epileptics 
NSAIDs
Phenytoin 
Chloramphenicol
43
Q

What is urticaria?

A

IgE mediated Type I hypersensitivity after rechallenge with a drug or direct release of inflammatory mediators from mast cells on first eposure

44
Q

What medications can cause acne?

A 
Glucocorticoids
Androgens 
Lithium 
Isoniazide
Phenytoin
45
Q

What drugs can induce bullous pemphigoid?

A

ACE inhibitors
Penicillin
Furosemide

46
Q

What drug can trigger linear IgA disease?

A

Vancomycin

47
Q

What are fied drug eruptopms?

A

Well demarcated plaques that occur at the same site every time

48
Q

What drugs are associated with fixed drug eruptions?

A

Tetracycline/doxycycline
Paracetamol
NSAIDs
Carbamazepine

49
Q

Examples of severe cutaneous adverse reactions

A

Stevens-Johnson syndrome
TEN
DRESS
Acute generalised eanthematous pustulosis

50
Q

What drugs can cause TEN?

A 
sulfonamide antibiotics
Cephalosporins 
Carbamazepine 
NSAIDs 
Tramadol
51
Q

Acute presentation of phototoxic drug reactions

A

Skin toxicity
Systemic toicity
Photodegradation

52
Q

Chronic effects of phototoxic drug reactions

A

Pigmentatino
Photoageing
Photocarcinogenesis

53
Q

Drugs that cause immediate prickiling with delayed erythema and pigmentation (cutaneous phototoxicity)

A

Chlorpromazine

Amiodarone

54
Q

Drugs that cause exaggerated sunburn

A

Quinine
Thiazides
DCMT

55
Q

What drug can cause exposed telangiectasia

A

Calcium channel lockers

56
Q

Clinical manifestations of allergy

A

Urticaria
Angioedema
Wheezing/asthma
Anaphylaxis

AY Dermatology (11 decks)

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