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Pathoma Bina > Skin pathology: Inflammatory dermatoses > Flashcards

Skin pathology: Inflammatory dermatoses Flashcards

1
Q

function of skin

A

barrier against environmental insults and fluid loss

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2
Q

what composes the skin

A

epidermis and dermis

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3
Q

Epidermis has what in it, and what are the layers

A

keratinocytes

  1. statum basalis
  2. stratum spinosum
  3. stratum granulosum
  4. statum corneum
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4
Q

characterize Stratum basalis

A

regenerative (stem cell) layer

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5
Q

characterize Stratum spinosum

A

desmosomes between keratinocytes

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6
Q

characterize Stratum granulosum

A

granules in keratinocytes

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7
Q

characterize Stratum corneum

A

keratin in anucleate cells

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8
Q

what is located in the dermis

A

connective tissue
nerve endings
blood and lymphatic vessels
adnexal structures

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9
Q

what are adnexal structures

A

hair shafts
sweat glands
sebaceous glands

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10
Q

What is atopic (eczematous dermatitis)

A

pruritic, erythematous, oozing rash with vesicles and edema

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11
Q

where does atopic (eczematous) dermatitis usually occur

A

face and flexor surfaces

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12
Q

what type of hypersensitivity is atopic (eczematous) dermatitis

A

Type I hypersensitivity

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13
Q

what is atopic (eczematous) dermatitis associated with

A

asthma

allergic rhinitis

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14
Q

what is conact dermatitis

A

pruritic, erythematous, oozing rash with vesicles and edema

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15
Q

what can cause contact dermatitis

A

exposure to allergens:

  1. Poison Ivy and Nickel Jewelry ( type IV)
  2. irritant chemicals (e.g., detergents)
  3. drugs (e.g., penicillin)
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16
Q

how is contact dermatitis treated

A
  • removal of offending agent

- topical glucocorticoids, if needed

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17
Q

what is acne vulgaris

A
  • comedones (whiteheads and blackheads)
  • pustules ( pimples)
  • nodules
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18
Q

who usually gets acne vulgaris

A

extremely common

-especially adolescents

19
Q

what causes acne vulgaris

A

chronic inflammation of hair follicles and associated sebaceous glands

20
Q

what are 2 causes of acne vulgaris

A
  1. hormone-associated

2. Propionibacterium acnes

21
Q

Propionibacterium acne causes acne how?

A
  1. produces lipases that break down sebum
  2. releasing proinflammatory fatty acids
    - results in pustule or nodule formation
22
Q

how does hormone -associated acne vulgaris cause acne

A
  1. increases in sebum production: sebaceous glands have androgen receptors
  2. excess keratin production: blocks follicles

forming comedones

23
Q

What is the treatment for acne vulgaris

A
  • Benzoyl peroxide ( antimicrobial)

- vitamin A derivatives ( isotretinoin) - reduces keratin production

24
Q

what is psoriasis

A

well-circumscribed, salmon-colored plaques with silvery scale

25
Q

where does psoriasis usually occur

A

extensor surfaces and saclp

26
Q

what is physical exam finding for psoriasis

A

pitting of nails

27
Q

what causes psoriasis

A

excessive keratinocyte proliferation

28
Q

what are 2 etiologies of psoriasis

A
  1. associated with HLA-C

2. Lesions often arise in areas of trauma ( environmental trigger)

29
Q

Name 4 things that show up in histo fo psoriasis

A
  1. acanthosis
  2. Parakeratosis
  3. Munro microabscesses
  4. thinning of epidermis above elongated dermal papillae
30
Q

acanthosis

A

epidermal hyperplasia

31
Q

parakeratosis

A

hyperkeratosis with retention of keratinocyte nuclei in stratum corneum

32
Q

munro microabscesses

A

collections of neutrophils in stratum corneum

33
Q

what is Auspitz sign

A

thinning of epidermis –> bleeding when scale is picked off

-psoriasis

34
Q

treatment for psoriasis

A

corticosteroids
UV light with psoralen
immune-modulating therapy

35
Q

what is lichen planus

A

pruritic, planar, polygonal, purple papules, often with reticular white lines on their surface ( Wickham striae)

36
Q

common location of lichen planus

A

wrists, elbows, oral mucosa

37
Q

oral involvement for lichen planus manifests as

A

Wichman striae

38
Q

etiology of lichen planus

A

unknown

- associated with chronic Hep C virus infection

39
Q

What is pemphigus vulgaris

A

autoimmune destruction of desmosomes between keratinocytes

40
Q

what causes pemphigus vulgaris

A

IgG antibody against desmoglein

Type II hypersensitivity

41
Q

how does pemphigus vulgaris present on the skin

A

skin and oral mucosa bullae

42
Q

what is the histo for pemphigus vulgaris

A
  • acantholysis (separation) of stratum spinosum keratinocytes ( normally connected by desmosomes) –> suprabasal blisters
  • basal layer of cells remain attached to basement membrane via hemidesmosomes (‘tombstone’ appearance)
43
Q

what is Nikolsky sign for pemphigus vulgaris

A

thin-walled bullae rupture easily

-leading to shallow erosions with dried crust

Pathoma Bina (38 decks)

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