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PT III - DEENT > Skin Pathophysiology (Maize) > Flashcards

Skin Pathophysiology (Maize) Flashcards

1
Q

A common, self-limiting disease of the pilosebaceous units of the skin, typically located on the face, upper back, and chest

A

Acne vulgaris

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2
Q

Types of non-inflammatory acne (2)

A
  • closed comedone (whitehead)
  • open comedone (blackhead)
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3
Q

Types of Inflammatory acne (4)

A
  • Pimple
  • Papule
  • Pustule
  • Nodule
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4
Q

(Type of Inflammatory acne)

  • Small, prominent, inflamed elevation of the skin
A

pimple

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5
Q

(Type of Inflammatory acne)

  • inflammatory comedo that resembles a small (<5 mm), red bump on the skin.
A

papule

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6
Q

(Type of Inflammatory acne)

  • An inflammatory comedo that bursts and has pus in it.
  • Area around lesion is red
A

pustule

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7
Q

(Type of Inflammatory acne)

  • Solid, dome-shaped or irregularly-shaped lesion that is larger than a papule (>5 mm).
  • May be very painful
  • Scarring is likely
A

nodule or cyst

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8
Q

Pathophysiology of acne:

  • Increased _____ production in ____ ____
A
  • androgen,

both sexes

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9
Q

Pathophysiology of acne:

  • Increased androgen production leads to three factors that correspond to acne development:
A
  1. Follicular hyperkeratinization
  2. Increased sebum production
  3. Proliferation of propionibacterium acnes (p. acnes)
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10
Q

Pathophysiology of acne:

__________ - cause skin cells to stick together

A

Follicular hyperkeratinization

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11
Q

Pathophysiology of acne:

  • An increase in ________ _______ size/number increases sebum production and also increases with an _________ ______ at puberty.
A

sebaceous gland; androgen surge

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12
Q

Formation of acne

  • Skin cells ____ ________ and are not ____
  • Channel is _______ by a combination of ____ ____ and _____
  • Normal flow of ____ is _______
A
  • stick together, shed
  • plugged, skin cells, sebum
  • sebum, blocked
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13
Q

Propionibacterium acnes (P. acnes)

  • Produces ____ which breaks down _______ from sebum into ____ ____ ____
  • Free ____ ____ irritate the _______ walls
  • Have an ________ effect
A
  • lipase, glyceride, free fatty acids
  • fatty acids, follicular
  • antigenic
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14
Q

What is this?

A

pustule

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15
Q

ACNE EXACERBATING FACTOR:

_____________ - anything that occludes the skin or irritates it

A

Acne mechanica

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16
Q

EXACERBATING FACTOR

_____________ - mild form of acne to comediogenic oils in cosmetics

A

Acne cosmetica

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17
Q

Acne Exacerbating Factors (5)

A
  • Environmental and Physical factors
  • Severe and prolonged periods of stress or emotions
  • Hormones
  • Acne medica mentosa
  • Genetics
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18
Q

Drug-induced acne

A

Acne medica mentosa

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19
Q

Unsubstantiated causes of acne (3)

A
  • diet (chocolate, fried foods, sugar)
  • poor personal hygiene (dirt)
  • sex
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20
Q

Chronic disease characterized by recurrent exacerbations and remissions of thickened, erythematous and scaling plaques

A

Psoriasis

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21
Q

What is this?

A

Psoriasis

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22
Q
  • Epidemiologic evidence suggests that psoriasis has a _____ basis that requires _________ triggers to activate the disease.
  • Initial diagnosis occurs between 20-60 years of age but typically in the __s with a second peak at __-__.
  • All racial groups but most common in _____
  • Symptomatic throughout life, deteriorates with ___ or go through cycles of __________ and ____________
A
  • genetic, environmental
  • 20s, 55-60
  • whites
  • age, remissions and exacerbations
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23
Q

Sebum consists of glycerides, wax esters and cholesterol, it retards ____ ____ from the skin and is on the face, scalp, back and neck

A

water loss

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24
Q

3 Hypotheses on the cause of psoriasis:

A
  • Defects in the epidermal cell cycle
  • Genetic disposition
  • Immunologic disorder
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25
Q

In a psoriatic epidermis, keratinocytes take __ days to divide and _ days to mature and shed (increase of _-____)

__-cells contribute this hyperproliferation of skin, resulting in ____ epidermis maturation.

A

1.5, 4, 7-fold

T-, altered

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26
Q

In a normal epidermis, ___________ take __ days to divide and __ days to mature, migrate to the stratum corneum and shed

A

keratinocytes, 13, 26

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27
Q

__/__ of patients with psoriasis have a family history and is __ times more common in monozygotic than in dizygotic twins.

A

1/3; 3

28
Q

Psoriasis immunologic disorder:

  • keratinocytes encounter an ____ or undergo trauma
  • ____ triggers result in _-_________ recruitment to the site
  • Histocompatibility complex triggers release of T-cell ____, resulting in ____, new capillary formation (____) and further inflammation
  • ____ acid levels become elevated
A
  • antigen
  • inflammatory; T-lymphocyte
  • cytokines; vasodilation; angiogenesis
  • arachidonic
29
Q

Psoriasis contributing factors (5):

A
  • climate (cold exacerbates)
  • stress
  • infections
  • trauma
  • medications (lithium & beta blockers)
30
Q

Type of psoriasis:

  • Sharply demarcated erythemateous papules covered with thick silvery scales
  • Salmon-pink lesion underneath with pinpoint bleeding (Ausptiz sign)

Distribution: Lesions most common on elbows, knees, sacrum, limbs, hands and scalp. However lesions can occur anywhere

A

Psoriasis vulgaris (plaque)

31
Q

Type of psoriasis:

Sudden eruption of pin-point (0.5-1.5 cm lesions) dark-red scaling lesions

Distribution: trunk and limbs

A

Guttate psoriasis (eruptive)

32
Q

Type of psoriasis:

smooth patches of red, inflamed skin

Distribution: armpits, groin, under the breasts, around the genitals, in skin folds

A

Inverse psoriasis

33
Q

Type of psoriasis:

Generalized eruption of painful erythematous plaques with rows or clusters of yellow 2-3 cm pustules

Distribution: may be generalized or localized to the palms and soles of the feet

A

pustular psoriasis (Von Zumbusch)

34
Q

Type of psoriasis:

Generalized erythema with little or no scaling that can lead to a generalized desquamation

Distribution: Affects all body sites, covering 75% of body surface area

A

erythrodermic psoriasis

35
Q

Psoriasis vulgaris characteristics:

  • ______ _______ form of psoriasis – 80%
  • ________ may occur in 20% of patients
  • Mildly _____, but can be highly ______
A
  • Most common
  • Pruritus
  • painful, itchy
36
Q

Guttate psoriasis characteristics:

  • Frequently found in ______ _______
  • Frequently preceded by a ______ _________
A
  • young adults
  • strep infection
37
Q

Inverse psoriasis characteristics:

  • more common in __________ people
  • is worsened by ________ and _____________
A
  • overweight
  • friction and sweating
38
Q

Pustular psoriasis characteristics:

  • Accompanied with _____ and _______
  • May be _________ to treatment but must treat ______________
A
  • fever and malaise
  • resistant; aggressively
39
Q

Erythrodermic psoriasis:

  • Most _______ form which may lead to _______
  • May occur __________ to injury or __________ may progress to this form
A
  • severe, death
  • secondary; pustular
40
Q

Misc type of psoriasis:

Pitting, ridging discoloration, and onycholysis (loss of nails)

A

Nail psoriasis

41
Q

Misc type of psoriasis:

Asymmetric involvement in hands, feet, and knee joints
Skin lesions usually precede joint involvement
Lacks elevation of rheumatoid factors and autoantibodies seen in rheumatoid arthritis

A

Psoriasis arthritis

42
Q

Psoriasis arthritis

  • ___________ involvement in hands, feet, and knee joints
  • ____ _______ usually precede joint involvement
  • Lacks elevation of _________ _______ and _________________ seen in rheumatoid arthritis
A
  • Asymmetric
  • Skin lesions
  • rheumatoid factors, autoantibodies
43
Q

A dermatological condition that presents as a rash, dry skin and itching

A

Dermatitis

44
Q

Causes of dermatitis (3)

A
  • Allergies (Atopic dermatitis, eczema, or contact dermatitis)
  • genetics
  • stress
45
Q

Exaggerated skin and mucosal reactivity to environmental stimuli

A

Atopic dermatitis

46
Q

Atopic dermatitis epidemiology:

  • Atopic triad is:
  • Three peak occurrences:
  • More common in ____, _____, higher socioeconomic class and urban areas
  • Strong ______ link – 60% if father and 80% if both parents
  • 30-80% will also have ____ or ____ _____
A
  • asthma, allergic rhinitis, and atopic dermatitis
  • 3 peak occurences:
    • infant (5% by age 6 months)
    • children (5-10% under 14 yrs)
    • adult (2-5%)
  • males, whites
  • genetic
  • asthma, allergic rhinitis
47
Q

Atopic Dermatitis Signs and Symptoms:

  • ___ to ______-____ colored patches that look like chapping
  • ________ which may be severe especially at night
  • Small, raised ______ which may leak ____ and _____ over when scratched
  • Thickened, _______ or _____ skin
  • Raw, sensitive skin from scratching
  • Secondary ________ infections are common
A
  • Red to brownish-gray
  • Pruritus
  • vesicles; fluid and crust
  • cracked or scaly
  • Raw, sensitive skin from scratching
  • bacterial
48
Q

Location of Atopic Dermatitis:

  • ____ and ____ are the most common sites in adults
  • ____ and _____ are most common in children
  • Inside ______, behind the ____, ankles, _____, neck and upper _______
  • Skin around ____ including ______
A
  • Hands and feet
  • face and scalp
  • elbows, knees, wrists, chest.
  • eyes; eyelids.
49
Q

Exacerbating factors of Atopic Dermatitis (8)

A
  1. Exposure to allergens – foods, soaps, detergents, fragrances and chemicals
  2. Long, hot baths or showers
  3. Dry skin
  4. Stress
  5. Sweating
  6. Rapid changes in temperature or low humidity
  7. Solvents, cleaners, soaps or detergents
  8. Wool or man-made fabrics or clothing
50
Q

Plant Dermatitis:

  • Allergic constituents
    • __________ is the active irritant (in poison ivy/oak/sumac)
  • Etiology (2 Phases)
A
  • Urushiol
  • Sensitization phase
  • Elicitation phase
51
Q

Plant dermatitis phase:

At initial exposure, the urushiol binds to epidermal proteins to form an antigen

A

Sensitization phase

52
Q

Plant dermatitis phase:

Upon subsequent exposures, hypersensitivity reaction occurs

A

Elicitation phase

53
Q

Symptoms of plant dermatitis

  • A rash and _____ first appear and then fluid filled ____ form
  • The vesicles can be _____ or highly _____
A
  • erythema; vesicles
  • painful; itchy
54
Q

plant dermatitis caused by:

A

poison ivy

55
Q

plant dermatitis caused by:

A

poison oak

56
Q

plant dermatitis caused by:

A

poison sumac

57
Q

________ ___/______ is an acute, transient inflammatory skin condition in the diaper area caused by either moisture, occlusion, chafing, continued contact with urine or feces or both, or mechanical or chemical irritation

A

Diaper rash/dermatitis

58
Q

Diaper dermatitis epidemiology

  • __% of children get diaper rash but only _% get it severe
  • The incidence peaks at _ to __ months
A
  • 65%, 5%
  • 9 to 12
59
Q

Diaper Dermatitis Symptoms:

  • Mild:
  • Moderate:
  • Severe:
A
  • Mild: mild erythema
  • Moderate: erythema with maceration and chafing
  • Severe: papules, vesicles, oozing, ulceration, and secondary infection
60
Q

Causes of Diaper Dermatitis symptoms (3):

*The combination of _____, _________, and ______ seems to be the cause of the symptoms

A
  1. urine and feces
  2. retention of fluid
  3. mechanical and chemical irritants

*urine, ammonia, and feces

61
Q

Retention of fluids:

  • Soiled diapers will hydrate the _______ ____ and ____
  • The keratin will ______ the _____ _______
  • ________ formation and _________ will occur
A
  • stratum corneum and swell
  • block; sweat glands
  • Vesicle; irritation
62
Q

Diaper dermatitis Mechanical and Chemical Irritants:

  • Tight fitting diapers and plastic pants increase __________ and __________ of the diaper region
  • ________ rubbing ______ skin, makes it susceptible to __________ infection
  • Chemical irritants can include ______, ______, _______ and ___________
A
  • moisture and temperature
  • Constant; erodes; secondary
  • detergents, bleaches, soaps and antiseptics
63
Q

Diaper Dermatitis Complications

  • ________ and ___________ infections are the most common complications
  • ___________ infections are secondary to untreated/improperly treated diaper rash
A
  • Fungal (Candida albicans) and bacterial (Staphylococcus aureus)
  • Cutaneous
64
Q

Organism implicated in diaper dermatitis fungal infection

A

Candida albicans

65
Q

Organism implicated in diaper dermatitis bacterial infection

A

Staph aureus

PT III - DEENT (12 decks)

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