Skin Through the Ages Flashcards
At gastrulation, skin divides into what 3 layers:q
endoderm, mesoderm, ectoderm
Ectoderm then divides into ectoderm and neuroectoderm (neural crest and neural tube)
truth
What layers are formed from the ectoderm?
Stratum Basale, Stratum spinulosum, stratum granulosum, stratum lucidum (only on palms and soles), stratum corneum
At week 6 of life in utero…
bilayered epidermis (periderm and basal layer)
week 8
stratification begins, you get an intermediate layer and a basal layer
Ectodermal dysplasias are
defects in hair, teeth, bone, skin
Terminally differentiated epidermal layers exist by when
third trimester. Fillagrin is formed and the cell envelope is formed
Defects at the third trimester lead to
Ichythosis…due to filaggrin mutations
Melanocytes migrate from
neural crest
Melanocytes originate where
neural crest
What is piebaldism
defects in melanocyte migration lead to patches to of depigmentation where no migration takes place, its auto dominant
What is Wardenburg syndrome
Defective survival of melanocytes leads to depigmentation patches. Also affects enteric ganglion cells which can lead to megacolon
Hermansky Pudlack and Chediak Higashi syndrome
Ineffective transfer of melanosomes to keratinocytes leads to pigment dilution, this can also effect other processes that involve lysosome trafficking
Pigmentary mosaicism is seen as
linear streaks or whorls, these develop along lines of blashko
Incontinentia Pigmenti
x-linked dominant, failure in utero to males, some females can survive though they have ocular dental and CNS defects
Dermis is derived from
both ectoderm and mesoder
Dermal-Epiderma junction is not fully functional until>
12 weeks
Barrier function of the skin is not developed until 3 weeks after birth
truth
What is the body surface area to wt ration of babies versus adults
Five times greater
What is the significance of this increased body surface area to weight ratio?
It means that absorption of topical medicines is greater and that premature infants have increased transepidermal water loss
Lots of concerns in prematurity, involving the skin they are…
Greater transepidermal water loss, greater absorption of topical ointments, lower temperature, difficulty with fluid regulation, increased infection risk, thinner stratum corneum
What is the vernix caseosa
its a protective membrane that is present at birth. Consists of epithelial cells, sebaceous secretions, shed hair
What is cutis marmota?
It looks like a spiderweb like- pattern that is accentuated with temperature decrease, goes away when the baby os warmed up
Mongolian spot
dark spot on the bottom, can be confused with bruises so may look like child abuse
Salmon patch
little pink area on forehead
Stork bite
red spot on the back of neck
Erythema Toxicum neonatorum
benign pustules with a wheel around them, up to 50% of infants, resolves spontaneously
Miliaria
due to overheating, leads to occlusion of eccrine glands. ITS A MILLION DEGREES IN HERE!
Neonatal acne
Also called neonatal cephalic pustullosis, possibly due to maternal hormones
Transient neonatal pustular melanosis
more common in african american kids, resolves spntaneously, often onvolves the hands and feet
Sabhorreic dermatitis
cradle cap, self-limited
Diaper dermatitis
several common causes: candida or irrittants
If you see redness in the crotch region with satellite pustules around it, think:
candida
Jaquet dermatitis
can be a sign of neglect. very red, almost ulcerative in the diaper area
Atopic dermatitis is often associated with?
asthma and allergic rhinitis…..”atopic march”
60% presesnt within first year of life, 85% by year 5
What kind of mutation is linked with early onset AD
filaggrin mutation
What is the pathogenesis of Atopic dermatitis
There is a disruption of barrier function, some type of environmental stimulus, and immune dysregulation. Don’t really know which comes first
Look at the slide on the AD clinical presentation?
ok
Main complications of atopic dermatitis?
staph aureus
eczema herpeticum- explosive herpes simplex
molluscum contagiosum
Atopic dermatitis kids are at greater risk of what behavioral issues?
ADHD
Atopic dermatitis also predisposes to
food allergens
acne is what
a multifactorial disorder or the pilosebaceous unit
Acne occurs where?
Where the densest population of sebaceous follicles are located: chest, back, face
Hyperproliferation and abnormal differentiation of keratinocytes leading to plugging of the follicular infundibulum
acne vulgaris
Excess sebum production occurs due to hormonal stimulation
truth
The 4 phase pathogenesis of acne vulgaris is:
1) hyperproliferation and abnormal differentiation of keratinocytes which plugs up the follicular infundibulum
2) Excess sebum production due to hormonal stimulation
3) Presence of Propionibacterium acnes (gram positive rod that lives deep within the follicle)
4) Inflammation
Two types of nodulocystic acne
Acne congloblata
Acne Fulminans- systemic infection (Acne Fuckminans)
Follicular occlusion tetrad
Hidradenitis suppurativa
Acne Conglobata
Dissecting Cellulitis
pilonidal cyst
Scurvy
vitamin C deficiency,,,old person on tea and toast diet
They may have bleeding gums, corkscrew hairs, perifolicular hemorrhage
Niacin deficiency
Pellagra- 3D’s. Dimentia, Dermatitis, Diarrhea
