Skin Throughout the Ages Flashcards
The epidermis is derived from what germ layer
ectoderm
What is the added layer of the epidermis on the palms and soles?
stratum lucidum
defects in hair, teeth, bone, and skin
ectodermal dysplasia
- defects in fillagrin lead to
- During what trimester of preganncy does this occur?
- Ischythosis vulgaris (*pictured*)
atopic dematitis (eczema)
- third timester
What are the specialized cells in the epidermis?
Melanocytes
Merkle Cells
Langerhans Cells
Melanocytes originate in the ____
where do they migrate to?
neural crest
ear, eye, skin, leptomeninges
patches of depigmentation is due to ….
defect in melanocyte migration, survival, or origin
here is another pic of it:
Waardenberg Syndrome
patches of depigmentation = defect in melanocyte survival
defect in production of melanin
albansim
pigment dilution is due to …
defect in melanosome = cannot transfer melanin to keratinocyes
ex: chediak-higashi, hermansky pudlack syndrome
linear streats or whorls (as picuted below)
Pigemntary Mosaicsm
lines of Blaschko
where melanocytes develop
What is this?
lines of blaschko
What germ layer is the dermis derived from?
ectoderm and mesoderm
Barrier function of skin is fully developed 3 weeks (before or after) birth
after
*dermal-epidermal junction is fully developed by 12 weeks gestation
neonates have (increased or decreased) topical absorption of medicine
increased
premature infants have (increased or decreaed) transepidermal water loss
increased
protective membrnae present at birth, in utero it was the mechanical barrier to prevent breakdown of skin since babies are living in a water environment in utero
What is this composed of?
Vernix Caseosa
epithelial cells, sebaceous fluid, and shed lanugo hair
What is this and what causes it?
Is this physiologic or pathologic?
cutis marmorate
baby gets cold
*physiologic
What is it?
Is this physiologic or pathologic?
lanugo
physiologic
What is it?
Is this physiologic or pathologic?
sebaceous gland hyperplasia
phsyiologic
What is it?
Is this physiologic or pathologic?
Sucking Blister
phys
What is it?
Is this physiologic or pathologic?
mongolian spot
What is it?
Is this physiologic or pathologic?
salmon patch
phys
What is it?
Is this physiologic or pathologic?
stork bite (same thing as a salmon patch)
phys
What is it?
Is this physiologic or pathologic?
Erythema Toxicum Neonatorum
**up to 50% of infants have this, resolves spontaneously
she has it under disorders, but it is benign
What is this?
What causes it?
Miliaria
due to occlusion of eccrine glands
another picture:
aka neonatal cephalic pustulosis
neonatal acne
What is it?
transient neonatal pustular melanosis
*more common in AA
What is it?
Seborrheic Dermatitis
aka cradle cap
What is this?
Diaper Dermatitis due to Candida (the dots tell you candida)
Below is diaper dermatitis due to an irritant. Note the lack of the dots
often assc with asthma and allergic rhinitis
atopic dermatitis
pathogeneis of atopic dermatitis
cycle of immune dysreguation, barrier dysfunction, and environmental allergens
What is the clinical criteria for atopic dermatitis?
PURITIS in the past 12 months
plus at least 3 of the following
- dry skin
- Hx of allergic rhinitis or asthma (or FHx)
- onset before 2 yo
- Hx of skin crease involvement
- visible flexural dermatitis
Favors cheeks, forehead, scalp and extensor surfaces
Spares diaper area
Intense pruritus, erythema, oozing
infantile phate of atopic dermatitis
Favors flexor surfaces, wrists, ankles, neck
Lichenification common
childhood phase of atopic dermatitis
What is it?
atopic dermatitis
What is it?
??
What is it?
??
Complication of atopic dermatitis
Staph Aureus infeciton
Eczema Herpeticum
Molluscum Contagiosum
Eczema Herpeticum
Multifactorial disorder of pilosebaceous unit
acne vulgaris
Where does acne occur?
denses population of sebaceous follicles:
face, upper chest, back
Pathogenesis of acne vulgaris
- hyperprolif and anb differentiation of keratinocytes = plugging of follicular infundibulum
- excess sebum production (hormones)
- propionibacterium acnes
- inflammation
How do androgens (produced inside sebaceous gland) affect acne?
increases sebum production, leading to acne vulgaris
Why does P. acnes suck so much?
G+ rod which breaks down sebum, produces inflammatory mediatiors
What causes acne inflammation?
- comedo rupture
- spilling of immunogenic contents (sebum, keratin, bacteria)
- neutrophil-rich inflammation
Hyperandrogenic states which cause acne:
polycystic ovarian syndrome
virilizng tumors
cong. adrenal hyperplasia
Histology of an inflammed comedo:
- fibrin
- neutrophils, especially at site of rupture
- keratin plug
Severe eruptive nodulocystic acne that does NOT have systemic symptoms
Acne conglobata
Severe eruptive nodulocystic acne that has systemic symptoms (fever, osteolytic bone lesions, hepatosplenomegaly)
Acne fulminans
Topical Acne vulgaris treatment
benzoyl peroxide
topical abx (combine with BPO to vaoid resistance)
topical retinoids (reduce comedones)
Systemic acne vulgaris treatments
abx (resistance)
hormonal therapy to decrease effective androgens
oral retinoids
How do oral retinoids work?
normalize epidermal differentiation, decrease sebum production, anti-inflmm
(teratogenic; combined w corticosteroids for acne fulminans)
Skin lesion more common with darker skin; high risk of recurrance with removal
keloids
Normal aging?
“Loss of elasticity”
yes
Normal aging?
“actinic keratosis”
nope- photoaging (extrinsic)
Normal aging?
“elastosis with giant comedones”
no: photoaging, extrinsic
Normal aging?
“thinning, wrinkling skin”
yes
Caused by pressure of bony prominences for extended periods of time
decubitus ulcers
How are decub ulcers graded?
I through IV
(with I nonblanching/intact; II superficial necrosis; III deep necrosis; IV necrosis into fascia +/- bone/muscle/etc)
4 types of geriatric dermatits
asteatotic eczema
nummular eczema
stasis dermatitis
seborrheic dermatitis
Due to venous insufficiency and edema, can result in venous ulcers
stasis dermatitis
Dermatitis treated with exercise, elevation, compression and steroids
stasis dermatitis
Diseases caused by nutritional deficiencies in geriatric patients
scurvy (vit C)
pellagra (niacin)
3 D’s of niacin deficiency
(*Pellagra)
Diarrhea, dermatitis, dementia
Kid with a fever, trouble eating
hand-foot-mouth
atopic dermatitis
erytheoma toxicum neonatorum
eczema herpeticum
shingles
itchy
scabies
kid
erythema infectiousum (parvo)
molluscum
ringworm
herpes simplex
perleche
(candida)
gianotti-crosti
