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Derm Rheum > Structure and Function of Skin - Schwarzenberger > Flashcards

Structure and Function of Skin - Schwarzenberger Flashcards

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Dermatology Board Prep flashcards
1
Q

List 6 important functions of skin

A
  • barrier function
  • immune recognition and surveillance
  • damage repair
  • thermoregulation
  • protection from UV radiation
  • communication
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2
Q

List common functions of skin as a barrier

A

Regulates water loss

Protect against mechanical, chemical and microbial insults from outside world

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3
Q

Skin deals with innate or adapative immunologic processes?

A

Both

Fun fact: skin has more lymphocytes than inside the body

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4
Q

Autoimmune bullous diseases are blistering skin diseases mediated by autoantibodies towards what?

A

skin adhesion molecules (desmosomes, hemidesmosomes)

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5
Q

Characteristic features of autoimmune bulous diseases?

A

erosions or blisters in skin, often in mucosa

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6
Q

Autoantibodies to hemidesmosomes. Name this skin condition?

A

Bullous pemphigoid

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7
Q

Autoantibodies to desmosomes. Name this condition?

A

Pemphigus vulgaris

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8
Q

Bullous pemphigoid vs Pemphigus vulgaris. Which is which?

A

Top = Pemphigus vulgaris

Bottom - Bullous pemphigoid

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9
Q

Immunofluorescence. Which is which

Bullous pemphigoid vs pemphigus

A

Top - Bullous Pempighoid

Bottom - Pemphigus Vulgaris

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10
Q

Impaired wound healing can lead to ?

A

chronic skin ulcers, risk of infection

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11
Q

Patients can also develop skin lesions bc they become ____ to injury? List 2 examples

A

insensitive

Neuropathic ulcers, trigeminal trophic syndrome

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12
Q

Melanin is found where in skin (epidermis/dermis). Purpose of it?

A

Found in epidermis, protect against UV radiation

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13
Q

Loss of photoprotection increases what 2 OBVIOUS risks?

A

risk of burning (duh), and skin cancer (duh)

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14
Q

Condition where person has abnormal pigment at birth?

A

Albinism

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15
Q

Condition where you lose your pigment as you get older?

A

Vitiligo

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16
Q

Acute effects of UV radiation on skin?

A

Inflammation (sunburn)

Immunosuppression

Tanning

Epidermal hyperplasia

Vitamin D photosynthesis

DNA damage (apoptosis, cell cycle arrest to repair)

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17
Q

What are the 2 chronic effects of UVR on skin?

A

Photoaging

Photocarcinogenesis (basal cell and squamous cell carcinomas, melanomas)

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18
Q

Term for histologic change that occurs due to chronic UV radiation

A

Solar elastosis (right picture)

Normal skin (left picture)

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19
Q

Incidence of melanoma in US?

A

1 in 50

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20
Q

Melanoma more commonly associated with chronic low exposure or acute intense exposure?

A

Acute intense exposure

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21
Q

Disease of skin that deals with inability to repair DNA?

A

Xeroderma pigmentosum, DNA excision abnormal

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22
Q

What condition does he have?

Mutation in what gene? Consequence of this?

Clinical manifestations?

A

Hypohidrotic ectodermal dysplasia

Mutation in EDAR (Ectodyplasin A receptor) gene. Protein is critical for proper interaction between developing ectoderm and mesorderm.

Results in abnormal hair follicles, sweat glands, and teeth. Unable to regulate temperature, overheat easily

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23
Q

3 layers of skin?

A

Epidermis, dermis, subcutis

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24
Q

Cells of epidermis? Which makes up the majority

A

Keratinocytes (90% of cells), melanocytes, langerhans cells, merkel cells

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25
Q

What cells of epidermis are important when they become malignant?

A

Merkel cells

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26
Q

if you cut your skin, and bleed, what layer of the skin have you at least affected?

A

Dermis, epidermis has no blood vessels

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27
Q

Dermis or epidermis?

Primarily barrier function, protection, wound healing?

A

Epidermis

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28
Q

Epidermis sheds itself every ___ days?

A

28+

14 days to reach stratum corneum

14 days to desquamate

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29
Q

4 Layers of Epidermis?

A

Stratum corneum, granulosum, spinosum, basale

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30
Q

Function of hemidesmosome?

A

Connect epidermis to dermis

Epidermis (pink in picture), dermis (blue)

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31
Q

Function of desmosomes?

A

Keratinocyte to keratinocyte adhesion

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32
Q

What epidermal layer is the source of stem cells?

A

Stratum basale

33
Q

Division of cells starts in what epidermal layer?

A

Stratum basale

34
Q

Basal cells (of basal layer) adhere to basement membrane via what?

A

hemidesmosomes

35
Q

Cells stop dividing and start terminal differentiation in what epidermal layer?

A

Stratum spinosum

36
Q

Lipids begin to develop in what epidermal layer?

A

Stratum spinosum

37
Q

Why is the stratum spinosum “spiny”

A

Due to visible desmosomes with which one KC adheres to another

38
Q

Profilaggrin synthesis occurs in what epidermal cell layer?

A

Stratum granulosum

Profilaggrin makes up part of the intracellular keratohyaline granules that are produced in this layer

39
Q

What layer of the epidermis plays a key role in maintaining a water barrier? How?

A

Stratum granulosum

  • Lipids in lamellar granules secreted into intercellular space to form water barrier to keep water in skin
40
Q

Nuclei and organelle should degenerate by the time they reach what layer?

A

Stratum corneum

41
Q

Profilaggrin is processed into ____ in the stratum ____? Purpose of this?

A

filaggrin, stratum corneum

  • helps keep water in cells
42
Q

Stratum corneum creates a protective layer via a combination of what 2 components?

A

Keratin + filaggrin = macrofibrils (creates protective layer)

43
Q

Keratin combines to form _____?

A

Intermediate filaments

44
Q

Pairs of keratin differ based on what?

A

location in the body.

Dif keratin pairs in palms/soles vs elsewhere

45
Q

What amino acid is found in keratin (esp hair and nails)?

A

Cysteine (which contains sulfur. why your hair smells like shit when it gets burned)

46
Q

Based on location within body, what layer of the epidermis has different characteristics?

A

Stratum corneum varies based on different areas within body, such as trunk/back (thinner) vs palms/soles (thicker)

47
Q

What layer of the epidermis is compared to a brick and mortar wall? What do #s 1 and 2 represent?

A

Stratum corneum

1 (bricks) = flattened keratinocytes filled with keratin and filaggrin

2 (mortar) = lipid mixture surrounding keratinocytes, providing water barrier

48
Q

Name for “pigment producting dendritic cells?”

What pigment is produced?

A

Melanocytes

  • produce melanin (a radiation absorbing pigment)
49
Q

Melanocytes are derived from what embryonic cell lineage?

A

Neural crest cells, migrat during embryonic development

50
Q

Where are melanocytes located in the epidermis? What is their ratio to keratinocytes?

A

“live” along basal cell

1:10 ratio between melanocytes:keratinocytes

51
Q

In addition to producing melanin, what else do melanocytes do with melanin?

A

transfers melanin to surrounding keratinocytes

52
Q

What is classified as the primary defense against UV radiation?

A

Melanocytes

53
Q

What is this a picture of?

A

Melanocyte

Notice the dendritic like appendages within this diagram, same as picture

54
Q

Besides melanocytes, name another dendritic cell of the epidermis? Where is its location in the epidermis?

A

Langerhans cells, found in mid epidermis

55
Q

Main purpose of Langerhans cells?

A

Recognize, take up, and present abnormal antigens in skin to lymphocytes in regional lymph nodes

  • this abnormal antigen can be a cancerous cell, virally infected cell, chemical allergen (like a fragrance), etc
56
Q

Name this cell:

Epidermal cell associated with light touch sensation

A

Merkel cell

57
Q

Merkel cells can develop into what pathologically?

A

malignant tumors

58
Q

Name 2 cells found in dermis

A

Fibroblasts, mast cells

59
Q

Besides fibroblasts/mast cells, what other components are found in dermis?

A

blood vessels and lymphatics, nerves, sweat and oil glands, hair follicles

60
Q

3 functions of dermis?

A

Structural support

vascular support

innervation (epidermis has NO innervation or vasculature)

61
Q

What is considered the primary cell in the dermis? What origin do these cells come from?

A

Fibroblast, mesenchymal origin

62
Q

Main purpose of fibroblasts?

A
  • Synthesis and degradation of CT proteins, including collagen, elastin, glycosaminoglycans, and other glycoproteins
  • Injury to skin triggers fibroblast mitosis
  • Responsible for wound healing and scar formation
63
Q

What cells in the dermis are rich in histamine and heparin granules?

A

Mast cells

  • release their granules when triggered by injury or when they bind IgE antibodies during allergic reactions
  • histamine and other mediators important in allergic reactions and wound healing
64
Q

Hair follicles stop in dermis or continue into subcutis?

A

Extend through dermis into subcutis

65
Q

Each hair follicle is associated with what gland?

A

sebaceous (oil) gland

66
Q

What are the 4 components of a pilosebaceous unit?

A
  • Hair follicle
  • sebaceous (oil) gland
  • apocrine sweat gland (in axilla and anogenital skin)
  • arrector pili muscle
67
Q

“True” sweat glands? Location in body?

A

Eccrine sweat glands, all over body (as opposed to apocrine found only in axilla/anogenital skin)

68
Q

Are eccrine sweat glands associated with a hair follice?

A

No

69
Q

Apocrine vs eccrine sweat glands?

  • function to regulate temperature by evaporative cooling of sweat?
A

Eccrine sweat glands

70
Q

Fat layer found in what layer of skin?

Function of this layer?

A

Subcutis

insulation, source of energy, protection from injury

71
Q

Cells/components of subcutis?

A

fat, blood vessels, fibrous septae

72
Q

Other than structure, why are fibrous septae important?

A

B/c the cause cellulite (Fibrous septae pull down in between fat lobules)

OMG I HAVE CELLULITE

73
Q

Apoptosis is (high or low) in epidermis?

A

Apoptosis normally low in epidermis, but can increase in some situations

74
Q

If you get sunburn, what cells in what layer become damaged? Relate this to apoptosis

A

Sun-damaged cells = damaged keratinocytes in epidermis

Apoptosis will increase (normal response to sun damaged cells)

75
Q

What happens if apoptosis of sun-damaged cells (keratinocytes) doesnt occur?

A

Can progress to skin cancer

76
Q

What disorder is shown in picture?

Associated with genetic defects in what protein?

A

Atopic dermatitis, defects in filaggrin

77
Q

What disease is shown here? What mutation is occuring?

A

Epidermolysis Bullosa Simplex

genetic mutations in Keratin 5/14

78
Q

Definition of nevus (mole)?

A

Benign collection of melanocytes

79
Q

Melanoma definition?

A

growth of malignant (cancerous) melanocytes

Derm Rheum (39 decks)

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