Structure, Function, And Disorders Of The Skin Flashcards
1
Q
What organ is involved in the production of vitamin D
A
Skin
2
Q
What is vitiligo
A
Auto immune related loss of melanocytes; Depigmentation of patches of skin
3
Q
What do Merkel cells function as
A
Slowly adapting mechanoreceptors
4
Q
What do fibroblasts secrete
A
Collagen
5
Q
What do mast cells secrete
A
Histamine
6
Q
Freckles, flat moles, petechiae, measles, scarlet fever are all examples of what
A
Macule
7
Q
Wart, elevated moles, like in planus, fibroma, insect bite or examples of what
A
Papule
8
Q
Vitiligo, port wine stains, Mongolian spots, café aublait spots are all examples of what
A
Patch
9
Q
Psoriasis, seborrheic and actinic keratoses are examples of what
A
Plaque
10
Q
What is a wheal?
A
Elevated, irregular shaped area of cutaneous edema, is solid and transient. Insect bites and allergic reactions
11
Q
Merkel cells?
A
Slowly adapting mechanoreceptors
12
Q
Where are Histiocytes located
A
Loose CT
13
Q
What do histiocytes do
A
Phagocytize pigments and debris of inflammation
14
Q
What nervous system regulates vasoconstriction and vasodilation
A
Sympathetic
15
Q
Nodule?
A
Elevated firm circumscribed lesion deeper in dermis than papule. 1-2 cm
16
Q
Tumor
A
Elevated solid lesion deeper in dermis. Over 2 cm in diameter
17
Q
Nodule example
A
Erythma nodosum and lipoma
18
Q
Tumor example
A
Neoplasm benign tumor lipoma neurofibroma hemangioma
19
Q
Does a vesicles go in the dermis
A
No
20
Q
Vesicle examples
A
Varicella/chicken pox, herpes zoster/shingles,herpes simplex
21
Q
Bulla example
A
Blister, pemphigus vulgaris
22
Q
Pustule
A
Elevated superficial lesion like a vesicle but filled with purulent fluid [pus)
23
Q
Pustule examples
A
Impetigo or acne
24
Q
Cyst
A
Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous
25
Cyst examples
Sebaceous cyst,cystic acne
26
Telangiectasia
Irregular red lines due to capillary dilation
27
Telangiectasia example
Rosscea
28
Scales
Heaped up keratinized cells that are irregular and vary in size
29
What is lichenification
Rough thickened epidermis usually secondary to itching skin
30
Where do pressure ulcers come from
Unrelieved pressure on skin
31
What occurs when an individual lies or sit in one position for a long time
DEcubitis ulcer
32
What are the most common spots of pressure ulcers
Sacrum, heels, ischia, greater trochanters
33
What is used to predict ulcers
Braden scale
34
What type of skin dysfunction has excessive collagen formation and abnormal fibroblast activity
Keloids
35
What kind of treatment is available for keloids
Intralesional corticosteroids, Cyrotherapy, radiotherapy, and surgical and laser procedures
36
Where are keloids common
Darkly pigmented skin types and burns
37
What are hypertrophic scars
Elevated erythrmatous fibrous lesions that do not expand beyond the injury border
38
What is the most common symptom of primary skin disorders
Pruritus
39
What causes an itch
Specific unmyelinated c nerve fibers
40
What is a neuropathic itch
Related to any pathologic condition along an afferent pathway
41
What is a psycho genic itch
Psychologic disorder
42
What is the treatment for an itch
Depends upon the H cause but both topical and systemic therapies
43
What is the Itch response modulated by
CNS
44
What is the most common inflammatory skin disorder
Dermatitis a.k.a. eczema
45
What are inflammatory skin disorder characterized by
Pruritus, lesions with indistinct borders, and epidermal changes
46
What does chronic eczema look like
Thickened, leathery, and hyperpigmented skin
47
What is chronic eczema from?
Recurrent itching and scratching
48
What type of inflammatory disorder is a common form of T cell mediated or delayed hypersensitivity
Allergic contact dermatitis
49
Clinical Manifestations of allergic contact dermatitis
Erythema, swelling, pruritus, and vesicular lesions
50
Treatment of allergic contact dermatitis
Removal of the Allergen and administration of topical or systemic steroid
51
Irritant contact dermatitis
Nonimmunologic inflammation of the skin. Due to chemical irritation
52
Treatment of irritant contact dermatitis
Removal of source of irritation, use of topical agents and non-irritating soaps
53
What is a topic/allergic dermatitis common?
In childhood and infancy but can last into adult life
54
What is atopic/allergic dermatitis associated with
A family history of allergies, hayfever, elevated IgE levels and increased histamine sensitivity
55
How do you get atopic/allergic dermatitis
Inhaling substance
56
Where and why does stasis dermatitis occur?
In the legs as a result of venous stasis, edema, and vascular trauma
57
What is the sequence of events in stasis dermatitis
Edema, erythema, pruritus, scaling, petechiae, hyperpigmentation, and ulceration
58
Stasis dermatitis treatment
Elevate legs, avoid wearing tight clothes and standing, antibiotics, and dressings, compression garments, and vein ablation therapy for chronic lesions/ulceration
59
What is seborrheic dermatitis
Chronic skin information involving the scalp, eyebrows, eyelids, nasal labial folds, axillary, chest, and back. Maybe periods of remission and exacerbations
60
Where do infants usually get Seborrheic dermatitis
Cradle cap
61
Clinical manifestations of seborrheic dermatitis
Greasy, scaly, white, or yellowish plaques
62
Seborrheic dermatitis trmt
Shampoo with sulfur, salicylic acid, or tar, keto o azalea with topical calcineurin inhibitors, corticosteroid applications
63
Clinical manifestations of psoriasis
Scaly, thick, silvery, and elevated lesions usually on the scalp elbows or knees
64
What is the epidermal turnover time for psoriasis
3 to 4 days meaning it cells don’t have time to mature or keratinized
65
What is the most common papulosquamous disorder
Plaque psoriasis
66
Where is Plaque psoriasis usually located
Scalp, elbows, knees, sites of trauma
67
What is Inverse psoriasis
Lesions that develop in skin folds that are large, smooth, dry, and deep red
68
Who is guttate psoriasis common in, when does it develop
Common in children after streptococcal respiratory infection
69
What is pustular psoriasis
Blisters filled with non-infectious pus that develop over areas of plaque psoriasis
70
What is erythrodermic psoriasis
Exfoliative dermatitis characterized by widespread read, scaling lesions
71
What are the systemic complications of papulosquamous disorders
Psoriatic arthritis, ankylosing spondylitis, psoriatic nail disease
72
What is psoriasis a risk factor for the development of?
IBD, metabolic syndrome, Atherosclerosis and cardiovascular disease
73
What is pityriasis rosea
A benign self-limiting inflammatory disorder associated with a virus
74
when does pityriasis usually occur during the year
Spring and fall
75
What disorder is a herald patch associated with
Pityriasis rosea
76
What is a Herald patch
Circular, demarcated, salmon pink patch
77
What is the treatment for pityriasis rosea
UV light, anti-histamines, topical corticosteroids
78
What is lichen planus
Benign, auto inflammatory disorder of the skin and mucous membranes
79
What is the ideology of lichen planus
Unknown
80
What parts of the auto immune system does lichen planus involve
T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells
81
What do the lesions of lichen planus look like
Non-scaling popular violet colored with pruritis wrist, ankles, lower legs, and genitalia
82
What is the treatment for lichen planus
Topical, intralesional, systemic corticosteroids
83
What do anti-histamines do?
Help with itching
84
What do topical or systemic corticosteroids do
Control inflammation
85
What do short term systemic glucocorticoids do
Treat oral lesions
86
What do potent topical steroids, topical retinoids, and systemic glucocorticoids do?
Treat mucous membrane lesions
87
What is acne vulgaris
Inflammatory disease of the pilosebaceous follicles
88
What are two features of acne vulgaris
Hyper trophy of sebaceous glands and telangiectasia
89
Who is acne vulgaris common in
Adolescents
90
Who is acne rosacea common in
Middle age adults
91
What does acne rosacea
Chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun
92
What are the four types of lesions in acne rosacea
Erythematotelangiectatic, papulopustular, phymatous, ocular
93
What is a Erythematotelangiectatic lesion
Facial redness
94
What is a papulopustular lesion
Bumps and pimples
95
What is a phymatous lesion
Enlargement of the nose (rhonophyma)
96
What is an ocular lesion
Eye irritation
97
What is the treatment for acne rosacea
Photoprotection, topical and oral drugs,surgical excision for rhonophyma
98
What is lupus erythematosus
Inflammatory autoimmune systemic disease with cutaneous manifestations
99
What is the female to male predominance
10:1
100
What are the two types of lupus erythematosus disorders
Systemic and skin (discoid)
101
Which popular squamous lupus disorder is restricted to the skin
Discoid/cutaneous
102
What disorder is known for a butterfly pattern over the nose and cheeks
Discoid lupus erythematosus
103
What is the immune response of discoid lupus erythematosus
Development of self reactive TNB cells, decrease number of regulatory T cells, and increased pro inflammatory cytokines
104
What is the tissue damage of discoid lupus caused by?
Auto antibodies and immune complexes
105
What is the treatment of discoid lupus
Sun protection, topical steroids, calcineurin inhibitors, anti-malarial drugs, immuno suppressant agents
106
What are vaesiculobullous disorders
Diseases that have different causes and clinical courses but share the common characteristics of vesicle or blister formation
107
What are the two types of vesiculobollus disorders
Pemphigus and erythema multiforme
108
What is pemphigus
Rare auto immune, chronic, blister forming disease of the skin and oral mucous membranes
109
Where do blisters form in Pemphigus
Deep and superficial layers of the epidermis
110
What is the auto immune disease of pemphigus caused by
IgG auto antibodies
111
What is the most common pemphigus disorder
Pemphigus vulgaris
112
What is acantholysis
Destruction of cell to cell adhesion
113
In pemphigus vulgaris where is acantholysis located
Suprabasal level
114
What occurs pathologically in pemphigus vulgaris
IgG and C3 complement bind to the desmoglein adhesion molecules causing acantholysis in the epidermis and blister formation
115
What precedes the onset of skin blistering in pemphigus vulgaris
Oral lesions on the face, scalp, and axilla
116
Which form of pemphigus is mild
foliaceus
117
What form of pemphigus is a subset of pemphigus foliaceus
Pemphigus erythematosus
118
What is the most severe form of pemphigus
Paraneoplastic pumphigus
119
What is the most benign form of pemphigus
IgA pemphigus
120
Where does acantholysis occur in pemphigus foliaceus
Subcorneal level
121
What clinical manifestations show in pemphigus foliaceus
Blistering, erosion, scaling, crusting, erythema of face and chest
122
Are oral mucous membranes involved in pemphigus foliaceus
No
123
What pemphigus disorder is also called paraneoplastic autoimmune multiorgan syndrome
Paraneoplastic pemphigus
124
What is the treatment for pemphigus
Systemic corticosteroids and immuno suppressant agents
125
What pemphigus disorder has bound IgGand IgE with blistering of the subepidermal dermal skin layer
Bollous/IgE pemphigoid
126
What is the loss of dermal epidermal adhesion caused by in bollous pemphigoid
Inflammatory cytokines
127
How do you distinguish bollous pemphigoid From pemphigus
Sub epidermal blistering and eosinophils
128
What is erythema multiforme
Acute recurring disorder of skin and mucous membranes
129
What is erythema multiforme associated with
Allergic or toxic reactions to drugs or micro organisms
130
What is erythema multiforme caused by Pathologically
Immune complex is formed and deposited around dermal blood vessels, basement membranes, and keratinocytes
131
What disorder is known for a bull’s-eye or target lesion
Erythema multiforme
132
What is formed when the lesions rupture in erythema multiforme
Erosions and crusts
133
What part of the body does erythema multiforme affect
Mouth, air passages, esophagus, urethra, and conjunctiva
134
What is cutaneous vasculitis
Inflammation of the blood vessels of the skin due to immune complexes in the small blood vessels that activate complements
135
What does cutaneous vasculitis develop from
Drugs, bacterial infections, viral infections, or allergens
136
What does the systemic form of lesions in cutaneous vasculitis look like
Palpable purpura, progressing to hemorrhagic bullae with necrosis and ulceration
137
What is urticaria /hives caused by
Type one hypersensitivity reactions to allergens
138
What does histamine release in urticaria/hives caused
Endothelial cells of the skin to contract
139
What are the clinical manifestations of urticaria/hives
Pruritic circumscribed area of raised erythema with central Pallor
140
Scleroderma?
Sclerosis of the skin that can progressed to muscles, bones, internal organs
141
Where does localized scleroderma affect
Skins of hands and face
142
What does scleroderma look like
Hard, hypo pigmented, taut, shiny, tightly connected to underlying tissue
143
Scleroderma auto immune?
Yes
144
Symptoms of scleroderma?
Calcinosis, Reynolds phenomenon, esophageal dysfunction, sclerodsctyly, telangiectasia
145
Seborrheic keratosis
Proliferation of cutaneous basal cells that produce smooth or warty elevated lesions
146
Keratoacanthoma
Tumor of squamous cell differentiation arising from hair follicles
147
types of benign tumors?
Seborrheic keratosis, keratoacanthoma, actinic keratosis, nevi
148
Actinic keratosis
Premalignant lesionMade of proliferations of epidermal keratinocyte is caused by prolonged exposure to UV radiation
149
Nevi/ moles
Pigmented or non-pigmented lesions that form from melanocytes. May undergo transition to malignant melanomas
150
Most prevalent forms of skin cancer?
Basal cell carcinoma and squamous cell carcinoma
151
Most serious in the most common cause of death from skin cancer?
Malignant melanomas
152
Causes skin cancer?
Chronic UV radiation
153
Basal cell carcinoma
Surface epithelial tumor that is pearly or ivory in appearance,elevated, depressed centers and rolled borders
154
Mutations in BCC?
TP 53 and PTCH1 genes
155
Squamous cell carcinoma
Tumor of the epidermis. Two types are situ and invasive
156
Mutations in Squamous cell carcinoma
TP 53 geneand other oncogenic signals
157
Malignant (cutaneous) melanocytes
Tumor of the skin originating from melanocytes
158
ABCDE rule for malignant melanoma
Asymmetry, border irregularity, color variation, diameter larger than 6 mm, elevation
159
Kaposi sarcoma
Vascular malignancy where there are purpleish brown macule developing into plaques and nodules
160
What is found in all forms of Kaposi sarcoma
Kaposi associated herpesvirus 8 HHV8
161
Primary cutaneous lymphomas
T cell and B cell lymphomas present in skin
162
Male pattern alopecia
Genetically predisposed response to androgens. Androgen sensitive and androgen insensitive follicles
163
Female pattern alopecia
Elevated levels of the serum adrenal androgen and hydroepiandrosterone sulfate
164
Alopecia areata
Auto immune T cell mediated inflammatory disease against hair follicles that result in Patchy baldness
165
Hirsutism
abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women
166
Paronychia
Bacterial infection of the cuticle
167
Onychomycosis
Fungal or dermatophyte infection of the nail where it turns yellow or white
