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Pathophysiology > Structure, Function, And Disorders Of The Skin > Flashcards

Structure, Function, And Disorders Of The Skin Flashcards

1
Q

What organ is involved in the production of vitamin D

A

Skin

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2
Q

What is vitiligo

A

Auto immune related loss of melanocytes; Depigmentation of patches of skin

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3
Q

What do Merkel cells function as

A

Slowly adapting mechanoreceptors

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4
Q

What do fibroblasts secrete

A

Collagen

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5
Q

What do mast cells secrete

A

Histamine

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6
Q

Freckles, flat moles, petechiae, measles, scarlet fever are all examples of what

A

Macule

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7
Q

Wart, elevated moles, like in planus, fibroma, insect bite or examples of what

A

Papule

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8
Q

Vitiligo, port wine stains, Mongolian spots, café aublait spots are all examples of what

A

Patch

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9
Q

Psoriasis, seborrheic and actinic keratoses are examples of what

A

Plaque

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10
Q

What is a wheal?

A

Elevated, irregular shaped area of cutaneous edema, is solid and transient. Insect bites and allergic reactions

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11
Q

Merkel cells?

A

Slowly adapting mechanoreceptors

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12
Q

Where are Histiocytes located

A

Loose CT

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13
Q

What do histiocytes do

A

Phagocytize pigments and debris of inflammation

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14
Q

What nervous system regulates vasoconstriction and vasodilation

A

Sympathetic

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15
Q

Nodule?

A

Elevated firm circumscribed lesion deeper in dermis than papule. 1-2 cm

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16
Q

Tumor

A

Elevated solid lesion deeper in dermis. Over 2 cm in diameter

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17
Q

Nodule example

A

Erythma nodosum and lipoma

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18
Q

Tumor example

A

Neoplasm benign tumor lipoma neurofibroma hemangioma

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19
Q

Does a vesicles go in the dermis

A

No

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20
Q

Vesicle examples

A

Varicella/chicken pox, herpes zoster/shingles,herpes simplex

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21
Q

Bulla example

A

Blister, pemphigus vulgaris

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22
Q

Pustule

A

Elevated superficial lesion like a vesicle but filled with purulent fluid [pus)

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23
Q

Pustule examples

A

Impetigo or acne

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24
Q

Cyst

A

Elevated, circumscribed, encapsulated lesion in dermis or subcutaneous

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25
Q

Cyst examples

A

Sebaceous cyst,cystic acne

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26
Q

Telangiectasia

A

Irregular red lines due to capillary dilation

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27
Q

Telangiectasia example

A

Rosscea

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28
Q

Scales

A

Heaped up keratinized cells that are irregular and vary in size

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29
Q

What is lichenification

A

Rough thickened epidermis usually secondary to itching skin

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30
Q

Where do pressure ulcers come from

A

Unrelieved pressure on skin

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31
Q

What occurs when an individual lies or sit in one position for a long time

A

DEcubitis ulcer

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32
Q

What are the most common spots of pressure ulcers

A

Sacrum, heels, ischia, greater trochanters

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33
Q

What is used to predict ulcers

A

Braden scale

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34
Q

What type of skin dysfunction has excessive collagen formation and abnormal fibroblast activity

A

Keloids

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35
Q

What kind of treatment is available for keloids

A

Intralesional corticosteroids, Cyrotherapy, radiotherapy, and surgical and laser procedures

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36
Q

Where are keloids common

A

Darkly pigmented skin types and burns

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37
Q

What are hypertrophic scars

A

Elevated erythrmatous fibrous lesions that do not expand beyond the injury border

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38
Q

What is the most common symptom of primary skin disorders

A

Pruritus

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39
Q

What causes an itch

A

Specific unmyelinated c nerve fibers

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40
Q

What is a neuropathic itch

A

Related to any pathologic condition along an afferent pathway

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41
Q

What is a psycho genic itch

A

Psychologic disorder

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42
Q

What is the treatment for an itch

A

Depends upon the H cause but both topical and systemic therapies

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43
Q

What is the Itch response modulated by

A

CNS

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44
Q

What is the most common inflammatory skin disorder

A

Dermatitis a.k.a. eczema

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45
Q

What are inflammatory skin disorder characterized by

A

Pruritus, lesions with indistinct borders, and epidermal changes

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46
Q

What does chronic eczema look like

A

Thickened, leathery, and hyperpigmented skin

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47
Q

What is chronic eczema from?

A

Recurrent itching and scratching

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48
Q

What type of inflammatory disorder is a common form of T cell mediated or delayed hypersensitivity

A

Allergic contact dermatitis

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49
Q

Clinical Manifestations of allergic contact dermatitis

A

Erythema, swelling, pruritus, and vesicular lesions

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50
Q

Treatment of allergic contact dermatitis

A

Removal of the Allergen and administration of topical or systemic steroid

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51
Q

Irritant contact dermatitis

A

Nonimmunologic inflammation of the skin. Due to chemical irritation

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52
Q

Treatment of irritant contact dermatitis

A

Removal of source of irritation, use of topical agents and non-irritating soaps

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53
Q

What is a topic/allergic dermatitis common?

A

In childhood and infancy but can last into adult life

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54
Q

What is atopic/allergic dermatitis associated with

A

A family history of allergies, hayfever, elevated IgE levels and increased histamine sensitivity

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55
Q

How do you get atopic/allergic dermatitis

A

Inhaling substance

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56
Q

Where and why does stasis dermatitis occur?

A

In the legs as a result of venous stasis, edema, and vascular trauma

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57
Q

What is the sequence of events in stasis dermatitis

A

Edema, erythema, pruritus, scaling, petechiae, hyperpigmentation, and ulceration

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58
Q

Stasis dermatitis treatment

A

Elevate legs, avoid wearing tight clothes and standing, antibiotics, and dressings, compression garments, and vein ablation therapy for chronic lesions/ulceration

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59
Q

What is seborrheic dermatitis

A

Chronic skin information involving the scalp, eyebrows, eyelids, nasal labial folds, axillary, chest, and back. Maybe periods of remission and exacerbations

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60
Q

Where do infants usually get Seborrheic dermatitis

A

Cradle cap

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61
Q

Clinical manifestations of seborrheic dermatitis

A

Greasy, scaly, white, or yellowish plaques

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62
Q

Seborrheic dermatitis trmt

A

Shampoo with sulfur, salicylic acid, or tar, keto o azalea with topical calcineurin inhibitors, corticosteroid applications

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63
Q

Clinical manifestations of psoriasis

A

Scaly, thick, silvery, and elevated lesions usually on the scalp elbows or knees

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64
Q

What is the epidermal turnover time for psoriasis

A

3 to 4 days meaning it cells don’t have time to mature or keratinized

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65
Q

What is the most common papulosquamous disorder

A

Plaque psoriasis

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66
Q

Where is Plaque psoriasis usually located

A

Scalp, elbows, knees, sites of trauma

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67
Q

What is Inverse psoriasis

A

Lesions that develop in skin folds that are large, smooth, dry, and deep red

68
Q

Who is guttate psoriasis common in, when does it develop

A

Common in children after streptococcal respiratory infection

69
Q

What is pustular psoriasis

A

Blisters filled with non-infectious pus that develop over areas of plaque psoriasis

70
Q

What is erythrodermic psoriasis

A

Exfoliative dermatitis characterized by widespread read, scaling lesions

71
Q

What are the systemic complications of papulosquamous disorders

A

Psoriatic arthritis, ankylosing spondylitis, psoriatic nail disease

72
Q

What is psoriasis a risk factor for the development of?

A

IBD, metabolic syndrome, Atherosclerosis and cardiovascular disease

73
Q

What is pityriasis rosea

A

A benign self-limiting inflammatory disorder associated with a virus

74
Q

when does pityriasis usually occur during the year

A

Spring and fall

75
Q

What disorder is a herald patch associated with

A

Pityriasis rosea

76
Q

What is a Herald patch

A

Circular, demarcated, salmon pink patch

77
Q

What is the treatment for pityriasis rosea

A

UV light, anti-histamines, topical corticosteroids

78
Q

What is lichen planus

A

Benign, auto inflammatory disorder of the skin and mucous membranes

79
Q

What is the ideology of lichen planus

A

Unknown

80
Q

What parts of the auto immune system does lichen planus involve

A

T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells

81
Q

What do the lesions of lichen planus look like

A

Non-scaling popular violet colored with pruritis wrist, ankles, lower legs, and genitalia

82
Q

What is the treatment for lichen planus

A

Topical, intralesional, systemic corticosteroids

83
Q

What do anti-histamines do?

A

Help with itching

84
Q

What do topical or systemic corticosteroids do

A

Control inflammation

85
Q

What do short term systemic glucocorticoids do

A

Treat oral lesions

86
Q

What do potent topical steroids, topical retinoids, and systemic glucocorticoids do?

A

Treat mucous membrane lesions

87
Q

What is acne vulgaris

A

Inflammatory disease of the pilosebaceous follicles

88
Q

What are two features of acne vulgaris

A

Hyper trophy of sebaceous glands and telangiectasia

89
Q

Who is acne vulgaris common in

A

Adolescents

90
Q

Who is acne rosacea common in

A

Middle age adults

91
Q

What does acne rosacea

A

Chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun

92
Q

What are the four types of lesions in acne rosacea

A

Erythematotelangiectatic, papulopustular, phymatous, ocular

93
Q

What is a Erythematotelangiectatic lesion

A

Facial redness

94
Q

What is a papulopustular lesion

A

Bumps and pimples

95
Q

What is a phymatous lesion

A

Enlargement of the nose (rhonophyma)

96
Q

What is an ocular lesion

A

Eye irritation

97
Q

What is the treatment for acne rosacea

A

Photoprotection, topical and oral drugs,surgical excision for rhonophyma

98
Q

What is lupus erythematosus

A

Inflammatory autoimmune systemic disease with cutaneous manifestations

99
Q

What is the female to male predominance

A

10:1

100
Q

What are the two types of lupus erythematosus disorders

A

Systemic and skin (discoid)

101
Q

Which popular squamous lupus disorder is restricted to the skin

A

Discoid/cutaneous

102
Q

What disorder is known for a butterfly pattern over the nose and cheeks

A

Discoid lupus erythematosus

103
Q

What is the immune response of discoid lupus erythematosus

A

Development of self reactive TNB cells, decrease number of regulatory T cells, and increased pro inflammatory cytokines

104
Q

What is the tissue damage of discoid lupus caused by?

A

Auto antibodies and immune complexes

105
Q

What is the treatment of discoid lupus

A

Sun protection, topical steroids, calcineurin inhibitors, anti-malarial drugs, immuno suppressant agents

106
Q

What are vaesiculobullous disorders

A

Diseases that have different causes and clinical courses but share the common characteristics of vesicle or blister formation

107
Q

What are the two types of vesiculobollus disorders

A

Pemphigus and erythema multiforme

108
Q

What is pemphigus

A

Rare auto immune, chronic, blister forming disease of the skin and oral mucous membranes

109
Q

Where do blisters form in Pemphigus

A

Deep and superficial layers of the epidermis

110
Q

What is the auto immune disease of pemphigus caused by

A

IgG auto antibodies

111
Q

What is the most common pemphigus disorder

A

Pemphigus vulgaris

112
Q

What is acantholysis

A

Destruction of cell to cell adhesion

113
Q

In pemphigus vulgaris where is acantholysis located

A

Suprabasal level

114
Q

What occurs pathologically in pemphigus vulgaris

A

IgG and C3 complement bind to the desmoglein adhesion molecules causing acantholysis in the epidermis and blister formation

115
Q

What precedes the onset of skin blistering in pemphigus vulgaris

A

Oral lesions on the face, scalp, and axilla

116
Q

Which form of pemphigus is mild

A

foliaceus

117
Q

What form of pemphigus is a subset of pemphigus foliaceus

A

Pemphigus erythematosus

118
Q

What is the most severe form of pemphigus

A

Paraneoplastic pumphigus

119
Q

What is the most benign form of pemphigus

A

IgA pemphigus

120
Q

Where does acantholysis occur in pemphigus foliaceus

A

Subcorneal level

121
Q

What clinical manifestations show in pemphigus foliaceus

A

Blistering, erosion, scaling, crusting, erythema of face and chest

122
Q

Are oral mucous membranes involved in pemphigus foliaceus

A

No

123
Q

What pemphigus disorder is also called paraneoplastic autoimmune multiorgan syndrome

A

Paraneoplastic pemphigus

124
Q

What is the treatment for pemphigus

A

Systemic corticosteroids and immuno suppressant agents

125
Q

What pemphigus disorder has bound IgGand IgE with blistering of the subepidermal dermal skin layer

A

Bollous/IgE pemphigoid

126
Q

What is the loss of dermal epidermal adhesion caused by in bollous pemphigoid

A

Inflammatory cytokines

127
Q

How do you distinguish bollous pemphigoid From pemphigus

A

Sub epidermal blistering and eosinophils

128
Q

What is erythema multiforme

A

Acute recurring disorder of skin and mucous membranes

129
Q

What is erythema multiforme associated with

A

Allergic or toxic reactions to drugs or micro organisms

130
Q

What is erythema multiforme caused by Pathologically

A

Immune complex is formed and deposited around dermal blood vessels, basement membranes, and keratinocytes

131
Q

What disorder is known for a bull’s-eye or target lesion

A

Erythema multiforme

132
Q

What is formed when the lesions rupture in erythema multiforme

A

Erosions and crusts

133
Q

What part of the body does erythema multiforme affect

A

Mouth, air passages, esophagus, urethra, and conjunctiva

134
Q

What is cutaneous vasculitis

A

Inflammation of the blood vessels of the skin due to immune complexes in the small blood vessels that activate complements

135
Q

What does cutaneous vasculitis develop from

A

Drugs, bacterial infections, viral infections, or allergens

136
Q

What does the systemic form of lesions in cutaneous vasculitis look like

A

Palpable purpura, progressing to hemorrhagic bullae with necrosis and ulceration

137
Q

What is urticaria /hives caused by

A

Type one hypersensitivity reactions to allergens

138
Q

What does histamine release in urticaria/hives caused

A

Endothelial cells of the skin to contract

139
Q

What are the clinical manifestations of urticaria/hives

A

Pruritic circumscribed area of raised erythema with central Pallor

140
Q

Scleroderma?

A

Sclerosis of the skin that can progressed to muscles, bones, internal organs

141
Q

Where does localized scleroderma affect

A

Skins of hands and face

142
Q

What does scleroderma look like

A

Hard, hypo pigmented, taut, shiny, tightly connected to underlying tissue

143
Q

Scleroderma auto immune?

A

Yes

144
Q

Symptoms of scleroderma?

A

Calcinosis, Reynolds phenomenon, esophageal dysfunction, sclerodsctyly, telangiectasia

145
Q

Seborrheic keratosis

A

Proliferation of cutaneous basal cells that produce smooth or warty elevated lesions

146
Q

Keratoacanthoma

A

Tumor of squamous cell differentiation arising from hair follicles

147
Q

types of benign tumors?

A

Seborrheic keratosis, keratoacanthoma, actinic keratosis, nevi

148
Q

Actinic keratosis

A

Premalignant lesionMade of proliferations of epidermal keratinocyte is caused by prolonged exposure to UV radiation

149
Q

Nevi/ moles

A

Pigmented or non-pigmented lesions that form from melanocytes. May undergo transition to malignant melanomas

150
Q

Most prevalent forms of skin cancer?

A

Basal cell carcinoma and squamous cell carcinoma

151
Q

Most serious in the most common cause of death from skin cancer?

A

Malignant melanomas

152
Q

Causes skin cancer?

A

Chronic UV radiation

153
Q

Basal cell carcinoma

A

Surface epithelial tumor that is pearly or ivory in appearance,elevated, depressed centers and rolled borders

154
Q

Mutations in BCC?

A

TP 53 and PTCH1 genes

155
Q

Squamous cell carcinoma

A

Tumor of the epidermis. Two types are situ and invasive

156
Q

Mutations in Squamous cell carcinoma

A

TP 53 geneand other oncogenic signals

157
Q

Malignant (cutaneous) melanocytes

A

Tumor of the skin originating from melanocytes

158
Q

ABCDE rule for malignant melanoma

A

Asymmetry, border irregularity, color variation, diameter larger than 6 mm, elevation

159
Q

Kaposi sarcoma

A

Vascular malignancy where there are purpleish brown macule developing into plaques and nodules

160
Q

What is found in all forms of Kaposi sarcoma

A

Kaposi associated herpesvirus 8 HHV8

161
Q

Primary cutaneous lymphomas

A

T cell and B cell lymphomas present in skin

162
Q

Male pattern alopecia

A

Genetically predisposed response to androgens. Androgen sensitive and androgen insensitive follicles

163
Q

Female pattern alopecia

A

Elevated levels of the serum adrenal androgen and hydroepiandrosterone sulfate

164
Q

Alopecia areata

A

Auto immune T cell mediated inflammatory disease against hair follicles that result in Patchy baldness

165
Q

Hirsutism

A

abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women

166
Q

Paronychia

A

Bacterial infection of the cuticle

167
Q

Onychomycosis

A

Fungal or dermatophyte infection of the nail where it turns yellow or white

Pathophysiology (17 decks)

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