Unit 3 Lectures Flashcards
What is the top problem associated with disability-adjusted life years?
dermatitis
What is the correct order of the following layers of epidermis?
stratum granulosum, stratum spinosum, stratum corenum, stratum basalis
stratum corneum
stratum granulosum
stratum spinosum
stratum basalis
The stratum spinosum contains adhesion complexes called ___________
desmosomes
Name some functions of the skin (7)
- decoration/beauty
- barrier (physical, light, immunologic)
- vitamin D synthesis
- water homeostasis
- thermoregulation
- insulation/calorie reservoir
- touch/sensation
(Eumelanin/pheomelanin) is not as effective at blocking UV ligth
pheomlanin
In lighter skin, melanocytes are (smaller/larger) and distributed (in clusters/individually) throughout the (cytoplasm/nucleus)
smaller, clusters, nucleus
___________ is an autoimmune disorder against the melanocyte
vitiligo
T/F: There is no genetic defect in tyrosinase in vitiligo
true
Vitamin D is taken up through the diet and converted to _________ in the __________
calcidiol, liver
Vitamin D gets converted from calcidiol to _________ in the _________
calcitriol (active form), kidneys
Hemidesmosomes are the attachment point of the ___________ to ___________
basal cells, basal lamina of the dermal-epidermal junction
Bullous pemphigoid is caused by….
autoantibodies to BP180 or BP230, leads to sub epidermal blisters (hemidesmosomes not attaching dermis to epidermis)
Bullous pemphigoid is (acquired/inherited)
acquired
Epidermolysis bullosa is an (acquired/inherited) blistering disorder due to a lack of ___________
inherited
- simplex: keratin 5 or 14
- junctional: collagen XVII or laminin 5
- dystrophic: collagen VII
Desmosomes attach _________ to ____________
keratinocytes to each other
Pemphigus vulgaris is due to acquired antibodies to _____________, leading to flaccid bulla
desmosomes (desmoglein 1, 3)
Cells in what epidermal layer start to lose their nuclei?
stratum granulosum
Keratohyalin granules contain ____________ that cross-links keratin
filaggrin
Breakdown of filaggrin forms ___________________
natural moisturizing factor
Loss of function filaggrin mutations lead to ____________ and ___________, which result in decreased NMF levels and increased transepidermal water loss
- icthyosis vulgaris
- atopic dermatitis
What is the role of Langerhans cells?
participate in cell-mediated immunity as APCs
Where is the stratum lucidum present?
thick skin (between stratum corner and stratum granulosum), reduces friction
patch
- flat area of color change
- bigger than 1cm
papule
- discrete, solid elevated body
- less than 1cm
plaque
- solid, flat-topped elevated area of skin
- greater than 1cm
nodule
- firm, well-defined lesion
- greater than 1cm (bigger papule)
vesicle
- fluid-filled cavity or elevation within/below epidermis
- less than 1cm
bulla
-fluid-filled vesicle greater than 1cm
pustule
- circumscribed elevation with pus
- less than 1cm
telangiectasia
-visible, persistant dilation of small, superficial cutaneous blood vessels
Petechiae are (blanching/non-blancing) pinpoint spots due to ____________
non-blancing, tiny hemorrhages
The dermis provides the major ___________ of the skin
tensile strength
What is the pattern of collagen?
Gly-X-Y
X = proline
Y = hydroxyproline
What collagen type is a large part of the fetal dermis?
Collagen type III
Procollagen is synthesized within __________ and excreted extracellularly
fibroblasts
Procollagen is cleaved enzymatically into ___________
tropocollagen
Cross-linking of tropocollagen depends on __________
vitamin C
What are some key findings of scurvy?
- keratotic plugging of hairs
- corkscrew hairs
- perifollicular hemorrhage
- hemorrhagic gingivitis
Ehlers-Danlos syndrome is an (acquired/inherited) disorder of erroneous ___________ synthesis
inherited, collagen
What is a histologic clue for diagnosis of solar elastosis?
basophilic (blue) material within superficial dermis
Pseudoxanthoma elasticum is caused by a defect in the ______ gene and results in…
MDR gene; calcified, brittle elastic fibers
Ground substance is “glued together” with __________
fibronectin
Vasculitis is caused by….
inflammation of capillaries and venules
Type A nerve fibers are (myelinated/unmyelinated) and conduct _______________ sensations
myelinated
- alpha: proprioception
- beta: touch
- gamma: stretch receptors
- delta: pain initation
Type B nerve fibers are (myelinated/unmyelinated) and conduct _______________ sensations
unmyelinated
-diffuse, dull (temperature, itching)
Finasteride inhibits _____________ to prevent androgenic hair loss
5-alpha-reductase
Eccrine glands are vital to _______________
thermoregulation
Miliaria is an (acquired/inherited) disorder of ___________ function
acquired, eccrine
-tube carrying sweat ruptures
Anhidrotic ectodermal dysplasia involves a mutation in the ____ gene, leading to aberrant _________ development and (increased/decreased) sweating
EDA, eccrine, decreased
Sebaceous glands produce _____________ secretions
holocrine
Seborrheic dermatitis is associated with _____________ (neurological disorder)
Parkinson’s
Acanthosis nigricans is most often associated with…
diabetes mellitus (obesity, endocrinopathies, etc.)
What are some symptoms of ineffective endocarditis?
- splinter hemorrhage in nails
- janeway lesions (bruise-like, not painful)
- Osler nodes (inflamed blood vessels, painful)
- Roth spots (retinal hemorrhage)
Skin tightening around the mouth (“lost smile”) is associated with….
systemic scleroderma
What immune findings are associated with systemic scleroderma?
- anticentromere antibody
- anti-scl70 (systemic)
An itchy rash, mouth sores, and being Dutch are associated with ___________
lichen planus
Prevalence of _____________ is 2-13.5 fold higher in patients with lichen planus than controls
hepatitis C
A middle-aged African American woman has a chest x-ray with bilateral lymphadenopathy. What is a likely diagnosis?
sarcoidosis
Porhyria cutanea tarda is caused by a deficiency in uroporhyrinogen decarboxylase and associated with __________
hepatitis
Porhyria cutanea tarda is treated with _____________
phlebotomy
50-70% of patients with __________ have an underlying associated condition
expanding ulcers
Surgery and debridement should be avoided for __________. Instead, most respond to __________
expanding ulcers; IVIg
What are skin symptoms of lupus?
malar rash, discoid rash, oral ulcers, photosensitivity
Where is stasis dermatitis often seen?
lower extremity (due to venous insufficiency)
How does the morphology of dermatitis and cellulitis differ?
dermatitis: erythematous papules, thin plaques with scale
cellulitis: warm, tender erythematous patches or plaques
What is the location of inflammation for dermatitis?
epidermis, dermis
What is the location of inflammation for cellulitis?
dermis, subcutaneous tissue
Bilateral lower extremity edema and rash is associated with __________ and unilateral rubor, calor, tumor, and dolor are associated with ___________
stasis dermatitis, cellulitis
What is the diagnostic criteria for atopic dermatitis?
itchy skin + (2)…
- history of involvement of skin creases
- onset under age 2
- personal history asthma or hay fever
- history dry skin
- flexural eczema
Ichthyosis vulgaris involves a problem with _________ and is present in 70% of people with atopic dermatitis
filaggrin
T/F: Irritant-contact dermatitis is an immunologically-mediated reaction resulting from a direct cytotoxic effect
false (not immunologically-mediated)
Allergic contact dermatitis is a type IV, _______________ reaction
delayed-type hypersensitivity
In allergic contact dermatitis, ___________ cells present allergen to T cells and _________ produce the ACD response
langerhans, IL-1 and TNFalpha (inflammatory cytokines)
Drug eruptions are usually type IV _____________
cell-mediated hypersensitivity
Urticaria is characterized by _________ and _________
hives, wheals
Urticaria is a type ___ hypersensitivity reaction and is mediated by ___ antibodies
I (immediate), IgE
The largest cause (72%) of chronic urticaria is _________
idopathic/autoimmune
Nummular dermatitis is caused by ____________ and most often occurs on the _______
excess use of soap + dry skin, legs
Cradle cap is an example of ______________
seborrheic dermatitis
Seborrheic dermatitis occurs in areas rich in _________ glands
sebaceous (scalp, face, ears, chest)
Seborrheic dermatitis is caused by an overproduction of skin oil and an irritation from yeast called ______________
malassezia furfur
Psoriasis histology shows a hyperproliferation of the ___________
epidermis
Guttate is a subtype of ________ that is associated with _________
psoriasis, strep throat
What are some comorbidities of psoriasis?
insulin resistance, obesity, metabolic syndrome, CVD
Where is seborrheic dermatitis most commonly found?
scalp
Where is psoriasis most commonly found?
extensors
Atopic dermatitis is associated with __________ and _________
allergic rhinitis, asthma
Eccrine sweat glands are found in the __________ dermis
reticular
Another word for acrochordon is…
skin tag
Dermatofibromas are found mostly on the _________
legs (papules, fibroblasts)
A rapid increase in size or number of seborrheic keratoses is a sign of _____________
Leser-Trelat
Cherry angiomas and hemangiomas are __________ tumors
vascular
What skin tumors have malignant potential? (4)
- seborrheic keratosis
- dysplastic nevi
- familial atypical mole and melanoma syndrome
- congenital nevi (rare)
Glucose is the preferred food source for ___________
candidiasis
Gram _________ bacteria stains violet due to layer of peptidoglycan in cell walls
positive
Dermatophytes are fungi that “eat” ____________
keratin
Match…
epidermophyton most common in US
microsporum “socks and jocks”
trichophyton tinea carpers from a cat
epidermophyton - “socks and jocks”
microsporum - tinea carpers from a cat
trichophyton - most common in US
Is miliaria inherited or acquired?
acquired
_______________ involves a mutation in the EDA gene
anhidrotic ectodermal dysplasia
acanthosis nigricans involves a proliferation of ____________
epidermal keratinocytes and dermal fibroblasts
nummular dermatitis occurs because _________ production decreases as you age
filaggrin
Infantile hemangioma can be treated with _________________
beta blockers
Keratoacanthoma is a type of _______
SCC
SCC in situ (Bowen’s disease) is induced by _______
HPV
_________ and __________ are found in the stratum spinosum
keratinocytes, Langerhans cells
