19.1: Inflammatory dermatoses

Question 1

What is the key cell that comprises the epidermis? How are these organized?

Answer 1

Keratinocyte

Layers

Question 2

What is the stem cell layer of the epidermis?

Answer 2

Stratum basale

Question 3

What are the five layers of the epidermis, from superficial to deep?

Answer 3

• Stratum corneum
• Stratum lucidum
• Stratum granulosum
• Stratum spinosum
• Stratum basale

(“Come Let’s Get SunBurned”)

Question 4

What connects the cells in the stratum spinosum?

Answer 4

Desmosomes

Question 5

Where are the blood vessels in the epidermis?

Answer 5

There are none–only in the dermis

Question 6

What are the s/sx of atopic dermatitis?

Answer 6

Pruritic, erythematous, oozing rash with vesicles and edema

Question 7

What parts of the body in particular are affected with atopic dermatitis?

Answer 7

Face and flexor surfaces

Question 8

What type of hypersensitivity reaction is atopic dermatitis? What other disorders are associated with this (2)?

Answer 8

• Type I

- Asthma and allergic rhinitis

Question 9

What is the common name for atopic dermatitis?

Answer 9

Eczema

Question 10

Pruritic, erythematous, oozing rash with vesicles and edema located over the face and flexor surfaces = ?

Answer 10

Atopic dermatitis

Question 11

Contact dermatitis and atopic dermatitis present similarly. What is the major difference between the two?

Answer 11

Contact dermatitis arises upon exposure to allergens, and is NOT associated with asthma / allergic rhinitis

Question 12

What type of hypersensitivity reaction is contact dermatitis?

Answer 12

Type IV

Question 13

What plant classically causes contact dermatitis? Jewelry type?

Answer 13

• Poison ivy

- Ni jewelry

Question 14

What is the abx that classically results in contact dermatitis?

Answer 14

PCN

Question 15

What is the treatment for contact dermatitis?

Answer 15

• Removal of offending agent

- Topical steroids

Question 16

What are comedones?

Answer 16

Whiteheads and blackheads seen in acne vulgaris

Question 17

What, generally, is acne vulgaris? (hint: what two parts are inflamed)

Answer 17

Chronic inflammation of the hair follicles and sebaceous glands

Question 18

What is the bacterium that infects in acne vulgaris, and leads to inflammation?

Answer 18

Propionibacterium acnes

Question 19

Why is it that acne is seen in adolescents?

Answer 19

Increased keratinocytes in the hair shaft and increased sebum production

Question 20

What is the enzyme that Propionibacterium acnes produces that causes inflammation?

Answer 20

Lipases

Question 21

What is the role of benzoyl peroxide in the treatment of acne?

Answer 21

Antimicrobial to kill Propionibacterium and thus stop the inflammatory process

Question 22

What is the role of vitamin A derivatives (retinoids) in the treatment of acne?

Answer 22

Reduces keratin production

Question 23

What, generally, is psoriasis?

Answer 23

Well circumscribed, salmon-colored plaques with silvery scale

Question 24

Where on the body does psoriasis usually manifest?

Answer 24

Extensor surfaces and scalp

Question 25

What fingernail pathology may be seen with psoriasis?

Answer 25

Pitting

Question 26

Well circumscribed, salmon colored plaques with silvery scale on the extensor surfaces and scalp = ?

Answer 26

Psoriasis

Question 27

What causes psoriasis?

Answer 27

Excessive keratinocyte proliferation, with a possible autoimmune etiology

Question 28

What HLA haplotype is associated with psoriasis?

Answer 28

HLA-C

Question 29

What is the supposed environmental trigger for psoriasis?

Answer 29

Trauma

Question 30

What is the acanthosis that is seen in psoriasis?

Answer 30

Increased thickness of the epidermis from keratinocyte proliferation

Question 31

What is parakeratosis?

Answer 31

Excess keratin production, with retained nuclei

Question 32

What is the significance of elongation of the dermal papillae, and the thin epidermis that lies above it in psoriasis?

Answer 32

Pinpoint bleeds that occur with removing the thin scale seen with psoriasis

Question 33

What is the name of the collection of PMNs in the stratum corneum?

Answer 33

Munro microabscesses

Question 34

What is the sign of the pinpoint bleeding from removal of the scaly plaque seen with psoriasis?

Answer 34

Osvet's sign

Question 35

What is the treatment for psoriasis? (3)

Answer 35

- Corticosteroids - UV light with psoralen - Immune modulating therapy

Question 36

What is the role of UVA light in the treatment of psoriasis?

Answer 36

Prevent the proliferation of keratinocytes

Question 37

What are the four P's of lichen Planus?

Answer 37

- Pruritic - Planar - Polygonal - Purple plaques

Question 38

What areas of the body are commonly affected with Lichen planus? (3)

Answer 38

- Wrists - Elbows - Oral mucosa

Question 39

What are the superficial findings of Lichen planus?

Answer 39

Reticular white lines on surface

Question 40

What is the histological characteristics of Lichen planus?

Answer 40

Inflammation of the dermal-epidermal junction, causing a *sawtooth appearance*

Question 41

Sawtooth histological appearance at the dermal-epidermal junction = ?

Answer 41

Lichen planus

Question 42

What infectious agent is associated with lichen planus?

Answer 42

Hep C