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LOCO2 > Skin Inflammation > Flashcards

Skin Inflammation Flashcards

1
Q

What are the signs of inflammation?

A
  • heat (increased blood flow and vessel dilatation)
  • redness (increased blood flow and vessel dilatation)
  • swelling (accumulation of fluid)
  • pain (pressure on nerve endings)
  • loss of function
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2
Q

What are the different types of inflammation in skin?

A
  • urticaria = mass cell mediated (oedema and inflammation of dermis)
  • pemphigus (antibody mediated)
  • vasculitis (immune complex mediated)
  • contact allergic dermatitis (delayed hypersensitivity)
  • TB, sarcoidosis (granuloma formation)
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3
Q

What activates mast cell mediated inflammation?

A
  • IgE release histamine, leukotrienes and PGs via mast cell binding
  • Th2 cells which have had the antigen presented to them produce IL4,5,GM-CSF which produce B cells producing IgE
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4
Q

What is the role of histamine?

A
  • stimulates sensory nerves (itch)
  • smooth muscle contraction (vessel leakage and oedema)
  • arteriole dilatation (headache and hypotension)
  • modulation of immune response via H2 receptors
  • bronchospasms
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5
Q

What is Der P1?

A
  • allergen
  • from faecal pellets of dust mite
  • breaks down components of tight junctions
  • help it cross mucosa
  • then get immune response
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6
Q

What are local allergic reactions?

A
  • urticaria
  • asthma
  • hay fever
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7
Q

What are generalised allergic reactions?

A

anaphylaxis:

  • antigen release into blood stream
  • binds to IgE on basophils
  • massive release of inflammatory mediators
  • bronchospasm and circulatory collapse
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8
Q

What are signs of acute angioedema?

A
  • lower lip swelling
  • uvular and tonsillar swelling
  • closure of pharynx so cannot talk
  • need EpiPen/adrenaline
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9
Q

What is omalizumab used for?

A
  • new treatment for resistant urticaria and asthma
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10
Q

What is pemphigus vulgaris?

A
  • autoimmune blistering disorder
  • IgG antibodies bind to desmoglein-3 (part of desmosome)
  • leads to suprabasal split and acantholysis
  • loss of cohesion between epidermal keratinocytes
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11
Q

What is the treatment for pemphigus vulgaris?

A
  • oral steroids
  • immunosuppression
  • rituximab
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12
Q

What is immune complex mediated vasculitis?

A

IgG activated complement:

  • deposition of fibrin
  • necrosis of vessel wall due to microthrombi blocking vessel
  • proteases degrade vessel BMZ
  • leaky vessel extravasation of blood and oedema
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13
Q

What are some cutaneous manifestations of immune complex mediated vasculitis?

A
  • early = erythema and oedema
  • established = palpable purpura
  • severe = ulceration and necrosis
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14
Q

What are some examples of human immune complex diseases in skin?

A
  • systemic lupus erythematosus (DNA and anti-DNA)

- polyarthritis nodose HbsAG (anti-HBs antibody)

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15
Q

What is an example of delayed hypersensitivity?

A

Contact dermatitis

  • wrist-nickel
  • watch
  • nickel, belt buckle
  • rubber in elastic clothing
  • topical antibiotics
  • primula
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16
Q

What is the role of IL-2 and IFN gamma in contact dermatitis?

A
  • promote Th1 response secretion of IL-2, IL-3, IFN gamma

- promotes macrophage-rich response

17
Q

What are examples of granuloma formation?

A
  • sarcoidosis
  • lupus vulgaris -> cutaneous TB
  • treat with JAK inhibitor = ruxolitinib
18
Q

What are the cells found in skin during inflammation?

A
  • neutrophil
  • eosinophil
  • lymphocyte
  • plasma cell
  • macrophage
  • mast cell
19
Q

What is the langerhan cell?

A
  • in the epidermis
  • has dendritic cell spine like projections
  • presents antigen to CD4+ helper T cell
  • picks up antigen entering skin and transport to lymph node
20
Q

What can cause mast cell degranulation?

A
  • Drugs - aspirin and NSAIDs
  • serum factors
  • insect sting
  • nuts
  • shell-fish
  • house dust mite
21
Q

What do mast cells release?-

A
  • histamine
  • leukotrienes
  • PG
  • platelet aggregating factor
22
Q

What are the effects of mast cell degranulation?

A
  • vascular leak
  • bronchoconstriction
  • intestinal hypermobility
  • inflammation
  • tissue remodelling
23
Q

How does a granuloma form?

A
  • TB causes clonal T cell expansion
  • secretion of Th1, cytokines IL2/IFN-y, TNF
  • macrophage formation
  • fuse to form giant cells/langhans giant cells = granuloma OR transform into histiocytes to form granuloma
24
Q

What are some common autoimmune skin examples?

A
  • alopecia areata (autoimmunity to hair follicle)
  • vitiligo (autoimmunity to melanocyte)
  • treat both with strong topical steroids and immunosuppressants
  • if Vitamin D levels are low they will not respond to treatment

LOCO2 (26 decks)

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