9- Immune-mediated and auto-immune skin disease Flashcards
What does CIMD stand for
Cutaneous immune-mediated disease- rare conditions
Name 2 target tissues of CIMD
Desmosomal proteins in the upper epidermis
Cells of the basal epidermis
Sebaceous glands
Dermal skin vessels
Subcuticular fat
In the condition of pemphigus foliaceus what is the target tissue
Desmosomal proteins in the upper part of the epidermis
Normal anchors between epidermal cells are broken down > Float around in pustule
How does pemphigus foliaceus present
Pustules which rapidly develop into crusts > leaving erosions
What is the target cell in facial cutaneous lupus erythematous
T cells target epithelial cells
How does facial cutaneous lupus erythematous present
Damaged epithelial cells causes the epithelium to form poorly resulting in ulceration and depigmentation
What is the target cell in vitiligo
Melanocytes (there are less of them compared to epithelial cells so there is less response)
How does vitiligo present
Removal of pigment from the epithelium, with minimal inflammation
Sebaceous adenines cause sebaceous glands to be destroyed… what does this mean for the presentation
No oil/greasy material produced to allow the hair to leave the follicle without friction
Causes broken hair, scale and alopecia
What is the target of vasculitis
dermal blood vessels
How does vasculitis present
tissue death and loss in the area supplied
What is panniculitis
inflammation of subcutaneous adipose tissue
What is the target of panniculitis
subcuticular fat
How does panniculitis present
soft-fluctating nodules that may rupture
In order to make an accurate diagnosis of a cutaneous immune mediated disease what 2 steps need to be undertaken
Exclusion of common differential diagnosis
Confirmation of correct histological pattern- not always possible
