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Flashcards in Adnaxial Structures Deck (17)
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1
Q

What is the divisions of the hair follicle?

A

Infindibulum - Opening to connection to sebaceous gland
Isthmus - Sebaceous gland down to erector pillae muscle
Inferior segment - Remainder, includes hair bulb and matrix

2
Q

Classes of pilosebaceous unit

A

Laguno (fetal)
Vellus (fine)
Terminal (coarse)

3
Q

Conditions which may be heralded by abnormal presence of hair types:

A

Anorexia - Lanugo

Hirsutism - Terminal (Females with male pattern hair, indicating androgen excess/polycystic ovarian syndrome PCOS)

4
Q

Sebaceous glands (Where, what how when)

A

Where - Greatest density on face and scalp but everywhere
What - Produce sebum: TriGly, Free FA, Squalene, Wax/Sterol esters, Free sterols
How - Holocrine secretion
When - Active at birth, but decreaes during infancy. Sebum production stimulated by androgen production (5-alpha dihydrotestosterone) in puberty

5
Q

Hair cycle

A
Growth phase (Anagen) - Majority of hair on scalp is in anagen, duration corresponds to hair length, deepest hair bulbs (in dermis)
Transition phase (Catagen) - Hair migrates up towards epidermis, degeneration of roots
Resting phase (Telogen) - Hair shed during this phase, rest in phase for 3-5 months
6
Q

Telogen effulvium

A
Stressor results (i.e. childbirth, febrile illness in children) in greater proportion of hair follicles entering telogen phase
Results in increase amount of hair being shed
Occurs approx. 3 mos after event, slowly returns to normal
Patient doesn't look bald, but can detect difference in hair thickness
7
Q

Alopecia Areta

A

Autoimmune condition
Smooth patches of complete alopecia develop
Nail pits (indentations in the nail plate) can also be assoc.
Tx: Topical cortical steroids

8
Q

Sweat gland types, location, communication to surface

A

Eccrine (Sweaty) - Palms and soles, Innervated by sympathetic fibers via ACh
Directly communicate to surface
Apocrine (Sweaty and smelly) - Axillae, Anogenital, Periumbilical
Part of hair follicle unit

9
Q

Disorders of sweat glands

A

Hyperhidrosis

Ani/hypohidrosis - Occur when sweat glands are absent/reduced, e.g. ectodermal dysplasia

10
Q

Acne development factors

A

Sebaceous cells: Sebum, Fatty Acids
Follicular keratinocytes: Hyperproliferation, keratohaline granules increase, disturbed desquamation
P. acnes: Immune reaction

Androgens increase sebum production and hyperproliferation

11
Q

Propionibacterium acnes - Type and activity

A

Anaerobic Gram + Rod
Dependent on glycerol, hydrolyzes sebum triglycerides
Produces - Porphyrins, proinflammatory mediators, lipases

Inflammatory action

12
Q

Acne treatment (Topical)

A

Retinoids - Counter follicular keratinocyte hyperproliferation, some action against P. acnes immune reactions
Benzoyl peroxide - Anti-P. acnes, also reduce fatty acids
Antibiotics - Anti-P. acnes, anti-inflammatory

13
Q

Systemic treatment for Acne

A

Antibioitcs
Oral Contraceptives
Isotretinoin

Often used for patients which have trunk involvement

14
Q

Antibiotic specifics

A

Tetracyclines: Tet, Dox, Mino
Mechanism - Inhibition of P. acnes, anti-inflammatory (decreases proinflammatory mediators)
Side effects - Dox - Pill esophagitis, photosensitivty
Mino - Drug hypersensitivity syndrome, drug induced lupus, hepatitis

Erythromycin
Bactrim
Penicillins

15
Q

Oral contraceptive specifics

A

Mechanism: Block production of androgens (adrenal and ovarian)
Types of acne: Inflammatory papules/pustules, peri-menstrual flare
Side effects: Nausea, vomiting, abnormal menses, weight gain, breast tenderness, thrombophlebitis, HTN

16
Q

Isotretinoin specifics

A

Indication - Severe nodulocystic acne, scarring, severe acne recalcitrant to systemic antibiotic therapy & topicals (3-4 month trial of minocycline)
Dose - Cum dose: 120-150 mg/kg, 1mg/kg/day divided BID x 5 months

17
Q

Tinea versicolor

A

Malassezia spp. globosa and furfur (Formerly Pityrosporum)
Oval to round scaly patches w/ fine overlying scale
Hyperpigmented or hypopigmented
Ziti and meatballs histo