Dr. Vishy - Immune Skin Conditions Flashcards by jamila rahmaan

Skin Layers Mnemonic (top to bottom):

Californians
Like
Girls (in)
String
Bikinis

Stratum Corneum, Lucidum, Granulosum, Spinosum, Basalis

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Glycoprotein desmosome glue

Desmogleins (1 and 3)

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Superficial desmoglein

Desmoglein 1

*the other one’s the other one

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Proteins in hemidesmosomes

Bullous pemphigoid antigen (BPA1&2)

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Connects keratinocytes of stratum basale to basement membrane

Hemidesmosomes

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Dendritic cells in dermis is called

Dermal DCs

*DC = dendritic cell

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DC in epidermis is called

Langerhans cell

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molecular wt for BPAg1

230

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molecular wt for BPAg2

180

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Important protein for keeping epidermal skin barrier intact. Also helps terminal differentiation of epidermis.

Filaggrin

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EXTRAcellular antigens are conjugated to which major histocompatibility class within dendritic cells?

MHC ClassII

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Antigens broken down by proteosomes are attached to which intracellular protein on its way to the endoplasmic reticulum?

TAP proteins

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Within the endoplasmic reticulum, viral antigens are attached to MHC class I and the entire complex is then presented to

CD8 (cytotoxic Tcells)

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Which signal pushes Tcells to become effector cells?

Signal 2

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Mutation of this protein can leave epidermis susceptible to infection

Filaggrin

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Homeostasis mechanism to “turn off Tcells”

CD 80/86 of APC bound to CTLA4 of Tcell

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During antigen recognition, IL-12 pushes Tcells to become

TH1 subset

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These T helper cells do the following

Aid in cell immunity
Secrete IL-2 and IFN-gamma

Th1

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These T helper cells do the following

Aid B cells to produce Abs
Secrete IL-4, IL-5, and IL-10

Th2

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During antigen recognition, IL-10 pushes Tcells to become

TH2 subset

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Which signal involves “polarizing cytokines” during antigen recognition?

Signal 3

*cytokines push Tcells to TH1 or TH2

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Released by Cytotoxic T lymphocytes and generates transmembrane pores in target cells

Perforins

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Released by CTLs and induce apoptosis inside cytosol of target cells

Granzymes

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Apoptotic signal of membrane bound molecule of target cells

Fas

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This ligand is on CTL cell surface and binds Fas on target cells

Fas ligand

Inflammatory DCs - very good at migration - very good at antigen presenting

IDECs

DCs that present Type I interferons

Plasmacytoid DCs

Type I interferons

Interferon alpha | Interferon beta

These interferons protect against viral infection

Type I interferons | alpha, beta

These are like basophils, but are present in DERMIS and cross link with IgE

Mast cells * have Fc epsilon Receptors for IgE

Name the Hypersensitivity Type: Immediate/Anaphylactic - IgE - allergy - Mast cells/ Basophils

Type I *seconds-mins

Name the Hypersensitivity Type: -Immune Complex mediated

Type III

Delayed-Type Hypersensitivity

Type IV

Which Hypersensitivity is antibody-mediated cytotoxic?

Type II

Hypersensitivity reaction involving IgM and IgG, resulting in complement activation and cell rupture

Type II

Basophils are like mast cells and travel in the

Blood

Hypersensitivity Reaction in which Abs bind to soluble antigen and forming immune complexes

Type III

Urticaria has pale center and raised red edges caused by histamine release. Which Hypersensitivity reaction is urticaria?

Type I

Type I Hypersensitivity reaction involving defective FILAGGRIN

Atopic dermatitis

With atopic dermatitis, which stage involves INF gamma and viral infection?

Chronic

During the chronic stage of atopic dermatitis, what DC type is low, leading to susceptibility to viral infection?

Plasmacytoid DCs

With atopic dermatitis, which stage involves rashes and bacterial infection?

Acute

During chronic atopic dermatitis which interferon is present and which Tcell subset is dominant?

IL-10 and TH2

T cell homing antigen important during atopic dermatitis

(CLA) Cutaneous lymphocyte associated antigen

Which hypersensitivity? - GOODPASTURE's - Pemphigus foliaceus - Bullous pemphigoid - Linear IgA Dz

Type II

During acute atopic dermatitis, which interferon is present ad which Tcell subset is dominant?

IL-12 and TH1

- IgG - Autoantibody - Desmoglein 3 - Ashkenazi Jews

Pemphigus vulgaris

Deeper Desmoglein

Deep blisters in skin and mouth

Pemphigus vulgaris -can cause death

- Looks worse than pemphigus vulgaris, but it's not - IgG - Autoantibody - Desmoglein 1

Pemphigus foliaceus

- Auto antibodies to BPAg1 & 2 - IgG - No acantholysis

Bullous Pemphigoid

Acantholysis

Pemphigus vulgaris

Desmoglein 1 and NO ACANTHOLYSIS

Pemphigus foliaceus

Autoantibodies from IgA class specific to BPAg2

Linear Immunoglobulin A Disease

- IgA - HLA: A1, B8, DR3, DQ2 - Gluten

Dermatitis herpetiformis *IgA

Which Hypersensitivity type? Dermatitis herpetiformis and SLE

Type III

Garbage DNA and histones trigger which Disease?

SLE

15mm TB induration

low risk individuals

10 mm TB induration

risk groups and researchers

5 mm TB induration

HIV

What type of hypersensitivity is contact dermatitis?

Type IV

These skin conditions caused by which hypersensitivity reaction? - Erythema multiform minor and major - Steven-Johnson - Toxic epidermal necrolysis

Type IV

Rashes on the extremities caused by autoimmune attack of keratinocytes by CD8+ -mycoplasma or HSV

Erythema multiform minor

Rashes on the extremities caused by autoimmune attack of keratinocytes and effecting mucous membranes

Erythema multiform major

Blisters on less than 10% of body surface | -usually trunk, mucosa

Steven-Johnson Syndrome

Life threatening blisters on more than 10% body surface. Hospitalized like burn victim

Toxic epidermal necrolysis

- Scleroderma | - Psoriasis

Autoimmune skin diseases

Systemic proliferation of fibroblasts

Scleroderma

Hyper proliferation of keratinocytes

Psoriasis

Collagen in the blood vessels causing red, white, blue fingertips

Scleroderma

Fibrosis in GI tract = peritonitis Fibrosis at heart = pericarditis Fibrosis in lungs

Scleroderma

Over activation of Tcell subtypes in skin by either - superantigens OR - lack of CTLA-4 (Tcell brakes)

Psoriasis

Which skin dz has biphasic Tcell responses during acute and chronic stages?

Atopic dermatitis

60y/o male complains of hemoptysis and hematuria. Lab test confirm presence of antibodies against glomerular basement membrane protein. What's his disease?

Goodpasture's

Which one is Type I? a. Pemphigus vulgaris b. Pemphigus foliaceus c. Goodpasture's d. Dermatitis herpetiformis e. Atopic dermatitis

Atopic dermatitis

A person has blisters all over body and tests positive for desmoglein 1 autoantibodies. What's his disease?

Pemphigus foliaceus

Dr. Vishy - Immune Skin Conditions Flashcards

(76 cards)