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Dermatology > Skin Barrier > Flashcards

Skin Barrier Flashcards

(70 cards)

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1
Q

Name the functions of the skin (5)

A
  • Barrier
  • Sensory interface with external environment
  • Synthesis and storage
  • Self repair
  • Thermoregulation
  • Signalling
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2
Q

What are the types of barrier that skin provides? (5)

A
  • Physical
  • Chemical
  • Immunological
  • UV radiation
  • Water conservation
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3
Q

What synthesis and storage is the skin responsible for? (2)

A
  • Vitamin D

- Endocrine

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4
Q

What type of signalling is carried out by the skin? (3)

A
  • Visual
  • Chemical
  • Pheromones
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5
Q

What is the skin a physical barrier against? (5)

A
  • Pathogen entry
  • Mechanical injury
  • UV damage
  • Chemical damage
  • Excessive transepidermal water loss prevention
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6
Q

What percentage of body weight is the skin?

A

15%

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7
Q

What is the general principle of skin

A

Keeps outside out (damaging stimuli and agents) and inside (e.g excessive water loss) in

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8
Q

What does the skin protect?

A

Internal organs from wear and tear

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9
Q

What is the skin resistant to?

A

Internal and external forces

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10
Q

What is transepidermal water loss?

A

Normal, insensible loss of water through the skin

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11
Q

Why is transepidermal water loss limited?

A

Hydrophobic nature of keratin and lipids

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12
Q

What is a major factor in initial management of patients with extensive burns?

A

Dehydration

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13
Q

What is classified as a major burn?

A

Covers more than 20% of skin

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14
Q

What do major burns require?

A

Fluid resuscitation

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15
Q

What are the main dangers of skin damage?

A
  • Dehydration (most immediate)

- Pathogen entry

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16
Q

What does a burn’s disruption in the skin barrier depend on?

A
  • Depth of burn

- Size of burn

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17
Q

Label the keratin and lipid epidermal barrier

A

See notes for diagram

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18
Q

What do desmosomes provide in the keratin and lipid epidermal barrier? (2)

A
  • Mechanical strength of epidermis

- Contribute to water barrier

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19
Q

Why do desmosomes provide mechanical strength?

A

They are the strongest cell to cell connections

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20
Q

What occurs if there are genetic abnormalities in the desmosomes?

A

Skin barrier function is impaired

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21
Q

What also provides strength to the skin barrier aside from desmosomes?

A

Dermis with collagen

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22
Q

What does the epidermis sit on?

A

The basement membrane

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23
Q

What do keratanocytes begin as on the basement membrane?

A

Basal cells

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24
Q

Name the pathway of keratanocyte differentiation

A
  • Basal cell
  • Spinous cell
  • Granular cell
  • Corneocyte
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25
What do keratonycytes undergo as they become more superficial?
Differentiation
26
What creates new keratinocytes?
Mitotic division at regular intervals
27
What are the 2 types of granular cell?
- Keratohyaline granules | - Lamellar granules
28
What happens to keratohyaline granules?
- They accumulate protein keratin - As differentiation proceeds keratin aggregates into fibres to form a kertanised envelope below plasma membrane as cell dies
29
What are the "bricks" of the epidermal barrier?
Kertatinous "bricks" of corneocytes surrounded by cell membrane
30
What are the kertatinous "bricks" of corneocytes surrounded by cell membrane formed by in the epidermal barrier?
Aggregation of keratin into highly interlinked fibres
31
What is the "mortar" of the epidermal barrier?
Intercellular lipid lamellae "mortar"
32
What is the intercellular lipid lamellae "mortar" in the epidermal barrier formed by?
Lamellar granules exocytosing into intercellular space
33
What is the intercellular lipid lamellae "mortar" in the epidermal barrier made up of? (3)
- Phospholipids - Ceramides - Sterols
34
How do we know that some proteins and enzymes exocytosed by lamellar granules play important roles in barrier function? (2)
When missing: - Skin fragility syndromes - Ichthyosis
35
What is the microbiome barrier?
Commensal microorganisms on and in skin include bacteria that have coevoled with humans and compete with potential pathogens
36
What do keratinocytes regulate in the microbiome barrier?
The composition of the microbial community
37
What influences the composition of the microbiome barrier? (6)
- Host physiology - Environment - Immune system - Host genotype - Lifestyle - Pathobiology
38
What is the most superficial barrier?
The microbiome barrier
39
What factors of host physiology influence the composition of the microbiome barrier? (3)
- Sex - Age - Site
40
What aspects of the environment influence the composition of the microbiome barrier? (2)
- Climate (hot/dry) | - Geographical location
41
What aspects of the immune system influence the composition of the microbiome barrier? (2)
- Previous exposures | - Inflammation
42
What part of host genotype influences the composition of the microbiome barrier?
Suspectibility genes e.g filaggrin
43
What 2 aspects of lifestyle influence the composition of the microbiome barrier? (2)
- Occupation | - Hygiene
44
How does pathobiology influence the composition of the microbiome barrier? (2)
Underlying conditions e.g diabetes
45
How does skin microbiota vary in the same individual?
Local environment e.g between areas of the body
46
Why do obese people have more of a variety of skin microbiota?
More skin folds
47
What type of barrier is the microbiome barrier?
A living first response barrier
48
What signals does the microbiome barrier transmit?
Potential pathogens to the immune survelliance system in skin
49
What does the microbiome barrier shape? (2)
- Regulatory immune response | - Development of tolerance
50
What pathogen does staphylococcus epidermidis protect against in the microbiome barrier?
- Staphylococcus aureus
51
How does staphylococcus epidermidis protect against staphylococcus aureus in the microbiome barrier? (2)
- Secretes a serine protease that inhibits its growth and biofilm formation - Stimulates keratinocytes to secrete antimicrobial peptides to specifically inhibit its survival
52
Name a commensal bacteria in the microbiome barrier
Staphylococcus epidermidis
53
What is the breakdown of commensal microbial community associated with?
Breakdown of skin barrier functions e.g atopic dermatitis
54
What is atopic dermatitis a form of?
Eczema
55
What does the epidermis contain in the immune barrier that aids in immune response?
- Keratinocytes and resident immune cells | - Langerhans cells
56
What are Langerhans cells?
Antigen presenting cells activating T cells forming adaptive immune response
57
What do keratinocytes have that allows them to carry out an immune response?
Passing recognition receptors that recognise lipids on bacteria
58
What is released by keratinocytes in the immune response>
Interleukin, triggers cytokine production
59
What does the interleukin released by keratinocytes in the immune response do?
- Triggers cytocrine production | - Recruits neutrophils from the bloodstream
60
What could recruiting neutrophils from the bloodstream cause?
They move into the skin and could cause abscess
61
What does the dermis contain in the immune barrier that aids in immune response? (6)
- Mast cells - Macrophages - Dendritic cells - B and T cells - NK cells - Plasma cells
62
What type of pH does skin have?
Acidic
63
What 2 things maintain skin acidity?
- Sweat acidity | - Triglyceride conversion to fatty acids
64
What are the purposes of sweat? (3)
- Maintains acidity of skin - Keeps it moist - Thermoregulation
65
Why is it important for the physical barrier properties of the epidermis for skin to have an acidic pH?
Lipids controlling transepidermal water loss made by enzymes needing acidic pH
66
How does acidic pH influence microbial barrier function?
Inhibits pathogen growth e.g S aureus
67
What would be the consequences of increasing skin pH from 5.5 to 6.5 in the microbial barrier?
Decreases efficacy of antimicrobial peptide dermcidin by 40%
68
What effects on the skin does vitamin D synthesis have? (7)
- Keratonycte differentiation and proliferation - Anti-microbial effects - Sebaceous gland regulation - Photoprotection - Adaptive immunity - Wound healing - Hair follicle cycling
69
What skin disoders has vitamin D deficiency been linked to? (5)
- Skin cancer - Acne - Hair loss - Atopic dermatitis - Photodermatoses
70
Label Kandel skin diagram
See notes

Dermatology (12 decks)

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