Skin Through the Ages

Question 1

At gastrulation, skin divides into what 3 layers:q

Answer 1

endoderm, mesoderm, ectoderm

Question 2

Ectoderm then divides into ectoderm and neuroectoderm (neural crest and neural tube)

Answer 2

truth

Question 3

What layers are formed from the ectoderm?

Answer 3

Stratum Basale, Stratum spinulosum, stratum granulosum, stratum lucidum (only on palms and soles), stratum corneum

Question 4

At week 6 of life in utero…

Answer 4

bilayered epidermis (periderm and basal layer)

Question 5

week 8

Answer 5

stratification begins, you get an intermediate layer and a basal layer

Question 6

Ectodermal dysplasias are

Answer 6

defects in hair, teeth, bone, skin

Question 7

Terminally differentiated epidermal layers exist by when

Answer 7

third trimester. Fillagrin is formed and the cell envelope is formed

Question 8

Defects at the third trimester lead to

Answer 8

Ichythosis…due to filaggrin mutations

Question 9

Melanocytes migrate from

Answer 9

neural crest

Question 10

Melanocytes originate where

Answer 10

neural crest

Question 11

What is piebaldism

Answer 11

defects in melanocyte migration lead to patches to of depigmentation where no migration takes place, its auto dominant

Question 12

What is Wardenburg syndrome

Answer 12

Defective survival of melanocytes leads to depigmentation patches. Also affects enteric ganglion cells which can lead to megacolon

Question 13

Hermansky Pudlack and Chediak Higashi syndrome

Answer 13

Ineffective transfer of melanosomes to keratinocytes leads to pigment dilution, this can also effect other processes that involve lysosome trafficking

Question 14

Pigmentary mosaicism is seen as

Answer 14

linear streaks or whorls, these develop along lines of blashko

Question 15

Incontinentia Pigmenti

Answer 15

x-linked dominant, failure in utero to males, some females can survive though they have ocular dental and CNS defects

Question 16

Dermis is derived from

Answer 16

both ectoderm and mesoder

Question 17

Dermal-Epiderma junction is not fully functional until>

Answer 17

12 weeks

Question 18

Barrier function of the skin is not developed until 3 weeks after birth

Answer 18

truth

Question 19

What is the body surface area to wt ration of babies versus adults

Answer 19

Five times greater

Question 20

What is the significance of this increased body surface area to weight ratio?

Answer 20

It means that absorption of topical medicines is greater and that premature infants have increased transepidermal water loss

Question 21

Lots of concerns in prematurity, involving the skin they are…

Answer 21

Greater transepidermal water loss, greater absorption of topical ointments, lower temperature, difficulty with fluid regulation, increased infection risk, thinner stratum corneum

Question 22

What is the vernix caseosa

Answer 22

its a protective membrane that is present at birth. Consists of epithelial cells, sebaceous secretions, shed hair

Question 23

What is cutis marmota?

Answer 23

It looks like a spiderweb like- pattern that is accentuated with temperature decrease, goes away when the baby os warmed up

Question 24

Mongolian spot

Answer 24

dark spot on the bottom, can be confused with bruises so may look like child abuse

Question 25

Salmon patch

Answer 25

little pink area on forehead

Question 26

Stork bite

Answer 26

red spot on the back of neck

Question 27

Erythema Toxicum neonatorum

Answer 27

benign pustules with a wheel around them, up to 50% of infants, resolves spontaneously

Question 28

Miliaria

Answer 28

due to overheating, leads to occlusion of eccrine glands. ITS A MILLION DEGREES IN HERE!

Question 29

Neonatal acne

Answer 29

Also called neonatal cephalic pustullosis, possibly due to maternal hormones

Question 30

Transient neonatal pustular melanosis

Answer 30

more common in african american kids, resolves spntaneously, often onvolves the hands and feet

Question 31

Sabhorreic dermatitis

Answer 31

cradle cap, self-limited

Question 32

Diaper dermatitis

Answer 32

several common causes: candida or irrittants

Question 33

If you see redness in the crotch region with satellite pustules around it, think:

Answer 33

candida

Question 34

Jaquet dermatitis

Answer 34

can be a sign of neglect. very red, almost ulcerative in the diaper area

Question 35

Atopic dermatitis is often associated with?

Answer 35

asthma and allergic rhinitis....."atopic march" | 60% presesnt within first year of life, 85% by year 5

Question 36

What kind of mutation is linked with early onset AD

Answer 36

filaggrin mutation

Question 37

What is the pathogenesis of Atopic dermatitis

Answer 37

There is a disruption of barrier function, some type of environmental stimulus, and immune dysregulation. Don't really know which comes first

Question 38

Look at the slide on the AD clinical presentation?

Answer 38

ok

Question 39

Main complications of atopic dermatitis?

Answer 39

staph aureus eczema herpeticum- explosive herpes simplex molluscum contagiosum

Question 40

Atopic dermatitis kids are at greater risk of what behavioral issues?

Answer 40

ADHD

Question 41

Atopic dermatitis also predisposes to

Answer 41

food allergens

Question 42

acne is what

Answer 42

a multifactorial disorder or the pilosebaceous unit

Question 43

Acne occurs where?

Answer 43

Where the densest population of sebaceous follicles are located: chest, back, face

Question 44

Hyperproliferation and abnormal differentiation of keratinocytes leading to plugging of the follicular infundibulum

Answer 44

acne vulgaris

Question 45

Excess sebum production occurs due to hormonal stimulation

Answer 45

truth

Question 46

The 4 phase pathogenesis of acne vulgaris is:

Answer 46

1) hyperproliferation and abnormal differentiation of keratinocytes which plugs up the follicular infundibulum 2) Excess sebum production due to hormonal stimulation 3) Presence of Propionibacterium acnes (gram positive rod that lives deep within the follicle) 4) Inflammation

Question 47

Two types of nodulocystic acne

Answer 47

Acne congloblata | Acne Fulminans- systemic infection (Acne Fuckminans)

Question 48

Follicular occlusion tetrad

Answer 48

Hidradenitis suppurativa Acne Conglobata Dissecting Cellulitis pilonidal cyst

Question 49

Scurvy

Answer 49

vitamin C deficiency,,,old person on tea and toast diet | They may have bleeding gums, corkscrew hairs, perifolicular hemorrhage

Question 50

Niacin deficiency

Answer 50

Pellagra- 3D's. Dimentia, Dermatitis, Diarrhea