- flat area of color change - bigger than 1cm

- discrete, solid elevated body - less than 1cm

Unit 3 Lectures Flashcards by Megan Kalata

What is the top problem associated with disability-adjusted life years?

dermatitis

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What is the correct order of the following layers of epidermis?
stratum granulosum, stratum spinosum, stratum corenum, stratum basalis

stratum corneum
stratum granulosum
stratum spinosum
stratum basalis

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The stratum spinosum contains adhesion complexes called ___________

desmosomes

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Name some functions of the skin (7)

decoration/beauty
barrier (physical, light, immunologic)
vitamin D synthesis
water homeostasis
thermoregulation
insulation/calorie reservoir
touch/sensation

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(Eumelanin/pheomelanin) is not as effective at blocking UV ligth

pheomlanin

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In lighter skin, melanocytes are (smaller/larger) and distributed (in clusters/individually) throughout the (cytoplasm/nucleus)

smaller, clusters, nucleus

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___________ is an autoimmune disorder against the melanocyte

vitiligo

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T/F: There is no genetic defect in tyrosinase in vitiligo

true

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Vitamin D is taken up through the diet and converted to _________ in the __________

calcidiol, liver

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Vitamin D gets converted from calcidiol to _________ in the _________

calcitriol (active form), kidneys

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Hemidesmosomes are the attachment point of the ___________ to ___________

basal cells, basal lamina of the dermal-epidermal junction

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Bullous pemphigoid is caused by….

autoantibodies to BP180 or BP230, leads to sub epidermal blisters (hemidesmosomes not attaching dermis to epidermis)

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Bullous pemphigoid is (acquired/inherited)

acquired

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Epidermolysis bullosa is an (acquired/inherited) blistering disorder due to a lack of ___________

inherited

simplex: keratin 5 or 14
junctional: collagen XVII or laminin 5
dystrophic: collagen VII

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Desmosomes attach _________ to ____________

keratinocytes to each other

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Pemphigus vulgaris is due to acquired antibodies to _____________, leading to flaccid bulla

desmosomes (desmoglein 1, 3)

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Cells in what epidermal layer start to lose their nuclei?

stratum granulosum

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Keratohyalin granules contain ____________ that cross-links keratin

filaggrin

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Breakdown of filaggrin forms ___________________

natural moisturizing factor

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Loss of function filaggrin mutations lead to ____________ and ___________, which result in decreased NMF levels and increased transepidermal water loss

icthyosis vulgaris

- atopic dermatitis

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What is the role of Langerhans cells?

participate in cell-mediated immunity as APCs

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Where is the stratum lucidum present?

thick skin (between stratum corner and stratum granulosum), reduces friction

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patch

flat area of color change

- bigger than 1cm

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papule

discrete, solid elevated body

- less than 1cm

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plaque

- solid, flat-topped elevated area of skin | - greater than 1cm

nodule

- firm, well-defined lesion | - greater than 1cm (bigger papule)

vesicle

- fluid-filled cavity or elevation within/below epidermis | - less than 1cm

bulla

-fluid-filled vesicle greater than 1cm

pustule

- circumscribed elevation with pus | - less than 1cm

telangiectasia

-visible, persistant dilation of small, superficial cutaneous blood vessels

Petechiae are (blanching/non-blancing) pinpoint spots due to ____________

non-blancing, tiny hemorrhages

The dermis provides the major ___________ of the skin

tensile strength

What is the pattern of collagen?

Gly-X-Y X = proline Y = hydroxyproline

What collagen type is a large part of the fetal dermis?

Collagen type III

Procollagen is synthesized within __________ and excreted extracellularly

fibroblasts

Procollagen is cleaved enzymatically into ___________

tropocollagen

Cross-linking of tropocollagen depends on __________

vitamin C

What are some key findings of scurvy?

- keratotic plugging of hairs - corkscrew hairs - perifollicular hemorrhage - hemorrhagic gingivitis

Ehlers-Danlos syndrome is an (acquired/inherited) disorder of erroneous ___________ synthesis

inherited, collagen

What is a histologic clue for diagnosis of solar elastosis?

basophilic (blue) material within superficial dermis

Pseudoxanthoma elasticum is caused by a defect in the ______ gene and results in...

MDR gene; calcified, brittle elastic fibers

Ground substance is "glued together" with __________

fibronectin

Vasculitis is caused by....

inflammation of capillaries and venules

Type A nerve fibers are (myelinated/unmyelinated) and conduct _______________ sensations

myelinated - alpha: proprioception - beta: touch - gamma: stretch receptors - delta: pain initation

Type B nerve fibers are (myelinated/unmyelinated) and conduct _______________ sensations

unmyelinated | -diffuse, dull (temperature, itching)

Finasteride inhibits _____________ to prevent androgenic hair loss

5-alpha-reductase

Eccrine glands are vital to _______________

thermoregulation

Miliaria is an (acquired/inherited) disorder of ___________ function

acquired, eccrine | -tube carrying sweat ruptures

Anhidrotic ectodermal dysplasia involves a mutation in the ____ gene, leading to aberrant _________ development and (increased/decreased) sweating

EDA, eccrine, decreased

Sebaceous glands produce _____________ secretions

holocrine

Seborrheic dermatitis is associated with _____________ (neurological disorder)

Parkinson's

Acanthosis nigricans is most often associated with...

diabetes mellitus (obesity, endocrinopathies, etc.)

What are some symptoms of ineffective endocarditis?

- splinter hemorrhage in nails - janeway lesions (bruise-like, not painful) - Osler nodes (inflamed blood vessels, painful) - Roth spots (retinal hemorrhage)

Skin tightening around the mouth ("lost smile") is associated with....

systemic scleroderma

What immune findings are associated with systemic scleroderma?

- anticentromere antibody | - anti-scl70 (systemic)

An itchy rash, mouth sores, and being Dutch are associated with ___________

lichen planus

Prevalence of _____________ is 2-13.5 fold higher in patients with lichen planus than controls

hepatitis C

A middle-aged African American woman has a chest x-ray with bilateral lymphadenopathy. What is a likely diagnosis?

sarcoidosis

Porhyria cutanea tarda is caused by a deficiency in uroporhyrinogen decarboxylase and associated with __________

hepatitis

Porhyria cutanea tarda is treated with _____________

phlebotomy

50-70% of patients with __________ have an underlying associated condition

expanding ulcers

Surgery and debridement should be avoided for __________. Instead, most respond to __________

expanding ulcers; IVIg

What are skin symptoms of lupus?

malar rash, discoid rash, oral ulcers, photosensitivity

Where is stasis dermatitis often seen?

lower extremity (due to venous insufficiency)

How does the morphology of dermatitis and cellulitis differ?

dermatitis: erythematous papules, thin plaques with scale cellulitis: warm, tender erythematous patches or plaques

What is the location of inflammation for dermatitis?

epidermis, dermis

What is the location of inflammation for cellulitis?

dermis, subcutaneous tissue

Bilateral lower extremity edema and rash is associated with __________ and unilateral rubor, calor, tumor, and dolor are associated with ___________

stasis dermatitis, cellulitis

What is the diagnostic criteria for atopic dermatitis?

itchy skin + (2)... - history of involvement of skin creases - onset under age 2 - personal history asthma or hay fever - history dry skin - flexural eczema

Ichthyosis vulgaris involves a problem with _________ and is present in 70% of people with atopic dermatitis

filaggrin

T/F: Irritant-contact dermatitis is an immunologically-mediated reaction resulting from a direct cytotoxic effect

false (not immunologically-mediated)

Allergic contact dermatitis is a type IV, _______________ reaction

delayed-type hypersensitivity

In allergic contact dermatitis, ___________ cells present allergen to T cells and _________ produce the ACD response

langerhans, IL-1 and TNFalpha (inflammatory cytokines)

Drug eruptions are usually type IV _____________

cell-mediated hypersensitivity

Urticaria is characterized by _________ and _________

hives, wheals

Urticaria is a type ___ hypersensitivity reaction and is mediated by ___ antibodies

I (immediate), IgE

The largest cause (72%) of chronic urticaria is _________

idopathic/autoimmune

Nummular dermatitis is caused by ____________ and most often occurs on the _______

excess use of soap + dry skin, legs

Cradle cap is an example of ______________

seborrheic dermatitis

Seborrheic dermatitis occurs in areas rich in _________ glands

sebaceous (scalp, face, ears, chest)

Seborrheic dermatitis is caused by an overproduction of skin oil and an irritation from yeast called ______________

malassezia furfur

Psoriasis histology shows a hyperproliferation of the ___________

epidermis

Guttate is a subtype of ________ that is associated with _________

psoriasis, strep throat

What are some comorbidities of psoriasis?

insulin resistance, obesity, metabolic syndrome, CVD

Where is seborrheic dermatitis most commonly found?

scalp

Where is psoriasis most commonly found?

extensors

Atopic dermatitis is associated with __________ and _________

allergic rhinitis, asthma

Eccrine sweat glands are found in the __________ dermis

reticular

Another word for acrochordon is...

skin tag

Dermatofibromas are found mostly on the _________

legs (papules, fibroblasts)

A rapid increase in size or number of seborrheic keratoses is a sign of _____________

Leser-Trelat

Cherry angiomas and hemangiomas are __________ tumors

vascular

What skin tumors have malignant potential? (4)

- seborrheic keratosis - dysplastic nevi - familial atypical mole and melanoma syndrome - congenital nevi (rare)

Glucose is the preferred food source for ___________

candidiasis

Gram _________ bacteria stains violet due to layer of peptidoglycan in cell walls

positive

Dermatophytes are fungi that "eat" ____________

keratin

Match... epidermophyton most common in US microsporum "socks and jocks" trichophyton tinea carpers from a cat

epidermophyton - "socks and jocks" microsporum - tinea carpers from a cat trichophyton - most common in US

Is miliaria inherited or acquired?

acquired

_______________ involves a mutation in the EDA gene

anhidrotic ectodermal dysplasia

acanthosis nigricans involves a proliferation of ____________

epidermal keratinocytes and dermal fibroblasts

nummular dermatitis occurs because _________ production decreases as you age

filaggrin

Infantile hemangioma can be treated with _________________

beta blockers

Keratoacanthoma is a type of _______

SCC

SCC in situ (Bowen's disease) is induced by _______

HPV

_________ and __________ are found in the stratum spinosum

keratinocytes, Langerhans cells