[PPT] Disorders of the Integumentary System

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Questions and Answers

What characterizes a fissure skin lesion?

  • Heaped-up, keratinized cells with flaky skin (correct)
  • Small blisters filled with clear fluid
  • Rough, red patches frequently oozing
  • Thickened epidermis from chronic irritation

Which condition is often characterized by lichenification?

  • Psoriasis
  • Contact dermatitis
  • Chronic dermatitis (correct)
  • Eczema

What role do Langerhans cells play in the epidermis?

  • They transmit immune signals from the epidermal surface. (correct)
  • They facilitate the healing of eczema.
  • They act as the primary barrier against pathogens.
  • They produce keratin for skin protection.

Which of the following is NOT typically a feature of inflammatory skin disorders?

<p>Excessive oil production (D)</p> Signup and view all the answers

What can modify the function of Langerhans cells in disease states?

<p>Aberrant signaling from the environment (D)</p> Signup and view all the answers

Which type of primary skin lesion is characterized by a small, flat spot without elevation?

<p>Macule (D)</p> Signup and view all the answers

What type of secondary skin lesion is formed from a loss of skin surface resulting in a shallow defect?

<p>Erosion (C)</p> Signup and view all the answers

Which of the following is a primary skin lesion that appears as a circumscribed, raised area often filled with fluid?

<p>Vesicle (A)</p> Signup and view all the answers

Which secondary lesion is characterized by an abnormal thickening of the skin?

<p>Keloid (C)</p> Signup and view all the answers

What describes a primary skin lesion that has elevated, irregular shapes and is transient in nature?

<p>Wheal (B)</p> Signup and view all the answers

What is the primary infectious cause of folliculitis?

<p>S.aureus (A)</p> Signup and view all the answers

Which type of secondary skin lesion involves a rough surface due to the accumulation of dead skin cells?

<p>Scale (A)</p> Signup and view all the answers

Which primary lesion is defined as a raised, palpable lesion with a diameter greater than 1 cm?

<p>Nodule (D)</p> Signup and view all the answers

What type of lesions are typically seen in folliculitis?

<p>Papules or pustules (B)</p> Signup and view all the answers

Which of the following is NOT a non-infectious cause of folliculitis?

<p>Bacterial infection (A)</p> Signup and view all the answers

What type of primary skin lesion is characterized by a large, flat area larger than 1 cm in size?

<p>Patch (B)</p> Signup and view all the answers

What factor contributes to the inflammation seen in folliculitis?

<p>Release of chemotactic factors (B)</p> Signup and view all the answers

Where are lesions most prominently found in cases of folliculitis?

<p>On the scalp and extremities (A)</p> Signup and view all the answers

Which treatment is effective for managing folliculitis?

<p>Topical antibiotics (A)</p> Signup and view all the answers

Which of the following factors is associated with the development of folliculitis?

<p>Prolonged skin moisture (C)</p> Signup and view all the answers

Which condition shares similar clinical manifestations with folliculitis?

<p>Impetigo (C)</p> Signup and view all the answers

Which of the following conditions are associated with papulosquamous disorders?

<p>Psoriasis (A), Pityriasis Rosea (B)</p> Signup and view all the answers

What is a primary characteristic of plaque psoriasis?

<p>Well-demarcated, erythematous plaques with silvery scale (C)</p> Signup and view all the answers

Which body parts are commonly affected by plaque psoriasis?

<p>Dorsal foot and elbows (D)</p> Signup and view all the answers

What mechanism contributes to the development of psoriasis?

<p>Keratinocyte hyperproliferation (C)</p> Signup and view all the answers

Which of the following is NOT classified under papulosquamous disorders?

<p>Acne Vulgaris (B)</p> Signup and view all the answers

Which factor is suspected to trigger the psoriatic response?

<p>Antigenic triggers (C)</p> Signup and view all the answers

What is a common feature of psoriatic nails?

<p>Dystrophy (D)</p> Signup and view all the answers

Which of the following best describes the appearance of psoriasis on the skin?

<p>Confluent red plaques with silvery scales (A)</p> Signup and view all the answers

What are dermatophytes primarily associated with?

<p>Fungal infections of the skin (D)</p> Signup and view all the answers

Which of the following best describes C.albicans?

<p>A fungal infection that penetrates the epidermal barrier (C)</p> Signup and view all the answers

Which of the following skin conditions has a high risk of developing into squamous cell carcinoma?

<p>Actinic keratosis (B)</p> Signup and view all the answers

What is Bowen's disease also known as?

<p>Squamous cell carcinoma in situ (D)</p> Signup and view all the answers

What is the primary characteristic of benign skin tumors like actinic keratosis?

<p>They can evolve into skin cancers. (C)</p> Signup and view all the answers

What primarily causes the superficial lesions associated with dermatophyte infections?

<p>Fungi thriving on keratin (D)</p> Signup and view all the answers

What is a clinical manifestation of candidiasis?

<p>Ulcers in the mouth and vagina (A)</p> Signup and view all the answers

What role does ultraviolet radiation play in skin health?

<p>It encourages the development of skin cancers. (A)</p> Signup and view all the answers

What is a characteristic feature of a papule?

<p>It is elevated, firm, and has a rough surface. (B)</p> Signup and view all the answers

What is the size limit for a macule?

<p>Less than 1 cm in diameter. (B)</p> Signup and view all the answers

Which primary skin lesion is characterized as an elevated, firm, circumscribed area less than 1 cm in diameter?

<p>Papule (B)</p> Signup and view all the answers

Which primary skin lesion resembles a papule but is larger and deeper?

<p>Nodule (C)</p> Signup and view all the answers

What defines a vesicle in terms of size and content?

<p>Elevated, filled with serous fluid, less than 1 cm. (B)</p> Signup and view all the answers

Which option is the best description for a tumor in relation to primary skin lesions?

<p>A solid mass of tissue that can be larger than 1 cm. (D)</p> Signup and view all the answers

What distinguishes a wheal from other skin lesions?

<p>It is elevated and often itchy, caused by an allergic reaction. (B)</p> Signup and view all the answers

Which of the following characteristics does NOT apply to a nodule?

<p>It is a flat, determined area of skin. (C)</p> Signup and view all the answers

What is the primary function of the integumentary system?

<p>Protects the body from external harm (B)</p> Signup and view all the answers

What constitutes the main component of skin, hair, and nails?

<p>Keratin (A)</p> Signup and view all the answers

Which cell type in the epidermis is responsible for absorbing ultraviolet light?

<p>Melanocytes (A)</p> Signup and view all the answers

What is the most significant role of Langerhans cells in the integumentary system?

<p>To present antigens and initiate immune responses (D)</p> Signup and view all the answers

Which layer of the skin is primarily composed of connective tissue?

<p>Dermis (B)</p> Signup and view all the answers

What percentage of the body's weight does the skin account for?

<p>20% (C)</p> Signup and view all the answers

Which of the following best describes the skin microbiome?

<p>A protective barrier against harmful bacteria (B)</p> Signup and view all the answers

What vitamin is produced in the skin as a response to sunlight?

<p>Vitamin D (C)</p> Signup and view all the answers

What type of dermatitis is characterized by skin inflammation and identified by pruritus and lesions with indistinct borders?

<p>Atopic Dermatitis (C)</p> Signup and view all the answers

Which hypersensitivity reaction is mediated by IgE and known as allergy?

<p>Type I (D)</p> Signup and view all the answers

Which secondary skin lesion is characterized by the formation of a thickened area of skin due to the accumulation of dead skin cells?

<p>Scale (D)</p> Signup and view all the answers

What is the primary characteristic of the subcutaneous layer of the skin?

<p>Consists of fat cells organized into lobules (B)</p> Signup and view all the answers

Which type of eczema is categorized as a Type IV hypersensitivity reaction?

<p>Allergic Contact Dermatitis (D)</p> Signup and view all the answers

Which of the following does NOT typically represent a secondary skin lesion?

<p>Plaque (A)</p> Signup and view all the answers

Which skin layer is primarily responsible for the presence of fibroblasts and mast cells?

<p>Dermis (D)</p> Signup and view all the answers

What is a common manifestation of dermatitis?

<p>Scaling (B)</p> Signup and view all the answers

What type of ultraviolet radiation is primarily responsible for causing sunburn?

<p>UVB (B)</p> Signup and view all the answers

Which type of skin cancer is classified as melanoma?

<p>Malignant melanoma (C)</p> Signup and view all the answers

What is the primary role of vitamin D in the body?

<p>Calcium homeostasis and bone health (D)</p> Signup and view all the answers

Which wavelength of UV light is responsible for converting 7-dehydrocholesterol into previtamin D3?

<p>300 nm (A)</p> Signup and view all the answers

How is the biologically active form of vitamin D, 1,25-dihydroxyvitamin D, produced?

<p>By hydroxylation in the kidney (C)</p> Signup and view all the answers

What potentially harmful effect does excessive exposure to UV radiation pose?

<p>Elevated risk of skin cancer (C)</p> Signup and view all the answers

Which of the following statements about vitamin D is true?

<p>Vitamin D requires exposure to sunlight for its production (B)</p> Signup and view all the answers

What happens to 25-hydroxyvitamin D as it circulates in the body?

<p>It requires hydroxylation in the kidney to become active (D)</p> Signup and view all the answers

What is the primary immune mechanism involved in atopic dermatitis?

<p>Type I hypersensitivity (B)</p> Signup and view all the answers

Which of the following is commonly associated with allergic contact dermatitis?

<p>Allergens like chemicals and metals (D)</p> Signup and view all the answers

What characterizes the lesions commonly seen in psoriasis?

<p>Silvery, elevated, well-demarcated erythematous lesions (A)</p> Signup and view all the answers

Which cytokines are notably involved in the activation of T cells in psoriasis?

<p>IL-12 and IL-23 (A)</p> Signup and view all the answers

What clinical manifestation is commonly observed in urticaria due to a type I hypersensitivity reaction?

<p>Wheals or hives (B)</p> Signup and view all the answers

In which demographic is atopic dermatitis most frequently observed?

<p>Infants and children (A)</p> Signup and view all the answers

What distinguishes allergic contact dermatitis from atopic dermatitis?

<p>Allergic contact dermatitis involves type IV hypersensitivity. (A)</p> Signup and view all the answers

Which of the following correctly describes a feature of papulosquamous disorders?

<p>They involve the development of papules and scales. (B)</p> Signup and view all the answers

Which mechanism contributes to the thickening of the skin in psoriasis?

<p>Altered differentiation and keratinocyte hyperproliferation (C)</p> Signup and view all the answers

Which of the following conditions is typically associated with asthma and allergic rhinitis?

<p>Atopic dermatitis (C)</p> Signup and view all the answers

What is the most common type of skin cancer?

<p>Basal Cell Carcinoma (C)</p> Signup and view all the answers

Which factor is primarily responsible for the increase in nonmelanoma skin cancer rates?

<p>UV radiation exposure (D)</p> Signup and view all the answers

How do basal cell carcinomas typically grow?

<p>Upward and laterally or downwards (A)</p> Signup and view all the answers

What is a characteristic feature of squamous cell carcinoma compared to basal cell carcinoma?

<p>It develops from premalignant lesions. (C)</p> Signup and view all the answers

What role do mutations in p53 tumor suppressor genes play in skin cancer?

<p>They lead to mutations in skin cells. (B)</p> Signup and view all the answers

Which skin cancer has the lowest mortality rate?

<p>Basal Cell Carcinoma (A)</p> Signup and view all the answers

What distinguishes melanoma in terms of its cellular origin?

<p>It arises from melanocytes. (C)</p> Signup and view all the answers

What is a typical appearance of basal cell carcinoma lesions?

<p>Nodular with depressed centers (A)</p> Signup and view all the answers

Which stage of melanoma indicates that it has not penetrated beyond the epidermis?

<p>In situ melanoma (D)</p> Signup and view all the answers

What symptom is commonly associated with suspicious nevi leading to melanoma?

<p>Uneven coloration (A)</p> Signup and view all the answers

What is the primary cause of acne vulgaris?

<p>Colonization of Cutibacterium acnes (C)</p> Signup and view all the answers

Which viral infection is characterized by an itchy, blistering rash lasting about 5-10 days?

<p>Varicella-Zoster Virus (D)</p> Signup and view all the answers

What is the mechanism behind Herpes Zoster (Shingles) occurring years after chickenpox?

<p>Activation of dormant virus (A)</p> Signup and view all the answers

Which bacterium is most commonly associated with folliculitis?

<p>Staphylococcus aureus (D)</p> Signup and view all the answers

What are the classic symptoms of cellulitis?

<p>Erythematous, warm, and painful swelling (C)</p> Signup and view all the answers

What skin infection is known for producing a honey-colored crust?

<p>Impetigo (B)</p> Signup and view all the answers

Which type of tinea infection specifically affects the feet and is commonly known as 'Athlete’s foot'?

<p>Tinea pedis (A)</p> Signup and view all the answers

What is the primary risk factor associated with developing cellulitis?

<p>Diabetes (C)</p> Signup and view all the answers

What is the main type of fungal infection that dermatophytes cause?

<p>Tinea infections (A)</p> Signup and view all the answers

Which ultraviolet radiation type is primarily responsible for the carcinogenic effects on skin cells?

<p>UVB (A)</p> Signup and view all the answers

What is the primary effect of ultraviolet light that penetrates the Earth's surface?

<p>Carcinogenic effects on skin cells (A)</p> Signup and view all the answers

What condition is characterized by active, vesicular eruptions followed by crusting?

<p>Chickenpox (A)</p> Signup and view all the answers

Which type of dermatophyte infection involves hair loss and is commonly referred to as 'ringworm of the scalp'?

<p>Tinea capitis (B)</p> Signup and view all the answers

What is the main function of Candida albicans in immunocompromised individuals?

<p>Pathogen switching from commensal to pathogenic (D)</p> Signup and view all the answers

Flashcards

Macule

A flat, circumscribed area that is a change in the color of the skin; less than 1 cm in diameter.

Papule

Elevated, firm, rough lesion with flat top surface, > 1mm in diameter.

Vesicle

Elevated, circumscribed, superficial; does not extend into dermis; filled with serous fluid; less than 1 cm in diameter.

Papule

Elevated, firm, circumscribed area less than 1 cm in diameter. Examples: Wart, elevated moles, lichen planus, fibroma, insect bite.

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Nodule

A solid, raised lesion larger than 1 cm in diameter.

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Nodule

A solid, raised lesion larger than 1 cm in diameter.

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Tumor

A solid, raised lesion usually greater than 2 cm in diameter.

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Nodule

A solid, raised lesion larger than 1 cm in diameter.

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Wheal

A raised, irregular-shaped area of cutaneous edema.

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Atrophy

A thinning of the skin that can cause wrinkling or depression.

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Lichenification

A thickened area of skin with exaggerated skin markings.

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Fissure

A type of skin lesion that involves abnormally thick, keratinized cells, often flaky, irregular in shape, and may be dry or oily. The size can vary.

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Langerhans Cells

Immune cells found in the epidermis that act as messengers for immune responses. They send signals about things like UV radiation, chemicals, and pathogens, helping to maintain a balance in the immune system.

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Contact Dermatitis

A common skin condition that involves the immune system, causing inflammation and itching. It's caused by a reaction to something like poison ivy, nickel in jewelry, or other allergens.

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Atopic Dermatitis

A chronic, inflammatory skin condition that causes dryness, itchiness, and often rashes. It's often associated with allergies and a weakened immune system.

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What is folliculitis?

Inflammation of the hair follicle, usually caused by bacteria, viruses, parasites, or fungi.

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What is S. aureus?

A common type of bacteria that often causes folliculitis.

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What is a furuncle?

A deep, painful infection of a hair follicle, characterized by a red, swollen, and painful bump.

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What is cellulitis?

A widespread inflammation of the skin, often caused by bacteria.

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What is impetigo?

A contagious skin infection caused by bacteria, usually Staphylococcus aureus or Streptococcus pyogenes.

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What is chickenpox?

A viral infection caused by the Varicella-zoster virus, characterized by itchy, fluid-filled blisters.

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What is shingles?

A reactivation of the Varicella-zoster virus, causing painful blisters along a nerve pathway.

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What is the Human Papilloma Virus (HPV)?

A group of viruses that cause warts, characterized by raised, rough growths on the skin.

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Papulosquamous Disorders

A group of skin disorders characterized by the development of papules, scales, plaques, and erythema.

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Plaque Psoriasis

A chronic, inflammatory skin disease characterized by well-defined, erythematous plaques topped with silvery scales.

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Keratinocyte Hyperproliferation

The rapid growth and shedding of keratinocytes, the main cells of the epidermis.

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Rapid Epidermal Turnover

The process where skin cells turnover at a faster rate than normal, resulting in a buildup of cells on the skin surface.

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Antigenic Triggers in Psoriasis

Antigenic triggers, such as infections, trauma, or stress, can initiate the immune response in psoriasis.

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DC Migration in Psoriasis

Dendritic cells (DCs) play a crucial role in psoriasis by migrating to the skin and presenting antigens to T cells, activating the immune response.

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Common Locations for Psoriasis

Psoriasis can appear on various body parts, with common locations including the elbows, knees, trunk, and scalp.

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Psoriatic Nail Dystrophy

Psoriatic nails can exhibit dystrophy, a deterioration of the nail structure, characterized by pitting, thickening, or discoloration.

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Tinea infections

Fungal infections of the skin caused by dermatophytes, which thrive on keratin and create superficial lesions.

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Dermatophytes

Fungi that inhabit keratinized tissues like skin, hair, and nails, and cause superficial infections.

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Candidiasis

A fungal infection caused by Candida albicans, often affecting mucous membranes like the mouth, vagina, penis, and skin.

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Actinic keratosis

A skin condition characterized by precancerous growths that can develop into squamous cell carcinoma.

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Nevus (mole)

A non-cancerous growth of melanocytes, appearing as a colored spot or bump on the skin.

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Basal cell carcinoma

The most common type of skin cancer, characterized by slow-growing, pearly or waxy bumps.

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Squamous cell carcinoma

A type of skin cancer that grows faster than basal cell carcinoma and can spread to other parts of the body.

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Melanoma

The most serious type of skin cancer, characterized by abnormal moles and rapid growth potential.

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What is skin?

The largest organ of the body, accounting for 20% of its weight. It is composed of three layers: the epidermis, dermis, and subcutaneous layer.

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What is the epidermis?

The outermost layer of skin, responsible for protection against microorganisms, ultraviolet radiation, and water loss. It is composed of keratinocytes, melanocytes, Langerhans cells, and Merkel cells.

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What is the dermis?

The layer of skin beneath the epidermis, containing connective tissue, blood vessels, nerves, hair follicles, and sweat glands. It provides structural support, flexibility, and insulation.

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What is the subcutaneous layer?

The deepest layer of skin, composed mainly of fat and connective tissue. It provides insulation, cushioning, and energy storage.

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What is keratin?

Insoluble protein that forms the main constituent of skin, hair, and nails.

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What is melanin?

A pigment produced by melanocytes in the skin, responsible for absorbing UV light to protect cells from damage.

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What are Langerhans cells?

Specialized dendritic cells found in the epidermis, they play a role in the immune response by presenting antigens to T cells.

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What are Merkel cells?

Sensory cells found in the epidermis, they are responsible for touch sensation.

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Reticulin

A type of loose connective tissue found in the dermis, it allows skin to stretch and contract, and contains structures like hair follicles, glands, vessels, and nerves.

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Subcutaneous Layer

The deepest layer of skin, primarily composed of fat cells (adipocytes) organized into lobules by collagen and blood vessels.

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Dermatitis (Eczema)

A general term describing skin inflammation, characterized by itching, lesions with blurry edges, and changes in the outermost skin layer.

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Allergic Contact Dermatitis

A type of dermatitis caused by an allergic reaction to something that touches the skin, such as poison ivy or nickel in jewelry.

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Hypersensitivity Reaction

An altered immune response to an antigen, resulting in disease or inflammation that harms the body.

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Type I Hypersensitivity (Allergy)

A type of hypersensitivity reaction triggered by IgE antibodies, leading to allergic reactions like hay fever or food allergies.

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Type II Hypersensitivity

A type of hypersensitivity reaction involving the body's own cells, like in autoimmune diseases.

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Type III Hypersensitivity

A type of hypersensitivity reaction involving immune complexes that deposit in tissues, as in rheumatoid arthritis.

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What is atopic dermatitis?

A chronic inflammatory skin condition characterized by itchy, red, and dry patches. It is often associated with allergies and a weakened immune system.

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What is allergic contact dermatitis?

A type IV hypersensitivity reaction caused by allergens like chemicals, metals, or plants. It involves a delayed immune response, leading to characteristic rashes and itching.

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What are urticaria (hives)?

A severe allergic reaction involving the release of histamine, causing hives, itching, and swelling. It is triggered by allergens such as drugs, foods, or environmental agents.

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What are papulosquamous disorders?

A group of skin disorders characterized by papules, scales, plaques, and erythema. Examples include psoriasis, pityriasis rosea, and lichen planus.

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What is psoriasis?

A chronic, autoimmune skin disorder causing thick, silvery plaques. It involves rapid skin cell turnover and inflammation, often affecting the elbows, knees, and scalp.

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What is plaque psoriasis?

The most common type of psoriasis, characterized by well-defined, raised plaques covered with silvery scales.

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What is keratinocyte hyperproliferation?

The rapid growth and shedding of keratinocytes, the main cells of the epidermis. This is a hallmark of psoriasis.

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What is rapid epidermal turnover?

The process where skin cells turnover at a faster rate than normal, resulting in a buildup of cells on the skin surface. This is a key feature of psoriasis.

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What are antigenic triggers in psoriasis?

Antigenic triggers, such as infections, trauma, or stress, can initiate the immune response in psoriasis. These triggers can vary from person to person.

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What is DC migration in psoriasis?

Dendritic cells (DCs) play a crucial role in psoriasis by migrating to the skin and presenting antigens to T cells, activating the immune response.

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UVA radiation

UV radiation that penetrates deep skin layers, contributing to long-term skin damage.

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UVB radiation

UV radiation that penetrates the skin's surface, causing sunburn and skin cancer.

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Vitamin D

A fat-soluble steroid hormone essential for calcium absorption and bone health.

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Vitamin D synthesis

The process where UV radiation converts 7-dehydrocholesterol in skin cells into previtamin D3, the precursor to vitamin D.

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1,25-dihydroxyvitamin D (1,25[OH2]D)

The biologically active form of vitamin D, essential for calcium absorption and bone health.

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UV Radiation and Skin Cancer

UV radiation exposure plays a significant role in the development of many skin cancers, including basal cell carcinoma and squamous cell carcinoma.

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Fitzpatrick Skin Types

The classification of sun-reactive skin types helps determine the risk of developing skin cancer. Individuals with skin types prone to sun sensitivity (Fitzpatrick skin types I-II) are at higher risk.

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What is Basal Cell Carcinoma (BCC)?

Basal cell carcinoma is the most common type of skin cancer, often appearing as a pearly or waxy bump. It typically grows slowly and rarely spreads.

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What is Squamous Cell Carcinoma (SCC)?

Squamous cell carcinoma (SCC) develops in the epidermis, the outer layer of skin. It is more likely to metastasize than BCC.

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What is the ABCD Rule?

The ABCD rule is used to identify potential signs of melanoma. It stands for Asymmetry, Border irregularity, Color variation, and Diameter greater than 6 mm.

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p53 Tumor Suppressor Gene in BCC

Basal cell carcinoma often arises from mutations in the p53 tumor suppressor gene. This gene plays a crucial role in preventing cell growth.

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p53 Tumor Suppressor Gene in SCC

UV radiation exposure promotes the mutations in the p53 tumor suppressor gene that can lead to squamous cell carcinoma.

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Mutations and Melanoma

Mutations that activate oncogenes (promote cell growth), inactivate tumor suppressor genes, and impair DNA repair genes can contribute to melanoma.

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Cutibacterium acnes shift

A shift in the type of Cutibacterium acnes bacteria, changing from a harmless resident to a harmful, potentially acne-causing species. This often occurs due to changes in the environment of the skin, like increased sebum production.

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Folliculitis

A skin condition characterized by inflamed hair follicles, often caused by bacteria like Staphylococcus aureus. These follicles become red, swollen, and may even produce pus.

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Cellulitis

An infection of the dermis and subcutaneous tissue, causing characteristic redness, warmth, swelling, and pain. Staphylococcus aureus, group A Streptococcus, and Streptococcus pyogenes are common culprits.

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Impetigo

A contagious bacterial skin infection commonly occurring in children, characterized by superficial blisters that rupture and form crusty scabs. Staphylococcus aureus and Streptococcus pyogenes are the primary bacteria involved.

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Chicken pox

A highly contagious viral infection caused by the Varicella-zoster virus, characterized by an itchy, blistering rash that typically affects the trunk, scalp, and face. The virus spreads through airborne droplets or close contact.

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Shingles

A reactivation of the Varicella-zoster virus, occurring after chickenpox, resulting in a painful, blistering rash along a nerve pathway. This typically occurs in individuals with weakened immune systems.

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Dendritic cell migration in psoriasis

Part of the immune system, dendritic cells are specialized cells that migrate to the skin and present antigens to T cells, activating the immune response in psoriasis.

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Study Notes

Integumentary System Overview

  • The integumentary system comprises skin and accessory structures.
  • Skin accounts for roughly 20% of the body's weight.
  • It's the largest organ of the body.
  • Primary functions include protection from microorganisms, UV radiation, fluid loss, and mechanical stress.
  • The skin microbiome is important for defense against pathogens.
  • Thermo-regulation of the body.
  • Involved in vitamin D synthesis
  • Touch and pressure receptors are present
  • Key accessory structures include hair, nails, and glands.

Epidermis Layers

  • Stratum corneum
  • Stratum lucidum
  • Stratum granulosum
  • Stratum spinosum
  • Stratum basale

Epidermal Cells

  • Keratinocytes: Main component of skin, hair, and nails.
  • Melanocytes: Produce melanin (pigment) that protects against UV radiation.
  • Langerhans cells: Specialized dendritic immune cells, migrate from bone marrow, present antigens to T cells.
  • Merkel cells: Sensory cells involved in touch.

Dermis Composition

  • Contains collagen, elastin, and reticulin connective tissue.
  • Allows the skin to stretch and contract.
  • Houses hair follicles, sebaceous and sweat glands, blood vessels, lymphatic vessels, and nerves.
  • Also includes fibroblasts, mast cells, and macrophages for wound healing.

Subcutaneous Layer

  • Composed of fat cells (adipocytes).
  • Provides insulation, cushioning, and energy storage.

Skin Lesions

  • Primary lesions: Initial changes in the skin.
    • Macule: Flat, circumscribed area of a change in color.
    • Papule: Elevated, firm, circumscribed lesion.
    • Plaque: Elevated, firm, rough, and flat-topped lesion.
    • Nodule: Elevated, firm, circumscribed lesion, deeper in the skin.
    • Vesicle: Elevated, circumscribed lesion filled with serous fluid (clear liquid less than 1cm).
    • Wheal: Elevated, irregularly shaped lesion, caused by edema.
    • Tumor: Mass of cells that can be benign or malignant.
    • Cyst: Encapsulated lesion filled with liquid or semisolid material.
  • Secondary lesions: Changes that occur in primary lesions.
    • Atrophy: Loss of skin thickness
    • Erosion: Loss of epidermis
    • Ulcer: Loss of epidermis and dermis
    • Lichenification: Thickening & roughening of skin, often due to chronic friction or scratching.
    • Scale: Layers of dead skin
    • Fissure: Linear crack or break
    • Scar: Area of fibrous tissue resulting from skin injury.
    • Keloid: Raised, fibrous scar tissue that extends beyond the original wound
    • Excoriation: Loss of epidermis through abrasion or scratching.

Inflammatory Skin Disorders

  • Dermatitis: General term for skin inflammation
  • Atopic ('allergic') Dermatitis: Chronic relapsing skin condition, mediated by IgE.
  • Allergic contact dermatitis: Type IV reaction due to allergen interaction with skin.
  • Non-allergic contact dermatitis: Non-immune response to irritant contact.
  • Stasis Dermatitis: Impaired vascular function
  • Seborrheic Dermatitis: Inflammatory skin condition of scalp or other parts of body.

Hypersensitivity Reactions

  • Type I: Allergic reactions, mediated by IgE.
  • Type II: Tissue-specific reactions, mediated by IgG or IgM antibodies.
  • Type III: Immune complex-mediated reactions.
  • Type IV: Cell-mediated (delayed) reactions.

Urticaria (Hives)

  • Episode of skin lesions (wheals and hives) caused by type I hypersensitivity to allergen.

Other Disorders

  • Psoriasis
  • Acne vulgaris
  • Acne rosacea
  • Lupus erythematosus
  • Lichen planus

Viral Skin Infections

  • Varicella-zoster virus: Causes chicken pox (varicella) and shingles (herpes zoster)
  • Herpes simplex virus: Causes cold sores and genital herpes.

Bacterial Skin Infections

  • Folliculitis: Infection of hair follicles.
  • Cellulitis: Infection of the dermis and subcutaneous tissue.
  • Impetigo: Superficial skin infection.

Fungal Skin Infections

  • Dermatophytes: Fungi that thrive on keratin
  • Tinea infections: Fungal skin infections categorized by location (e.g., Tinea capitis [scalp], Tinea pedis [feet]).
  • Candidiasis: Yeast infection of mucous membranes, skin

UV Radiation and Skin Cancer

  • Types of UV radiation are UVA, UVB, and UVC.
  • UV radiation causes DNA damage which can lead to skin cancer.
  • Types of skin cancers include basal cell carcinoma, squamous cell carcinoma, and malignant melanoma.

Vitamin D

  • Skin synthesizes vitamin D, a critical fat-soluble hormone, upon exposure to sunlight.
  • Crucial for bone health, calcium absorption, and several other bodily processes.

Skin Cancer

  • Exposure to UV radiation increases the risk of skin cancer.
  • Key risk factors include excessive sun exposure, tanning beds, and certain light sources.
  • Common types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma.
  • Early detection is crucial for treatment.

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