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list the layers of the epidermis, from outermost to inner most:
horny cell layer
granular layer
stratum spinosum
basal layer and melanocytes
what layer of the skin are fibroblasts located?
dermis
list the characteristics of melanocytes
have dendrites
different people have the same amount of melanocytes but different amounts of melanosomes
protects the cells from UV light.
what is the average area of skin in adults?
1.6 m^2
what is the pH of the skin?
5.5
what are the 3 glands in the skin?
eccrine gland, apocrine gland, sebaceous gland
what is synthesized in the skin?
vitamin D and various cytokines (IL-1, 3, 6, 8, INFalpha and beta)
what cytodifferentiation is keratinization?
cytodifferentiation of bsasal cells to stratum corneum (horny cell layer)
how many layers are there of dead keratinocytes in the horny cell layer?
10
in the granular cell layer, what is the characteristic of granules in the cells?
basophilic
which layer of the epidermis has well-developed desmosomes?
spinous cell layer (stratum spinosum)
what are the 2 types of melanin and what color are they?
eumelanin (black) and phomelanin (yellow)
what stimulates melanin synthesis?
ACTH, MSH, thyroid hormone, estrogen, UV ray, X ray
what white blood cell resides in the epidermis?
langerhans cells (they migrate to lymph nodes one they are exposed to an antigen)
what cell resides in the basal cell layer and responsible for sensing stimuli?
merkel cell
what does the eccrine glands secrete?
sweat
what part of the body has the highest density of eccrine glands?
palms and soles
what are the 2 types of secretory cells in the eccrine gland?
clear cells and dark cells
where are apocrine glands found?
axillae, areola, nipples, perianal region, external genitalia.
how does apocrine secretion gain odor?
when it is secretes it is odorless, but when it reacts with the bacteria on the skin, it gains an odor.
where does the apocrine excretory duct open up to?
hair follicle
what is decapsulation secretion?
when the substance is secreted from the “head” of the cells of the secretory gland. Apocrine glands undergo decapsulation.
what are the components of a hair follicle?
sebaceous gland, arrector pili muscle, hair bulge
what are the 3 phases of the hair cycle?
anagen (growth), catagen (transition), telogen (rest)
what sensations are sensed by the Meissner’s corpuscle?
light touch
what sensations are sensed by the Ruffini corpuscle?
sense and control of finger position and movement
what sensations are sensed by the Vater-pacinian corpuscle?
vibration and pressure
what sensations are sensed by the krause’s corpuscle?
cold temperature
what type of secretion is the sebaceous gland?
holocrine secretion
what type of secretion is eccrine glands?
merocrine secretion (exocytosis and diacrine)
what are the 3 stages of wound healing?
inflammation, tissue growth, remodelling
what is a decubitus ulcer?
Decubitus ulcers occur when there is prolonged pressure on specific areas of the body that are susceptible to friction and shear force injuries.
how is a decubitus ulcer rated?
DESIGN-P (depth, exudate, size, inflammation/infection, granulation tissue, necreotic tissue, pocket)
list examples of primary lesions
erhythema, telangiectasia, wheel, purpura, macule, papule, nodule, tumor, cyst, abscess, bulla, pustule
list examples of secondary lesions
erosion, ulcer, scale, crust, etc.
what is auspitz’s sign?"
pinpoint bleeding of the skin after scratching the skin off
what diseases are auspitz’s sign positive?
psoriasis
what is darier’s sign and what condition is darier’s sign positive?
2-5 mintues after rubbing or stroking a lesion, erythema and a wheel formation occurs. A sign of mastocytosis (urticaria pigmentosa) and malignancies
list 4 diseases that are Nikolsky’s sign positive
pemphigus vulgaris
staphylococcal scalded skin syndrome
stevens-johnson syndrome
toxic epidermal necrolysis
what skin test is useful for distinguishing between erythema and purpura?
diascopy (tumbler test)
drug lymphocyte stimulation test requires a blood sample. true or false?
true
what test should be done for a patient with polymorphous light eruption?
measurement of minimal erythema dose
atopic dermatitis shows an elevation of Ig ( )
E
what is the treatment of atopic dermatitis?
topical steroids
what disease is white dermographism seen?
atopic dermatitis
what type of hypersensitivity is allergic contact dermatitis?
type 4
neutrophilic dermatosis is associated with what diseases?
rheumatoid arthritis
myelodyplastic syndrome
ulcerative colitis
what are the clinical findings of sweet syndrome?
high fever, pain, tender plaque and nodules, leukocytosis
what are the side effects of systemic steroids?
weight gain, sleep disturbances, infection, peptic ulceration, osteoporosis
what is the pathogenesis of sweet syndrome?
dermal neutrophilic infiltration
what virus is reactivated in drug-induced hyperactivity syndrome?
HPV6
what are the treatments of psoriasis?
UV light, topical corticosteroids, cyclosporine, biologic agents
what are clinical findings of paoriasis?
nail pitting, arthritis, scales on the scalp
what disease is known for its christmas tree appearance?
pityriasis rosea gibert
what is the B-cell surface marker?
CD20
where are keloids most frequently seen?
chest, ear, shoulder
syphilis can cause baldness. true or false?
true
SLE patients present with a mask-like face. true or false?
false. butterly rash
what are the 5 types of psoriasis?
psoriasis vulgaris
guttate psoriasis
pustular psoriasis
psoriatic erythroderma
psoriatic arthritis
what is Kobner phenomenon?
when additional psoriasis occurs on non-lesional skin after injury on the site.
what are the causes of Lichen Planus?
drugs (antihypertensivee, antitubercular, cerebral excitometabolic)
hepatitis C
dental metals
how is Pityriasis rosea Gibert treated?
it heals spontaneously in 1-3 months, but topical steroids are also used.
what are the risk factors of palmoplantal pustulosis (PPP)
history of smoking, baccterial infection (tonsillitis), dental caries, dental metal allergies
what is the appearance of seborrheic keratosis?
sharply demarcated, grayish-brown to blackish-brown nodules, 1-2cm in diameter.
what is Leser-Trelat syndrome, and what is it a sign of?
seborrheic keratosis occuring rapidly in multiple itchy lesions on the whole body.
it can be a sign of internal malignancy
what is the most common site of keloids?
ear, shoulder, upper part of trunk
how are keratoacanthomas treated?
it heals spontaneously in several months.
what stain is used for epithelial tissue?
cytokeratin
what is the treatment of alopecia areata?
topical steroids and PUVA
what underlying health problems can cause alopecia?
endocrine abnormalities, infections (syphilis, leprosy, tinea capitis), collagen disease (SLE, DLE, SSc, morphea), trichotillomania.
what is the most common cause of erysipelas?
groups A (beta-hemolytic) streptococcal infections
what is the most common cause of impetigo contagiosa?
staphylococcus aureus and group a strep
what is the treatment of erysipelas?
penicillin or cephem antibiotics
what is the treatment of impetigo?
cephem antibiotics
what is the difference between furuncle and carbuncle?
furuncle only involved one hair follice. carbuncle spreads to multiple hair follicles
what are the 5 types of acne?
comedones, folliculitis, papules, pustules, superficial pus-filled cysts.
what sign is positive in staphylococcal scalded skin syndrome?
nikolsky’s sign
what are the most common types of tinea?
tinea pedis, tinea capitis, tinea corporis, tinea cruris, tinea unguium
what test is used to diagnose tinea?
KOH test
what can acanthosis nigricans be a sign of?
malignant tumor, especially stomach cancer
what types of diseases can clubbed finders indicate?
idiopathic pulmonary fibrosis, lung cancer, liver cirrhosis, cyanotic congenital heart disease, etc.
what can cause pruritis cutaneous?
underlying systemic disease (liver dysfunction, renal failure, diabetes mellitus, malignancy tumors)
describe the 6 types of eczema
atopic dermatitis (repeating eczema for more than 6 months, elevated IgE)
contact dermatitis (eczema is localized to the site of extrinsic stimulation by a foreign substance)
seborrheic dermatitis (erythematous lesions and yellowish scales where sebum is actively secreted, such as the scalp)
nummular/discoid eczema (round and large plaque on the lower leg)
stasis dermatitis (plaques on the lower thigh and varicose veins. caused by poor blood circulation due to obesity or sedentary lifestyle)
asteatotic eczema (skin dryness caused by decrease in sebum with aging or excess washing)
what are underlying associations of neutrophilic dermatosis?
myoproliferative diseases, autoimmune diseases, G-CSF usage, visceral malignancies
what is the cause of pemphigus vulgaris?
autoantibodies against Dsg3
what sign is positive in pemphigus vulgaris?
nikolsky’s sign
what is the cause of pemphigus foliaceus?
autoantibodies against Dsg1
list 5 diseases that show nikolsky’s sign
steven johnson syndrome
toxic epidermal ncrolysis
SSSS
pemphigus vulgaris
pemphigus folicaceus
what are the skin lesions of neurofibromatosis type 1?
cafe-au-leit spots
neurofibroma
what diseases are caused by antibodies against desmosomes?
pemphigus vulgaris and pemphigus folicaceus
what diseases are caused by antibodies against hemidesmosomes?
pemphigoid gestationis and bullous pemphigoid
what is dermatitis herpetiformis duhring caused by?
IgA depositions
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