Derm Patho

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Derm Patho
2013-12-08 00:22:55
Exam 3
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  1. 5 layers of epidermis
    o basalis, spinosum, granulosum, lucidium + corneum
  2. 5 layer functions of epidermis
    • basalis –skin regenerates
    • spinosum –largest
    • granulosum –has granules  
    • lucidium –very thick (prominent in palms + feet)
    • corneum –gets dislocated
  3. melanin formed by...
    Melanin is formed within the melanosomes of the melanocytes by conversion of tyrosine to dopa through tyrosinase. Dopa is hydroxylated to melanin.
  4. Birbeck Granule
    • In a langerhan 
    • rod-shaped and attached to a vesicle at one end giving a characteristic tennis racquet appearance
  5. Dermis compostion
    • ELASTIC fibers
    • nerves
    • appendageal structures
  6. 4 skin adnexa
    • Hair follicles
    • Sebaceous glands
    • Eccrine sweat glands
    • Apocrine sweat glands
  7. Papule:
    • elevated, solid area, up to 5mm
  8. Macule:
    • flat, circumscribed area of any size distinguished from surrounding skin by discoloration.
  9. Nodule:
    • elevated, solid area, >5mm diameter.
  10. Plaque:
    • elevated, flat-topped area, usually >5mm diameter.
  11. Vesicle
    • fluid-filled raised area, up to 5 mm diameter.
  12. Pustle
    • discrete
    • pus filled raised area
  13. Licheanification
    • rough and irregular
    • due to chronic rubbing on skin
    • treek bark
  14. Scaling
  15. Crusting
    • Vesicle has eroded
  16. Dyskeratosis:
    • abnormal keratinization occurring prematurely in cells below stratum granulosum.
    • malignancy? like keratoma
  17. Acantholysis:
    • loss of intercellular connections between keratinocytes
    • start to break apart and separate
  18. Spongiosis:
    epidermal intercellular edema
  19. Acanthosis:
    diffuse epidermal hyperplasia
  20. Erosion:
    discontinuity of the skin with incomplete loss of the epidermis. 
  21. Ulceration
    • discontinuity of the skin with complete loss of the epidermis and often of portion of the dermis and subcutis
  22. Hyperkeratosis:
    • thickening of the stratum corneum by abnormal keratin
  23. Parakeratosis:
    • retention of nuclei in stratum corneum
  24. Lentiginous:
    • linear pattern of melanocyte proliferation within the epidermal basal cell layer
    • dark area on basal cell layer
  25. Inflammatory Dermatoses
    • Mediated by local or systemic immunologic factors.
    • Acute lesions: (days to weeks) inflammation (mononuclear cells), edema, epidermal and vascular injury.
    • Chronic lesions: (months to years) significant alteration in epidermal growth (atrophy or hyperplasia), or dermal fibrosis.
  26. Urticaria: Acute dermatosis
    • Common.
    • Unknown cause in majority of cases.
    • Pruritic edematous plaques and papules called wheals.
    • Angioedema; closely related, deeper edema of dermis and subcutaneous fat.
    • All ages, mostly 20-40 years old.
    • Lesionsdevelop and fade within hours (<24 hrs). Episodes can last days or months.
    • Develop on sites exposed to pressure such as trunk and distal extremities.
  27. What is erthema multiforme assocatied with?
    • 1. Infections: herpes simplex, mycoplasma, histoplasmosis, coccidiodomycosis, typhoid, leprosy.
    • 2. Drugs: sulfonamides, penicillin, barbiturates, salicylates, hydantoins and antimalarials.
    • 3. Malignant disease
    • 4. Collagen vascular disease
  28. erythema mulitiforme
    • multiform lesions:macules, papules, vesicles and bullae 
    • symmetrical on both extremities.
  29. Steven Johnson Syndrome
    • extensive febrile form of the disease--
    • Hemorrhagic crusts involve the lips and oral mucosa
    • might involve conjunctiva, urethra, genital and perianal areas.
    • May result in life-threatening sepsis.
  30. Toxic epidermal necrolysis
    a severe variant , diffuse necrosis and sloughing of cutaneous and mucosal epithelial surfaces, producing a clinical picture analogous to extensive burn.