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WVSOM - Immunity

Skin Immune System & Dermatologic Diseases

Role of langerhans cells in the skins defenses Antigen presenting cells (APCs)
What specific molecules allow Langerhans cells to act as APCs? MHC-I, MHC-II, CD40 (co-stimulatory molecule), CAMs (adhesion molecule), B7
How do keratinocytes partake in the immune response? Induced to express MHC-I, MHC-II, CAM (adhesion molecule), cytokine production (IL-1,6,8, TNF = pro-inflammatory), produce prostaglandins
What is allergic contact dermatitis? Inflammatory skin disease caused by cell-mediated hypersensitivity to external agents that contact skin (ex: poison ivy)
Term used to describe antigen that contacts skin and become immnunogenic Hapten
Role of LC in allergic contact dermatitis LC transports antigen via vascular to lymph, presents antigen to T cells
Process whereby T cells are activated and memory T cells are formed when first encountering antigen Sensitization
Cause of erythema in allergic contact dermatitis Mast cell degranulation due to sensitized antigen activating memory T cells, cytokines
Treatment for allergic contact dermatitis Topical steroids, education (avoid contact allergin) - skin testing (patch testing) = type IV
Sensitization takes _____ days 10-14
Types of immunobullous diseases Bullous pemphigoid, pemphigus, dermatitis herpetiformis
Which immunobullous disease is most serious? Pemphigus
Histaological location of bullous pemphigoid Junction btw dermis and epidermis
Etiology of bullous pemphigoid Ab against keratinocyte Ag
Immunobullous disease most common in > 60 years old Bullous pemphigoid
Bullous pemphigoid treatment Corticosteroids
Clinical presentation of bullous pemphigoid Large tense blisters
Immune response to bullous pemphigoid IgG and complement
Types of pemphigus Pemphigus vulgaris (more common) and pemphigus foliaceus (usually just skin)
Pemphigus is characterized by widespread blistering of ______ and _______ membranes skin, mucous
Pemphigus treatment Corticosteroids, azathioprine
Pemphigus has a strong association with which allele? HLA-DR allele (MHC-II)
Pemphigus etiology Auto-Ab against keratinocyte Ag
Histalogical location of pemphigus Intraepidermal acantholysis; located in desmosomes; lack of adhesion btw keratinocytes
Clinical presentation of dermatitis herpetiformis Intensely pruritic vesicles
Clinical location of dermatitis herpetiformis lesions Elbows, knees, back, neck, buttocks
Dermatitis herpetiformis is associated with Gluten-sensitive enteropathy (Celiac disease) and certain HLA alleles
Histalogical location of dermatitis herpetiformis Btw epidermis and dermis
Immune response associated with dermatitis herpetiformis IgA - starts inflammatory response; LOTS of PMNs
Psoriasis features Sharply demarcated with clear-cut borders, non-coherent silvery scales, glossy homogeneous erythema, positive Auspitz sign (scratch off scale = drop of blood immediately forms)
Koebner phenomenon Skin lesion appears along lines of trauma
Psoriatic arthritis Negative for RA factor
Keratinocyte maturation in psoriasis 3-4 days
What causes accelerated keratinocyte maturation in psoriasis? T cells (cytokines increase process)
Treatment of psoriasis Monoclonal Ab that bind Il-12 (assists Th1 helper cell differentiation = pro-inflammatory), IL-23 (produce Th17 helper T cells = recruit PMNs)
Created by: JaneO