produce keratin which provides protection

keratinocytes (aka squamous cells) are constantly produced by basale layer and take 26-42 days to reach surface

connected by desmosomes

the basal layer of palms and soles, mucus membranes, nail beds

have special nerven endings that can detect touch

Stratum lucidum

Contain organelles called Odland bodies

   (barrier to water loss)

Seen in thick epidermis-palms, soles

 -scavengers of the dermis

 Histiocytes-engulfs hemosiderin, melanin, debris

3 types

Lanugo – fetus

Vellus – Fine

Covers most of body

at puberty, develops into terminal hair on certain areas i.e. beard, pubic, axilla

Terminal – larger, coarser, more pigmented

Cyclic pattern of growth and regression

Anagen – cells of hair bulb divide-growing

Catagen –cells stop dividing

Telogen –club hair remains until a new anagen follicle develops and dislodges the club hair-resting phase (if it has the white bulb on the end, that's good because it's being displaced naturally)

dried exudate

it is serous honey colored, purulent brown, of blood-rusty brown

define Intertriginous

ultraviolet light at 365 nm where certain bacteria will illuminate (i.e. pseudomonas, minutissmum, cornebacteriium)

can also detect fungus, porphyrias, and pigmentary disorders

determines if their is blood underneath such as in:

manipulations of clinical lesions

dandruff in adults, cradle cap in kids (more common in men)

flares with sunlight

has been linked to immunosupression

pityrosporum ovale may be a cause

white dry scalp with macules and papules of varying size resulting in scaling

occurs in regions where sebaceous glands are most active

recurs and goes into remission

can alleviate with age if originally present as an infant

non-pustular and pustular

non is chronic plaque (psoriasis vulgaris) and can be initiated by rubbing Koebner's phenomenon (cover up a lesion and it get worse once you remove the bandage) and scratching, certain drugs, stress, HIV

-the epidermal growth period is severely quickened

-severe itch

-DDx: seb derm, tinea capitis

the pustular can be life threatening because skin will come off and expose pt to infection

-nGeneralized type-von zumbusch

  impetigo herpetiformis-pregnant

  acrodermatitis continua of hallopeau-nail/finger

  annular type-mostly in children

  the pustules are always sterile

hyperkeratosis, eczema related

thickened corneum while basale layer proliferates normally

what types of ichthyosis takes place in males that is ichthyosisin males that is

dirty brown scales on neck, trunk, extremities

small and large variety, both are gradual

the large type may be premycotic and least to CTCL

  leonine facies (LION FACE)

  erythroderma“red man syndrome”

  lymphadenopathy (lymph nodes)

  elevated WBC (>20,000)

  atypical lymphocytes (sezary cells)

  in skin and blood

  pruritis (itch), hair loss

two types, acute (PLEVA); papules, vescicles and crusts

and chronic (PLC), some scales

lichen planus

on the feet of black men

follicular leading to "graham little syndome" incolving mucus membranes and leading to alopecia

oropharyngeal involvement usually affecting white papules on buccal mucosa and lips

treat with steroids

worse with sebum production

spaghetti and meatball appearance on a skin scrape because of hyphae and spores

  distal & lateral subungual (mc type of   onychomycosis;T. rubrum),

nDx: KOH prep, fungal culture, Woods lamp

  superficial white (T. mentagrophytes), proximal subungual (assoc w/HIV), candida onychomycosis

  systemic antifungals (Lamisil)

  selenium sulfide shampoo

what might this tetrad indicate?

-palpable purpura

-nephritis

-colicky abd. pain

-arthritis

-adult onset asthma

-peripheral eosinophilia

-pulmonary lung involvment

-vasculitis of respiratory tract

-glomerulonephritis

-medium vessel vasculitis

hereditary disorder in which elastin fibers are calcified

-yellow papules in a reticular pattern

-peau d'orange (chicken neck)

-ocular involvement-ANGIOD STREAKS which are grey discolorations around the optical disc

>100 polyps so may have malignant potential 

MALABSORPTION
Acrodermatitisenteropathica

Dermatitis herpetiformis

what might someone be lacking?

ZINC in acro

gluten sensitivity in herpetiformis

cause drying and scaling, allopecia, liver fibrosis, the vitamin circulates as retinol

ACCUTANE

a deficiency could cause night blindness and hyperkeratosis

vitamin B1 disorder

---------------

B2 deficiency

---------------

B12 deficiency

beriberi-burning red tongue

B=beriberi

--------------------

                         -HYPERPIGMENTATION

                         -CASAL’S NECKLACE***

-follicular hyperkeratosis

-corkscrew hairs

-HEMORRHAGE!!

paroxysmal flushing face and chest due to the bodie's release of a vasoreactive substance

-seratonin