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Kaplan Qbank USMLE



Author5 Posts
  #1

which layer(s) will be affected in a patient with psoriasis?

  #2

Is it basal layer ?

  #3

stratum basale and stratum spinosum

  #4

what do u ppl think?

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  #5

Epidermis Mitotic activity of basal keratinocytes is increased, with keratinocytes migrating from the basal to the cornified layers in only 3-5 days (compared to the normal 28-30 days). With hyperproliferation of skin cells, the epidermis becomes thickened (or acanthotic) in appearance and an increase in size of the rete ridges is observed. Abnormal keratinocyte differentiation is noted throughout the psoriatic plaques, as manifested by the loss of the granular layer. The stratum corneum is also thickened, and the retention of cell nuclei in this layer is referred to as parakeratosis. Neutrophils and lymphocytes can be observed migrating upwards from the dermis into the epidermis. Neutrophils may form localized collections known as Munro microabscesses. The presence of alternating collections of neutrophils sandwiched between layers of parakeratotic stratum corneum is virtually pathognomonic for psoriasis. Dermis Signs of inflammation can be observed throughout the dermis in persons with psoriasis. Marked hypervascularity and an increase in the size of the dermal papillae occur. A lymphocytic infiltrate is noted around blood vessels, with T cells expressing cutaneous lymphocyte–associated antigen, co-stimulatory molecules such as CD2, and LFA-1 adhesion molecules. An aggregation of neutrophils in the dermis occurs that extends up into the epidermis



So pretty much affects everything! Doesn't seem too specific as to the skin layer(s) affected.


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