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Dermatology > Rashes > Flashcards

Rashes Flashcards

1
Q

where is psoriasis found?

A

extensor surfaces
scalp, sacrum, hands, feet, trunk
nails

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2
Q

is psoriasis usually symmetrical or asymmetrical?

A

symmetrical

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3
Q

describe a psoriasis lesion

A

sharply demarcated
scaly
erythematous
plaques

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4
Q

name some types of psoriasis

A

guttate
palmoplantar pustular
nail disease
erythrodermic/widespread pustular (rare)

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5
Q

what is the koebner phenomenon?

A

thickening of the skin after trauma

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6
Q

what is oncholysis?

A

nail coming away from the nail bed

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7
Q

what topical treatments can be used in psoriasis?

A
  • vit. D analogues (calcipotriol/calcitriol)
  • coal tar
  • steroid ointments
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8
Q

when are topical treatments enough in psoriasis?

A

when psoriasis is mild - moderate

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9
Q

aside from topical treatments, what else can be used in psoriasis?

A
  • phototherapy (narrowband UVB/PUVA)

- systemic treatments

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10
Q

what systemic treatments can be used in psoriasis?

A
  • retinoid
  • immunosuppresion (methotrexate, ciclosporin)
  • fumaric acid ester
  • immune modulators
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11
Q

what does retinoid do & what are the side effects?

A

reduces skin cell turnover

S/E: increase cholesterol, problems with fertility in females even 3 yrs after stopping therapy

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12
Q

what is the main side effect of long term immunosuppression?

A

cancer

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13
Q

what does fumaric acid ester do & what are the side effects?

A

disrupts lymphocytes, very effective & not immunosuppressant
S/E: can effect kidneys, GI side effects (nausea/bowel discomfort)

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14
Q

what are immuno modulators?

A

biological agents e.g. TNF blockers

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15
Q

where can pain be felt by patients with psoriasis?

A

joints, hands & feet (rheumatoid)

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16
Q

what 4 nail features could you expect to see in someone with psoriasis?

A
  • oncholysis
  • pitting
  • dystrophy
  • subungal hyperkeratosis
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17
Q

what is acne vulgaris?

A

chronic inflammatory disease of the pilosebaceous unit

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18
Q

when is acne vulgaris likely to present?

A

females - 14-17

mailes- 16-19

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19
Q

what is the morphology of acne vulgaris?

A

comedones - open & closed
pustules
papules
cysts

20
Q

what is the distribution of acne vulgaris like?

A

related to sites with most sebaceous glands

face, upper back, anterior chest

21
Q

what secondary features can be found in acne vulgaris?

A

scars - atrophic, ice-pick, texture changes, hypertrophic

22
Q

what is mild acne described as?

A

scattered papules & pustules, comedones

23
Q

what is moderate acne described as?

A

numerous papules, pustules & mild atrophic scarring

24
Q

what is severe acne described as?

A

as in moderate acne + cysts, nodules & signifiant scarring

25
Q

how is acne treated?

A
  • avoid oily substances & triggers
  • topical treatments
  • systemic treatments
26
Q

what topical treatments are given in acne?

A

benzoyl peroxide - keratolytic, antibacterial
topical Vit. A derivatives - e.g. adapalene (drying effect)
topical antibiotics - antibacterial & anti-inflammatory

27
Q

what systemic treatments are given in acne?

A

antibiotics

isotretinoin

28
Q

what does isotretinoin do?

A

oral retinoid
effects sebaceous gland activity
los of side effects including initial aggravation of acne

29
Q

what can be given in a isotretinoin flare of acne?

A

oral steroids & dapsone as anti-inflammatory

30
Q

where is rosacea usually seen?

A

nose, chin, cheeks & forehead

31
Q

what is seen in rosacea?

A

papules, pustules & erythema with no comedones

prominent facial flushing

32
Q

what is rosacea exacerbated by?

A

sudden in change in temperature, alcohol & spicy food

33
Q

when does rosacea usually present?

A

30s/40s

34
Q

how is rosacea managed?

A
  • reduce aggrevating factors
  • antibiotics
  • isotretinoin low dose if severe
  • telangiectasia: vascular laser
  • rhinophyma: surgery/laser shaving
35
Q

what are the aggravating factors in rosacea?

A

dietary triggers
sun exposure
topical steroids

36
Q

when is bullous pemphigoid seen?

A

in elderly patients

37
Q

where on the body is bullous pemphigoid seen?

A

localised to one area or widespread on the trunk & proximal limbs

38
Q

what is seen on the skin in bullous pemphigoid?

A

large tense bullae on normal skin or erythematous base

39
Q

what might the presenting feature be in bullous pemphigoid?

A

itchy erythematous plaques & papules

40
Q

what is the nikolsky sign?

A

put your finger on the blister & press it to the side, if blister ruptures then positive, if not then negative

41
Q

is the nikolsky sign negative or positive in bullous pemphigoid?

A

negative

42
Q

where does pemphigus vulgaris usually affect?

A

scalp, face, axillae, groins

43
Q

what is seen in pemphigus vulgaris?

A

flaccid vesicles/bulllae (thin roofed)
mucosal involvement
lesions rupture to leave raw areas
positive nikolsky sign

44
Q

how are pemphigoid & pemphigus treated?

A

systemic steroids
immunosuppressive agents: azathioprine, ciclosporin, mycophenolate
topicals: emollients, topical steroids

45
Q

what else can be give in pemphigoid?

A

tetracycline antibiotics, nitotinamide

Dermatology (16 decks)

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