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DERMATOLOGY > Common skin conditions > Flashcards

Common skin conditions Flashcards

(45 cards)

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1
Q

What percentage of adults does psoriasis affect?

A

2%

=> COMMON

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2
Q

What is the most common type of psoriasis?

A

chronic plaque psoriasis (psoriasis vulgaris)

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3
Q

Where do the plaques in psoriasis commonly appear?

A

extensors (elbow, knee)

scalp, sacrum, hands, feet, trunk

nails

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4
Q

How do the plaques in psoriasis commonly look?

A

Symmetrical on body
Sharply demarcated
scaly
erythematous plaques

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5
Q

What is the Koebner phenomenon?

A

psoriasis develops in area of skin trauma

e.g. scar from surgery

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6
Q

What is Auspitz sign?

A
  • removal of surface scale reveals tiny bleeding points

dilated capillaries in elongated dermal papillae

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7
Q

Describe the appearance of Guttate psoriasis

A

Widespread
Smaller plaques
closer together

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8
Q

Describe the appearance of Palmoplantar pustular psoriasis

A

Psoriasis with pustules focused on the palms of hands and soles of feet

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9
Q

Describe the appearance of Erythrodermic psoriasis

A

widespread and pustular

rare

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10
Q

What problems can psoriasis cause in the nails?

A

Onycholysis
Nail pitting
Dystrophy
Subungal hyperkeratosis

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11
Q

What comorbidities often exist with psoriasis?

A

metabolic syndrome (obesity, hypertension, diabetes, lipid abnormalities)

arthritis
Crohn’s disease
cancer
depression
uveitis
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12
Q

In what case of psoriasis is life expectancy reduced, and by how much?

A

reduced by 4 years in patients with severe psoriasis

Due to increased cardiovascular risk
3x increased risk of myocardial infarction

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13
Q

What topical therapies can be given for psoriasis?

A 
Vitamin D analogues
e.g. Calcipotriol (Dovonex) ointment 
Coal tar
Dithranol 
Steroid ointments
EMOLLIENTS
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14
Q

What phototherapy treatments can be used for psoriasis?

A

Narrowband UVB then PUVA

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15
Q

What systemic treatments can be used for psoriasis?

A 
immunosuppression e.g. methotrexate
Immune modulation (targeted biological agents) e.g. TNF Alpha
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16
Q

How is acne vulgaris defined?

A

inflammatory disease of the pilosebaceous unit

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17
Q

What age does acne usually affect males vs females?

A

14 -17 years in females

16 -19 years in males

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18
Q

Describe the pathogenesis of acne

A

Poral occlusion
Bacterial colonisation of duct (P acnes)
Dermal inflammation
Sebum production

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19
Q

What sites does acne vulgaris affect most?

Study These Flashcards
A

Face, upper back, anterior chest

most sebaceous glands

20
Q

Describe the morphology of lesions seen in acne

Study These Flashcards
A

Comedones - open (blackhead) and closed (whitehead)
Pustules and papules
Cysts
Erythema

21
Q

How is acne graded?

Study These Flashcards
A

Mild- scattered papules and pustules, comedones

Moderate - numerous papules, pustules and
mild atrophic scarring

Severe - cysts, nodules and significant scarring

22
Q

Describe the progression of treatments for acne

Study These Flashcards
A

Avoid oily substances, triggers

Topical Tx:
Benzoyl peroxide
Retinoids
Topical antibiotics

Systemic treatment:
Antibiotics (at least 6 months)
Isotretinoin (Roaccutane)

23
Q

What areas does rosacea normally affect?

Study These Flashcards
A

Nose, chin, cheeks and forehead

24
Q

What age does rosacea usually affect?

Study These Flashcards
A

30 – 60 years, male and female

25
Describe the morphology of Rosacea lesions?
Papules, pustules and erythema with no comedones Prominent facial flushing **can also cause unshapely/large nose – rhinophyma Conjunctivitis / gritty eyes**
26
What can exacerbate the facial flushing seen in rosacea?
sudden change in temperature alcohol spicy food
27
How is rosacea managed without drugs?
Avoid triggers wear high factor sunscreen avoid topical steroids
28
What topical treatments are used in rosacea?
Metronidazole, Ivermectin (to reduce demodex mite)
29
What oral therapy is used in rosacea?
Oral tetracycline long term | Isotretinoin low dose if severe
30
What special treatments can be offered if a rosacea patient has Telangiectasia OR Rhinophyma?
Telangiectasia : vascular laser | Rhinophyma: surgery/ laser shaving
31
Describe the morphology of Lichen Planus
Violaceous (pink/ purple) flat-topped shiny papules volar wrists/ forearms, shins and ankles Wickham’s striae – fine lace-like pattern on surface of papules and buccal mucosa
32
How long does Lichen Planus usually last before burning out?
12- 18 months
33
How should Lichen Planus be treated?
TREAT SYMPTOMATICALLY topical steroids (potent or very potent), oral steroids if extensive
34
How do we differentiate between Bullous Pemphigoid and Pemphigus?
Bullous pemphigoiD – split is Deeper, through DEJ. Pemphigus – split more Superficial, intra-epidermal
35
What is Nikolsky's Sign?
Top layers of the skin slip away from the lower layers when slightly rubbed Indicates plane of cleavage within the epidermis
36
Is Bullous Pemphigoid Nikolsky's Sign positive or negative?
Negative
37
Is Pemphigus Nikolsky's Sign positive or negative?
Positive
38
Patients of what age usually get Bullous Pemphigoid?
elderly
39
Describe the distribution and appearance of Bullous Pemphigoid
localized to one area, or widespread on the trunk and proximal limbs large tense bullae on normal skin on erythematous base blisters burst to leave erosions
40
How can bullous pemphigoid present earlier in disease?
Uritcarial itchy plaques
41
Where does Pemphigus Vulgaris usually affect?
scalp, face, axillae, groins
42
How does Pemphigus Vulgaris appear on the skin?
Flaccid vesicles/bullae – thin roofed Lesions rupture to leave raw areas Mucosal involvement (eyes, genitals)
43
How long does it take for Pemphigus Patients to achieve remission?
Most patients achieve remission on treatment within 3 – 6 months
44
How can Bullous pemphigoid and pemphigus be diagnosed?
Skin biospy with direct immunofluorescence | Indirect immunofluorescence
45
How can bullous pemphigoid and pemphigus be treated?
Systemic steroids Other immunosuppressive agents In pemphigoid: tetracycline antibiotics Topicals: emollients, topical steroids, topical antisepsis / hygiene measures

DERMATOLOGY (18 decks)

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