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MB2:Dermatology > Rashes, psoriasis and dermatitis > Flashcards

Rashes, psoriasis and dermatitis Flashcards

1
Q

what would you see on biopsy of a person with dermatitis

A

spongiosis

inflammatory cell infiltrate

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2
Q

biggest issue with a child with atopic dermatitis?

A

pruritus at night when sleeping

can cause insomnia and impaired cognitive function

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3
Q

what else is atopic dermatitis associated with

A

asthma
allergic rhinitis
food allergy

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4
Q

how would atopic dermatitis be seen in a patient with skin of colour

A

well defined, papular instead of macular, extensive lichenification

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5
Q

what is discoid eczema

A

well defined border, disc shaped

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6
Q

what is photosensitive eczema

A

dermatitis due to photosensitivity to certain wavelengths of light

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7
Q

what is stasis eczema

A

dermatitis due to increased hydrostatic pressure or oedema, commonly in the legs

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8
Q

what is pompholyx eczema

A

joining of pongiotic vesicles to create a larger vesicle that may weep

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9
Q

what is lichen simplex

A

not a disease, person scratches at an area so much it gives them dermatitis

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10
Q

causes of psoriasis (not the immunology of it)

A

genes
stress
drugs - BB
Infection - strep throat

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11
Q

increases risk factors due to psoriasis?

A 
3x MI
diabetes
hyperlipidaemia 
diabetes
obesity 
depression 
chron's disease 
cancer
psoriatic arthritis
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12
Q

what is koebner phenomenon

A

psoriasis in area of skin trauma

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13
Q

what is auspitz sign

A

pinpoint bleeding under scale due to elongated dermal papillae

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14
Q

pathogenesis of acne?

A

poral occlusion of pilosebaceous unit due to increased sebum
bacterial colonisation and dermal inflammation

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15
Q

what is wickham’s striae

A

lace like pattern on surface of papules and buccal mucosae

hallmark of lichen planus

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16
Q

what is nikolsky’s sign

A

shearing off of a blister

+ve is indicative of pemphigus vulgaris

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17
Q

why is mortality increased in pemphigus vulgaris

A

blister bursts easily so secondary bacterial infection

18
Q

types of allergic drug reactions and their rashes involved

A

type I - urticaria
type II - pemphigus and pemphigoid
type III -purpura
type IV - maculopapular

19
Q

true/false - allergic drug reactions are dose dependent

A

false - they are not

20
Q

types of non-allergic drug reactions

A 
eczema 
phototoxicity 
atrophy 
psoriasis 
xerosis 
erosion
21
Q

most common drug rash

A

exanthemous - maculopapular

22
Q

what type of hypersensitivity is an exanthemous drug reaction and what immune cell mediates it

A

type IV

t cell

23
Q

when would you see an exanthemous rash present

A

4-21 days after being on a drug

24
Q

when would an exanthemous rash become life threatening

A 
wheeze
blisters
very high fever
purpura
facial erythema/oedema and genital involvement 
widespread confluent oedema
25
Q

what drugs commonly cause exanthemous rashes

A 
penicllin 
suphonamide 
erythromycin 
NSAIDs 
antiepileptics
26
Q

an urticarial rash has two methods of pathophysiology, describe them and the drugs that happen

A

immediate IgE after exposure - beta lactams

direct mast cell mediator release - aspirin, opiates, NSAIDs, vancomycin

27
Q

what can cause purputic rash

A

warfarin necrosis

28
Q

what can cause an acneiform rash

A

glucocorticoids

androgens, lithium, isoniazid, phenytoin

29
Q

what can cause drug induced bullous pemphigoid

A

ACEI, penicillin, furosemide

30
Q

what drugs can cause pigmentation

A

minocyclone

hydroxyurea

31
Q

who to consider for drug rash

A

any patient on medication with symmetrical skin rash
elderly, females, viral infection, genes
B-lactams, multiple drugs

32
Q

what is a fixed drug eruption ans what causes it

A

well demarcated painful red round plaque, causes pigmentation when drug stiopped
doxy, paracetamol, NSAIDs

33
Q

what causes toxic epidermal necrolysis

A

cephalosporins, sulphonimides, NSAIDs, sertraline, pantoprazole

34
Q

what causes AGEP

A

antibiotics, CCB, antimalarials

35
Q

consequences of DRESS, TEN, AGEP

A 
hypothermia
fluid loss
protein loss
sepsis 
multi organ failure
36
Q

how do drugs cause phototoxic reactions

A

can act as a chromophore

37
Q

managing drug reactions?

A 
discontinue 
use alternative 
topical steroids and antihistamines for type I
allergy bracelet 
tell MRHA
38
Q

causes of pruritoceptive itch

A

lichen planus
asteatotic eczema
psoriasis
insect bite

39
Q

causes of neuropathic itch

A

shingles

40
Q

causes of neurogenic itch

A 
haematological
paraneoplastic 
liver/bile duct 
kidney disease
thyroid disease
41
Q

psychogenic itch is?

A

psychological

MB2:Dermatology (11 decks)

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