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Dermatology finals > Inflammatory skin conditions > Flashcards

Inflammatory skin conditions Flashcards

1
Q

Describe eczema

A

Characterised by papules and vesicles on an erythematous base

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2
Q

What is the most common type of eczema

A

Atopic

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3
Q

When does atopic eczema commonly present?

A

Infant/early childhood - some recur

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4
Q

What causes eczema

A

Not fully understood
Associated with atopy - asthma, eczema, allergic rhinitis
A primary genetic defect in skin barrier function (loss of function variants of protein filaggrin) appears to underlie atopic eczema

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5
Q

List some exacerbating factors for eczema

A 
Infection
Allergens - chemicals, fur, dust
Sweating
Heat
Severe stress
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6
Q

How does eczema present

A

Itchy, erythematous, dry scaly patches
Extensor aspects of limbs and on face in infants
Flexor aspects in children and adults
Chronic scratching and rubbing can lead to excoriations and Lichenification
Nail pitting and ridging may be present

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7
Q

Describe the management of eczema

A

General measures - topical emollients, avoid exacerbating factors, bandages, bath/oil soap substitute

Topical therapies - topical steroids for flare ups, topical immunomodulators (tacrolimus and pimecrolimus) can be steroid sparing

Oral therapies - antihistamines for symptomatic relief, antibiotics for secondary bacterial infection and antivirals for secondary viral infection

Phototherapy and immunosuppressants - for severe non responsive cases

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8
Q

List some complications of eczema

A

Secondary bacterial infection - crusted weepy lesions

Secondary viral infection - eczema herpeticum

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9
Q

What is acne vulgaris?

A

An inflammatory disease of the pilosebaceous follicle

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10
Q

Who does acne vulgaris commonly affect

A

Over 80% of those aged 13-18

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11
Q

What causes acne vulgaris

A 
Hormonal (androgen)
Increased sebum production
Abnormal follicular keratinization
Bacterial colonisation (Propionibacterium acne) 
Inflammation
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12
Q

Describe the presentation of acne vulgaris

A 
Non inflammatory lesions (mild acne) - open and closed comedones
Inflammatory lesions (moderate and severe acne) - papules, pustules, nodules and cysts
Commonly affects the face, chest and back
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13
Q

Describe the management of acne vulgaris

A

Topical therapies - benzoyl peroxide and topical antibiotics (antimicrobial properties) and topical retinoids (comedolytic and anti-inflammatory properties)

Oral therapies - oral antibiotics and anti-androgens (in females)

Oral retinoids for severe acne

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14
Q

What are the complications of acne vulgaris

A

Post inflammatory hyperpigmentation
Scarring
Deformity
Psychological and social effects

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15
Q

What is psoriasis

A

A chronic inflammatory skin disease due to hyperproliferation of keratinocytes and inflammatory cell infiltration

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16
Q

List the types of psoriasis

A 
Chronic plaque - most common
Guttate - raindrop lesions
Seborrheic - nasolabial folds, retro-auricular 
Flexural - body folds
Pustular - palmar plantar 
Erythrodermic - total body redness
17
Q

What percentage of the population is affected by psoriasis

A

25

18
Q

What causes psoriasis

A

Complex interaction between genetic, immunological and environmental factors

19
Q

List the precipitating factors of psoriasis

A 
Trauma - koebner phenomenon 
Infection
Drugs
Stress
Alcohol
20
Q

Describe the presentation of psoriasis

A

Well demarcated erythematous scaly plaques
Lesions can itch, burn or be painful
Common on the extensor surfaces of the body and over the scalp
Auspitz sign
Nail changes - pitting and onycholysis in 50%
5-8% suffer psoriatic arthropathy - symmetrical polyarthritis, asymmetrical oligomonoarthritis, lone DIP disease, psoriatic spondylosis and arthritis mutilans (flexion deformity of DIP)

21
Q

What is Auspitz sign

A

Scratch and gently remove the scales to cause capillary bleeding

22
Q

Describe the management of psoriasis

A

General measures - avoid precipitants , emollients to reduce scales

Topical therapies - vitamin D analogues, topical corticosteroids, coal tar preparations, dithranol, topical retinoids, keratolytic and scalp preparations

Phototherapy - UVB and PUVA for extensive disease

Oral therapies - methotrexate, retinoids, ciclosporin, mycophenolate mofetil, fumaric acid esters and biologic agents (infliximab, etanercept and efalizumab)

23
Q

What are the complications of psoriasis

A

Erythroderma

Dermatology finals (8 decks)

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