Adnexal Diseases Flashcards
(7 cards)
Acne
1. What is the utility of Wood’s lamp for acne?
2. How can acne be graded?
3. DDx acneiform drug eruption
4. Re acne fulminans:
- Clinical picture
- Who gets it
- Predisposing factors
- Mgmt
5. Signs of hyperandrogenism
6. DDx acneiform lesions
7. Topical acne Rx - groups and examples
8. Oral acne Rx - groups and examples
9. Isotretinoin recap
10. Follicular occlusion tetrad
- C acnes produces porphyrins. Red glow fluorescence (in progressive macular hypomelanosis)
- Dermnet. Based on type and number of lesions
Mild: total lesions <30 (comedones, inflammatory lesions)
Mod: 30-125
Severe: >125 - PIMPLE J CATS
- Abrupt development nodular and suppurative lesions a/w systemic feat. Fever, arthralgias, myalgias, malaise. EN. Osteolytic bone lesions (clavicle, sternum)
- M, 13-16
- Commencing isotret, anabolic steroid use, late onset CAH
- Pred 0.5-1mg/kg/day 2-4/52, taper over 1-2/12 as isotret started. Coprescribe ABx erythro
- Hirsutism, coarse voice, muscular habitus, AGA, clitoromegaly, increased libido
- ACNE PHAD
- Retinoids, antimicrobial, combination, chemical peels, keratolytics, hormonal
- Antibiotics, antiandrogen, isotretinion
- Acne conglobata, HS, dissecting cellulitis, pilonidal sinus
Rosacea
1. Clinical subtypes and their features
2. Types of phymatous rosacea
3. DDx facial plaques
4. Mgmt - general measures
5. Mgmt - topical measures
6. POD - risk factors
- Erythematotelangiectatic: erythema, flushing, telangiectasia
Papulopustular: erythema, papules, pustules
Phymatous: sebaceous gland hypertrophy, fibrosis. Patulous follicles
Ocular: dry, gritty, tearing, crusting - Rhinophyma, otophyma, gnathophyma, metophyma, blepharophyma
- GIRLS FAT
4, 5. See notes - TCS use, cosmetics use, allergfens/irritants, inhaled steroids, atopic predisposition, organisms (demodex, candida)
HS
1.DDx
2. Staging systems
3. Describe Hurley
4. Comorbidities
5. Explain to pt in terms they will understand
6. Mgmt - general
7. Mgmt - topical / local
8. Mgmt - systemic. Groups, examples
9. Humira PBS criteria
10. HS surgery - types / differences
- DDx: cutaneous Crohn’s, granuloma inguinale, TB, carbuncles, furunculosis, acne, LGV
- Sartorius, Hurley, HS PGA, HiSCR, DLQI
- 1 - 1+ abscesses, no sinus tract or scar. 2 - 1+ widely separated recurrent abscesses, sinus tracts and scars. 3 - multiple interconnected sinus tracts, extensive scarring
- ADIOS PAPI
- Check w notes
- Weight reduction, smoking cease, reduce friction, tight clothes. Diet mods. Vit D. Zn, B3
- Antiseptic wash. Clinda lotion. Resorcinol. ILCS
- Oral ABx. Oral anti androgens. Metformin. Pred. Zn gluconate
Retinoids
IV abx
Immunosuppression - I+D. Deroofing (partial, complete. Lesional, regional). Excision +/- flap or graft (lesional vs regional excision)
- PAPA
- PASH
- PAPASH
- SAPHO
- PAPA: Pyogenic arthritis, pyoderma, acne conglobata
- Autosomal dominant
- PSTPIP1 variant. Autoinflammatory syndrome - PASH: PG, acne, suppurative hidradenitis
- PAPASH: Pyogenic arthritis, pyoderma, acne, suppurative hidradenitis
- Synovitis, acne, pustulosis, hyperostosis and osteitis
- Neutrophilic derm a/w aseptic osteoarticular lesions
- Skin, bone, joints
- may be a/w IBD
- Skin: PPP, pustular psoriasis, Sneddon Wilkinson, psoriasis, follicular occlusion tetrad, acne, Behcet, Sweet, PG, LABD
Folliculitis
1. Eosinophilic pustular folliculitis ( + of Ofuji type):
- Clinical presentation
- Associations
- Histopath
- Mgmt - Ofuji, other
2. Pseudofolliculitis barbae
- Pathomech
- Clinical
- mgmt advice
3. Acne keloidalis
- Clin picture
- Rx ladder
1
- Recurrent episodes pruritic eruptive papulopustules. Involute 7-10 days
- Immunosuppression, HIV
- Spongiosis. Infundibular eosinophilic pustules. Eos around hair follicles and sebaceous glands
- Ofuji: oral indomethacin. Mino, dapsone, pred. Topicals
Immunosupp: HIV treatment. TCS, tacro, antihistamines for itch. NSAID, nbUVB, mino, dapsone, colchicine
2.
- See notes
- Beard area. Papules, pustules, keloid. PIH
- Stop shaving. See table in notes
3.
- Chronic folliculitis > keloidal papules and plaques which coalesce. Alopecia, tufting
- Top tret, TCS, antimicrobials
ILCS. Oral ABx, isotret. Laser hair remopval. Excision to fascia, allow to heal by secondary intention
How to Ix PCOS
Confirm Dx:
Total / free testosterone
Abdo USS
FSH:LH (LH elevated)
Associations:
Fasting glucose
Insulin
Lipids
Check BP
Weight, waist circumference, BMI
Miliaria
1. % of newborns affected, and why
2. Risk factors
- Up to 15%. Eccrine ducts not fully developed
- Incubator warming, over swaddling, fever, occlusive clothes, ointments
