Classic Dermatology Presentations Flashcards
Appearance of an eczema lesion described
Generalised
Erythematous
Ill-defined
Patches
Erosions
Scaly
What can eczema progress to?
Lichenification - skin becomes thickened and leathery
Characteristics of eczema
Pruiritis and inflammation
Epidermal changes - papules and vesicles
Often flexural
Can be acute or chronic
Exogenous and endogenous causes
Often have history of atopy eg hayfever, asthma
Treatment for eczema
- Education and support
- Avoid exacerbating factors
- Topical therapies - emolients, soap subsititute, steroids/calcineurin inhibitors
- Phototherapy - UV
- Systemic therapies
What are calcineurin inhibitors?
Immunosupressors - dampen down inflammation
Classic description of acne vulgaris
Well defined
Discrete (can also be confluent)
Erythema
Papules
Vesicles
Pustules
Crusts
Comedones
Acne Vulgaris key features
Mostly on skin of face, neck and upper body (eg back/chest)
Chronic skin disease - due to blockage of hair follicles in the skin
Multifactoral cause
Causes of Acne Vulgaris
- Increased sebum production (androgen influence)
- Excessive deposition of keratin in pores
- Overgrowth of cutibacterium acnes (skin commensal)
- Pro-inflammatory chemicals are released into skin
How is acne classified?
Mild
Moderate
Severe
Depending on what features are present
Treatment for Acne Vulgaris
Topical:
* Non-antibiotic eg benzoyl peroxide, retinoids
* Antibiotics - erythromycin, tetracycline, clindamycin
Systemic:
* Antibiotics
* COCP
* Isotretinoin - roaccutane
Problems with isotretinoin
LOTS of side effects and requires close monitoring - hospital managed, not GP
Eg dry eyes/lips, headaches, muscle/joint pain, depression, increased cholesterol, cannot have in pregnancy
Typical description of psoriasis
Extensor areas
Well defined
Plaque
Scaly
(can be erythematous)
What is psoriasis?
Chronic skin condition which can appear at any age but often 20-30 and 50-60
Strong genetic predispostion with relapsing and remission
Where does psoriasis occur usually?
Extensors eg elbows, knees, scalp and lower back - eczema is flexors
Cause of psoriasis
Immune mediated inflammatory disease causing increased cell turnover
T cells cytokine production stimulated = keratinocyte proliferation
