Flashcards in Clinical rashes Deck (22):
Chronic inflammatory disease of the pilosebaceous unit
Scattered papules, pustules, comedones
Numerous papules, pustules and mild atrophic scarring
Numerous papules, pustules, cysts, nodules, significant scarring
Benzoyl peroxide – keratolytic, antibacterial
Topical vitamin A derivatives (retinoid): eg adapalene – drying effect
topical antibiotics – antibacterial and anti-inflammatory
Isotretinoin (oral retinoid) – effect on sebaceous gland activity. Lot of side effects including initial aggravation of acne.
Name a side effect of isotretinoin (used for acne)
Can initially aggravate acne
Difference between acne and roasacea
No comedones in rosacea
Factors exacerbating rosacea
Sudden change in temp, alcohol, spicy food
How to reduce aggravating factors in Rosacea?
Reduce dietary triggers, wear high factor sunscreen, avoid topical steroids
Antibiotics to use in Rosacea
Oral tetracycline long term
Isotretinoin low dose if severe
Telangiectasia : vascular laser
Rhinophyma: surgery/ laser shaving
Bullous pemphigoid and pemphigus vulgaris, which is deeper?
Bullous pemphigoid = DEJ
Pemphigus = superficial, intra-epidermal
What may be the initial presenting complaint in bullous pemphigoid?
itchy erythematous plaques and papules may be the presenting feature
Mucosal lesions in bullous pemphigoid?
--> pemphigus vulgaris usually
Where would you develop bullous pemphigoid?
localized to one area, or widespread on the trunk and proximal limbs
Where would you get pemphigus vulgaris?
Typically affects scalp, face, axillae, groins
Investigations for bullous pemphigoid/pemphigus vulgaris?
Skin biospy with direct immunofluorescence
Bullous pemphigoid/pemphigus vulgaris prognosis?
Chronic self- limiting course
Duration varies from months to years
Most patients achieve remission on treatment within 3 – 6 months
Pemphigus very high mortality if untreated
Pemphigoid up to 20% mortality I year treated
Psoriasis symmetrical or non-symmetrical?
Sharply demaracted, scaly, erythematous plaques
Psoriatic nail diseas
Treatment of psoriasis
Vitamin D analogues:
Calcipotriol (Dovonex) ointment
Calcitriol (Silkis) ointment
reduces skin turnover, can be used in psoriasis