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Flashcards in Clinical rashes Deck (22):
1

Chronic inflammatory disease of the pilosebaceous unit

Acne vulgaris

2

Mild acne

Scattered papules, pustules, comedones

3

Moderate acne

Numerous papules, pustules and mild atrophic scarring

4

Severe acne

Numerous papules, pustules, cysts, nodules, significant scarring

5

Acne treatment

Topical treatment:
Benzoyl peroxide – keratolytic, antibacterial
Topical vitamin A derivatives (retinoid): eg adapalene – drying effect
topical antibiotics – antibacterial and anti-inflammatory

Systemic treatment:
Antibiotics
Isotretinoin (oral retinoid) – effect on sebaceous gland activity. Lot of side effects including initial aggravation of acne.

6

Name a side effect of isotretinoin (used for acne)

Can initially aggravate acne

7

Difference between acne and roasacea

No comedones in rosacea

8

Factors exacerbating rosacea

Sudden change in temp, alcohol, spicy food

9

How to reduce aggravating factors in Rosacea?

Reduce dietary triggers, wear high factor sunscreen, avoid topical steroids

10

Antibiotics to use in Rosacea

TOPICAL metronidazole
Oral tetracycline long term

Isotretinoin low dose if severe
Telangiectasia : vascular laser
Rhinophyma: surgery/ laser shaving

11

Bullous pemphigoid and pemphigus vulgaris, which is deeper?

Bullous pemphigoid = DEJ
Pemphigus = superficial, intra-epidermal

12

What may be the initial presenting complaint in bullous pemphigoid?

itchy erythematous plaques and papules may be the presenting feature

13

Mucosal lesions in bullous pemphigoid?

Not likely
--> pemphigus vulgaris usually

14

Where would you develop bullous pemphigoid?

localized to one area, or widespread on the trunk and proximal limbs

15

Where would you get pemphigus vulgaris?

Typically affects scalp, face, axillae, groins

16

Investigations for bullous pemphigoid/pemphigus vulgaris?

Skin biospy with direct immunofluorescence
Indirect immunofluorescence

17

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

18

Psoriasis symmetrical or non-symmetrical?

Symmetrical
Sharply demaracted, scaly, erythematous plaques

19

Psoriatic nail diseas

Oncholysis
Nail pitting
Dystrophy
Subungal hyperkeratosis

20

Treatment of psoriasis

Vitamin D analogues:
Calcipotriol (Dovonex) ointment
Calcitriol (Silkis) ointment
Coal tar
Steroid ointments

21

Retinoid

reduces skin turnover, can be used in psoriasis

22

Fumaric acid ester

Disrupts lymphocytes, can be used in psoriasis