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Medicine > Derma - Rosacea + perioral dermatitis > Flashcards

Derma - Rosacea + perioral dermatitis Flashcards

1
Q

Chronic and recurrent inflammatory disorder of the pilosebaceous units and vasculature of the face
It also involves erythema of the central face that has persisted for months or more. - Red face

A

Rosacea

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2
Q

Rosacea common among what populations

A

Caucasians
Men and women affected
After 30 y/o onset usually

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3
Q

Onset of rosacea age

A

30y/o

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4
Q

Flushing, persistent erythema, papules and pustules, telangiectasia

A

Primary rosacea

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5
Q

Burning/ stinging, dry appearance, edema/plaques, ocular signs, phyma

A

Secondary rosacea

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6
Q

Are there comedones present in rosacea

A

None

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7
Q

Triggers of rosacea

A 
Heat/cold
Hot drinks
Spicy foods
Exercise
Alcohol
Strong emotions
Topical irritants
Medications
Menopausal flushing
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8
Q

What diagnostic modality?
Rosacea

Exclude other cutaenous diseases such as lupus

A

Skin biopsy

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9
Q

Rosacea tx

A 
Identification and avoidance of triggers
Photoprotection
Gentle cleanser and emollient
Topical antibiotics
Systemic: antibiotics, isotretinoin, anti-androgen
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10
Q

Topical antibiotics rosacea

A

Metronidazole cream
Azelaic acid
Clindamycin, erythromycin
Sodium sulfacetamide

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11
Q

Systemic antibiotics rosacea

A

Tetracycline
Minocycline
Doxycycline
Lymecycline

Erythromycin
Metronidazole

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12
Q

Chronic facial dermatitis characterized by small discrete erythematous papules and/or pustules that often become confluent on perioral and periorbital skin

A

Perioral dermatitis

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13
Q

Initial lesions of perioral dermatitis

Site

A

On nasolabial folds with rum of sparing around the vermillion border of lips

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14
Q

Usual population affected by perioral dermatitis

A

Women and children

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15
Q

Perioral dermatitis related to use of

A

Potent topical steroids

Highly fluorinated toothpaste

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16
Q

Tx perioral dermatitis

A 
Topical antibiotics:
Metronidazole cream/gel
Azelaic acid
Clindamycin, erythromycin
Sodium sulfacetamide

Systemic antibiotics
Tetracycline, minocycline, doxycline, lymecycline
Erythromycin

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17
Q

Circumscribed areas of raised erythema and edema of superficial dermis

A

Urticaria

18
Q

Acute urticatia

A

< 6 weeks

19
Q

Chronic urticaria

A

> 6 weeks

20
Q

Acute urticaria

Gender

A

Men = women

21
Q

Chronic urticatia

A

Women > men

22
Q

Age group

Acute urticaria

A

Any

23
Q

Chronic urticaria

Age group

A

4th-5th decade

24
Q

Signals associated with urticaria

A

Histamine, bradykinin, kallikrein, acetylcholine

25
Q

Central swelling of variable size, surrounded by a reflex erythema
Associated with itching or sometimes burning
Transient

A

Wheal

26
Q

Sudden pronounced swelling of lower dermis and subcutis
Sometimes pain than itching
Frequent involvement of the mucous membranes

A

Angioedema

27
Q

Resolution

Wheal

A

1-24 hr

28
Q

Resolution angioedema

A

Within 72 hours

29
Q

New classification of urticaria based on its duration, frequency and cause

A

Spontaneous urticaria
Physical urticaria
Special types of urticaria
Disorders related to urticaria

30
Q

New guidelines for routine diagnosis of urticaria

A

Thorough history - possible trigger factors, characteristic of urticaria
Physical examination - dermatographism test
Specific challenge and lab tests
- on basis of suspected cause

31
Q

Key questions urticaria

A

Time of onset of disease
Frequency and duration of whealing
Associated angio-oedema
Associated subjective symptoms (e.g. pain)
Family history (urticaria, atopy)
Previous or current allergies, infections, internal diseases

Induction by physical agents or exercise

Use of drugs (NSAIDs, injections, immunisations, hormones, laxatives)

Food, smoking habits

Occupation, hobbies

32
Q

Tx urticaria

A

H1 antihistamines
H2 antihistamines
Glucocorticoids
Epinephrine

33
Q

Receptor that mediates wheal and flare reactions, bronchal constriction, mucus secretion, smooth muscle contraction, edema, hypotension, CNS depression, cardiac arrhythmias

A

H1 receptor

34
Q

Antihistamines

May cause drowsiness

A

First gen antihistamines

35
Q

Less of nonsedating antihistamines

A

Second gen H1 antihistamines

36
Q

First gen antihistamines

Enumerate

A

Hydroxyzine hydrochloride
Diphenhydramine
Chlorpheniramine

37
Q

Second gen antihistamines

Enumerate

A 
Loratadine
Cetirizine
Desloratadine
Levocetirizine
Fexofenadine
Bilastine
38
Q

H2 antihistamines

Enumerate

A

Cimetidine
Ranitidine
Famotidine

39
Q

Stabilize mast cell membranes and inhibit further histamine release

Reduce inflammatory effect of histamine and other mediators

A

Glucocorticoids

40
Q

Glucocorticoids

How to prescribe for urticaria

A

40 mg prednisone in a short

Children: 1 mg/kg/d for 5 days

41
Q

– alpha-adrenergic effects result in vasoconstriction of the superficial cutaneous vessels and directly oppose the vasodilatory effect of histamine

– has no effect on pruritus

A

Epinephrine

Medicine (29 decks)

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