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Eczema, Psoriasis, Papulopustular Conditions Flashcards

(58 cards)

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1
Q

Eczema risk factors?

A
  1. Asthma, Hayfever

2. FH of Atopic eczema

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2
Q

Eczema pathogenesis?

A

Mutations of Filaggrin gene -> decreased epidermal fatty acid -> dry skin

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3
Q

How common is eczema, what ethnicity, what environment?

A
  1. 20% Children, 10% adults
  2. Atopic for Asians and Africans
  3. Dry places (Melbourne), cold (heaters are drying)
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4
Q

3 main features of Eczema?

A
  1. “Water-color” Red, Dry, Itchy, Scaly
  2. Ill-defined edges
  3. Lichenification
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5
Q

How common is allergen causing Eczema, where on the body (Infant/Child n adult)?

A
  1. Only 10%
  2. Infants: around the mouth (food)
  3. Child/Adults: face & hands (dust mite, pet fur)
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6
Q

What are the distributions of eczema in Infants vs Child n Adult?

A

Infant: Face

Child/Adult: Flexors

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7
Q

Endogenous Variants of Eczema (5)?

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A

Pompholyx (Blistering)
Infected (Crust)

Discoid
Varicose
Asteatotic (Dry)

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8
Q

Infected Eczema most commonly infected by?

A
  1. Staph Aureus (Impetiginsation)

2. HSV (Eczema Herpeticum)

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9
Q

What is the prognosis of Eczema? Any occupational precautions?

A
  1. Most child improve with age
  2. Severe cases persist
  3. Dry skin occupational: nursing, hair-dressing, mechanic
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10
Q

Most common cause of butterfly rash?

A

Seborrhoeic dermatitis

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11
Q

Pompholyx eczema

A

Blisters and vesicles

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12
Q

Discoid Eczema cause?

A

Unknown

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13
Q

Asteatotic Eczema features (3)?

A
  1. “Crazy Paving appearance”
  2. Elderly
  3. Lower legs
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14
Q

Exogenous variants of Eczema (3)

A
  1. Irritant Contact
  2. Allergic Contact
  3. Photoallergic
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15
Q

Irritant Contact Dermatitis is? Commonly affects where?

A
  1. Agents directly damaging skin

2. Hands

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16
Q

Common agents causing Irritant Contact Dermatitis? (4)

A
  1. Water, Oils
  2. Detergents, soaps
  3. Acids and Alkalis (cement)
  4. Solvents and abrasives
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17
Q

Allergic Contact Dermatitis is?

A
  1. Allergic (T4HSR)

2. Contact (allergen contacting skin)

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18
Q

Common contact allergens?

A

Nickel, Chrome, Plants, Rubber, Hair dyes, Latex

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19
Q

Eczema lifestyle management? (3)

A
  1. Avoid Dry: no long hot showers, no soap (use moisturiser/bath oil as substitute)
  2. Avoid Overheat: bed, heater
  3. Avoid Irritation: clothing label, wool
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20
Q

Ointment vs Cream

A

Ointment
OILment, messier, more effective
Cream more pleasant, not moisturising if skin is dry, when infective

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21
Q

Eczema treatment? (3)

A
  1. Moisturisers (ointment)
  2. Topical Steroids (ointment, infected use cream)
  3. Wet dressing (on steroid ointment, remove when dry)
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22
Q

Infected Eczema treatment? (3)

A
  1. Soak off crusts (gauze)
  2. Topical Steroids (CREAM)
  3. PO abx or antivirals
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23
Q

Topical Steroid Side effects?

A
  1. Skin atrophy
  2. Steroid acne, rosacea, perioral dermatitis
  3. Glaucoma/cataracts
  4. Tachyphylaxis (tolerance)
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24
Q

How common is Psoriasis? What ethnicity?

Study These Flashcards
A
  1. 2% of population

2. All racial types

25
Psoriasis is a risk factor of? (2)
1. 10% Psoriatic Arthritis | 2. 2 times increased risk of CV disease (chronic inflammatory condition)
26
Psoriasis core features? (3)
1. "oil-color" mahogany Red, no itch, silver scale, salmon plaque 2. Well-defined border 3. Improves with sunlight (thus UV therapy)
27
Psoriasis onset and peak incidence age? Poor prognosis if?
1. Onset any age 2. Peak early adulthood 3. Early onset, severe disease
28
Psoriasis pathogenesis?
1. Rapid turnover of keratinocytes | 2. New layer of epidermis in 4 days rather than 1 month -> Thick scale
29
Psoriasis distribution? Spares where? (4)
1. Extensors 2. Lower back/buttocks 3. Nails/scalp 4. Spares faces (sunlight exposure)
30
Koebner Phoenomenon
Skin lesions developing on the lines of injury (e.g. scratch)
31
Flexural Psoriasis is psoriasis but?
Loses scaling characteristic
32
Nail sign of Psoriasis? (3)
1. Nail Thickening 2. Onycholysis 3. Nail pitting
33
Variants of psoriasis?
1. Flexural 2. Pustular 3. Guttate
34
Pustular Psoriasis features? (3)
1. Hands/feet 2. NO plaque (pustule and brown dots) 3. Maybe painful
35
Guttate Psoriasis features? (3)
1. "Rain-drop"and retains typical signs 2. Young patient 3. Triggered by Strep Throat
36
Guttate Psoriasis prognosis?
1. Good prognosis with phototherapy | 2. Early abx if recurrent tonsilitis
37
Psoriasis topical treatment? (4)
1. Moisturisers (ointment) 2. Topical steroids (short term high dose) 3. Topical Calcipotriol (VitD long term) 4. Topical Tar/Salicylic acid/Anthralin
38
Phototherapy concept? Difference from solarium?
1. UVB light, resembles natural sunlight | 2. Solarium is UVA, damages skin
39
Psoriasis systemic therapy? (3)
1. Immunomodulator: PO MTX, Cyclosporin 2. PO Acitretin (vitA) 3. TNF Biologics: etanercept, infliximab, adalimumab
40
4 factors for Acne pathogenesis ?
1. Androgen mediated sebum increase 2. Hyperproliferation of keratin -> comedones 3. Inflammation 4. Infection of Propionibacterium Acne
41
RF of acne?
1. Avoid high Glycaemic diet 2. Oils on skin (make-up) 3. Drugs (Steorids, OCP) 4. Endocrine (PCOS)
42
Acne patients must check? (3)
1. Type and grade of acne (guides tx) 2. Psychological impact 3. Check for any scarring
43
What are Comedones, whats the difference between whiteheads and blackheads?
1. Keratin buildup in pores | 2. White = closed, Black = open
44
3 Severity of Acne
1. Comedonal 2. Papulopustular 3. Nodulocystic
45
What are the lifestyle mx of Acne? (3)
1. Cleansing: Only wash face 1-2 daily, wash hair regularly 2. Don't squeeze spots (aggravates inflammation) 3. Avoid excessive/oil-based makeup, remove before bed
46
Treatment for comedonal Acne
1. Extraction | 2. Topical Retinoid (like SABA prn)
47
Treatment for Papulopustular acne? Avoid what combination?
Mild: Topical Retinoid/abx + Benzyl Peroxide Moderate: Topical Retinoid + PO abx (Doxy, Minocycline, Trimethoprim) Avoid Topical + PO abx
48
Treatment for papulopustular Acne in Female patients? (2)
1. Topical Retinoid/abx + Benzyl Peroxide | 2. Hormonal: Cyproterone acetate (anti-androgen)
49
Acne involving back or chest warrants what treatment?
Oral abx
50
Severe nodulocystic acne treatment? Side effects?
1. PO Isotretinoin 6mo (refer Dermatologist) | 2. Teratogenic, LFT/lipids, dryness, mood changes
51
Rosacea onset age? Cause and RF?
1. 30-50y/o 2. Unknown 3. Fair-skin
52
Rosacea triggers? (3)
1. Heat/sunlight 2. Alcohol 3. Spicy foods
53
What are the core features of Rosacea? (4)
1. Erythema/Flushing, Telangiectasia, papulopustular 2. Ace of clubs distribution 3. NO comedones 4. Rhinophyma
54
How do you treat Rosacea? (4)
1. Avoid triggers, sun protection 2. Topical MNZ gel (papules) 3. PO abx (Doxy/Mino/Trimethroprim) 6mo, prevent Rhinophyma 4. Laser (Vascular for flush, Ablative for rhinophyma)
55
Variants of Rosacea (2)?
1. Peri-oral dermatitis | 2. Peri-orofacial dermatitis
56
POD distribution? (3)
1. Peri-mouth 2. Base of nose 3. Eyelids
57
What causes of POD? (2)
1. Idiopathic (Young women, mainly mouth) | 2. Topical steroids
58
Treatment of POD and prognosis?
1. Stop Topical Steroids 2. PO abx as per acne, but 2 mo (Doxy/mino/trimeth) 3. Usually clears does not recur

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