What is the go-to treatment for inflammatory skin conditions?
What side effects are associated with it? (skin only)
Topical corticosteroids, eg Hydrocortisone.
Hypopigmentation, hypertrichosis, skin atrophy, telangiectasia (reversible), & striae (irreversible).
Name 4 inflammatory skin conditions.
What is the etiology of psoriasis?
Describe the appearance of its lesions.
Where are the lesions distributed?
Psoriasis is immune reaction resulting from many possible triggers (trauma, infection, meds)
Papules & plaques which are silvery & scaly. Also, nail pitting.
On extensor surfaces, eg elbows & knees.
Distinguish between the 4 subtypes of psoriasis.
Plaque (most common, often chronic)
Guttate (numerous, small lesions from Strep rxn)
Erythrodermic (generalized erythema)
Pustular (erythema, pustules)
What are some possible complications of psoriasis?
Psoriatic arthritis, increased risk of metabolic syndrome, atherosclerosis.
Besides corticosteroids, how is psoriasis treated?
Various other immunosuppressants.
Vitamin D analogs.
PUVA: Psoralen + UVA.
What is the etiology of Atopic Dermatitis?
Who is affected?
What are some disease associations it has?
Usually in infancy, but may affect adults.
Associated with Ichthyosis Vulgaris, Staph infection, Herpes infefction.
Describe the lesions seen in atopic dermatitis.
Erythematous paplues & plaques which may be crusty. Very pruritis, so presents with evidence of scratching and dry skin (xerosis).
How can atopic dermatitis be treated?
What is the etiology of Seborrheic Dermatitis?
Who is affected?
Describe the lesions found.
Usually infants, but sometimes adolescents/adults.
Seborrheic, fatty scales of the scalp (cradle-cap) or sebaceous regions.
How should seborrheic dermatitis be treated?
Maybe low-potency topical corticosteroids.
What is the etiology of Lichen Planus?
Who is affected?
How can it be treated?
T-cell expansion; usually idiopathic but sometimes in response to drugs, viruses, or vaccines.
Topical corticosteroids & antihistamines, maybe other immunosuppressants (MTX, Mycophenolate). NBUVB.
What are the 6 Ps of Lichen Planus?
Are there any other findings than these lesions?
Purple, polygonal, pruritic, planar, papules/plaques.
Reticular white patches, usually in mucosae ("Wickham's Striae")
Does psoriasis have a genetic component?
What medication can trigger psoriasis?
Yes, about 1/3 of patients have an affected family member.
Beta blockers, lithium, anti-malarials, interferons. Steroid withdrawal.
What is the Koebner phenomenon?
What is the Auspitz sign?
Koebner - Development of psoriatic lesions at injury sites.
Auspitz - Pinpoint bleeding under removed scales (due to papillary extension)
How many Lichen Planus patients have nail involvement? What occurs?
10%; nail plate thinning, longitudinal ridging, pterygium formation (scarring)
Distinguish between the two forms of mucosal lichen planus. Where are they found?
Usually oral > genital.
Reticulated: Lace-like pattern of small white papules.
Erosive: On gingiva/tongue, painful.
Describe its distribution.
What name is assigned to infraorbital folds seen here?
Flexural surfaces, neck & hands.
What is eczema herpeticum?
Does atopic dermatitis of thin skin merit more or less aggressive treatment than that of thick skin?
Widespread Herpes simplex infection.
Thin skin = better penetrance and higher SEs >> Use weaker meds.