Flashcards in Miscellaneous Deck (37):
2-3% of pop
Cell turnover is reduced from 29 days to 4 days
Physical trauma (koebner's pnenominon)
Rubbing and scratching
Psoriasis plaques that develop at site of skin injury.
1-2 wks after injury
50% will experience this
Psoriasis bimodal age distribution
30-40 then 50-70
Salmon pink papules and plaques, sharply marginated w/ silvery white scaling.
Scales are loose and easily removed
Scale removal results in small blood droplets (auspitz sign)
Elbows, knees, intertriginous
Most common, 80% of cases
Slow forming, stable
Well-defined and symmetrical
Knees, scalp, elbows, lower back
Sharply demarcated plaques
Axilla, groin, naval, submammary, palms, soles
No scales like plaque psoriasis
More common in obese
Young adults and kids
Many small teardrop shaped erythematous papules scattered diffusely on proximal extremities and trunk
Affects the whole body
Erythema and scaling from head to toe
High risk of infxn, electrolyte imbalance
Generalized on body
Severe form, acute onset
Pustules with erosions
Malaise, fever, diarrhea, hypocalcemia
Most common precipitating factor for erythrodermic and pustular psoriasis?
Withdrawl from systemic steroids
Useful in all cases of psoriasis
Hydrate stratum corneum
Softens scales and plaques
Apply BID after bathing while skin is damp
Topical steroids for psoriasis
FIrst-line for mild/limited plaque psoriasis
Cannot use for extended periods in high dose
When used alone only as effective as mild to mid potency steroids
Generally used as add-on
Vitamin D Analogues
Mild to mod plaque psoriasis
Cannot use of face/groin
Psoralen and UV-A Light.
Generally has excellent results
Use after mild tx failure
Drugs that may exacerbate psoriasis
Beta blockers, NSAIDS, lithium, ACE, digoxin
immune-mediated skin eruption of well-circumscribed wheals on erythematous base.
Hypersensitivity rxn involving deep layers of skin.
Swelling of lips, eyelids, palms, soles, genitals.
Urticaria and Angioedema prevelance
50% get both
40% only urticaria
10% only angioedema
Food and drug induced allergy
Tend to be brief
Usually do NOT cause chronic urticaria
May have angioedema
Punctate hives triggered by exercise or hot shower
Urt and Angio tx
Antihistamines: H1 or H2
Epi for anaphylaxis
Half of patients with chronic urticaria are free of lesions in one year
Onset early in life, white patches, loss of pigment.
Lesions on face, upper trunk, fingertips, hands, armpits, genitals, perioral, body prominences.
White hair and skin in involved areas.
Autoimmune against melanocytes
Occurs in pernicious anemia, hashimotos like alopecia areata
Rare, chronic, potentially fatal dz of mucous membranes.
Autoimmune intraepidermal blistering
Flaccid bullae that begin of oropharynx, then spread to scalp, face, chest, axillae, groin.
Tender and painful
Slight rubbing of skin results in sloughing and blister formation.
Seen in Pemphigus
May require admission for severe dz
Systemic steroids, immunosuppressives
Chronic, subepidermal blistering cause by autoimmune process.
Exclusively in elderly >60
WIdespread blistering eruption
Bullous Pemphigoid lesions
Associated urticarial plaques
Tense and fluid filled blisters
Bullous Pemphigoid tx
High dose oral steroids
Sevaceous cyst, infundibular cyst, epidermal cyst.
Most common cutaneous cyst.
Rupture is common, results in painful inflammatory mass.
Very common, button like nodule
Lesion may be tender