Papulosquamous Diseases

Question 1

Identify the pathophysiology of psoriasis

Answer 1

• Chronic inflammatory condition

Question 2

Describe signs and symptoms of psoriasis

Answer 2

• Well demarcated erythematous plaque with silvery scale
• Most common sites: elbows, knees and scalp
• Plaques may fissure and bleed
• Pruritis, pain, arthralgias

Question 3

Verbalize at least 3 treatments for psoriasis

Answer 3

Topical treatments (steroids, Calcipotriene, Tazarotene, Tar, Ointments, Emollients), Phototherapy, Oral Medications (Methotrexate, Soriatane, Otezla), Biologics (SQ injection/IV infusion)

Question 4

Describe the clinical features of pityriasis rosea

Answer 4

• Acute self limited eruption of unknown cause
• Younger population
• Located on the trunk and proximal extremities (“Christmas tree”)
• Very itchy
• Management: address itching with topical steroids or antihistamines, potentially use phototherapy if very significant

Question 5

Describe the clinical features of lichen planus

Answer 5

• Uncommon
• 4 P’s (pruritic, purple, polygonal, papule or plaques)
• Different distributions (Wickham’s Striae, scarring alopecia, nail deformity, skin lesions)
• Treatment: topical/oral steroids

Question 6

Identify the diagnostic studies utilized to diagnose lichen planus

Answer 6

Diagnosed by biopsy

Question 7

Identify the associated diagnosis related to lichen planus

Answer 7

Hepatitis C

Question 8

Describe the clinical features of a drug eruption and fixed drug eruption

Answer 8

General Drug Eruption
- Symmetric sudden onset
- Bright red papular rash
- Proximal start, then spreads
- Usually itchy
Fixed Drug Eruption
- Individual lesion
- Isolated dusky red
- Possible itch/burn
- Hyperpigmentation as it heals
- New spots appear with repeated dose and the initial spot “lights up”

Question 9

List medications commonly implicated in a regular or fixed drug eruption

Answer 9

Antibiotics - Bactrim, Penicillins, Cephalosporins
Diuretics - Furosemide
NSAIDS
Blood Products - blood transfusions