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Photodermatoses Flashcards

1
Q

Make key notes on sunburn and pigment darkening

A
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2
Q

Make key notes on photoaging

A
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3
Q

Make key notes on polymorphous light eruption

A
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4
Q

Make key notes on chronic actinic dermatitis

A
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5
Q

Nake key notes on solar urticria

A
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6
Q

Make key notes on porphyrias with cutaneous findings

A
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7
Q

Make key notes on hydroa vacciniforme

A
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8
Q

Make key notes on actinic prurigo

A
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9
Q

Make key notes on juvenile spring eruption

A
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10
Q

Classify photodermatologic disorders

A

1) Immune mediated - PMLE, actinic prurigo, hydroa vacciniforme, chronic actinic dermatitis, solar urticaria
2) defective DNA repair - Xeroderma pigmentosa, cockayne syndrome, trichothiodystrophy, Bloom sybdrome, Rothmund thomson syndorme, Hartnup disease, Kindler syndrome
3) Photoaggrevated dermatosis (underlying skin diseases worsened by UV exposure) - acne, rosacea, bullous pemphigoid, penphigus, auto-immune eg lupus, dermatomyositis, lichen planus, prllagra, mycosis fungoides, HHD/Dariers
4) chemical and drug induced
- exogenous: photoallergic+ photoroxic dryg reaction
-endogenous: porphyrias
*specific subtypes of chemical/drug induced = pseudoporphyria, hyperpigmentation, licheniud, phytophotodermatiris, tar
5) physiological response to UV exposure acute: sunburn
chronic photoageing/cancer

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11
Q

Define polymorphous lighteruption

A
  • immune mediated photosensitive d\o
  • polymorphous skin lesions in photo disreibution
  • 1-4 days following sun exposure
  • distinct seasonal pattern
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12
Q

Epidemiology of polymorphous lightt eruption

A

5-20% of population, female to male 2:1, usually <40y, peaks in spring -> hardening, not severe by summer

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13
Q

Pathogenesis of PMLE

A

Genetic predisposition
UVA> UVB

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14
Q

Clinical features of PMLE

A
  • photo distribution
    -macules, papules, plaques, vesicles, eczema
    -patient usually has consitent lesion types
    -onset 1-4 days after uv exposure
  • itch and erythema during uv exposure
  • heals without scarring
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15
Q

histology of PMLE

A
  • perivascular infiltrate (lymphocytes)
    -dermal oedema
  • no mucin
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16
Q

clinical variant of PMLE

A

Juvenile spring druption
-outbreaks in boys
-ears/helices: grouped vesicles

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17
Q

Diagnosis of PMLE

A

-exclude other causes
-history = characteristic

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18
Q

Investigations for PMLE

A

-) H/E and IMF (vesicle)
2) ANA, anti-Ro, anti-La
3) porphyria screen (Erythropoeitic porphyria)
4) photopatch testing
5) light testing

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19
Q

Prognosis of PMLE

A

-controlled Uv exposure leads to hardening
-recurs each spring/summer

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20
Q

management of PMLE

A

1) sun avoidance, sun protection, sunscreen (with UVA)
2) topical c/s
3) topical calcineurin inhibitors
4) anti-malarials
5) UV expoaure
6) other: anti-histamines, AZA

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21
Q

Define actinic prurigo

A

Sunlight induced pruritic papular or nodular eruption

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22
Q

Epidemiology of actinic prurigo

A

female to make 2:1, childhood onset-fade by adolescnece, 1-3-% of population

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23
Q

Clinical features of actinic prurigo

A

-worsening correlated with UV exposure
-highly pruritic papules/vesicles on face
-cheilitis - may be presenting sign
-nodules/papules on forarms ++ pruritic
-heals with scarring

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24
Q

Histology of actinic prurigo

A

1) early : epidermal spongiosis, acanthosis, perivascular infiltrate +~ eosinophils
2) late: crusts, acanthosis, lichenification

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25
Diff dx if actinic prurigo
Lupus eythenatosus, porphyria, insect bites, scabies
26
Mangement of PMLE
1) sun avoidance 2) topical c/s or calcineurin inhibitors 3) Thalidiomide 4) Anti-malarials, AZA, cyclosporin A
27
Prognosis of actinic prurigo
-Does not improve over lengthy periods of sun exposure -childhood onset type improves with age -rare adult type: persist
28
Write short notes on solar uricaria
29
Define hydroa vacciniforme
Rare, childhood onset, UV induced eruption of clustered vesicles with secondary scarring
30
epidemiology of hydroa vacciniforme
male more than female bimodal age distribution: 1-7y, 12-16y Resolve over time (except ebv form) white> black
31
Pathogenesis of hydroa vacciniforme
-exact moa not known -ebv assosiated with cut lesions +~ progression to NK-t cell lymphoma -may be a scarring variant of PMLE -UVA>UVB
32
Clinical features of hydroa vacciniforme
- symmetrical, clustered crops of vesicles - within 6-24hr post UV exposure - highly pruritic -vesicles-> necrotic -> crusted -> scar -site: ears, nose, throat, extensor forearms
33
Histology of hydroa vacciniforme
1) spongiosis +~ intra-epidermal vesicle 2) epidermal +~ dermal necrosis 3) mixed infiltrate
34
Diff dx of hydroa vacciniforme
PMLE actinic prurigo porphyria
35
Treatment of hyroa vacciniforme
1) photoprotection 2) refractory to treatment 3) NB - UVB used prophylactically 4) anti-malarials , B carotene, CyA, aza
36
Outcome of hydroa vacciniforme
improves with age scarring = permanent
37
Write short notes on chronic actinic dermatitis 1) epidemiology 2) pathogenesis 3) clinical features 4) diff dx 5) histology 6) investigations. 7) treatment 8) outcome/prognosis
38
Write short notes on actinic lichenoud leukomelanoderma of HIV
39
Write conditions associated with HIV and photosensitivity
1) PCT 2) pseudoporphyria 3) phototoxic\photoallergic drug reactions 4) actinic prurigo 5) chronic actinic dermatosis 6) PMLE 7) Pellagra
40
Compare phototoxic and photoallergic reactions (1) -definition -onset -prev exposure -clinical
41
Compare phototoxic and photoallergic reactions (2) - symptoms -subtypes/photoallergic agents
42
Compare phototoxic and photoallergic histology
43
Describe photopatch testing
44
Describe a systemic photoprovacation test
45
Describe other investigations for photosensitivity
46
Describe the normal cutanoeus effects of sun exposure (acute + subacute)
47
Describe the chronic effects if sun exposure
48
pictures of polymorphic light eruption
49
Pictures of photoaging
50
Clues to the diagnosis of specific photodermatosis in adults
51
Pictures of chronic actinic and photoallergic dermatitis
52
Pictures of photoaging
53
classification of photodermatosis (bolognia table)
54
Idiopathic possible immune mediated photodermatosis
55
pictures of hydroa vacciniforme
56
pictures of actinic orurigo
57
Photoaggrevated dermatoses
58
pictures
59
picture
60
cutaneous signs of photodamage
61
Picture of grovers disease
62
Evaluation of photosensitivity- laboratory investigations
63
endogenous chemical-induced photosensitivity
64
common phototoxic and photoallergic agents
65
interpretation of photopatch test
66
Write short notes on Trichothiodystrophy
67
Write short notes on Bloom syndrome
68
Write short noted on Rothmund thomson syndrome
69
write short notes on xeroderma pigmentosa
70
write short notes on cockayne syndrome
71
write short notes on COFS syndrome
72
Name 3 commonly employed photopatch test series
73
Name 3 common sunscreen ingredients tested in photapatch testing

Test 1 (17 decks)

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