acne pathogenesis: 1. increased _____ production 2. dermal ____________ 3. bacterial colonisation of ____ 4. poral _________

acne pathogenesis: 1. increased SEBUM production 2. dermal INFLAMMATION 3. bacterial colonisation of DUCT 4. poral OCCLUSION

Rash Flashcards by Matthew Turnbull

John - 18
scaly plaques at elbows, knees and shins for 8 weeks
scaly scalp for 1 year
joint pains
smoker
40 units of alcohol a week
nail pitting and onycholysis

diagnosis?

psoriasis

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katy - 21
acute onset widespread rash over past 2 days
using E45
tonsilitis 2 weeks ago - treated with oral penicillin

diagnosis?

guttate psoriasis

(the trigger to the condition is often a streptococcal (bacterial) sore throat followed within two to three weeks by the skin eruption)

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is there a cure for psoriasis?

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name 3 environmental causes of psoriasis

stress
drugs
infection

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what is the commonest form of psoriasis?

chronic plaque psoriasis (psoriasis vulgaris)

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psoriasis is symmetrical

true or false?

true

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name the common site of psoriasis

extensors (elbow and knee)
scalp, sacrum, hands, feet and trunk
nails

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psoriasis is sharply __________, scaly, ____________ plaques

psoriasis is sharply DEMARCATED, scaly, ERYTHEMATOUS plaques

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psoriasis that develops in an area of skin trauma (stretch mark or scar) is known as what phenomenon?

Koebner phenomenon

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removal of surface scale reveals tiny bleeding points (dilated capillaries in elongated dermal papillae) is known as what psoriatic sign?

Auspitz sign

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name 4 psoriatic nail changes

onycholysis
nail pitting
dystrophy
subungal hyperkeratosis

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name some psoriatic co-morbidities

arthritis
obesity, hypertension, diabetes
crohns
cancer
depression
uveitis

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name the 5 topical therapies for psoriasis

vitamin D analogues - calcipotriol or calcitriol
coal tar
dithranol
steroid ointments
emollients

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name the 2 other treatments for psoriasis

phototherapy - UVB and PUVA

immunosuppression - MTX
biologics

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shona - 19
oily skin - blackheads
pustules and papules

diagnosis?

acne vulgaris

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acne vulgaris is a chronic ____________ disease of the _____________ unit

acne vulgaris is a chronic INFLAMMATORY disease of the PILOSEBACEOUS unit

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acne pathogenesis:

increased _____ production
dermal ____________
bacterial colonisation of ____
poral _________

acne pathogenesis:

increased SEBUM production
dermal INFLAMMATION
bacterial colonisation of DUCT
poral OCCLUSION

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comedones:

open =
closed =

open = blackhead
closed = whitehead

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where is acne distributed?

face
upper back
anterior chest

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name the 3 grades of acne

mild - scattered

moderate - numerous + mild scarring

severe - cysts + significant scarring

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name the 3 topical treatments of acne vulgaris

benzoyl peroxide
topical vitamin A derivatives (retinoid)
topical antibiotics

name the 2 systemic treatments of acne vulgaris

oral antibiotics

isotretinoin (oral retinoid)

Wilma - 36
increasing redness of face over 1-2 years
aggravated by wine and curry
recurrent papule and pustules of central fat and chin
father has red face and enlarged nose

diagnosis?

rosacea

rosacea treatment?

oral antibiotic - tetracycline

consider isotretinoin

where does rosacea affect (be specific)

nose cheeks and forehead

rosacea has papules, pustules and erythema with __ comedones

rosacea has papules, pustules and erythema with NO comedones

rosacea is prominent facial ________ exacerbated by sudden ______ in ___________, alcohol and _____ food

rosacea is prominent facial FLUSHING exacerbated by sudden CHANGE in TEMPERATURE, alcohol and SPICY food

an enlarged nose is known as what?

rhinophyma

conjunctivitis/gritty eyes are seen in rosacea true or false

true

what is the management of rosacea?

reduce aggravating factors (topical steroids) topical therapies - metronidazole oral therapy - tetracycline and isotretinoin

telangiectasia management?

vascular laser

rhinophyma management?

surgery/laser shaving

``` karen - 40 8 week history of very itchy rash on lower legs, flexor wrists, abdo and thighs discomfort in mouth PMH of eczema and asthma med - inhalers ``` diagnosis?

lichen planus

what is the special striae in lichen planus called?

Wickham's striae

what colour of buccal mucous and what nail are seen in lichen planus?

white reticular network or buccal mucosa and nail ridges

Lichenoid eruptions are characterized by damage and ____________ between the _________ and ______

Lichenoid eruptions are characterized by damage and infiltration between the epidermis and dermis

name the 2 commonest types of Lichenoid eruptions

lichen planus and lichenoid drug eruption

lichen planus has violaceous (____/______) flat-topped shiny papules typically affecting the volar wrists/________, shins and ______

lichen planus has violaceous (PINK/PURPLE) flat-topped shiny papules typically affecting the volar wrists/FOREARM, shins and ANKLES

how long does lichen planus last?

12-18 months

lichen planus treatment?

topical or oral steroids (extent of disease)

name the 2 bullous disorders

bullous pemphigoid | pemphigus

identify where the split is in the following bullous disorders: (a) bullous pemphigoid (b) pemphigus

(a) bullous pemphigoiD - split is Deeper - through DEJ | (b) pemphiguS - split is more Superficial - intra-epidermal

'the top layers of the skin slip away from the lower layers when slightly rubbed' what sign is this?

Nikolsky's sign indicates plane of cleavage within the epidermis

indicate whether or not nikolsky's sign is positive or negative in: (a) bullous pemphigoid (b) pemphigus

indicate whether or not nikolsky's sign is positive or negative in: (a) bullous pemphigoid - negative (b) pemphigus - positive

# choose the following which apply to bullous pemphigoid: ``` young/old patients? small/large tense bullae on skin? blisters that burst and leave/don't leave erosions? scarring/non scarring? itchy/non-itchy? Nikolsky sign positive/negative? mucosal lesions likely/unlikely? ```

# choose the following which apply to bullous pemphigoid: ``` old patients large tense bullae on skin blisters that burst and leave erosions non scarring itchy Nikolsky sign negative mucosal lesions unlikely ```

in early disease, bullous pemphigoid is seen as urticated itchy plaques rather than bullae true or false?

true

mucosal involvement (eyes and genitals) in pemphigus vulgaris is not common true or false?

false mucosal involvement and pemphigus vulgaris is VERY common

which has a higher mortality rate: pemphigus or bullous pemphigoid?

pemphigus - by far

name the investigations performed in pemphigus/pemphigoid

dkin biopsy + direct immunofluorescence or indirect immunofluorescence

outline the treatment of pemphigoid and pemphigus

systemic steroids immunosuppressive agents pemphigoid: tetracycline antibiotics topicals: emollients, steroids, antisepsis/hygiene measures