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Flashcards in Rashes Deck (37):
1

Pathogensis of acne

Increased androgens at puberty
Increased androgen sensitivity of sebaceous glands
Keratin plugging of pilosebaceous units
Infection with corynebacterium acnes

2

Clinical presentation of rosacea

More commonly females
Recurrent facial flushing
Visible blood vessels
Pustules
Tickening of skin - rhinophyma

3

Triggers of rosacea

Sunlight
Alcohol
Spicy foods
Stress

4

What are the 3 important bullous disorders?

Pemphigus
Bullous pemphigoid
Dermatitis herpetiformis

5

What is bullous pemphigus?

Rare autoimmun bullous disease resulting in loss of integrity of epidermal cell adhesion

6

Which subtype are 80% of pemphigus cases?

Pemphigus vulgaris

7

What immunology results would be indicative of pemphigus vulgaris?

IgG auto-antibodies against desmoglein 3

8

Pathogenesis of pemphigus vulgaris

Demsoglein (glue) contains desmosomal attachments
Immune complexes form on cell surface
Compliment activation & protease release
Disruption of desmosomes
Ending in ACANTHOLYSIS (cells float apart)

9

What process is common to all variants of pemphigus?

Acantholysis

10

Clinical presentation of pemphigus vulgaris

Ruptured fluid filled blisters
Involves esp. scalp, face, axillae, groin, trunk
May affect mucosa

11

What is bullous pemphigoid?

Subepidermal blister with no evidence of acantholysis
Epidermis lifts of basement membrane

12

What is the findings of bullous pemphigoid on immunofluorescence?

Linear IgG & complement depositied around the basement membrane

13

Why is it important to always send early lesions for histology of bullous pemphigoid?

As older lesions show re-epithelialisation of their floor - mimicking pemphigus vulgaris

14

What is dermatitis herpetiformis?

Rare autoimmune bullous disease associated with coeliac disease

15

Clinical presentation of dermatitis herpetiformis

Intensely itchy symmetrical lesions
Elbows, knees and buttocks - often excoriated
Hallmark is papillary dermal microabscesses

16

Findings of dermatitis herpetiformis on immunofluorescence

Deposits of IgA in dermal papillae

17

What are the common sites involved in psoriasis?

Extensors
Scalp, sacrum, hands, feet, trunk
Nails

18

Describe psoriasis plaques

Sharply demarcated, scaly, erythematous plaques

19

Psoriatic nail symptoms

Pitting
Oncholysis
Dystrophy
Subyngal hyperkeratosis

20

What is the Koebner phenomenon?

Appearance of new skin lesions on areas of cutaneous injury

21

Topical treatment options for psoriasis

Vit D analogues (calcipotriol, calcitrol)
Coal tar
Steroid ointments

22

Other alternative treatment options for psoriasis

Phototherapy
Retinoid
Immunosupression
Fumaric acid ester

23

Morphology of acne vulgaris

Comedones
Pustules
Papules
Cysts

24

Characteristics of mild acne

Scattered papules and pustules, comedones

25

Characteristics of moderate acne

Numerous papules, pustules & mild atrophic scarring

26

Characteristics of severe acne

Numerous papules, pustules, cysts, nodules and significant scarring

27

Topical treatment avaliable for acne

Benzoyl peroxide (keratolytic, antibacterial)
Topical vit A derivatives - adapalene (drying effect)
Topical antibiotics (antibacterial & anti-inflammatory)

28

Systemic treatments available for acne

Antibiotics
Isotretinoin (oral retinoid)

29

What is the initial effect of isotretinoin?

Flare up

30

Which topical antibiotic can be particularly effective in rosacea?

Metranidazole

31

Which bullous disorder is nikolsky sign negative?

Bullous pemphigoid

32

Which bullous disorder is more supperficial?

Pemphigus

33

Which bullous disorder is more likely to involve mucosa?

Pemphigus

34

Where is acne found?

Sebaceous gland sites (face, upper back, anterior chest)

35

Which skin disorders are associated with pregnancy?

Polymorphic eruption with pregnancy
Pemphigoid gestationis

36

Characteristics of pemphigoid gestationis

Pruritic blistering lesions
Peri-umbilical region
Rarely seen in first pregnancy
Oral corticosteroids usually required

37

Characteristics of polymorphic eruption of pregnancy

Pruritic condition associated with third trimester
Lesions in abdominal striae