Rashes

Question 1

T/F: eczema and dermatitis can be used interchangeably to describe inflammatory skin disease

Answer 1

True

Question 2

types of eczema?

Answer 2

endogenous

• atopic
• seborrheic
• stasis
• discoid
• asteatotic
• pompholyx
• lichen simplex
• photosensitive

exogenous: allergic, irritant

Question 3

__ % of global population suffer from eczema

Answer 3

10

Question 4

atopic eczema is associated with..

Answer 4

kids <2 and other atopy

Question 5

stasis and asteatotic (seasonal-winter) associated with…

Answer 5

elderly

Question 6

pompholyx is associated with

Answer 6

adults

Question 7

atopic eczema pathophysiology?

Answer 7

abnormalities in skin barrier function, combined with abnormalities of immunity possibly caused by filaggrin deficiency

Question 8

s/s of atopic eczema?

Answer 8

pruritus, erythema, scaling, FLEXURAL distribution, dryness, lichenification (skin thickening) in chronic disease

Question 9

sites for atopic eczema?

Answer 9

back of knees, ankles, wrists, inside of elbows, neck, eyes, genitals

Question 10

main complication of atopic eczema?

Answer 10

2y infection due to scratching by staph a, eczema herpeticum (multiple small blisters/ monomorphic punched out crusted papules)

Question 11

aetiology of seborrheic eczema?

Answer 11

malassezia yeast, HIV, parkinsons

Question 12

s/s of seborrheic eczema?

Answer 12

greasy body areas, scaling & erythema, around nose, medial eyebrows, ear canals, dandruff

Question 13

mx of seborrheic eczema?

Answer 13

anti-fungals/ steroids

Question 14

T/F: stasis eczema more common in people with varicose veins

Answer 14

T

Question 15

s/s of stasis eczema

Answer 15

inner calf, associated with signs of venous HT e.g. hemoiderin deposits

Question 16

s/s of discoid eczema

Answer 16

well demarcated scaly patches with small vesicles affecting limbs and torso, itchy

Question 17

T/F: asteatotic eczema is mildly itchy and occurs at lower back and lower legs

Answer 17

F: intensely itchy but site is correct

Question 18

causes of pompholyx eczema?

Answer 18

contact dermatitis, endogenous, cold/dry weather, frequent hand washing

Question 19

s/s of hand/foot eczema/pompholyx?

Answer 19

blistering/ bumpy spots on hands, dry shape skin- patch testing recommended

Question 20

lichen simplex eczema aetiology ?

Answer 20

repeated rubbing/scratching- may be due to emotional stress present

Question 21

s/s of lichen simplex

Answer 21

thickened skin and lichneified- common at nape of neck, outer calves, anogenital area

Question 22

photosensitive eczema some on with exposure to sunlight- what are its s/s?

Answer 22

confined to exposed areas- behind ears, cut off at collar- usually rash but may be blistering or scaly

Question 23

what are the mainstays of treatments for endogenous eczema

Answer 23

emollients, avoid irritant, topical steroids

phototherapy or systemic immunosuppressants for severe disease

Question 24

what is exogenous eczema

Answer 24

inflammatory skin reaction due to contact with a substance or irritant

Question 25

pathophysiology for allergic exogenous eczema

Answer 25

Langerhans cells react to antigen which is presented to T-helper cells in dermis > migration to lymph nodes> antigen presentation amplified

Question 26

common causes of allergic exogenous eczema and irritant EE

Answer 26

fragrance, rubber, metals, chemicals, medications | irritants- usually cleaning products

Question 27

T/F: exogenous eczema s/s are similar to endogenous

Answer 27

T: erythema, scaling, itch- usually pattern follows exposure

Question 28

retinoid is rx for what?

Answer 28

chronic cases of exogenous eczema

Question 29

what is psoriasis

Answer 29

chronic inflammatory papule-squamous disorder characterised by well demarcated red, scaly plaques

Question 30

bimodal pattern for psoriasis is...

Answer 30

1st- 16-22, 2nd wave: 55-60

Question 31

pathophysiology of psoriasis

Answer 31

skin is inflamed and hyperpoliferates (complement mediated attack on keratin layer causing epidermal hyperplasia)

Question 32

4 types of psoriasis...

Answer 32

chronic plaque psoriasis (psoriasis vulgaris)- most common guttae- rain-drop psoriasis (oval plaques), trunk, 2 weeks post sore throat erythrodermic- wide-spread, sterile pustules, malaise, pyrexia palmoplantar pustular- hands and feet, heavy smokers

Question 33

which type of psoriasis is life-threatening

Answer 33

erythrodermic

Question 34

what is psoriasis vulgarisms classic presentation?

Answer 34

symmetrical, pink, well demarcated plaques- may have silver scale- on EXTENSORS (elbows and knees)

Question 35

what is the Kobner phenomenon

Answer 35

new plaques forming at sites of skin trauma e.g. stretch marks

Question 36

tiny bleeding spots is called..

Answer 36

Auspitz sign

Question 37

T/F: psoriasis may have nail signs

Answer 37

T- onchylosis, nail pitting, hyperkeratosis

Question 38

mx for psoriasis?

Answer 38

vitD analogues, emollients, steroids, coal tar, phototherapy (UVB/ PUVA)

Question 39

name an example of a vitamin D analogue

Answer 39

calcipotrol

Question 40

what is lichenoid

Answer 40

chronic inflammatory rash of unknown cause

Question 41

sites lichenoid affects?

Answer 41

wrists and forearms, shins and ankles

Question 42

pathophysiology of lichenoid?

Answer 42

t-cell mediated inflammation targeting proteins in skin and keratinocytes*

Question 43

what are the types of lichenoid

Answer 43

lichenoid planes | lichenoid drug eruption

Question 44

which drugs trigger lichenoid?

Answer 44

BB, ACEI, gold

Question 45

telltale histological sign of lichenoid?

Answer 45

sawtooth acanthosis and hypergranulosis

Question 46

s/s of lichenoid

Answer 46

violaceous flat-topped shiny papules, Wickam's striae (lace like), itchy may have mucosal involvement- white streaks on tongue

Question 47

T/F: lichenoid may also kobnerize

Answer 47

T

Question 48

mx for lichenoid?

Answer 48

resolves within 12-18months, emollients, corticosteroids, phototherapy check for drug precipitant