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Specific skin disorders Flashcards

Blistering disorders: pemphigus, pemphigoid Strawberry naevus Pyogenic granuloma Lichen planus Haemangiomas Pityriasis rosea Alopecia Photosensitivity (62 cards)

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1
Q

How does lichen planus present on flexor aspects?

A 
lesions are:
Purple
Pruritic (itchy)
Poly-angular
Planar (flat topped)
Papules 
\+ with lacy markings (wickhams striae)
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2
Q

Which other areas can lichen planus affect and how does it appear?

A

scalp - scarring alopecia
nails - longitudinal ridges
mouth - lacy white areas on inner cheeks

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3
Q

How long does lichen planus tend to last for?

A

6-18 months

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4
Q

what is the treatment of lichen planus?

A

topical steroids
moderate to potent topical steroids help itch
if severe systemic steroids

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5
Q

What are strawberry naevae? who do they effect? when do they disappear? when is treatment indicated?

A
  1. hemangioma which appears as a raised, red, lumpy area of flesh anywhere on the body
  2. neonates
  3. 5-7yrs
  4. if a vital function is impaired
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6
Q

What are pyogenic granulomas?What area is typically affected?

A
  1. lesion thought to arise as a result of minor trauma

2. fingers

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7
Q

How do pyogenic granulomas present?

A

most red lesion which grows rapidly and bleeds easily

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8
Q

What is rx of pyogenic granulomas?

A

curettage

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9
Q

What is pityriasis Rosea? who does it tend to affect? what is the cause?

A
  1. acute self limiting rash
  2. young adults
  3. not fully known , maybe HHV-7?
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10
Q

What are the features of pityriasis rosea?

A
  1. herald patch - single red and slightly scaly area

2. followed by erythematous scaly patches following line of Langer - fir tree appearance

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11
Q

What is the treatment of pityriasis rosea?

A

none - self limiting - usually disappears after 6-12 weeks

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12
Q

What are the two main types of alopecia?

A

scarring and non-scarring

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13
Q

wHat are the causes of non-scarring alopecia?

A
  • androgenetic
  • nutritional - Fe or Zn deficiency
  • Autoimmune - alopecia areata, alopecia totalis, alopecia universalis
  • Telogen effluvium
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14
Q

What are the causes of scarring alopecia?

A

lichen planus
discoid lupus erythematosus
trauma

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15
Q

What is alopecia areata?

A

autoimmune condition causing localised well demarcated patches of hair losss

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16
Q

What is pathognomonic of alopecia areata?

A

exclamation mark hairs at the edge of hair loss, wider at the top and taper to a progressively thinner hair as it meets the scalp

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17
Q

What is the prognosis of alopecia areata?

A

hair will regrow in 50% by 1 year and in 80-90% eventually

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18
Q

What are treatment options for alopecia areata?

A

topical or intralesional CS
topical minoxidil
phototherapy

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19
Q

What are the different causes of blisters?

A 
infection 
bites
drugs
dermatitis herpetiformis 
friction
discoid eczema 
autoimmune blistering disorders
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20
Q

What is the difference between blisters that are intraepidermal and sub epidermal?

A

intra-epidermal - blisters rupture easily

sub-epidermal - between epidermis and dermis and are less fragile

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21
Q

Who does bullous pemphigoid tend to affect?

A

elderly

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22
Q

What causes bullous pemphigoid?

A

autoabs against antigens between epidermis and dermis -> sub epidermal split

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23
Q

How does bullous pemphigoid present?

A

tense blisters on urticated base (itchy raised)

usually on trunk and limbs

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24
Q

What is the treatment of bullous pemphigoid?

A

clobetasol if localised

oral corticosteroids if widespread

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25
What causes pemphigus vulgaris?
autoabs against antigens in the epidermis intraepidermal split in the skin
26
How does pemphigus vulgaris present?
flaccid easily ruptured blisters forms erosions and crusts painful lesions
27
what areas are usually affected in pemphigus vulgaris?
mucosa
28
What is the management of pemphigus vulgaris?
steroids and immunosuppressants (method,azathioprine,cyclophosphamide)
29
What are the differences between bullous pemphigoid and pemphigus vulgaris?
``` BP sub epidermal split - less fragile affects elderly immunofluorescence - line at base of epidermis PV intraepidermal split - v fragile affects middle aged immunofluorescence - outline of each epidermal cell (autoabs bound to junctions between the cells) ```
30
What is dermatitis herpetiformis?
autoimmune blistering skin disorder associated w coeliac | caused by deposition of IgA in the dermis
31
What are the features of dermatitis herpetiformis?
itchy vesicular skin lesions on extensor surfaces
32
How is dermatitis herpetiformis diagnosed?
skin biopsy - direct immunofluorescence shows deposition of IgA in a granular pattern in upper dermis
33
What is the management of dermatitis herpetiformis?
dapsone and gluten free diet
34
What is livedo reticularis?
non blanching vague persisting red blue zig/zag - looks like a net
35
What is the appearance of erythema migrans?
bulls eye rash
36
what causes erythema migrans/
Lyme disease caused by spirochaete Borrelia burgdorferi spread by ticks
37
What is the treatment of erythema migrans?
doxycycline if early disease | ceftriaxone fi disseminated disease
38
What is erythema multiforme?
hypersensitivity reaction most commonly triggered by infections
39
How does erythema multiforme present?
target lesions initially seen on the back on the hands/feet before spreading to the torso upper limbs> lower limbs pruritus sometimes
40
What are the causes of erythema multiforme
Viruses - herpes idiopathic bacteria - mycoplasma, strep (major) drugs - penicillin, sulphonamides
41
How does erythema multiforme major present?
systemic upset, fever, sever mucosal involvement including conjunctivae
42
What is the management of erythema multiforme?
treat the cause supportive care steroids other immunomodulators
43
What is Stevens-Johnson syndrome?
potentially fatal skin reaction w sheet like skin and mucosal loss
44
What causes SJS
Usually drugs - sulphonamides, pencilling, anti-convulsants, allopurinol
45
How does SJS present?
prodromal illness resembling flu (fever, sore throat etc) Abrupt onset of tender/painful red skin rash starting over trunk and extending rapidly onto face and limbs Skin lesions - macule, diffuse erythema, target lesions, flaccid blisters Nikolsky sign - slight rubbing of the skin results in exfoliation of the outermost layer
46
What is toxic epidermal necrolysis?
bad bad end of spectrum w SJS
47
How does TEN present?
same as SJS: prodromal illness resembling flu (fever, sore throat etc) Abrupt onset of tender/painful red skin rash starting over trunk and extending rapidly onto face and limbs Skin lesions - macule, diffuse erythema, target lesions, flaccid blisters Nikolsky sign - slight rubbing of the skin results in exfoliation of the outermost layer
48
What is the management of TEN?
Stop DRUG ITU IV Ig Other rx: immunosuppressives (cyclosporin, cyclophosphamide) plasmapheresis
49
What is the difference between SJS and TEN?
SJS <10% of SA | TEN >30%
50
What is erythroderma?
term used when >95% of skin is involved in a rash of any kind
51
What are the causes of erythroderma?
``` eczema psoriasis drugs e.g. gold lymphomas, leukaemia idiopathic ```
52
What is erythema nodosum
inflammation of subcutaneous fat
53
What are the causes of erythema nodosum ?
``` infection - strep, TB Systemic disease - sarcoidosis, IBD, Malignancy/lymphoma Drugs: penicillin, sulphonamides Pregnancy ```
54
How does erythema nodosum present?
tender, erythematous nodular lesions | usually over shins
55
How long does erythema nodosum typically last for?
6 weeks
56
What are rx options for erythema nodosum
pain management | systemic CS
57
What is the inheritance pattern of tuberous sclerosis?
auto dom
58
What are the cutaneous features of tuberous sclerosis?
1. depigmented ash lead spots which fluoresce under UV light 2. Shagreen patches - roughened patches of skin over lumbar spine 3. Adenoma sebaceum - butterfly distribution over nose 4. Fibromata beneath nails 5. Cafe au lait
59
What are the neurological features of tuberous sclerosis?
developmental delay epilepsy intellectual impairment
60
What is an ocular feature of TS?
retinal hamartomas (benign retinal tumour)
61
What are the similarities of NF and TS?
both neurocutaneous autosomal dominant ocular hamartomas present
62
What are the differences between NF and TS?
``` NF: Cafe au lait Iris hamartomas - Lisch nodules Pheochromocytomas Axillary/groin freckles TS: Ash leaf spots Adenoma sebaceum Shagreen patches Subungual fibromata Epilepsy and DD Retinal hamartomas ```

Dermatology (11 decks)

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