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65 Cards in this Set
- Front
- Back
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Psoriasis
Clinical Findings |
-Sharply marginated papules & plaques
-Silvery-white scale - + Auspitz sign -3-4% have concommitant arthritis |
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Psoriasis
Location of |
-extensor surfaces
-sacral area -palms, soles, nails, scalp |
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Psoriasis
Diagnostic Features |
Peak age 20s & 50s
Koebnerization Biopsy |
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Koebnerization
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phenomenon where in areas of trauma, psoriasis will pop up in the area of trauma
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Psoriasis
When to biopsy |
usually done when areas of psoriasis are in uncommon areas (flexor areas)
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Guttate Psoriasis
Occurs when... |
commonly after streptococcal pharyngitis or other stress
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Guttate Psoriasis
Characteristics |
-Tiny tear drop shaped lesions
-Multiple scaling red papules on the trunk and extremities |
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Guttate Psoriasis
Distribution |
-trunk & proximal extremities
-nail pitting |
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Psoriasis
Topical Treatment |
-Topical Steroids
-Emollients (greasier the better) -Tars (gel or paste) -Calcipotriene (Dovonex) -Tazorotene -Keratolytics |
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Psoriasis
Systemic Treatment |
-Acitretin - highly teratogenic
-Methotrexate -Cyclosporine -Biologics (expensive, injectable) -Adalimumab (not FDA approved) |
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Psorasis
Phototherapy |
PUVA
UVA UVB Narrow Band UVB (decrease skin CA risks & inc. therapeutic effects) |
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Pityriasis Rosea
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Maculopapular, red, scaling eruption
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Pityriasis Rosea
Clinical Findings |
-on trunk
-follows viral infection -fine scaling, oval macules & papules with marginal collarette |
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Pityriasis Rosea
Diagnosis & Treatment |
Dx: history, clinical finding
-- Perform RPR to r/o Syphilis Tx: Palliative for pruritis, self-limiting |
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Seborrheic Dermatitis
AKA |
-Cradle cap in infants
-Dandruff in adults -Seborrheic blepharitis on eyelashes |
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Seborrheic Dermatitis
Clinical findings |
-Yellowish-red, greasy macules and papules
-on Scalp, eyebrows, eyelashes, beard area, behind ears, forehead |
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Seborrheic Dermatitis
Clinical findings in babies |
failure to thrive, bad rash, bacterial infections, diarrhea
(work up for immunodeficiency disease) |
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Seborrheic Dermatitis
Treatment |
-Salicylic acid (P&S Shampoo)
-Selenium sulfide -Zinc pyrithrone (head & shoulders) -Tar preparations -Topical steroids |
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Lichen Planus
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Acute or chronic inflammation of the skin and mucous membranes
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Lichen Planus
Clinical findings |
Pruritic, purple, papules, planar, polygonal
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Lichen planus
Location & Age |
Wrists, lumbar area, shins, scalp, eyelids, groin, nails
Age -- 30-60 years old |
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Lichen planus
Etiology |
-Unknown
-Severe emotional stress -Drug-induced -Hepatitis C |
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Lichen planus
Treatment |
-spontaneous resolution in weeks or may persist for years
-topical steroids, PUVA, oral retinoids |
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Contact Dermatitis
Cause |
Caused by external agents, toxicity, or allergic reactions
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Contact Dermatitis
Clinical findings |
-Pruritis or burning of skin
-Irregular, well-demarcated patches of erythema & edema -Non-umbilicated vesicles -Punctate erosions exuding serum & crusts -Often linear arrangement |
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Contact Dermatitis
Treatment |
-Remove etiologic agent
-Burow's (drying) soaks -Calamine lotion -Antihistamines -Topical & systemic corticosteroids |
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Toxicodendrons
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Oil from plant causes infection not the serum in the vesicles
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Types of Toxicodendrons
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Poison ivy
Poison oak Poison sumac |
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Toxicodendrons
Treatment |
-Wash all items in contact with oil
-Topical steroids -Oral or IM steroids (2-3 week coverage) -Antihistamines -Ivy Block (before exposure) |
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Eczema (Atopic Dermatitis)
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Pruritic inflammation of the epidermis and dermis
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Eczema (Atopic Dermatitis)
Characteristics |
-Chronic & Recurrent
-Personal or family hx of hay fever, asthma, or allergic rhinitis |
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Eczema
Clinical Findings |
-erythema -keratosis pilaris
-papules -Dennie-Morgan sign -scaling -Pityriasis alba -excoriations -ichthyosis vulgaris -crusting & lichenification |
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Eczema
Location of irritation |
Infants: (2 months to 2 years) Extensor surfaces & cheeks
Adults: Flexor surfaces |
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Dyshidrotic eczema
What is it?? |
Common in teenage boys b/c they wear tennis shoes all day and sweat
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Nummular eczema
Cause & AKA |
usually caused by underlying fungal infection
"Dermatofitid reaction" |
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Manifestations of Scratching
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Dermatographism
Lichen Simplex Chronicus Excoriations Prurigo nodularis Pruritis scroti/ani |
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Eczema
Treatment |
-Avoid scratching
-Avoid allergic trigger -Hydration with topical emollients -Topical steroids |
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Steps in the formation of Comedo
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1. Keratinocytes proliferate and stick together
2. Bacteria multiply and colonize follicle 3. PMNs migrate to site as part of inflammatory response |
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Action of Anti-Acne Therapies
Topical Retinoids |
-Normalize desquamation
-Reduce inflammatory response |
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Action of Anti-Acne Therapies
Antibiotics |
-Reduce microorganisms
-Reduce inflammatory response |
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Action of Anti-Acne Therapies
Benzoly peroxide |
-Reduce microorganisms
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Action of Anti-Acne Therapies
Acutane |
-Reduce sebum
-Normalizes desquamation -Inhibits P. acnes growth -Reduces inflammatory response |
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Action of Anti-Acne Therapies
Hormones |
-Reduce sebum production
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Acne Vulgaris
Location & Who is affected |
Chronic inflammation of pilosebaceous units
-Face & Trunk -Adolescence to adulthood |
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Acne Vulgaris
Clinical Findings (Grade 1) |
Comedones
-Open -- blackheads -Closed -- whiteheads |
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Acne Vulgaris
Clinical Findings (Grade 2) |
Papules
Papulopustules Nodules |
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Acne Vulgaris
Clinical Findings (Grade 3) |
Cysts
Pitted or hypertrophic scars |
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Acne Rosacea
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Chronic acniform inflammation of the pilosebaceous units with increased reactivity of capillaries to heat
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Acne Rosacea
Who gets it? |
Male to female ratio -- 1:3
Rhinophyma -- Males > Female Fair-skinned individuals |
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Acne Rosacea
Clinical Findings |
-30-50 years of age
-Central face |
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Acne Rosacea
Stage 1 |
-intermittent flushing with few telangiectasias
-flushing occurs in response to caffeine, alcohol, spicy foods, extreme temps, stress |
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Acne Rosacea
Stage 2 |
-persistent flushing,
-increased telangiectasias, papules, and pustules -absence of comedones |
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Ance Rosacea
Stage 3 |
-persistent erythema
-numerous telangiectasias, papules, pustules, nodules, & rhinophyma formation |
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Acne Rosacea
Development of rhinophyma |
results from increase in connective tissue with deep inflammation and sebaceous gland hyperplasia
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Acne Rosacea
Treatment |
-reduction of products that flare the flushing
-daily sunscreen -Metronidazole cream, gel or lotion -Clindamycin cream, lotion, gel |
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Acne Rosacea
Tx with Tetracyclines for what? |
good for antibiotic & anti-inflammatory effects
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Acne Rosacea
Tx with Isotretinoin for what? |
Used most in stage 3 with rhinophyma and rosacea fulminans
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Acne Rosacea
Tx for Rhinophyma |
-Dermabrasion
-Planing with scalpel or razor -Electrocautery & ablation of tissue with CO2 laser |
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Acne Rosacea
Tx for Telangiectasias |
Electrocautery
Vascular lasers (more common) |
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Folliculitis
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superficial infection of the pilosebaceous unit
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Folliculitis
Clinical findings |
follicular based pustule, frequently grouped
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Folliculitis
Etiology |
Face/legs -- Staph aureus, 2nd to shaving
Back -- Candida albicans in febrile hospitalized patient |
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Impetigo
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Acute purulent infection
-intially vesicular then crusted -Staph aureus, GABH strept |
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Impetigo
Clinical findings |
transient thin-roofed vesicles
-Golden yellow -- "stuck on" crusts -Face, arms, legs, & buttocks |
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Impetigo
How to make dx. Treatment Complications |
Dx: clinical findings, gram stain, culture
Tx: Mupirocin, Dicloxacillin, erythromycin Complications: Glomerulonephritis with some strept strains |
