Dermatology: 7: Misc. Inflammatory Disorders

Front 1

Pityriasis Rosea- definition?

Back 1

Acute exanthematous eruption-- Herald lesion followed 2 wks later by generalized eruption ("exanthematous phase") ; remits spontaneously in 6 weeks without therapy

Front 2

ptyriasis rosea- demographics?

Back 2

10-35yrs, common more in winter/fall

Front 3

ptyriasis rosea- exam findings?

Back 3

Herald Patch-scattered oval lesions (bright red w/ fine collarette scales at periphery)
Christmas tree distribution of dull pink or tawny (exanthem) lesions

Front 4

ptyriasis rosea- tx?

Back 4

-UVB phototherapy
-sunlight exposure
-low dose topical corticosteroids

Front 5

Lichen planus- definition?

Back 5

acute/chronic inflammatory dermatosis of skin/mucous membranes-- flat topped, violaceous, shiny, pruritic papules on the skin and milky white papules in the mouth

Front 6

lichen planus- demographics?

Back 6

30-80 y/o, females, idiopathic

Front 7

lichen planus- exam findings?

Back 7

1-10mm WICKHAM'S STRIAE
oral lesions
grouped, linear, annular, or disseminated distribution

Front 8

lichen planus- prognosis and tx?

Back 8

oral cancer risk inc. by 5%
PUNCH BIOPSY to confirm assoc. w/ HEP C!

Tx= Corticosteroids
Cylcosporine
Systemic retinoids
PUVA photochemotherapy

Front 9

Granuloma Annulare- definition?

Back 9

self-limited, idiopathic dermatosis common in the hands, feet, elbows, and knees; lasts mos to yrs

Front 10

granuloma annulare- demographics?

Back 10

female children and young adults

Front 11

graunloma annulare- exam findings?

Back 11

inflammatory rxn around BV altering collagen & elastic tissues
-skin lesions=Dome shape, annular/arciform arrangement
-lesions on hands, feet, arms, legs, trunk

Front 12

granuloma annulare- tx?

Back 12

-dx with PUNCH BIOPSY
-topical corticosteroids
-intralesional triamcinolone
-cryospray
-PUVA photochemotherapy

Front 13

morphea - definition?

Back 13

idiopathic cutaneous sclerosis-- ivory plaques and atrophy (possible cxn to B. burgdorferi)

Front 14

morphea- demographics?

Back 14

females, 20-50 y/o
before 14 = Pansclerotic morphea
also common in ppl with SCLERODERMA and RAYNAUD'S phenomenon

Front 15

morphea- exam findings?

Back 15

-indurated plaques, may be hypesthetic (sensitive to touch)
-hair follicles/sweat ducts disappear
-muscle & bone atrophy
-flexion contracture
-distal edema
-alopecia w/ scalp involvement
-lesions: initially PURPLISH or MAUVE and then become hyperpigmented

Front 16

morphea- tx?

Back 16

topical calipotriene may help
no cure

Front 17

Lichen Sclerosis et Atrophicus (LSA)- definition?

Back 17

chronic, idiopathic, mucocutaneous disorder with white papules, plaques, and keratotic plugs

Front 18

LSA- demographics?

Back 18

FEMALES (10:1), 40-50 y/o
rarely, children 1-13 y/o

Front 19

LSA- exam findings?

Back 19

GENITAL: female: vulvar lesions, pruritus, dysuria, dyspareunia; REABSORPTION OF LABIA /CLITORIS!!! ugh.
males: phimosis, penile lesions (Balantis Xerotica Obliterans)

Hint 19

-macules/papules/plaques w/ puncta
-DELLS (dilates pseb. glands w/ keratin plugs)
-*PURPURA*
-Keyhole/ fig 8 arrangement in anogenital area
-bluish/whitish plaques

Front 20

LSA- prognosis and tx?

Back 20

waxes/wanes; reoccurences of morhea/vitiligo
-tx = topical corticosteroids,
circumcision in males (prevents phimosis/sclerosis in some cases)

Front 21

Erythema Multiforme Syndrome- definition?

Back 21

Idiopathic, Iris-shaped, vesicolobulous lesions in hands/ feet/ mucous membranes

Front 22

Erythema Multiforme Syndrome- demographics?

Back 22

males, under 20 y/o
-assoc. with drugs, infection (esp HERPES and MYCOPLASMA)

Front 23

Erythema Multiforme Syndrome: EM MINOR form- exam findings?

Back 23

-assoc. w/ herpes simplex outbreak
- little to no mucous membrane involvement
-confined to extensor areas of extremeties
-classic target lesions

Front 24

Erythema Multiforme Syndrome: EM MAJOR- exam findings?

Back 24

-m/c as a DRUG RXN
-always has mucous membrane involvement
-confluent, bullous
-positive NIKOLSKY SIGN (like in pimphagus vulgaris)
-cheilitis & stomatitis
-vulvitis & balanitis
-conjunctivitis, keratitis, ulceration
-lesions in pharynx, larynx, trachea

Front 25

Erythema Multiforme Syndrome: MAXIMAL VARIANT- findings?

Back 25

-necrotizing tracheobronchitis
-meningitis
-renal tubular necrosis
-LIFE THREATENING!!!

Front 26

Erythema Multiforme- tx?

Back 26

pain is a key symptom
check for M. Pneumoniae or herpes simplex
tx= eliminate baterial agent; pruritus tx with antihistamines
systemic corticosteroids work well

Front 27

Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis (SJS / TEN)- definiton?

Back 27

idiopathic or drug-induced mucocutaneous lesions; skin tenderness, erythema, exfoliations, potentially fatal

Front 28

SJS/ TEN- progression?

Back 28

Erythema Multiforme Major - SJS - TEN
-start with target lesions
-1-3 day prodrome w/ fever, conjunctivitis, pruritus
-mucosal blisters & patches on eyes, ass, genitalia

Front 29

SJS/ TEN- dx and tx?

Back 29

dx= PUNCH biopsy
tx= high dose, systemic corticosteroids, plamapheresis

Front 30

Erythema Nodosum Syndrome- definition?

Back 30

acute inflammatory/ immunologic rxn of panniculus w/ appearence of nodules on the legs

Front 31

Erythema Nodosum Syndrome- demographics & etiology?

Back 31

Females, 15-30y/o,
-infections, drugs, assoc. paths (sarcoidosis, ulcerative colitis, Behcet's syndrome)

Front 32

Erythema Nodosum Syndrome- exam findings?

Back 32

nodules in subQ fat and lower legs
-pain/tenderness
-yellow-green or purplish lesions
-fever, arthralgia, malaise

Front 33

Erythema Nodosum Syndrome- prognosis and tx?

Back 33

resolution in 6 wks
-bed rest
-compressive bandages
-Salicylates/NSAIDS
-systemic corticosteroids (when etiology is known)