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17 Cards in this Set

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How does pityriasis rosea present?
red pink base (fawn) with fine scale near periphery ("collarette" of scale), often mistaken for ringworm, pruritis, symmetrical long axis distribution on trunk and proximal extremities, spares face, palms, and soles (think syphilis instead!). Stages: oval herald plaque on trunk which becomes multiple lesions within weeks. Tends to occur in spring
What is unusual about the inverse variant of pityriasis rosea?
symmetrical lesions in axilla and groin
Who does pityriasis rosea tend to affect?
healthy adolescents/young adults...doesn't tend to recur
What is the DDx for pityriasis rosea?
Tinea corporis, nummular excema, and psoriasis can also have herald patch. Secondary syphilis (use VDRL to exclude this!), viral exanthem, drug eruption, and psoriasis also have generalized symmetrical eruption.
How do you treat pityriasis rosea?
The dz is usually self limited. But can use erythromycin, UV light, or acyclovir
On what parts of the body does psoriasis tend to occur?
elbows, knees, nails, scalp (check Auspict sign...pinpoint bleeding from scalp plaque)
Which variant of psoriasis has a good prognosis and which doesn't?
Good prognosis: guttate psoriasis
Poor prognosis: localized pustular psoriasis (on palms, soles, all over body! often includes systemic involvement)
What is the Koebner phenomenon?
lesions that occur after local trauma, common in psoriasis
Why is psoriasis worse in the winter?
if there was light, it would clear up because it responds to UV light
What treatment should be avoided when treating psoriasis?
systemic steroids because the disease will worsen and precipitate pustular psoriasis
What are the 4 P's of lichen planus?
purple, polygonal, papule, pruritic
What are Wickham's striae and what papulosquamous dz are they associated with?
fine white lacy lines on papules associated with lichen planus
How does lichen planus present?
symmetrical distribution on wrists, ankles, mucous membranes, nail involvement (angel wing deformity), koebnerization, pruritis, lichen planopilaris (scalp lesions), can lead to development of squamous cell carcinoma of the oral cavity
What viral illness is lichen planus associated with? How do you treat lichen planus?
Hepatitis C, steroids!
What is the DDx for the oral lesions of lichen planus?
leukoplakia, candida, cheek biting
What is the DDx for the skin lesions of lichen planus?
psoriasis, localized neurodermatitis
Name two childhood syndromes related to lichen planus? Explain them!
Lichen nitidus: group pinhead papules, koebnerize, non contagious, self limited, rule out molluscum and warts
Lichen striatus: linear eruption of scaly papules, which is often asymptomatic and self-limited, probably post-viral infection causation