091714 inflammatory disorders Flashcards
side effects of topical corticosteroids
mainly restricted to area of application
from chronic use: hypopigmentation, hypertrichosis, skin atrophy, telangiectasia. also striae. (if used on face, get acne or forms of rosacea) (if used around eyes, may increase risk of glaucoma and cataracts)
ointment vs cream
ointments are preferred by many dermatologists (they allow for better penetration of active ingredient through stratum corneum)
cons of ointment
greasy
patient non compliance
cream pros
better pt compliance
lotion and solution pros and cons
pros: good for scalp and places w hair
cons: stinging
foam pros and cons
good for scalp and places w hair
cons: stinging
gel pros and cons
pros: good for intraoral use
cons: drying, stinging
psoriasis characteristic lesion
well demaracted erythematous papules and plaques, with overlying silvery scale
clinical variants of psoraisis
plaque psoriasis (most common)
guttate psorasis (numermous smaller lesions, often triggered by strep)
erythrodermic (generalized erythema)
pustular (broad patches of erythema and overlying pustules)
plaque psorasis
symmetric, with elbows and knees being commonly invovled
tx of psoriasis
topical corticosteroids
others include: retinoids, coal tar, calcineurin inhibitors
topical vitamin D to induce terminal differentiation and inhibit proliferation of keratinocytes and to modulate the imune response
atopic dermatitis
most common chronic inflam skin disease
often occurs in setting of other atopic disorders including allergic rhinoconjunctivitis and asthma
pathogenesis of atopic dermatitis
multifactorial with genetics, epidermal barrier dysfxn and immunopathology all playing roles
major predisposing factor is mutations in profilaggrin gene
appearance of atopic dermatitis
acute lesions are usually edematous, erythematous papules and plaques and may ooze
subacute: erythematous and scaly, may be crusted
chronic: thickened with lichenification
diff btwn atopic dermatitis and psoriasis
AD lesions tend to be less well defined than those of psoriasis
tx of atopic dermatitis
topical corticosteroids
education regarding skin care to minimize further disruption of skin barrier with use of non drying cleansers and frequent application of emollients
antihistamines for pruritis
seborrheic dermatitis
mild inflammatory condition with variable presentation based on age
pathogenesis of seborrheic dermatitis
not understood
proposed contributing factors to seborrheic dermatitis
Malessezia furfur, sebum production, skin surface lipids
infant signs of seborrheic dermatitis
greasy yellow scale (cradle cap)
infantile seborrheic dermatitis lasts how long
it’s selflimited, with most having resolution by several months of age
where does seborrheic dermatitis occur for adolescents and adults
areas of high sebum production
tends to be more diffuse on scalp and ill defined than psoriasis
tx for seborrheic dermatitis
in infants, gentle skin care alone
adults-topical antifungal medications for chronic, or low potency topical croticosteroids for early stage
lichen planus
idiopathic inflam disease of skin and mucous membranes (sometimes drug, infec, or vaccine)
most common in middle aged adults
appearance of lichen planus
small, polygonal shaped violaceous flat topped papules
typically pruritic
fine white lines called Wickham’s striae
can affect orogenital mucosa
tx for lichen planus
spontaenous remission may occur, or course may be prolonged
treat by eliminating any suspected medications
mild cases: topical croticosteroids and antihistamines
extensive cases: phototherapy and immunosuppressive drugs
