10- Seb Derm, Psoriasis, Erythroderma Flashcards

1
Q

Chronic, superficial, inflammatory disease with a predilection for the scalp, eyebrows, eyelids, nasolabial crease, lips, ears, groin, axillae

Yellow, greasy scaling on erythematous base

A

Seborrheic dermatitis

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2
Q

Mild form of seborrheic dermatitis -dandruff is also called

A

Pityriasis sicca

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3
Q

Treatment of seborrheic dermatitis

A

Antifungals-
Scalp: ketoconazole selenium sulfide tar zinc pyrithione shampoo 2-3x a week

Topical calcineurin inhibitors- associated with burning sensation (tacrolimus etc)

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4
Q

Chronic recurrent inflammatory disease characterized by circumscribed, erythematous, dry, scaling plaques of various sizes covered by silvery white lamellar scales

Scalp, nails, extensor surfaces, umbilical, sacrum

A

Psoriasis

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5
Q

This sign is seen in psoriasis

- removal of scale produces bleeding points

A

Auspitz sign

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6
Q

Almost half of psoriatic arthritis patients have this type of human leukocyte antigen

A

HLA B27

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7
Q

Patients with this type of psoriasis have plaque psoriasis and psoriatic arthritis

A

Generalized pustular psoriasis

Von Zumbusch psoriasis

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8
Q

Sudden onset with lakes of pus periungually, on palms and plaque edges

Erythema and pustules all over with pruritus and intense burning
Mucous membranes affected- geographic tongue

Fever, erythroderma, hypocalcemia and cachexia

A

Generalized pustular psoriasis

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9
Q

Episodes of generalized pustular psoriasis are often provoked by

A

Withdrawal of systemic corticosteroids

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10
Q

Drug of choice for generalized pustular psoriasis (von Zumbusch)

A

Acitretin

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11
Q

Pustular psoriasis of pregnancy

Flexural erythema studded with pustules— generalized pustular flare

A

Impetigo herpetiformis

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12
Q

Treatment for impetigo herpetiformis

A

Delivery

Prednisone 1mg/kg/day

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13
Q

This disease resembles psoriasis except for its tendency for thicker keratotic lesions

(+) HLA B27

Develop reactive arthritis and skin disease after a bout of urethritis or enteritis

A

Reiter syndrome

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14
Q

Isomorphic response in psoriasis where lesions of psoriasis appear at a different site (scratches, incisions, burns etc)

A

Koebner phenomenon

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15
Q

Concentric blanching of erythematous skin at or near the periphery of a healing psoriatic plaque

First sign that psoriasis is responding to phototherapy

A

Woronoff ring

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16
Q

Which HLA is more associated with pustular psoriasis?

A

HLA B27

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17
Q

Which HLA is more associated with palmoplantar psoriasis?

18
Q

Which HLA is more associated with guttate and erythrodermic psoriasis?

A

HLA B13 B17

19
Q

Which interleukin is capable of inducing Th2 response and improve psoriasis?

20
Q

Psoriasis is a hyperproliferative disorder driven by inflammatory mediators

Which of the T helper cells are involved?

21
Q

Antimalarials can induce erythrodermic flares of psoriasis

What is the best prophylactic drug to take when traveling to an endemic area?

A

Quinine derivatives

22
Q

Steroid Topical tx for psoriasis

A

Class 1 steroids x 2 weeks
Low to mid strength- intertriginous, face
Intralesional triamcinolone- diluted with saline to make 2.5-5mg/mL

23
Q

Other topicals for psoriasis

A
  • Crude coal tar
  • Tazarotene-retinoid: modulate keratinocyte differentiation and hyper proliferation (combined with steroids)
  • tacrolimus- thin lesions
  • phototherapy: NB UVB 311nm
  • PUVA
24
Q

Effective in treatment of plaque type and scalp psoriasis

A

Calcipotriene (Vit D3)

25
This therapy for psoriasis is an effective method treatment that is inexpensive even in patients with poor response to biologic agents
Goeckerman technique
26
What is the Goeckerman technique
2-5% tar prep applied to skin and tar bath OD remove with vegetable oil THEN UV light given Option: add steroids to shorten time for remission
27
What is the Ingram technique for psoriasis?
Daily coal tar bath in warm water Daily exposure to UV light Anthralin paste to each plaque Talcum powder and stockinette dressings
28
Oral psoralen used in PUVA may produce this disease
Cataracts
29
PUVA therapy can increase the risk of acquiring this cancer
SCC | melanoma
30
Standard systemic treatment for psoriasis
Methotrexate 15-30mg per week
31
Before starting methotrexate treatment, these are the labs to be requested 9
``` LFT Bilirubin Serum albumin Creatinine Alkaline phosphatase CBC with platelet Hepa B and C serology HIV Urinalysis ```
32
Monitoring for methotrexate therapy in psoriasis
CBC once a week LFT once a month At the start or when dosage is changed
33
What is the therapeutic benefit of cyclosporine in psoriasis? 2-5mg/day
Downmodulation of pro inflammatory epidermal cytokines
34
Monitoring for cyclosporine treatment in psoriasis
Blood pressure | Creatinine
35
Biologic agents in psoriasis can block this immunologic modulator
TNF a
36
Characteristic triad of Reiter syndrome
Arthritis Conjunctivitis Urethritis
37
There is no specific test to diagnose Reiter syndrome but these are the most consistent
Peripheral leukocytosis 10-20k | Increased ESR
38
Males, mean onset 35y Pruritic, follicular papulopustules, grouped- peripheral extension Trunk and UE affected, asymmetric distribution Spontaneous remission and exacerbation for several years
Eosinophilic pustular folliculitis
39
Treatment of eosinophilic pustular psoriasis
Indomethacin
40
Chronic inflammatory disease of the hands and feet Begins on a digit, paronychia, extending with eruption of pustules and crusting — anonychia (chronic) May involve mucous membranes-tongue Asymmetric throughout course
Dermatitis repens
41
Bilateral and symmetrical dermatosis Thenar/hypothenar eminences or cental palms or soles Erythematous pustules that enlarge and coalesce to form small lakes of pus
Palmoplantar pustulosis
42
Palmoplantar pustulosis is strongly associated with
Thyroid disorder Cigarette smoking Lithium