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👩🏼‍⚕️ ANDREWS' DISEASES OF THE SKIN 13TH EDITION > 10- Seb Derm, Psoriasis, Erythroderma > Flashcards

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?

A

HLA B8

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?

A

IL-4

20
Q

Psoriasis is a hyperproliferative disorder driven by inflammatory mediators

Which of the T helper cells are involved?

A

Th1

Th17

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
Q

This therapy for psoriasis is an effective method treatment that is inexpensive even in patients with poor response to biologic agents

A

Goeckerman technique

26
Q

What is the Goeckerman technique

A

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
Q

What is the Ingram technique for psoriasis?

A

Daily coal tar bath in warm water
Daily exposure to UV light
Anthralin paste to each plaque
Talcum powder and stockinette dressings

28
Q

Oral psoralen used in PUVA may produce this disease

A

Cataracts

29
Q

PUVA therapy can increase the risk of acquiring this cancer

A

SCC

melanoma

30
Q

Standard systemic treatment for psoriasis

A

Methotrexate

15-30mg per week

31
Q

Before starting methotrexate treatment, these are the labs to be requested

9

A 
LFT
Bilirubin
Serum albumin
Creatinine
Alkaline phosphatase
CBC with platelet
Hepa B and C serology 
HIV
Urinalysis
32
Q

Monitoring for methotrexate therapy in psoriasis

A

CBC once a week
LFT once a month

At the start or when dosage is changed

33
Q

What is the therapeutic benefit of cyclosporine in psoriasis?

2-5mg/day

A

Downmodulation of pro inflammatory epidermal cytokines

34
Q

Monitoring for cyclosporine treatment in psoriasis

A

Blood pressure

Creatinine

35
Q

Biologic agents in psoriasis can block this immunologic modulator

A

TNF a

36
Q

Characteristic triad of Reiter syndrome

A

Arthritis
Conjunctivitis
Urethritis

37
Q

There is no specific test to diagnose Reiter syndrome but these are the most consistent

A

Peripheral leukocytosis 10-20k

Increased ESR

38
Q

Males, mean onset 35y
Pruritic, follicular papulopustules, grouped- peripheral extension

Trunk and UE affected, asymmetric distribution

Spontaneous remission and exacerbation for several years

A

Eosinophilic pustular folliculitis

39
Q

Treatment of eosinophilic pustular psoriasis

A

Indomethacin

40
Q

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

A

Dermatitis repens

41
Q

Bilateral and symmetrical dermatosis
Thenar/hypothenar eminences or cental palms or soles

Erythematous pustules that enlarge and coalesce to form small lakes of pus

A

Palmoplantar pustulosis

42
Q

Palmoplantar pustulosis is strongly associated with

A

Thyroid disorder
Cigarette smoking
Lithium

👩🏼‍⚕️ ANDREWS' DISEASES OF THE SKIN 13TH EDITION (32 decks)

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