102. Skin rash- Tinea, psoriasis, seborrhoeic dermatitis Flashcards
when assessing a skin rash, important q to ask?
site, location, numbers shape- annular, round raised/flat onset change in size over time (they tend to spread outwards) other members in family any medications any allergies have they treated it with cream/other? itchy bleeding dry/scaly any sickness/malaise? any travel? animals/pets?
give examples of dry scaly rash?
atopic dermatitis, psoriasis, seborrhoeic dermatitis, ringworm
cutaneous mycoses (skin fungal infections) give examples? Tinea?
Tinea pedis tinea cruris tinea corporis (ringworm) tinea capitus (head/scalp) tinea unguium (fingernails)
describe tinea? what is the organism?
pruritic lesions with a central clearing resembling a ring
microsporum canis
what is the treatment of tinea?
preferably topical cream. (sometimes tablets)
antifungals- AZOLES- eg miconazole,
ketoconazole- not for children
terbinafine- not for children, not an azole
what is the MOA of AZOLES?
inhibit ergosterol synthesis by inhibiting the enzyme 14-alpha-demythylase (conversion of lanosterol to ergosterol)
general advise to patients with ringworm?
keep dry and clean do not share towels etc, do not scratch
DDX of ringworm?
psoriasis
describe psoriasis?
Well-demarcated, erythematous, scaly plaques are present
Psoriasis is a common chronic skin disorder most commonly characterized by well-demarcated erythematous plaques with silver scale (picture 1A-E). Other presentations, such as guttate, pustular, erythrodermic, inverse, and nail psoriasis also occur (picture 2A-D).
treatment of psoriasis?
Emollients — Hydration and emollients are valuable and inexpensive adjuncts to psoriasis treatment.
Corticosteroids exert antiinflammatory, antiproliferative, and immunosuppressive actions by affecting gene transcription.
Topical vitamin D analogs — Topical vitamin D analogs for the treatment of psoriasis include calcipotriene (calcipotriol), calcitriol, and tacalcitol.
ULTRAVIOLET LIGHT — Ultraviolet (UV) irradiation has long been recognized as beneficial for the control of psoriatic skin lesions.
name the associated disorders of psoriasis?
Psoriatic arthritis — Psoriatic arthritis is one of several seronegative spondyloarthropathies that include ankylosing spondylitis and reactive arthritis
Ocular findings — Disorders of the eye, such as blepharitis, conjunctivitis, xerosis, corneal lesions, and uveitis may occur with increased frequency in patients with psoriasis.
Inflammatory bowel disease. There also seems to be some connection between psoriasis and inflammatory bowel disease, particularly Crohn’s disease.
special group of patients that get very severe psoriasis?
HIV-infected patients — Psoriasis may be the presenting sign of human immunodeficiency virus (HIV) infection, or it can develop after the diagnosis has been made. Psoriasis associated with HIV infection frequently is severe, with palmar and plantar involvement, nail disease, arthritis, and widespread, nearly erythrodermic disease
