2/24 Red Scaly Rashes Flashcards
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Psoriasis
genetic predisposition and environmental triggers, and associated with inflammatory diseases of other organs, including psoriatic arthritis, MI, HTN, hyperlipidemia and obesity.
Pink to red. Inflamed, well-demarcated plaques, with thick white scale “silvery” on extensor surfaces (sometimes on umbilicus, gluteal cleft, scalp)
Variants
- Guttate or “raindrop-like” eruption,
- Palmar Plantar Pustulosis
- Erythrodermic
- Pustular
- Acrodermatitis (Continua of Hallopeau)
Unique Features: Inverse Nail pitting/nail dystrophies
What does this person have?
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What are some features of this skin d/o?
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Psoriasis
genetic predisposition and environmental triggers, and associated with inflammatory diseases of other organs, including psoriatic arthritis, MI, HTN, hyperlipidemia and obesity.
Pink to red. Inflamed, well-demarcated plaques, with thick white scale “silvery” on extensor surfaces (sometimes on umbilicus, gluteal cleft, scalp)
Variants
- Guttate or “raindrop-like” eruption,
- Palmar Plantar Pustulosis
- Erythrodermic
- Pustular
- Acrodermatitis (Continua of Hallopeau)
Unique Features: Inverse Nail pitting/nail dystrophies
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Pityriasis Rosea
papulosquamous disease related to a viral illness (HHV 6 and 7)
pink to salmon oval shaped patches with thin trailing central scales
sparsely scattered over the central trunk, rarely on the face
“Herald Patch” at onset
What does this person have?
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What are some features of this skin d/o?
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Pityriasis Rosea
papulosquamous disease related to a viral illness (HHV 6 and 7)
pink to salmon oval shaped patches with thin trailing central scales
sparsely scattered over the central trunk, rarely on the face
“Herald Patch” at onset
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Syphilis
multi-organ infection caused by Treponema pallidum
1˚ chancre in genital mucosa
2˚ generalized round pink scaly patches, asymptomatic non-descript.
Evolves through 1˚, 2˚ and 3˚ stages; can be transmtited congenitally
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Syphilis
multi-organ infection caused by Treponema pallidum
1˚ chancre in genital mucosa
2˚ generalized round pink scaly patches, asymptomatic non-descript.
Evolves through 1˚, 2˚ and 3˚ stages; can be transmtited congenitally
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Lichen Planus
- inflammatory papulosquamous disease of the skin, hair and nails
- violaceous papules with lacy white lines and mild scale
Other Key features
- Wickham’s striae (white lines within papules and plaques)
- Linear confluent papules, development in areas of injury (Koebner phenomenon)
- Erosions within mucosa
- Pterygium (scar) formation of nails
Variants
- Hypertrophic lichen planus, Genital involvement
- Oral erosive lichen planus
- Nail dystrophy,
- Lichen planopilaris (hair follicle scarring process)
What does this person have?
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What are some features of this skin d/o?
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Lichen Planus
- inflammatory papulosquamous disease of the skin, hair and nails
- violaceous papules with lacy white lines and mild scale
Other Key features
- Wickham’s striae (white lines within papules and plaques)
- Linear confluent papules, development in areas of injury (Koebner phenomenon)
- Erosions within mucosa
- Pterygium (scar) formation of nails
Variants
- Hypertrophic lichen planus, Genital involvement
- Oral erosive lichen planus
- Nail dystrophy,
- Lichen planopilaris (hair follicle scarring process)
What does this person have?
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What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)
Lichen Planus
- inflammatory papulosquamous disease of the skin, hair and nails
- violaceous papules with lacy white lines and mild scale
Other Key features
- Wickham’s striae (white lines within papules and plaques)
- Linear confluent papules, development in areas of injury (Koebner phenomenon)
- Erosions within mucosa
- Pterygium (scar) formation of nails
Variants
- Hypertrophic lichen planus, Genital involvement
- Oral erosive lichen planus
- Nail dystrophy,
- Lichen planopilaris (hair follicle scarring process)
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What are some features of this skin d/o?
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What are some key features of it?
Tinea / Dermatophytosis
- infection of the skin, hair and nails, with multiple species of fungi
- Pink annular patches with an inflamed border and central clearing with trailing scale
KOH positive
Many variants, based on location; Capitis (head)
- Faciei
- Corporis
- Manum (hand)
- Crurus
- Unguium
- Pedis
What does this person have?
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What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)
What are some key features of it?
Tinea / Dermatophytosis
- infection of the skin, hair and nails, with multiple species of fungi
- Pink annular patches with an inflamed border and central clearing with trailing scale
KOH positive
Many variants, based on location; Capitis (head)
- Faciei
- Corporis
- Manum (hand)
- Crurus
- Unguium
- Pedis
What does this person have?
How do you know?
What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)
What are some key features of it?
Tinea / Dermatophytosis
- infection of the skin, hair and nails, with multiple species of fungi
- Pink annular patches with an inflamed border and central clearing with trailing scale
KOH positive
Many variants, based on location; Capitis (head)
- Faciei
- Corporis
- Manum (hand)
- Crurus
- Unguium
- Pedis
What does this person have?
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What are some features of this skin d/o?
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Granuloma Annulare
- infiltrative granulomatous disease, unknown cause
- Asymptomatic annular patches, central clearing, lacks scales
- dorsal feet and hands, but can generalize
Features: KOH negative
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Granuloma Annulare
- infiltrative granulomatous disease, unknown cause
- Asymptomatic annular patches, central clearing, lacks scales
- dorsal feet and hands, but can generalize
Features: KOH negative
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What are some features of this skin d/o?
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Granuloma Annulare
- infiltrative granulomatous disease, unknown cause
- Asymptomatic annular patches, central clearing, lacks scales
- dorsal feet and hands, but can generalize
Features: KOH negative
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How is it diagnosed?
Mycosis Fungoides (CTCL)
- malignant infiltrative disease of the skin
- red to violaceous patches, linear to oval and annular, with mild elevation and scale
Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.
Various stages:
- plaques
- nodules
- ulcerative lesions,
- erythrodermic systemic variant (Sézary’s Syndrome)
What does this person have?
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What are some features of this skin d/o?
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How is it diagnosed?
Mycosis Fungoides (CTCL)
- malignant infiltrative disease of the skin
- red to violaceous patches, linear to oval and annular, with mild elevation and scale
Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.
Various stages:
- plaques
- nodules
- ulcerative lesions,
- erythrodermic systemic variant (Sézary’s Syndrome)
What does this person have?
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What are some features of this skin d/o?
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How is it diagnosed?
Mycosis Fungoides (CTCL) - Sezary CTCL
- malignant infiltrative disease of the skin
- red to violaceous patches, linear to oval and annular, with mild elevation and scale
Histology necessary, may take multiple biopsies and immunohistochemistry to confirm the diagnosis.
Various stages:
- plaques
- nodules
- ulcerative lesions,
- erythrodermic systemic variant (Sézary’s Syndrome)
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Tinea Versicolor
superficial dermatophyte (fungal) infection caused by Malassezia furfur
Pink to orange to hyperpigmented oval and annular patches on the central chest and back, with thin, superficial KOH positive scale.
Color variation from light, pink, yellow-orange, and brown; depends on the pigmentation and sunlight exposure of the host
Usually in the “oily” areas of the upper chest and mid back
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What are some features of this skin d/o?
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Tinea Versicolor
superficial dermatophyte (fungal) infection caused by Malassezia furfur
Pink to orange to hyperpigmented oval and annular patches on the central chest and back, with thin, superficial KOH positive scale.
Color variation from light, pink, yellow-orange, and brown; depends on the pigmentation and sunlight exposure of the host
Usually in the “oily” areas of the upper chest and mid back
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What stage is it in particular?
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Cutaneous Lupus - ACUTE
Immunologic and inflammatory skin disease, may be related to systemic lupus
Acute: Inflamed tender red skin, malar area of face and sun-exposed skin
Subacute: Annular and arcuate patches, may coalesce, upper chest and back
Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar
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Cutaneous Lupus - SUBACUTE
Immunologic and inflammatory skin disease, may be related to systemic lupus
Acute: Inflamed tender red skin, malar area of face and sun-exposed skin
Subacute: Annular and arcuate patches, may coalesce, upper chest and back
Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar
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Cutaneous Lupus - CHRONIC
Immunologic and inflammatory skin disease, may be related to systemic lupus
Acute: Inflamed tender red skin, malar area of face and sun-exposed skin
Subacute: Annular and arcuate patches, may coalesce, upper chest and back
Chronic (Discoid): Usually annular, elevated plaques, may depigment and scar
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drug interactions to medications
Urticarial: small to large wheals which migrate form arcuate shapes and coalesce
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Drug rash
Morbilliform: measle-like distribution of pink to red round patches
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Erythema Multiforme
temporal relationship with medication administration
Red to pink “targetoid” macules on the palms and soles (specific, not always diagnostic)
Major variant: skin + mucosal erosions; can progress to internal organs
Minor: skin only
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What does it mean if this person had multiple ECM lesions?
Erythema Chronica Migrans
infection with Borrelia burgdorferi
Bright red, blanchable, expanding macule to patch, with some central clearing and central blue hue
warm to touch, but usually asymptomatic
Multiple ECM lesions, which implies long-standing and/or systemic infection
What does this person have?
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What is it usually coinfected with?
Eczema
common inflammatory process; may be
- *- familial** (atopic dermatitis),
- contact (poison ivy) - LINEAR distribution
- irritant
- *Pink, pruritic, scaly patches and thin plaques**
- *poorly demarcated**, diffusely spread and characteristically on the flexor surfaces.
Variants
- Atopic Dermatitis
- Eczematous Dermatitis
- Contact Dermatitis
- Irritant Dermatitis
- Dyshidrotic
Frequency co-infected with Staph aureus
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What are some features of this skin d/o?
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What is it usually coinfected with?
Scabies
infection and infestation with Sarcoptes scabiei var. hominis mites
Pink pruritic papules, some scale and linear vesicles and burrows, often in the skin folds especially the finger web spaces.
Key features
- Close contacts are almost always infected
- Genital infection may be sexually transmitted in adults
- Fails to respond to oral steroids
Variants
Nodular
Crusted (Norwegian)
Genital
2˚ infection with S. aureus involvement of the palms and soles in infants
What does this person have?
How do you know?
What are some features of this skin d/o?
(ie What is it? What causes it? Where does it affect?)
What is it usually coinfected with?
Scabies
infection and infestation with Sarcoptes scabiei var. hominis mites
Pink pruritic papules, some scale and linear vesicles and burrows, often in the skin folds especially the finger web spaces.
Key features
- Close contacts are almost always infected
- Genital infection may be sexually transmitted in adults
- Fails to respond to oral steroids
Variants
Nodular
Crusted (Norwegian)
Genital
2˚ infection with S. aureus involvement of the palms and soles in infants
