Adnexal Diseases Flashcards
Acne
1. What is the utility of Wood’s lamp for acne?
2. How can acne be graded?
3. DDx acneiform drug eruption
4. Re acne fulminans:
- Clinical picture
- Who gets it
- Predisposing factors
- Mgmt
5. Signs of hyperandrogenism
6. DDx acneiform lesions
7. Topical acne Rx - groups and examples
8. Oral acne Rx - groups and examples
9. Isotretinoin recap
10. Follicular occlusion tetrad
- C acnes produces porphyrins. Red glow fluorescence (in progressive macular hypomelanosis)
- Dermnet. Based on type and number of lesions
Mild: total lesions <30 (comedones, inflammatory lesions)
Mod: 30-125
Severe: >125 - PIMPLE J CATS
- Abrupt development nodular and suppurative lesions a/w systemic feat. Fever, arthralgias, myalgias, malaise. EN. Osteolytic bone lesions (clavicle, sternum)
- M, 13-16
- Commencing isotret, anabolic steroid use, late onset CAH
- Pred 0.5-1mg/kg/day 2-4/52, taper over 1-2/12 as isotret started. Coprescribe ABx erythro
- Hirsutism, coarse voice, muscular habitus, AGA, clitoromegaly, increased libido
- ACNE PHAD
- Retinoids, antimicrobial, combination, chemical peels, keratolytics, hormonal
- Antibiotics, antiandrogen, isotretinion
- Acne conglobata, HS, dissecting cellulitis, pilonidal sinus
Rosacea
1. Clinical subtypes and their features
2. Types of phymatous rosacea
3. DDx facial plaques
4. Mgmt - general measures
5. Mgmt - topical measures
6. POD - risk factors
- Erythematotelangiectatic: erythema, flushing, telangiectasia
Papulopustular: erythema, papules, pustules
Phymatous: sebaceous gland hypertrophy, fibrosis. Patulous follicles
Ocular: dry, gritty, tearing, crusting - Rhinophyma, otophyma, gnathophyma, metophyma, blepharophyma
- GIRLS FAT
4, 5. See notes - TCS use, cosmetics use, allergfens/irritants, inhaled steroids, atopic predisposition, organisms (demodex, candida)
HS
1.DDx
2. Staging systems
3. Describe Hurley
4. Comorbidities
5. Explain to pt in terms they will understand
6. Mgmt - general
7. Mgmt - topical / local
8. Mgmt - systemic. Groups, examples
9. Humira PBS criteria
10. HS surgery - types / differences
- DDx: cutaneous Crohn’s, granuloma inguinale, TB, carbuncles, furunculosis, acne, LGV
- Sartorius, Hurley, HS PGA, HiSCR, DLQI
- 1 - 1+ abscesses, no sinus tract or scar. 2 - 1+ widely separated recurrent abscesses, sinus tracts and scars. 3 - multiple interconnected sinus tracts, extensive scarring
- ADIOS PAPI
- Check w notes
- Weight reduction, smoking cease, reduce friction, tight clothes. Diet mods. Vit D. Zn, B3
- Antiseptic wash. Clinda lotion. Resorcinol. ILCS
- Oral ABx. Oral anti androgens. Metformin. Pred. Zn gluconate
Retinoids
IV abx
Immunosuppression - I+D. Deroofing (partial, complete. Lesional, regional). Excision +/- flap or graft (lesional vs regional excision)
- PAPA
- PASH
- PAPASH
- SAPHO
- PAPA: Pyogenic arthritis, pyoderma, acne conglobata
- Autosomal dominant
- PSTPIP1 variant. Autoinflammatory syndrome - PASH: PG, acne, suppurative hidradenitis
- PAPASH: Pyogenic arthritis, pyoderma, acne, suppurative hidradenitis
- Synovitis, acne, pustulosis, hyperostosis and osteitis
- Neutrophilic derm a/w aseptic osteoarticular lesions
- Skin, bone, joints
- may be a/w IBD
- Skin: PPP, pustular psoriasis, Sneddon Wilkinson, psoriasis, follicular occlusion tetrad, acne, Behcet, Sweet, PG, LABD
Folliculitis
1. Eosinophilic pustular folliculitis ( + of Ofuji type):
- Clinical presentation
- Associations
- Histopath
- Mgmt - Ofuji, other
2. Pseudofolliculitis barbae
- Pathomech
- Clinical
- mgmt advice
3. Acne keloidalis
- Clin picture
- Rx ladder
1
- Recurrent episodes pruritic eruptive papulopustules. Involute 7-10 days
- Immunosuppression, HIV
- Spongiosis. Infundibular eosinophilic pustules. Eos around hair follicles and sebaceous glands
- Ofuji: oral indomethacin. Mino, dapsone, pred. Topicals
Immunosupp: HIV treatment. TCS, tacro, antihistamines for itch. NSAID, nbUVB, mino, dapsone, colchicine
2.
- See notes
- Beard area. Papules, pustules, keloid. PIH
- Stop shaving. See table in notes
3.
- Chronic folliculitis > keloidal papules and plaques which coalesce. Alopecia, tufting
- Top tret, TCS, antimicrobials
ILCS. Oral ABx, isotret. Laser hair remopval. Excision to fascia, allow to heal by secondary intention
How to Ix PCOS
Confirm Dx:
Total / free testosterone
Abdo USS
FSH:LH (LH elevated)
Associations:
Fasting glucose
Insulin
Lipids
Check BP
Weight, waist circumference, BMI
Miliaria
1. % of newborns affected, and why
2. Risk factors
- Up to 15%. Eccrine ducts not fully developed
- Incubator warming, over swaddling, fever, occlusive clothes, ointments
