autoimmune conditions

Question 1

what is dermatitis herpetiformis

Answer 1

autoimmune blistering skin disorder associated with coeliac disease. It is caused by deposition of IgA in the dermis.

Question 2

features of dermatits herpetiforms

Answer 2

itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

Question 3

Ix for dermatitis herpetiformis

Answer 3

skin biopsy: direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

Question 4

management of dermatits herpetiformis

Answer 4

gluten-free diet

dapsone

Question 5

antibody for coeliac disease

Answer 5

anti-tissue transglutaminase antibody

Question 6

causes of reactive arthritis

Answer 6

STI - Chlamydia, infection of the bowel, food poisoning

• glandular fever
• slapped cheek syndrome

HLA-B27

Question 7

features of reactive arthritis reiters

Answer 7

pain in joints
conjunctivitis
genital tract – causing pain when peeing, or discharge from the penis or vagina
eyes – causing eye pain, redness, sticky discharge, conjunctivitis and, rarely, inflammation of the eye (iritis)

Question 8

what skin condition is ass with reiter or reactive arthriits

Answer 8

Keratoderma blenorrhagica

Question 9

what is Keratoderma blenorrhagica

Answer 9

waxy yellow papules on the palms and soles.

Question 10

what is keratoacanthoma

Answer 10

benign epithelial tumour

Question 11

keratoacanthoma common in who

Answer 11

advancing age and rare in young people.

Question 12

features of keratoacanthoma

Answer 12

said to look like a volcano or crater
initially a smooth dome-shaped papule
rapidly grows to become a crater centrally-filled with keratin

Question 13

management of keratoacanthoma

Answer 13

removal to exclude SCC - prevent scarring

regress within 3 months causing scarring