Clinical Cases Flashcards

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1
Q

What are some causes of psoriasis

A
Genetic 
Environmental 
Stress
Drugs (B blockers and lithium)
Infection
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2
Q

What is the commonest form of psoriasis

A

Chronic plaque psoriasis (psoriasis vulgaris)

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3
Q

What sites of the body are commonly affected by psoriasis

A
Extensors 
scalp
sacrum
hands
feet
trunk
nails
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4
Q

Describe the appearance of psoriasis

A

Sharply demarcated, scaly, erythematous plaques

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5
Q

What type of psoriasis can be life threatening

A

Erythrodermic

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6
Q

What 4 things can happen to nails in psoriasis (psoriatic nail disease)

A

Oncholysis (lifting of nail from nailed)
Nail pitting
Dystrophy
Subungal hyperkeratosis

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7
Q

What are the main treatments of psoriasis

A
TOPICAL 
vitamin D ointments
Coal tar
Steroid ointments 
OTHERS
phototherapy (UVB and PUVA) 
Immunosuppresion
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8
Q

Psoriasis has an association with some other medical problems. What are these

A

Obesity - losing weight may help to revers the condition

Joints - rheumatology

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9
Q

Describe what acne vulgarise is

A

chronic inflammatory disease of the pilosebaceous unit

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10
Q

What are the gradings of acne

A

Mild
Moderate
Severe

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11
Q

What is the treatment for acne

A
To control/ prevent scarring 
Topical treatments (antibacterial, topical vitamin A derivatives, topical antibiotics
systemic treatment (antibiotics, isotretinoin)
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12
Q

What is a disadvantage of isotretinoin

A

You need to have contraceptive cover if female and of child bearing age

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13
Q

What can be used to treat an isotretinoin flare

A

Oral steroids

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14
Q

What areas of the body are affected by rosacea

A

Nose, chin, cheeks and forehead

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15
Q

What are some of the features of rosacea

A

Papules

Pustules and erythema with no comedones

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16
Q

What is the management of rosacea

A
Reduce aggravating factors 
Antibiotics 
Isotretinoin low dose if severe
Telangiectasia
Rhinophyma
17
Q

What are some aggravating factors of rosacea

A

Dietary triggers
Sun exposure
Avoid topical steroids

18
Q

What is the difference between Bullous disorders

A

Bullous pemphogoiD - split is Deeper, through DEJ

PemphiguS split more Superficial, intra-epidermal

19
Q

What age group of patients get Bullous pemphigoid

A

Elderly patients

20
Q

What is often the presenting feature of Bullous Pemphigoid

A

Itchy erythematous plaques and papillose

21
Q

What is a negative nikolsky sign

A

When a blister will not rupture if gently pressed.

22
Q

Where is affected in pemphigus vulgaris

A

scalp
face
axillae
groins

23
Q

What happens when the lesions burst

A

they leave raw areas which cause an increased infection

24
Q

Where else might be affected in pemphigus vulgaris

A

eyes

genitals

25
Q

Most patients achieve remission on treatment within 3-6 months. True or False

A

True

26
Q

What happens if pemphigus is left untreated

A

very high chance of mortality

27
Q

What 2 investigations can be carried out for pemphigus

A

Skin biopsy with direct immunofluorescence

Indirect immunofluorescence

28
Q

What is used to treat pemphigoid and pemphigus

A

Systemic steroids
Other immunosuppressive agents
Topicals (emollients, topical steroids)