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Common Rashes Flashcards

1
Q

Clinical features of acute eczema

A

Papulovesicular erythematous lesions
Itch
Ill defined
Oedema
Ooze or scaling and crusting

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2
Q

Histology of acute eczema

A

Inflammatory infiltrate in the upper dermis
Fluid collections

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3
Q

Clinical presentation of chronic eczema

A

Lichenification
Elevated plaques
Increased scaling
Excoriation
Secondary infection

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4
Q

Clinical feature of adult eczema

A

Generalised dryness and itching, hand eczema may be the primary manifestation of

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5
Q

Clinical feature of childhood eczema

A

Predominantly flexural

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6
Q

Clinical features of infantile eczema

A

Primarily involves face, scalp, and extensor surfaces of the limbs
Nappy area usually spared

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7
Q

What kind of reaction is contact allergy dermatitis

A

Type 4 hypersensitivity reaction to an external antigen

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8
Q

Sensitisation stage of contact allergic dermatitis

A

Generation of memory T cells following exposure to antigen via langerhans cells in the epidermis and MHC-II

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9
Q

Allergic stage of contact allergic dermatitis

A

Activation of sensitised Th cells in response to antigen causing the release of inflammatory cytokines and cell mediated cytotoxicity

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10
Q

Investigations for contact allergy dermatitis

A

Patch testing

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11
Q

What happens in patch testing

A

Allergens prepared into Finn chambers which are applied on the back and removed at 48 hours

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12
Q

What is contact irritant dermatitis

A

Non-specific physical irritation

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13
Q

What can cause contact irritant dermatitis

A

Soap
Water
Cleaning products
Nappy rash

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14
Q

Where does contact irritant dermatitis usually present

A

On the hands

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15
Q

Genetic association with atopic eczema

A

Mutations in fillagrin gene

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16
Q

Clinical features of atopic eczema

A

Ill defined erythema and scaling
Itch-scratch cycle
Generalised dry skin

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17
Q

What distribution is seen in atopic eczema

A

Flexural

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18
Q

Complication of atopic eczema

A

nodular prurigo

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19
Q

What is nodular prurigo

A

Itchy nodules or papules on the skin

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20
Q

What is atopic eczema usually associated with

A

Asthma, allergic rhinitis, food allergy

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21
Q

Diagnostic criteria for atopic eczema

A

Itching + 3 or more of the following:
Visible flexural rash or history
History of atopy
Generally dry skin
Onset before age of 2

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22
Q

Management of atopic eczema

A

Targeted blocking of IL4 and IL14

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23
Q

Drug related eczema

A

Type 1 or 4 hypersensitivity, eosinophils will be present

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24
Q

Photo-induced or photosensitive eczema

A

Well defined
Patients are often atopic
Reaction to UV light OR secondary to photosensitising drugs

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25
What causes lichen simplex
Physical trauma to skin
26
What causes stasis dermatitis
Physical trauma to skin caused by increased hydrostatic pressure of the blood (venous insufficiency)
27
Where is stasis dermatitis seen
Lower legs
28
What is discoid eczema
Eczema which occurs in well defined circular or oval patches
29
What is another name for seborrhoeic eczema
Cradle cap
30
Where does seborrhoeic eczema tend to affect
Nose, eyebrows, ears and scalp
31
When does dyshidrotic eczema occur
When there is a very sudden acute flare up of eczema and the spongiotic vesicles join together
32
Clinical presentation of dyshidrotic eczema
Tiny blisters develop in hands and feet Classically on the sides of fingers
33
What is another name for dyshidrotic eczema
Pompholyx eczema
34
General measures for managing eczema
Avoid irritants Loose cotton clothing Emollients
35
Management of mild eczema
Topical steroid
36
Management of moderate eczema
Moderate topical steroid
37
Give an example of a moderate topical steroid
Betamethasone valerate 0.025%
38
Management of severe eczema
Potent topical steroid Consider occlusive dressings Treat infection if that’s a factor
39
Secondary care options for the management of eczema
Phototherapy Immunosuppression Biological agents
40
What is psoriasis
A common chronic inflammatory dermatosis
41
Genetic links in psoriasis
Associated with HLA genes and PSORS1 locus
42
When does psoriasis usually present
2 peaks in incidence 20s and 50s
43
Precipitating factors for psoriasis
Stress Trauma Alcohol and smoking Infection HIV/AIDS Drugs
44
Name some drugs associated with psoriasis
B blockers Lithium Anti malarial drugs
45
What causes rebound psoriasis
Swift withdrawal of topical or systemic steroids
46
What is the Koebner phenomenon
The development of new skin lesions on previously unaffected skin following trauma, injury or irritation
47
Give an example of an infection which can precipitate psoriasis
Strep throat
48
Pathophysiology of psoriasis
Hyperproliferation of epidermal cells
49
Clinical presentation of psoriasis
Symmetrically distributed, red scaly plaques with well defined edges Scale is silvery white Itchy
50
Common sites for psoriasis
Scalp, elbows and knees
51
What is auspitz sign
When psioritic plaques are scraped or removed, pinpoint bleeding points are observed on the skin surface
52
Name 3 nail changes that can be seen in patients with psoriasis
Nail bed pitting Onycholysis Subungual hyperkeratosis
53
What is nail bed pitting
Superficial depressions in the nail bed
54
What is onycholysis
Separation of the nail plate from the nail bed
55
What is subungual hyperkeratosis
Thickening of the nail bed
56
What is the commonest type of psoriasis
Chronic plaque psoriasis
57
Presentation of chronic plaque psoriasis
Symmetrical plaques on the extensor surface of the limbs, scalp and lower back Plaques are raised with silvery scale
58
How does flexural psoriasis present
Smooth, erythematous plaques without scale in flexures and skin folds colonised by candida yeasts
59
Where does flexural psoriasis present
Groin, axilla, inframammary areas
60
Management of flexural psoriasis
Mild topical steroid + antifungal preparations
61
When does guttate psoriasis occur
After a strep infection in young adults
62
What does guttate psoriasis present like
Multiple small, tear drop shaped erythematous plaques
63
Where does guttate psoriasis present
On the trunk
64
How does pustular psoriasis present
Multiple petechiae and pustules on the palms and soles
65
Causes of pustular psoriasis
Withdrawal of steroids, infection, pregnancy, hypocalcaemia
66
Causes of erythrodermic psoriasis
Withdrawal of potential topical or systemic steroids Drug reactions UV burns
67
Management of erythrodermic psoriasis
Fluid balance, bed rest, emollients, systemic immunosuppression
68
Unstable plaque psoriasis
The rapid extension of existing or new plaques
69
Histological features of psoriasis
Rete pegs Munro micro-abscesses in stratum corneum Expanded prickle cell layer
70
Management pathway for psoriasis
1. Topical 2. Phototherapy 3. Oral treatments 4. Biologic therapy
71
Topical treatments for psoriasis
Topical corticosteroids Emollients Tar preparations Vitamin D analogues Salicylic acid
72
What is acne
Inflammatory condition of the pilosebaceous unit
73
When does acne present
12-24
74
Diet associated with acne
High glycemic index and excess dairy consumption
75
Pathophysiology of acne
Increased androgens at puberty Hypercornification causes keratin plugging of pilosebaceous unit Infection with corynebacterium acnes within sebum in the hair follicles Production of comedones due to the build up of keratin and sebum Rupture causes acute inflammation
76
Closed comedones
whiteheads
77
Open comedones
Blackheads
78
Acne conglobata
Severe form of nodulocystic acne
79
Acne fulminans
Acute, painful, ulcerating and haemorrhagic clinical form of acne
80
Where does acne present
Reflects sebaceous gland sites Face, upper back, anterior chest
81
Complications of chronic acne
Atrophic scars and hyperpigmentation
82
Mild acne
Comedones, papules and pustules
83
Moderate acne
Numerous papules, pustules and mild atrophic scarring
84
Severe acne
Numerous papules, pustules, severe atrophic scarring and cysts and nodules
85
Histology of acne vulgaris (3)
Dilated follicular opening with cellular debris and bacteria Leukocytes and fragmented hair shaft Marked perifollicular inflammation
86
Management of mild acne
Topical treatment
87
Management of moderate acne
Topical treatment and oral antibiotics
88
Management of severe acne
Isotretinoin
89
Topical treatments for acne
Benzoyl peroxide Retinoids Topical antibiotics
90
Caution of benzoyl peroxide
Bleaches clothes etc.
91
Systemic treatments of acne
Oral antibiotics Contraceptives
92
Give some examples of oral antibiotics used in acne
Erythromycin, doxycycline, lymecycline
93
Who usually presents with rosacea
Women in 30-40s
94
Pathophysiology of rosacea
Involves chronic inflammation of the skin and is especially associated with triggers that increase body temp
95
Clinical presentation of rosacea
Recurrent facial blushing Erythema with papules and pustules on the nose, chin cheeks and forehead - sparing of naso-labial folds Thickening of the skin
96
Management pathway for rosacea
1. Topical metronidazole 2. Topical therapies + doxycycline 3. Isotretinoin
97
Complications of rosacea
Rhinophyma Telangiectasia Ocular inflammation
98
What is rhinophyma
Thickening of skin on the nose resulting in a bulbous and enlarged appearance
99
What is the most common lichenoid disorder
Lichen planus
100
What characterises lichenoid disorders
Damage to the basal epidermis
101
What condition is associated with lichen planus
Hepatitis C
102
Clinical presentation of lichen planus
Itchy flat-topped violaceous papules Oral lesions - lacy white on the inside of the cheek
103
Distribution seen in lichen planus
Flexor surfaces if the wrist/forearm, ankles and legs
104
Histology of lichen planus
Irregular sawtooth acanthosis Hypergranulosis and orthohyperkeratosis Upper-dermal infiltrate of lymphocytes Basal damage with formation of cytoid bodies
105
Management of lichen planus
Topical steroid + antihistamine

dermatology (13 decks)

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