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DERMATOLOGY > Common skin conditions > Flashcards

Common skin conditions Flashcards

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Dermatology Board Prep flashcards
1
Q

What percentage of adults does psoriasis affect?

A

2%

=> COMMON

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2
Q

What is the most common type of psoriasis?

A

chronic plaque psoriasis (psoriasis vulgaris)

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3
Q

Where do the plaques in psoriasis commonly appear?

A

extensors (elbow, knee)

scalp, sacrum, hands, feet, trunk

nails

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4
Q

How do the plaques in psoriasis commonly look?

A

Symmetrical on body
Sharply demarcated
scaly
erythematous plaques

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5
Q

What is the Koebner phenomenon?

A

psoriasis develops in area of skin trauma

e.g. scar from surgery

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6
Q

What is Auspitz sign?

A
  • removal of surface scale reveals tiny bleeding points

dilated capillaries in elongated dermal papillae

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7
Q

Describe the appearance of Guttate psoriasis

A

Widespread
Smaller plaques
closer together

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8
Q

Describe the appearance of Palmoplantar pustular psoriasis

A

Psoriasis with pustules focused on the palms of hands and soles of feet

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9
Q

Describe the appearance of Erythrodermic psoriasis

A

widespread and pustular

rare

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10
Q

What problems can psoriasis cause in the nails?

A

Onycholysis
Nail pitting
Dystrophy
Subungal hyperkeratosis

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11
Q

What comorbidities often exist with psoriasis?

A

metabolic syndrome (obesity, hypertension, diabetes, lipid abnormalities)

arthritis
Crohn’s disease
cancer
depression
uveitis
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12
Q

In what case of psoriasis is life expectancy reduced, and by how much?

A

reduced by 4 years in patients with severe psoriasis

Due to increased cardiovascular risk
3x increased risk of myocardial infarction

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13
Q

What topical therapies can be given for psoriasis?

A 
Vitamin D analogues
e.g. Calcipotriol (Dovonex) ointment 
Coal tar
Dithranol 
Steroid ointments
EMOLLIENTS
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14
Q

What phototherapy treatments can be used for psoriasis?

A

Narrowband UVB then PUVA

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15
Q

What systemic treatments can be used for psoriasis?

A 
immunosuppression e.g. methotrexate
Immune modulation (targeted biological agents) e.g. TNF Alpha
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16
Q

How is acne vulgaris defined?

A

inflammatory disease of the pilosebaceous unit

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17
Q

What age does acne usually affect males vs females?

A

14 -17 years in females

16 -19 years in males

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18
Q

Describe the pathogenesis of acne

A

Poral occlusion
Bacterial colonisation of duct (P acnes)
Dermal inflammation
Sebum production

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19
Q

What sites does acne vulgaris affect most?

A

Face, upper back, anterior chest

most sebaceous glands

20
Q

Describe the morphology of lesions seen in acne

A

Comedones - open (blackhead) and closed (whitehead)
Pustules and papules
Cysts
Erythema

21
Q

How is acne graded?

A

Mild- scattered papules and pustules, comedones

Moderate - numerous papules, pustules and
mild atrophic scarring

Severe - cysts, nodules and significant scarring

22
Q

Describe the progression of treatments for acne

A

Avoid oily substances, triggers

Topical Tx:
Benzoyl peroxide
Retinoids
Topical antibiotics

Systemic treatment:
Antibiotics (at least 6 months)
Isotretinoin (Roaccutane)

23
Q

What areas does rosacea normally affect?

A

Nose, chin, cheeks and forehead

24
Q

What age does rosacea usually affect?

A

30 – 60 years, male and female

25
Q

Describe the morphology of Rosacea lesions?

A

Papules, pustules and erythema with no comedones
Prominent facial flushing

can also cause unshapely/large nose – rhinophyma
Conjunctivitis / gritty eyes

26
Q

What can exacerbate the facial flushing seen in rosacea?

A

sudden change in temperature
alcohol
spicy food

27
Q

How is rosacea managed without drugs?

A

Avoid triggers
wear high factor sunscreen
avoid topical steroids

28
Q

What topical treatments are used in rosacea?

A

Metronidazole, Ivermectin (to reduce demodex mite)

29
Q

What oral therapy is used in rosacea?

A

Oral tetracycline long term

Isotretinoin low dose if severe

30
Q

What special treatments can be offered if a rosacea patient has Telangiectasia OR
Rhinophyma?

A

Telangiectasia : vascular laser

Rhinophyma: surgery/ laser shaving

31
Q

Describe the morphology of Lichen Planus

A

Violaceous (pink/ purple) flat-topped shiny papules

volar wrists/ forearms, shins and ankles

Wickham’s striae – fine lace-like pattern on surface of papules and buccal mucosa

32
Q

How long does Lichen Planus usually last before burning out?

A

12- 18 months

33
Q

How should Lichen Planus be treated?

A

TREAT SYMPTOMATICALLY

topical steroids (potent or very potent), oral steroids if extensive

34
Q

How do we differentiate between Bullous Pemphigoid and Pemphigus?

A

Bullous pemphigoiD –
split is Deeper, through DEJ.

Pemphigus –
split more Superficial, intra-epidermal

35
Q

What is Nikolsky’s Sign?

A

Top layers of the skin slip away from the lower layers when slightly rubbed

Indicates plane of cleavage within the epidermis

36
Q

Is Bullous Pemphigoid Nikolsky’s Sign positive or negative?

A

Negative

37
Q

Is Pemphigus Nikolsky’s Sign positive or negative?

A

Positive

38
Q

Patients of what age usually get Bullous Pemphigoid?

A

elderly

39
Q

Describe the distribution and appearance of Bullous Pemphigoid

A

localized to one area, or widespread on the trunk and proximal limbs

large tense bullae on normal skin on erythematous base
blisters burst to leave erosions

40
Q

How can bullous pemphigoid present earlier in disease?

A

Uritcarial itchy plaques

41
Q

Where does Pemphigus Vulgaris usually affect?

A

scalp, face, axillae, groins

42
Q

How does Pemphigus Vulgaris appear on the skin?

A

Flaccid vesicles/bullae – thin roofed
Lesions rupture to leave raw areas
Mucosal involvement (eyes, genitals)

43
Q

How long does it take for Pemphigus Patients to achieve remission?

A

Most patients achieve remission on treatment within 3 – 6 months

44
Q

How can Bullous pemphigoid and pemphigus be diagnosed?

A

Skin biospy with direct immunofluorescence

Indirect immunofluorescence

45
Q

How can bullous pemphigoid and pemphigus be treated?

A

Systemic steroids
Other immunosuppressive agents

In pemphigoid: tetracycline antibiotics
Topicals: emollients, topical steroids, topical antisepsis / hygiene measures

DERMATOLOGY (18 decks)

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