derm Flashcards
Tx erythema nodosum
NSAIDS
resp infections associated with what type of vasculitis
Henoch schonlein purpura HSP
Ix HSP
AUTOANTIBODIES- ANCA, ANA, RF
Bloods- FBC, renal, CXR- for pulmonary involvement
Mx HSP
rest, analgesia
SEVERE cases- corticosteroids/immunosuppressants
what skin condition associated with coeliac disease
dermatitis herpetiformis
what skin condition is DAPSONE used to treat
dermatitis herpetiformis
most common type of skin drug reaction
TOXIC ERYTHEMA
NAME the 3 types of erythema multiforme in order of severity
least
Erythema multiforme
-Stevens-Johnson syndrome
-Toxic epidermal necrolysis
MOST
what does erythema multiforme look like
target lesions
Prodrome of fever, weakness, respiratory symptoms
Typical target-shaped lesion
Red/pink macules > papules > plaques > darkening (purpuric), blistering/crusting
Lesions may begin on backs of hands/feet > progress proximally
Always affects mucosal sites - commonly lips/tongue/cheeks, also conjunctivae and others
SJS
Toxic epidermal necrolysis:
Widespread erythema, then significant necrosis + detachment of epidermis (>30% of body area)
Mucosal, respiratory and GI involvement
7-21 days initiation
~30% mortality
1000x increased risk in HIV+
Causes:
o Drugs - penicillin, sulphonamides, NSAIDs, allopurinol, anticonvulsants
Management:
o Burns unit/ITU
o Withdraw offending drug
o Hydration
o Nutritional support
o Short term dexamethasone, IV immunoglobulin
Antibodies against desmoglein 3 are seen in ????
pemphigus vulgaris
Pityriasis versicolor is caused by
Malassezia furfur
typically affects nose, cheeks and forehead
flushing is often first symptom
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma
ocular involvement: blepharitis
sunlight may exacerbate symptoms/
acne rosacea
keloid scars common in?
young black males
keloid treatment
intra-lesional steroids e.g. triamcinolone
what medication exacerbates plaque psoriasis
beta blocker propanolol
what causes eczema herpeticum
MOST common: HSV1+2
Rarely coxasackie
bullous pemphygoid vs pemphigus vulgaris
mucosal involvement in pemphigus VULGARIS
renal transplant skin ca risk
SCC
scabies management
permethrin 5% is first-line
malathion 0.5% is second-line
normal for pruitus 6-8 weeks after treatment
Acne vulgaris in pregnancy treatment
oral erythromycin
deficiency of what causes pellagra
niacin deficency- comes from nicotinic acid
which mineral and which vitamin deficiency causes angular chelitis?
ZINC
vit b2 riboflavin
pityriasis rosea causative organism
Herpes hominis virus 7 (HHV-7)
pityriasis versicolor treatment
ketoconazole shampoo (NOT cream)
acne rosacea treatment
moderate: topical ivermectin (other- metronidazole)
severe: oral doxy and ivermectin
bullous pemphygoid treatment
oral corticosteroid
OID– sterOID oral
skin ca associated with pUVA therapy
SCC
lichen planus first line management
topical steroids
Pemphigoid gestationis vs Polymorphic eruption of pregnancy
and their treatments
Polymorphic eruption of pregnancy: no blisters Tx= emollients, mild potency topical steroids and oral steroids may be used
looks MORE WIDESPREAD and bitty
pehmphygoid gestationis; blistering, peri umbilical
Tx= oral corticosteroids are usually required
which psych med worsens psoriasis
lithium
photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands
hypertrichosis
hyperpigmentation
Porphyria cutanea tarda
Ix Porphyria cutanea tarda
urine: elevated uroporphyrinogen and pink fluorescence of urine under Wood’s lamp
serum iron ferritin level is used to guide therapy
management porphyria cutanea tarda
chloroquine
venesection
dermatitis artefacta
Linear, well-demarcated skin lesions that appear suddenly, with ‘la belle indifference’
pts doing it them self- self harm
wood-grain’ pattern and figurate erythema commonly seen in patients with lung cancer
Erythema gyratum repens
meds causing erythema nodosum
COCP
sulphonamides
penicillins
treatment MRSA impetigo golden crust
what orgs cause impetigo
- fusidic acid
- mupirocin
caused by
staph aureus or strep pyogenes
fir tree appearance
fir tree
Pityriasis rosea
Porphyria cutanea tarda
cause
CFs
Ix
Tx
most common hepatic porphyria. It is due to an inherited defect in uroporphyrinogen decarboxylase or caused by hepatocyte damage e.g. alcohol, hepatitis C, oestrogen.
CFs
photosensitive rash with blistering and skin fragility on the face and dorsal aspect of hands
hypertrichosis
hyperpigmentation
Investigations
urine: elevated uroporphyrinogen and pink fluorescence of urine under Wood’s lamp
serum iron ferritin level is used to guide therapy
Management
chloroquine
venesection
preferred if iron ferritin is above 600 ng/ml
topical steroid strength
Topical steroids
moderate: Clobetasone butyrate 0.05%
potent: Betamethasone valerate 0.1%
very potent: Clobetasol propionate 0.05%
systemic mastocytosis
CFs
diagnosis
Features
urticaria pigmentosa - produces a wheal on rubbing (Darier’s sign)
flushing
abdominal pain
monocytosis on the blood film
Diagnosis
raised serum tryptase levels
urinary histamine
which viruses )numbers) cause eczema herpeticum
HSV 1 AND 2
dermophyte nail fungal infection treatment
PO terbinafine 12 weeks
irritant contact dermatitis VS allergic contact dermatitis:
allergic contact dermatitis:
common
not allergy
caused by hair dyes
allergic contact dermatitis:
type 4 hypersensitivity reaction
more uncommon
causative drugs SJS
COCP
sulphonamides- co trimoxazole
penicillin
lamotrigine, carbamazepine
allopurinol
NSAIDs
caused by IgA deposition in the dermis
dermatitis herpetiformis
‘wood-grain’ pattern, lung ca
Erythema gyratum repens
Dermatitis in acral, peri-orificial and perianal distribution– deficiency of what??
ZINC
which antibiotic can cause irreversible skin hypopigmentation
minocycline
bullous pemphygoid antibodies
vs
pemphigus vulgaris
Hemidesmosomal BP antigens
pemphigus vulgaris = desmoelgein 3
Severe vit a toxicity caused by retinoids in psoriasis cfs
bilateral pappiloedema
pemphigus vulgaris treatment levels
- prednisolone
if no response- immunosuppresion with
RITUXIMAB
