derm Flashcards
causes erythema nodosum
infection: TB, atypical pneumonia
medication: penicillin, sulfonamides, OCP
inflammation: IBD, sarcoidosis
malignancy: leukaemia, lymphoma
definition erythema nodosum
panniculitis (inflammation of subcutaneous fat) affecting anterior aspect of lower legs
management psoriasis
conservative: pt education, address psychosocial effects, monitor for psoriatic arthropathy
medical:
1. topical corticosteroids + vit D analogue (dovonex, calcitriol)
topical dithranol
tar preparations
regular emollients
2. phototherapy (UV-B)
systemic agents: methotrexate, ciclosporin
3. biologics: adalimumab, etanercept, infliximab
types of psoriasis
plaque psoriasis: most common, scaly salmon plaques
guttate psoriasis: tear-drop shaped, post-strep infection, often clears spontaneously
pustular psorasis: sterile pustules on hands / soles
flexural psoriasis
erythrodermic psoriasis: dry red skin all over body, triggers: drugs, infections, ↓Ca, steroid withdrawal
complications: dehydration, heart failure, hypothermia, infection, death
Tx: hospitalisation, IV fluids, temperature regulation, emollients
nail changes in psoriasis
POSH
pitting
onycholysis (separation from nail bed)
subungual hyperkeratosis (thickening + scaling)
psoriatic arthritis subtypes
monoarthritis: DIP toes / fingers, most common, nail changes, resembles OA
asymmetric: any joint, sausage fingers, nail changes, sacroiliitis
symmetric: large joints, resembles RA
arthritis mutilans: rare, severe, deforming, small joints of fingers / toes, rapid progression, difficult to treat
psoriatic spondylitis: sacroiliac joint + spine (stiffness)
management pyoderma gangrenosum
topical tacrolimus / steroids
management erythema nodosum
pain relief
oral corticosteroids
oral potassium iodine
bullous pemphigus vs pemphigoid
pemphigus: easily ruptured, Nikolsky +ve, biopsy → acantholysis
pemphigoid: itchy tense blisters, heal w/o scarring, skin biopsy → immunofluorescence shows IgG and C3 at dermoepidermal junction
