Derm - skin disorders Flashcards
What type of disease is psoriasis?
Immune-mediated
Chronic
Psoriasis predispositions?
Polygenic + environmental triggers
Psoriasis signs/symptoms and location?
Sharply demarcated scaly erythematlus plaques
Scalp, elbows, knees commonest
Then nails, hands, feet and trunk
What is the commonest systemic manifestation of psoriasis?
Psoriatic arthritis
Outline the pathophysiology of psoriasis?
DNA released from stressed keratinocytes Form complexes with peptides → cytokines produced → dermal DCs activated → go to lymph nodes → chemokines → more cytokines in dermis → keratinocytes proliferate → plaques
3 triggers for psoriasis?
Stress
Trauma
Pathogens
Indirect management of psoriasis?
Treat/manage co-morbiditiss
Stop smoking, reduce alcohol
4 therapeutics of psoriasis?
Topical therapies
Phototherapy
Systemic immunosuppression
Advanced therapies
4 topical therapies of psoriasis?
Vit D analogues
Topical corticosteroids
Retinoids
Tacrolimus/pimecrolimus
2 types of psoriasis phototherapy?
Narrowband UVB
Psoralen + UVA (puva)
Two immunosuppressive drugs for psoriasis?
Methotrexate
Cyclosporine
3 advanced therapies for psoriasis?
PDE4 inhibitors - apremilast
Biologics- anti-tnf a
JAK inhibit
Atopic eczema type of disease?
Chronic
Inflammatory
Pruritic
Atopic eczema causes?
Genetic + environment
When does atopic eczema normally present?
Infancy or early childhood
What other conditions can eczema be associated with?
Asthma
Rhinoconjuctivitis
Signs/symptoms of eczema in infants?
Acute inflammation of cheeks scalp and extensors in infants
Signs/symptoms of eczema in children and adults?
Flexiral inflammation
Lichenification
Fissuring
Main forms of management for eczema?
Emollients
Anti inflammatory therapy
Eczema pathophysiology?
Barrier defect → filaggrin mutations → less extracellular lipids and ceramide → increased transepidermal water loss → less protection against microbes and allergens
Immune dysregulation
What is impetigiinisation?
Gold crust forms
Secondary infection of atopic eczema by staphylococcus aureus
Which eczema is an emergency and which virus causes it?
Eczema herpeticum
HSV herpes simplex virus
When is a biopsy taken in patients thought to have eczema?
Nipple eczema that is not getting better with treatment - could be cancerous , Paget’s disease
2 types of topical therapies for eczema?
Topical corticosteroids
Tacrolimus/pimecrolimus
Phototherapy for eczema?
Narrowband UVB
PUVA
What can be some of the issues with topical therapies?
Underuse - poor adherence
Overuse - tachyphylaxis or adverse effects
Eczema topical steroids from least to most potent? (5)
Hydrocortisone Clobetasone Betamethasone Mometasone Clobetasol
5 ways of managing eczema?
Topical therapies Phototherapy Retinoids Immunsuppression Advanced therapies
