Derma Flashcards
1
Q
Examples of Papulosquamous Diseases
A
- Psoriasis
- Lichen Planus
- DLE
2
Q
Def of Psoriasis
A
- Psoriasis is a genetically determined common skin disease characterized by: chronic relapsing nature and variable clinical features.
3
Q
Etiology of Psoriasis
A
4
Q
Pathology of Psoriasis
A
5
Q
Clinical types of Psoriasis
A
1- Psoriasis vulgaris.
2- Erythrodermic psoriasis
3- Pustular psoriasis.
4- Arthropathic psoriasis.
6
Q
Koebner Phenomenon in Psoriasis Vulgaris
A
- Trauma to the apparently normal skin may elicit new psoriatic lesions.
7
Q
Auspitz Sign in Psoriasis Vulgaris
A
- Removal of scales by scraping gives rise to small bleeding points which is pathognomonic for psoriasis
8
Q
what is the most comn form of Psoriasis Vulgaris?
A
Plaque Psoriasis
9
Q
Shape of Plaque Psoriasis
A
10
Q
Color of Plaque Psoriasis
A
Salmon Pink Erythema
11
Q
Covering of Plaque Psoriasis
A
Silvery white scales
12
Q
Specific Charaters of Plaque Psoriasis
A
+ve Koebner phenomenon
+ve Auspitz sign
13
Q
Site of Plaque Psoriasis
A
- Elbows, knees and lower sacrum.
- However, any site may be affected
14
Q
Shape of Scalp Psoriasis
A
15
Q
Specific Characters of Scalp Psoriasis
A
No hair loss
16
Q
Sites of Scalp Psoriasis
A
Scalp
17
Q
Shape of Palms & Soles Psoriasis
A
18
Q
Color of Palms & Soles Psoriasis
A
Red
19
Q
Covering of Color of Palms & Soles Psoriasis
A
Fine silvery scales
20
Q
Sites of Palms & Soles Psoriasis
A
Palms & Soles
21
Q
Shape of Psoriasis of Nails
A
22
Q
Site of Psoriasis of Nails
A
Nails
23
Q
Lesion in Intertriginous Psoriasis
A
24
Q
Specific Characters of Intertriginous Psoriasis
A
- Itching is common & fissuring is often seen in the gluteal crease
25
Site of **Intertriginous Psoriasis**
Localized to groins, gluteal crease, axillae and sub-mammary areas
26
Lesion in **Mucosal Psoriasis**
27
Lesion in **Guttate Psoriasis**
28
Site of **Guttate Psoriasis**
trunk and proximal extremities
29
Incidence of **Guttate Psoriasis**
- Usually occurs in children and young adults following acute streptococcal infection
30
Course of **Guttate Psoriasis**
- The lesions may subside after about 6 weeks without treatment or change to plaque type
31
Erythrodermic Psoriasis
- The entire skin is red and covered with scales.
32
Pustular psoriasis
Macroscopic sterile pustules appear.
- Localized to palms and soles.
- Generalized pustular psoriasis.
33
Arthropathic psoriasis
Psoriasis associated with arthropathy.
34
Course of Psoriasis
The disease is usually chronic with remission and relapse.
35
TTT of **Psoriasis**
- Topical
- Phototherapy
- Systemic
36
Topical TTT of **Psoriasis**
- Steroids
- Salicylic Acid
- Tar
- Calcipotriol (vitamin D analogue)
37
Steroids In TTT of **Psoriasis**
- Antimitotic & anti-inflammatory. (Topical, intralesional)
- They are applied alone or in combination with salicylic acid.
- Intralesional injection of steroid is used in localized small resistant lesion.
- Also, it is used for nail psoriasis by injection in the nail fold. However.
38
Salicylic acid in TTT of **Psoriasis**
- Keratolytic agent which is used to remove the scales. It is usually used in combination with steroid, tar or anthralin.
39
Tar in TTT of **Psoriasis**
Antimitotic 2-5% tar ointment is applied at night, and then removed in the next day by mineral oil before exposure to UVB. (goekerman technique)
40
when is Tar Contraindicated in **Psoriasis**?
- Application on face, flexures & genitals.
- Erythroderrnic and generalized pustular psoriasis.
- Severe acne & folliculitis.
41
Calcipotriol in TTT of **Psoriasis**
(vitamin D analogue)
- It inhibits proliferation of keratinocytes.
- It is applied twice daily with maximum dose of 100 gm weekly for 6 week
- This drug may increase serum calcium.
42
Phototherapy in TTT of **Psoriasis**
- UVB (broad band or narrow band) exposure 3 times weekly in mildly erythemogenic dose.
43
Systemic Therapy in TTT of **Psoriasis**
- Methotrexate. (given once weekly, hepatotoxic and myelotoxic)
- PUVA (psoralen+ UVA).
- Retinoids (acitretin), etretinate: teratogenic.
- Cyclosporine: nephrotoxic.
- Biologic therapy as TNFa blockers (as adalimumab, etanercept) and IL-17 antagonists (as sekicinumab)
44
Indications of Systemic Therspy in TTT of **Psoriasis**
should be used only by specialist in:
- Extensive psoriasis vulgaris not responding to topical therapy.
- Erythrodermic psoriasis.
- Pustular psoriasis.
- Arthropathic psoriasis
45
Why are Systemic corticosteroids absolutely contraindicated in psoriasis vulgaris?
Cause flare at withdrawl
46
Def of **Lichen Planus**
- a chronic sometimes acute disease of the skin and mucous membranes, with distinctive clinical and pathological features.
47
Etiology of **Lichen Planus**
- Psychic stress is a predisposing factor.
- Lichen planus may be more common among patients suffering from HCV.
48
Pathology of **Lichen Planus**
49
CP of **Lichen Planus**
50
what is the clsssic 1ry lesion of **Lichen Planus**?
- itchy flat topped, polygonal violaceous papules.
51
Wickham's striae
The surface of the papule may show white fine dots and lines known as (Wickham's striae).
52
**Lichen Planus** Lesions in oral mucosa
53
**Lichen Planus** lesion in nail
54
**Lichen Planus** lesions in palms & soles
55
Sites of **Lichen Planus**
56
Clinical Varieties of **Lichen Planus**
57
Course of **Lichen Planus**
58
TTT of **Lichen Planus**
59
7 Characters starting with **P** for **Lichen Planus**
Papules
Purple
Polygonal (flat topped)
Pruritic
Peripheral extremities + oral
Positive Koebner
Pterygium in nail
60
Def of **Discoid lupus erythematosus (DLE)**
- Localized inflammatory skin disease characterized by plaques of erythema, scaling and atrophic scar.
61
what is the most common type of chronic cutaneous lupus?
**Discoid lupus erythematosus (DLE)**
62
Types of **Lupus erythematosus (LE)**
DLE & SLE
63
Predisposing factors for **Discoid lupus erythematosus (DLE)**
64
CP of **Discoid lupus erythematosus (DLE)**
65
Age & sex of **Discoid lupus erythematosus (DLE)**
adults 20-40 years. (4 decade)
{Female: male = 2:1}
66
Lesions of **DLE**
67
Sites of **Discoid lupus erythematosus (DLE)**
- Face especially the butterfly area, scalp, arms, legs, dorsum of hands and retro-auricular areas.
- However, any site may be affected including oral mucosa.
- Lesions on the scalp cause scarring alopecia.
68
Course of **Discoid lupus erythematosus (DLE)**
- Spontaneous regression may occur with or without scar.
- Calcification
- Spread to other area
- In 6-6.5% of DLE patients they may change to SLE.
69
TTT of **Discoid lupus erythematosus (DLE)**
70
Systemic TTT of **Discoid lupus erythematosus (DLE)**
- Antimalarial drugs as hydroxychloroquine in cases not responding to topical steroid.
- Prednisone 15 mg/d.
- Etretinate
