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Drafts > Derma > Flashcards

Derma Flashcards

1
Q

Examples of Papulosquamous Diseases

A
  • Psoriasis
  • Lichen Planus
  • DLE
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2
Q

Def of Psoriasis

A
  • Psoriasis is a genetically determined common skin disease characterized by: chronic relapsing nature and variable clinical features.
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3
Q

Etiology of Psoriasis

A
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4
Q

Pathology of Psoriasis

A
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5
Q

Clinical types of Psoriasis

A

1- Psoriasis vulgaris.
2- Erythrodermic psoriasis
3- Pustular psoriasis.
4- Arthropathic psoriasis.

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6
Q

Koebner Phenomenon in Psoriasis Vulgaris

A
  • Trauma to the apparently normal skin may elicit new psoriatic lesions.
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7
Q

Auspitz Sign in Psoriasis Vulgaris

A
  • Removal of scales by scraping gives rise to small bleeding points which is pathognomonic for psoriasis
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8
Q

what is the most comn form of Psoriasis Vulgaris?

A

Plaque Psoriasis

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9
Q

Shape of Plaque Psoriasis

A
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10
Q

Color of Plaque Psoriasis

A

Salmon Pink Erythema

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11
Q

Covering of Plaque Psoriasis

A

Silvery white scales

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12
Q

Specific Charaters of Plaque Psoriasis

A

+ve Koebner phenomenon
+ve Auspitz sign

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13
Q

Site of Plaque Psoriasis

A
  • Elbows, knees and lower sacrum.
  • However, any site may be affected
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14
Q

Shape of Scalp Psoriasis

A
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15
Q

Specific Characters of Scalp Psoriasis

A

No hair loss

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16
Q

Sites of Scalp Psoriasis

A

Scalp

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17
Q

Shape of Palms & Soles Psoriasis

A
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18
Q

Color of Palms & Soles Psoriasis

A

Red

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19
Q

Covering of Color of Palms & Soles Psoriasis

A

Fine silvery scales

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20
Q

Sites of Palms & Soles Psoriasis

A

Palms & Soles

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21
Q

Shape of Psoriasis of Nails

A
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22
Q

Site of Psoriasis of Nails

A

Nails

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23
Q

Lesion in Intertriginous Psoriasis

A
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24
Q

Specific Characters of Intertriginous Psoriasis

A
  • Itching is common & fissuring is often seen in the gluteal crease
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25
Q

Site of Intertriginous Psoriasis

A

Localized to groins, gluteal crease, axillae and sub-mammary areas

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26
Q

Lesion in Mucosal Psoriasis

A
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27
Q

Lesion in Guttate Psoriasis

A
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28
Q

Site of Guttate Psoriasis

A

trunk and proximal extremities

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29
Q

Incidence of Guttate Psoriasis

A
  • Usually occurs in children and young adults following acute streptococcal infection
30
Q

Course of Guttate Psoriasis

A
  • The lesions may subside after about 6 weeks without treatment or change to plaque type
31
Q

Erythrodermic Psoriasis

A
  • The entire skin is red and covered with scales.
32
Q

Pustular psoriasis

A

Macroscopic sterile pustules appear.
- Localized to palms and soles.
- Generalized pustular psoriasis.

33
Q

Arthropathic psoriasis

A

Psoriasis associated with arthropathy.

34
Q

Course of Psoriasis

A

The disease is usually chronic with remission and relapse.

35
Q

TTT of Psoriasis

A
  • Topical
  • Phototherapy
  • Systemic
36
Q

Topical TTT of Psoriasis

A
  • Steroids
  • Salicylic Acid
  • Tar
  • Calcipotriol (vitamin D analogue)
37
Q

Steroids In TTT of Psoriasis

A
  • 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
Q

Salicylic acid in TTT of Psoriasis

A
  • Keratolytic agent which is used to remove the scales. It is usually used in combination with steroid, tar or anthralin.
39
Q

Tar in TTT of Psoriasis

A

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
Q

when is Tar Contraindicated in Psoriasis?

A
  • Application on face, flexures & genitals.
  • Erythroderrnic and generalized pustular psoriasis.
  • Severe acne & folliculitis.
41
Q

Calcipotriol in TTT of Psoriasis

A

(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
Q

Phototherapy in TTT of Psoriasis

A
  • UVB (broad band or narrow band) exposure 3 times weekly in mildly erythemogenic dose.
43
Q

Systemic Therapy in TTT of Psoriasis

A
  • 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
Q

Indications of Systemic Therspy in TTT of Psoriasis

A

should be used only by specialist in:

  • Extensive psoriasis vulgaris not responding to topical therapy.
  • Erythrodermic psoriasis.
  • Pustular psoriasis.
  • Arthropathic psoriasis
45
Q

Why are Systemic corticosteroids absolutely contraindicated in psoriasis vulgaris?

A

Cause flare at withdrawl

46
Q

Def of Lichen Planus

A
  • a chronic sometimes acute disease of the skin and mucous membranes, with distinctive clinical and pathological features.
47
Q

Etiology of Lichen Planus

A
  • Psychic stress is a predisposing factor.
  • Lichen planus may be more common among patients suffering from HCV.
48
Q

Pathology of Lichen Planus

A
49
Q

CP of Lichen Planus

A
50
Q

what is the clsssic 1ry lesion of Lichen Planus?

A
  • itchy flat topped, polygonal violaceous papules.
51
Q

Wickham’s striae

A

The surface of the papule may show white fine dots and lines known as (Wickham’s striae).

52
Q

Lichen Planus Lesions in oral mucosa

A
53
Q

Lichen Planus lesion in nail

A
54
Q

Lichen Planus lesions in palms & soles

A
55
Q

Sites of Lichen Planus

A
56
Q

Clinical Varieties of Lichen Planus

A
57
Q

Course of Lichen Planus

A
58
Q

TTT of Lichen Planus

A
59
Q

7 Characters starting with P for Lichen Planus

A

Papules
Purple
Polygonal (flat topped)
Pruritic
Peripheral extremities + oral
Positive Koebner
Pterygium in nail

60
Q

Def of Discoid lupus erythematosus (DLE)

A
  • Localized inflammatory skin disease characterized by plaques of erythema, scaling and atrophic scar.
61
Q

what is the most common type of chronic cutaneous lupus?

A

Discoid lupus erythematosus (DLE)

62
Q

Types of Lupus erythematosus (LE)

A

DLE & SLE

63
Q

Predisposing factors for Discoid lupus erythematosus (DLE)

A
64
Q

CP of Discoid lupus erythematosus (DLE)

A
65
Q

Age & sex of Discoid lupus erythematosus (DLE)

A

adults 20-40 years. (4 decade)
{Female: male = 2:1}

66
Q

Lesions of DLE

A
67
Q

Sites of Discoid lupus erythematosus (DLE)

A
  • 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
Q

Course of Discoid lupus erythematosus (DLE)

A
  • 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
Q

TTT of Discoid lupus erythematosus (DLE)

A
70
Q

Systemic TTT of Discoid lupus erythematosus (DLE)

A
  • Antimalarial drugs as hydroxychloroquine in cases not responding to topical steroid.
  • Prednisone 15 mg/d.
  • Etretinate

Drafts (10 decks)

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