Derma - Papulosquamous Disorders Flashcards
Papulosquamous disorders
Psoriasis
Lichen planus
Pityriasis rosea
A chronic inflammatory papulo-squamous disease of unknown etiology characterized by sharply demarcated, dull red scaly papules and plaques, particularly on the extensor prominences and in the scalp.
Psoriasis
Prevalence of psoriasis
1-3 % of population
Population affected by psoriasis
Men = women
Siblings and offspring - inc risk
Early onset - less stable, more severe
Age of onset peaks at these ages
Psoriasis
20s
50s
Once expressed, it is likely to follow a relentless, waxing, and waning course
Psoriasis
How many % of ptx with psoriasis have nail involvement
1/3
How many % of ptx have psoriatic arthritis
5-8%
Clinical types of psoriasis
Plaque psoriasis Guttate Psoriasis Localized pustular psoriasis Inverse or intertriginous psoriasis Generalized pustular psoriasis Erythrodermic psoriasis
Nail findings of psoriasis (w/ nail involvement)
Pitting Oncholysis Subungual thickening Oil drop sign Nail dystrophy
Most common form of psoriatic arthritis
Asymmetric oligoarticular (70%)
A translucent yellow-red discoloration int he nail bed proximal to onycholysis
Oil drop or salmon patch
Sign of partial loss of cells from the surface of the proximal nail matrix
Pitting
Rheumatoid factor result of psoriatic arthritis
Negative
Tx of psoriasis
Topical therapy (topical steroids, tar, anthralin, vit. A analogue - tazarotene)
Phototherapy - PUVA, Selective UVB therapy (Narrowband UVB)
Systemic therapy - methotrexate, cyclosporine, retinoids
Acute or chronic inflammation of mucous membranes or skin characterized by violaceous, shiny, pruritic papules topped with fine white lines (wickham’s striae)
Lichen planus
Sites of lichen planus
Flexor surface of wrists Lumbar region Shins Eyelids Scalp Buccal mucosa Tongue Lips Nails
Scalp lesions of lichen planus are associated with
Alopecia
Mnemonic 6P’s of lichen planus
Pruritic Purple Polygonal Peripheral Papules Penis
Precipitating factor of lichen planus
Severe emotional stress
Lichen planus associated with this infection
Hep C
Tx lichen planus
Topical or intralesional corticosteroids
Short courses of oral prednisone (rarely)
PUVA for generalized or resistance cases
Oral retinoids for erosive lichen planus in the mouth
Acute self-limiting erythematous eruption characterized by red, oval patches, and papules with marginal collarette of scales
Pityriasis rosea
Sites affected by pityriasis rosea
Trunk
Proximal aspect of arms and legs
Etiology of pityriasis rosea
Viral (probably)
Christmas tree pattern
Pityriasis rosea
Long axis of lesions follow lines of cleavage producing Christmas tree pattern on the back
Pityriasis rosea
Pityriasis rosea starts with a
Herald patch
How long does it take for other lesions to precede the herald patch in pityriasis rosea
1-2 weeks
When does pityriasis clear up
6-12 weeks
Tx pityriasis rosea
No tx needed unless itchy or widespread
