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Dermatitis - others Flashcards

1
Q

Seborrheic Dermatitis Peak incidence pop

A

Infancy
Maternity
Teens - high hormones

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2
Q

Seborrheic Dermatitis Flares what time frame

A

Dry winter
Stress
Change hygiene - field

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3
Q

Seborrheic Dermatitis Is very serious in what pop?

A

Old w/ neuro issues

-dementia,stroke,parkinsons

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4
Q

Seborrheic Dermatitis Is very common when ass/w what dz process?

A

Aids

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5
Q

Seborrheic Dermatitis Morphology

A

Fine white/yellow greasy flakes
Inflamed base
Red papules
Annular w/ raised edge

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6
Q

Seborrheic Dermatitis Can cause

A

Cradle cap
2ndy staph inf if chronic
Prurituc

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7
Q

Seborrheic Dermatitis Distribution

A 
Scalp + margins
Eye brows/lashes
Nasolabial folds
Ext ear canals
Others - hair areas
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8
Q

Seborrheic Dermatitis etiology

A

Hereditary, environment, yeast.

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9
Q

Seborrheic Dermatitis Pathophys

A

Hyperprolif like CPP

Glandular issue - oily skin

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10
Q

Seborrheic Dermatitis management - shampoo

A
  • otc antidandruf (supfur/zinc for inflam areas)
  • selenium sulfide - dry flake
  • tar based - if like CPP
  • ketaconazole - yeast
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11
Q

Seborrheic Dermatitis management - topical steroids/others

A
  • Face - 1% HC
  • chest/back - triamcinolone spray
  • ears - fluocinolone sol
  • Dense scalp scaling - flucinolone C-IV
  • fungus - itraconazole
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12
Q

Atopic dermatitis is?

A

Chronic pruritic eczematous disease

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13
Q

Atopic dermatitis Pop it begins in?

A

Childhood - improves w/ age (remit/recur)

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14
Q

Hx correlated w/ Atopic dermatitis?

A

Atopy triad, sinusitis

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15
Q

Atopic dermatitis Morphology

A 
Erythema progressing to patchy/confluent papules/plaques w/...
-flaking
-xerosis
-excoriations
-fissures
Lichen/staph Inf 
Dermatographism
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16
Q

Atopic dermatitis Distribution adults

A

Bilat flexor creases
Hands, wrist, ankles
Neck, waist
Eyelids on face only

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17
Q

Atopic dermatitis Distribution children

2-12yo

A

Flexural areas
Face/scalp (honey crust)
Patchy or generalized body eczema

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18
Q

Atopic dermatitis Distribution infants

0-2yo

A

3rd month
Dry, red, scaling on cheeks
Progress to child distro

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19
Q

Atopic is AKA

A

Itch that rashes

-that itch causes eruptiveness

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20
Q

Eczematous essentially is

A

Dry > cracking > itch > rash

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21
Q

What are another two forms of atopic dermatitis

A

Ichthyosis vulgaris

Keratosis pilaris

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22
Q

Atopic dermatitis triggers

A 
Temp/sweat
Dry humidity
Excess washing
Irritative substances
Contact allergy
Aeroallergens
Foods/stress
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23
Q

Atopic dermatitis Management goals

A

Stop inf/inflam/triggers
Restore stratum corneum w/ emollients/anti-itch
Hydrate skin
Mild soap

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24
Q

Atopic dermatitis Inflam txt (adults/children)

A

Adults - Mid-high top CCS = triamcinolone

PEDs - C-V fluticasone propionate cream

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25
Atopic dermatitis Txt inf
Abx- 1 for 10xD Dicloxacillin Erythromycin Cephalexin
26
Atopic dermatitis Txt pruritus
Break itch-scratch cycle w/ hydroxyzine or benadryl
27
Atopic dermatitis Main txt creams/ointments (short/long term)
Pimecrolimus cream - no burn | Tacrolimus ointment - failed everything else burning sensation
28
MC inflammatory skin dz?
Eczema (not a dermatitis)
29
Eczema general attributes
Erythema
30
3 stages of eczema
Occurs in any order Acute Subacute Chronic
31
Eczema acute appearance
Intense erythema/itch, vesicles, bullae
32
Eczema acute Etiology
Contact allergy Acute nummular eczema Stasis derm Pomphylox
33
Eczema acute Txt
Cold/wet compress (PO)/top CCS AH ABX -2ndy inf
34
Eczema subacute appears
Erythema, scaling, fissuring, parched look, scaling | Itch,pain,burn
35
Eczema subacute Etiology
``` Contact allergy Irritant Atopy Nummular eczema Asteatotic eczema ```
36
Eczema subacute Txt
Top CCS - prn occl. Emollients after AH or ABX
37
Eczema chronic appearance
``` Thickened skin Accentuated skin lines Excoriations Fissuring Mod-intense itch ```
38
Eczema chronic Etiology
``` Atopy Habitual scratch Lichen Nummular ecz Asteatotic ecz ```
39
Eczema chronic Txt
Top steroids w/ occl = best | AH, ABX, emollients
40
Another name for dyshidrotic ecz?
Pompholyx
41
dyshidrotic ecz is/distro
Distinct rxn pattern w/ symmetric bilat vesicular hand/foot dermatitis localized laterally W/ mod-sev itching prior to vesicles +- hyperhidrosis (sweat)
42
Dyshidrotic ecz MC pop?
1st - teens, then middle aged
43
Dyshidrotic ecz Morphology
Multiple tiny deep seated vesicles (tapioca lesions) on palms/soles
44
Dyshidrotic ecz May present w/
Red/wet pruritic palms/soles
45
Dyshidrotic ecz Progression
Vesicles resolve 3-4wks Become scales > lichen > cracking > peeling > fissuring 1st pruritis > pain
46
Dyshidrotic ecz Management
``` Lifestyle mod (avoid h2o irritants, diet) CCS potent steroids then wean ABX bacterial inf -dicloxacillin -erythromycin -cephalexin Itch - hydroxyzine PUVA Fail - low dose methotrexate ```
47
Asteatotic ecz AKA
``` Eczema craquele or Winter itch (more itch than rash) ```
48
Asteatotic ecz Etiology
Cold/dry weather | Long hot showers
49
Asteatotic ecz morphology
Anterolat Low legs dry/scaly w/ xerosis -can occur anywhere Red plaques, w/ thin long horizontal superficial fissures (cracked porcelain) Excoriation w/out other lesions.
50
Asteatotic ecz Management
``` Mods to skin care -decrease baths/temp -less/mild soap Emollients often esp after bath CCS- short term C-III-IV ointments Severe - wet dress/Abx ```
51
Asteatotic ecz Severe presentation
Oozing, crusts, infection
52
Nummular Ecz pop
Middle age-old
53
Nummular Ecz Distro
Recur same spot every winter - MC back of hand | -also low legs, forearms, flanks/hips
54
Nummular Ecz Presents w/
Intense itching > habitual > lichenification
55
Nummular Ecz Morphology
Discrete, round, coin-shaped red plaque 1-5 cm diameter. Intense erythema Thin, sparse scales +- flakes +- thick w/ vesicles on top
56
Nummular Ecz Management
C III-V potent steroids 4-6wks (TAC MC) depends on thickness Correct dryness PRN antipruritic
57
Lichen Simplex Chronicus aka
LSC or | Localized/circumscribed nuerodermatitis
58
LSC is
Nerve entrapment ass/w Eczematous eruption from habitual scratching which is very satisfying.
59
LSC is precipitated by
``` Seborrheic Dermatitis Atopic Dermatitis Nummular Eczema Irritant/contact dermatitis Other lichenification ```
60
LSC pop
Any age - adults MC
61
LSC Morphology
``` Red papules coalesce to red scaly thick plaques w/ accentuation of skin lines Lichen 2/2 excoriation/chronic rubbing Cracks/fissures +- Hyperpigmented Nodules - prurigo nodularis ```
62
LSC Distro
Convenient areas to scratch/rub
63
LSC basic Management
Long term therapy goal - soften/break lichen Break itch-cycle Emollients for dryness
64
LSC rx management
Thick area - C-I clobetasol prop or betamethasone diprop Nodules - intralesion TAC Scratch in sleep - AH Flurandrenolide - w/ plastic occl.
65
Another name for LSC nodules
Prurigo Nodularis
66
Pityriasis Rosea Pop
Young adults 10-35yo
67
PR incidence higher when
Winter
68
Pityriasis Rosea Pathogen ass/w
HHV 6 Or Hx - URI Consider 2/2 syphillis
69
Pityriasis Rosea S/S
``` Asymp to very pruritic Sudden onset (harold patch) ```
70
Pityriasis Rosea Outcome
Self limiting Resolves 6-8wks Recurrent
71
Pityriasis Rosea Morphology
Herald patch 2-10cm 1st/lrgst lesion - pt thinks ringworm? Next lesion is during eruptive phase - macules/papules peak # 1-2wks -round-oval 1-2cm plaques
72
Pityriasis Rosea Distro
Christmas tree lesions/drooping skin lines on back Herald patch or eruptive lesions- trunk/prox extremities Eruptive conc on low Abd
73
Reverse Pityriasis Rosea
Uncommon, affects neck, face, arms, legs, palm soles
74
Pityriasis Rosea basic Management
Benign, self limited | Itch - top C-V CCS or AH
75
Pityriasis Rosea Severe management
PO prednisone UVB 2wks PO acyclovir
76
Lichen planus is
Unique inflam cutaneous/mucocutaneous membrane rxn
77
Lichen planus Pop
20-60yo
78
Lichen planus Presents
+- intensly pruritic Flaring lesions - no cause or Rx/chem/transplant Persists then fades Can koebnerize
79
5 P’s to Lichen planus
``` Pruritic Planar Polygonal Purple Papules/plaques (And persists - 6) ```
80
Whats Wickhams straie? is ass/w?
Lichen planus - white lacy pattern crisscrossed lines on lesion
81
Lichen planus Morphology
Primary lesion 2-10mm Flat topped papules w. Irregular angulated polygonal borders -wickhams straie New lesions = pink-white progress to violaceous/purpke hue w/ waxy look
82
Lichen planus Distro
``` Acral - hands/feet/ankles/wrist Extensor or flexor Oral lesions- white/lacy painful erosions Nail splitting Scalp - scarring hair loss Genital lesions ```
83
Lichen planus Dx
Clinical - or Bx to confirm
84
Lichen planus Localized Management
``` Localized LP - top C I-II - Intralesion inj Mucous membranes -CCS + adhesive base -resist - Azathioprine ```
85
Lichen planus Mucous membrane Management
Mucous membranes - CCS + adhesive base - resist - Azathioprine - Tacrolimus/pimecrolimus
86
Lichen planus Generalized Management
PO CCS steroids 2-4wks | Bx - R/O SCC
87
Contact Dermatitis Is a form of?
Eczematous dermatitis from irritants/allergies
88
Contact Dermatitis Due to irritant patho?
Damages barrier (non-immunologic)
89
Contact Dermatitis Due to allergic patho?
Antigen absorption (sensitized) > eruption (immunologic process)
90
Dx of Contact Dermatitis?
Patch testing
91
MC Irritant dermatitis
Occupational - hands | Diaper dermatitis
92
Irritant dermatitis Morphology
Damage to stratum corneum Inflamed, cracked, fissures skin, vesicular, exudative (acute-subacute) Chronic - scaly, flaky, lichenified w/ less eryrhema
93
Which is more common of the two contact dermatitis
Irritant dermatitis
94
Irritant dermatitis Management
``` Avoidance Emollients as protective barrier Cool compress - acutely Severe - top CCS Wash cool water ```
95
Allergic contact dermatitis MC
1 MC - Nickel | 2 MC - Poison ivy
96
Allergic dermatitis Morphology
Acute eczematous eruption Red, swollen, vesicular bullous Exudative > crusty Intense pruritic
97
Allergic dermatitis Distro
Usually well defined w/ The contact
98
Allergic dermatitis Mangement
``` Minimize avoid allergen Wet compress Potent PO/top CCS 2-3w AH Triamcinolone spray ```

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