Dermatology Flashcards
Describe the pathological processes which result in acne
- Increased sebum production by sebaceous glands
- Blockage of pilosebaceous units
- Follicular epidermal hyperproliferation
- Infection with Propionibacterium acnes
How does acne vulgaris present?
Features of acne vulgaris:
- Open comedones (blackheads)
- Closed comedones (white heads)
- Inflammatory papules and pustules
- Hypertrophic/keloid scarring
- Hyperpigmentation
Conservative management of acne vulgaris
- Avoid overwashing
- Avoid picking
Pharmacological management of acne vulgaris
1st line
- Topical benzoyl peroxide
- Topical clindamycin/erythromycin
- Topical retinoids
2nd line:
- Low dose oral antibiotics, e.g. erythromycin, tetracycline
- Hormonal therapy in women (OCP)
3rd line:
- Oral retinoids (TERATOGENIC!!)
What is the other name given to ‘eczema’?
Dermatitis
What are the types of eczema?
Atopic eczema and contact dermatitis
What causes atopic eczema?
Atopy - hereditary predisposition to developing an allergic reaction (eczema, allergic rhinitis, asthma)
Describe the pathological processes which result in eczema
- Abnormal epithelial barrier function - allows irritant agents to penetrate and reach immune cells
What are the clinical features of atopic eczema?
- Itchy, red, scaly patches
- Commonly presents in flexures (in infants, often presents on the face)
Conservative management of atopic eczema
- Avoid irritants/exacerbating factors, e.g. strong chemicals, dog/cat fur
- Avoid scratching
Pharmacological management of atopic eczema
- Regular use of emollients
- Antihistamines and topical corticosteroids in attacks: mild steroids (e.g. hydrocortisone) used on face and more potent steroids (e.g. betamethasone) used on rest of body
- Immunosuppressants, e.g. ciclosporin, and phototherapy if severe
Complications of eczema
Secondary Staph. aureus infection due to broken skin - treat with antibiotics
Distinguishing contact dermatitis from atopic eczema from clinical features…
- Itchy, red, scaly rash (same as atopic eczema)
BUT
- Unusual pattern of rash (i.e. not in flexures) and clear cut demarcation/odd-shaped rash
Investigations for contact dermatitis
Patch testing may be necessary to identify particular allergen
Conservative management of contact dermatitis
Avoid allergen
Pharmacological management of contact dermatitis
- Antihistamines and topical corticosteroids used in attacks - mild steroids (e.g. hydrocortisone) used on face and more potent steroids (e.g. betamethasone) used on rest of body
When does psoriasis most commonly present?
Late teens/early twenties and 50s/60s
What causes psoriasis?
Combination of genes and environmental triggers: e.g. group A strep infection, high alcohol consumption, stress
Types of psoriasis…
- Chronic plaque psoriasis (MOST COMMON)
- Flexural/inverse psoriasis
- Guttate (‘raindrop’-like pattern)
- Erythrodermic and pustular psoriasis
How does chronic plaque psoriasis present?
- Well-demarcated, red plaques covered with silvery scales
- Commonly affects extensor surfaces and scalp
- May affect sites of sites of skin trauma (Koebner phenomenon)
Other associated clinical features:
- Nail changes: pitting/onycholysis/discoloration
- Psoriatic arthritis