Dermatology II Flashcards
where does atopic eczema usually occur? look like?
ill defined
scaly
patches
in flexures
what is filaggrin mutation?
genetic reduced skin barrier function, more likely atopic eczema
atopic eczema happens where on infant more likely?
face
what is lichenification?
chronic rubbing/scratching of atopic eczema
what is discoid eczema?
in annular discs,
mimics psoriasis and tinea
discoid eczema responds to?
potent topical steroids
what is asteatotic eczema? where? who? when
front of legs of elderly in winter
how does pompholyx/vesicular hand/foot eczema happen?
excessive washing/sweating
avoid soaps
what is diffuse erythrodermic eczema?
> 90% body eczema
treat with systemic immunosuppression
eczema has golden crust around it, what is it probably?
staph aureus colonized the eczema
treatments for staph aureus in eczema?
chlorine bath
systemic antibiotics
eczema herpeticum is? looks like
secondary infection by HSV
punched out erosions
why is eczema herpeticum medical emergency? how treat?
corneal scarring
systemic antivirals
how to diagnose contact dermatitis?
patch testing
how to diagnose contact dermatitis?
patch testing
what kind of phototherapy for atopic eczema?
UVB 311nm
immunodesensitization
atopic eczema immunosuppression options?
short: oral prednisolone
med-long: methotrexate, azathioprine etc.
erythematous, scaly well demarcated plaques most likely dx?
chronic plaque psoriasis
2 peaks of onset for psoriasis?
20s
50s
where get rash in psoriasis?
extensor rash
psoriasis appearance classical?
symmetrical extensor surface scaly well demarcated erythematous
most common cause of eruption on penis is?
genital psoriasis
nail psoriasis can cause what to nail?
onycholysis
what is guttate psoriasis? who gets it? trigger?
‘raindrop’ psoriasis
kids
triggered 1-2/52 post strep infections, URTI
how to treat guttate psoriasis?
phototherapy
pustular psoriasis dangerous?
yes. medical emergency
systemic fever, chills, loss of barrier function
psoriatic arthritis affects how many % of psoriasis patients?
10%
systemic Rx of psoriatic arthritis
methotrexate, cyclosporin A, biologics
Acne is disorder of what structure?
pilosebaceous unit
acne influences by genetics?
strongly
acne influences by genetics?
strongly
4 components of acne?
- keratinization of sebaceous duct
- bacteria colonization
- increase androgen levels
- inflammation
what bacteria causes acne?
propionobactrium acnes
comedones are made of what?
oxidized sebum
whiteheads and black heads are?
whiteheads: closed comedones
blackheads: open comedones
whiteheads and black heads are?
whiteheads: closed comedones
blackheads: open comedones
mild-mod inflammatory lesions of acne are?
papules
pustules
severe acne called?
acne conglobata
adult onset acne in female if has androgenisation, alopecia, consider what?
PCOS
describe acne scars
textural change is permanent
colour is treatable
what meds get rid of comedones?
keratolytics
comedolytics
what topical Abx in acne?
erythromycin
clindamycin
what systemic ABx in acne?
doxy
minocycline
erythromycin
trimethoprim
big contraindication for systemic isotretinoin?
teratogenic
systemic isotretinoin treatment course?
6-12 months
Rosacea has 2 components:
vascular reactivity
inflammatory papules and pustules
difference between Rosacea and acne?
no comedones
long term: complication of Rosacea in men
Rhinophyma: sebaceus hyperplasia
ocular Rosacea happens to who?
20-40% of ppl with cutaneous Rosacea
scabies danger?
very contagious
scabies danger in indigenous?
predispose to staph and strep: rheumatic fever
scabies danger in indigenous?
predispose to staph and strep: rheumatic fever
symptoms of scabies?
intensely itchy, starts in hands then spreads
how long does it take for itch to come on first time you get scabies? second time?
first: about a month
second: immediately
3 things to confirm dx of scabies under microscope?
egg
scabies mite
faeces
first line Rx for scabies?
5% permethrin cream leave on overnight, wash off in AM,
treat who in scabies?
all contacts
wash everything
