Diseas Of Sweat And Sebaceous Glands + DLE

Question 1

The initial event of miliaria (sweat rash)

Answer 1

Eccrine sweat duct occlusion

Question 2

Sites of eccrine duct affection in Miliaria

Answer 2

• At skin surface : M. Crystallina ( clear drop or vesicle with little or no erythema
• Occlusion of intraepidermal part of duct : M. Rural ( papules and vesicles surrounded by red halo
• At dermoepidermal junction: M. Profunda
  If 2ry infected: M. Pustulosa
  TTT by Cold compressors & proper ventilation

Question 3

Etiology of Acne vulgaris

Answer 3

• Increased Sebum production.
• Ductal hypercornification.
• Inflammation by P. acnes.
• Release of inflamm. mediators

Question 4

Sepum is deficient in

Answer 4

Linoleic acid
Causing Hyperkeatosis of pilosebecous duct with obstruction of serum pathway

Question 5

Propinobactrium acne is responsible for

Answer 5

The inflammatory process of acne vulgaris (papules, nodules, pustules)

Question 6

Cause of irritation in Acne vulgaris

Answer 6

Free fatty acids

Question 7

Primary lesion of Acne vulgaris

Answer 7

Comedone.
Common affected sites : face, chest & back

Question 8

TTT of Acne vulgaris

Answer 8

• Topical :
  1. Topical retenoids as tretinoin, adapalene and tazarotene
  Normalize cornification, aids in expulsion of existing comedones and prevents appearance of new ones & anti-inflammatory
  2. Benzoyl peroxide : Changes the medium around P. Acnesmto aerobic
  3. Topical Antibiotics as Topical erythromycin,clindamycin
  4. Others :
• Topical azaleic acid
  controlcornification & anti-inflammatory
• exfoliating agents : 2% sulfur ppt. In calamine lotion and 3% salicylic acid lotion
• Systemic Antibiotics : doxycycline and minocycline
  ( in sub-therapeutic dose have an anti-lipase action )
• Systemic Retinoids : Isotretinoin 0.5-1 mg/kg (average 6 months)
  Side effects:
  • Cracked lips (very common), dry skin, nose bleeding, Transient increase in serum triglycerides and liver enzymes
  • Teratogenic
• Antiandrogens as cyproterone acetate ( C.I in males )
• Intralesional steroids for nodulocyctic acne.
• Fractional CO2 laser, chemotherapy & Dermabrasion for postacne scars

Question 9

Leison of Discoid lupus erythematousis

Answer 9

• Sharply demarcated, coin shaped erythematous plaques covered by prominent adherent scales
• Healing by thin atrophied Non contractile, healthy stipple scars ( hypo or depegmented in center wi5h peripheral hyperpigmentation

Question 10

DD of DLE

Answer 10

Lupus vulgaris
Psoriasis
Vitiligo

Question 11

TTT of DLE

Answer 11

• Local therapy
  Broad spectrum sun screens
  Potent topical steroids
  Intralesional steroids
• Systemic therapy
  Oral antimalarial ( immunomodulatory ) f9r widespread disease

Question 12

TTT of DLE

Answer 12

• Local therapy
  Broad spectrum sun screens
  Potent topical steroids
  Intralesional steroids
• Systemic therapy
  Oral antimalarial ( immunomodulatory ) f9r widespread disease