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Dermatology > Diseases 1 > Flashcards

Diseases 1 Flashcards

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Dermatology Board Prep flashcards
1
Q

Psoriasis

  • definition
  • risk factors
  • triggers
A
  • chronic proliferative inflammatory, relapsing skin disorder
  • genetic predisposition, family history –> HLA-encoding genes
  • acute and chronic infections, diabetes and obesity, alcohol consumption, smoking, stress, contact irritants, allergens, medications
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2
Q

Psoriasis

-pathogenesis

A
  1. Accelerated proliferation of epidermis (acanthosis) and abnormal differentiation of keratinocytes (parakeratosis)
  2. Proliferation of capillaries
  3. Immunologic inflammation
    - two imp. cytokines: IL-12 (induces Th1) and IL-23 (induces Th17)
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3
Q

Psoriasis

-classification (4)

A
  1. Psoriasis vulgaris - most common - guttate psoriasis (severe), plaque like psoriasis (slow growing)
  2. Inverse psoriasis
  3. Pustular psoriasis - white pustules (blister of non-infectious pus) surrounded by red skin, most often in the hand
  4. Erythrodermic psoriasis
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4
Q
  1. Plaque psoriasis
  2. Guttate psoriasis
  3. Erythrodermic psoriasis
  4. Inverse psoriasis
A
  1. symmetrically distributed, thick, scaly, erythematous lesions, itchy and painful, they can crack
  2. small dot like lesions, occurs mainly in children and adolescents after streptococcal infection
  3. generalized erythematous lesions with diffuse scaling, can cause severe itching and pain
  4. very red lesions, mainly affects skin folds and flexural creases of large joints, appears as smooth and shinny
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5
Q

Koebner phenomenon psoriasis

A

-isomorphic response to irritation –> incisions, scratching lesions, UV radiation, tattoos

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6
Q

Psoriasis

-diagnosis (4)

A
  • anamnesis
  • physical examination - Auspitz sign triad (small, pinpoint bleeding, no scales), Koebner phenomenon, PASI index
  • lab tests - CRP, liver enzymes, serological tests
  • radiography, skin biopsy
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7
Q

Psoriasis

-treatment

A
  • anti-inflammatory
  • anti-hyperproliferative
  1. local medications - keratolytics, emollients, vitamin D3, corticosteroids, local retinoids
  2. phototherapy - sunbathes, UVB
  3. systemic treatment - methotrexate, antibiotics, biological therapy
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8
Q

Lichen planus

  • definition
  • triggers
  • pathogenesis
A
  • inflammatory, t-cell mediated disease that involves the dermal-epidermal junction
  • liver problems, diabetes, viral infections, stress, drugs, autoimmune processes
  • autoimmune CD8+ T cell response against the epidermal basal later keratinocytes, causing apoptosis
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9
Q

Clinical features - 5 P’s

A
  1. Planar - rash is flat
  2. Polygonal - rash has multiple sides
  3. Papular - less than 5mm in diameter
  4. Purple color
  5. Pruritic
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10
Q

Lichen planus

-clinical features (4)

A
  • Wickham’s phenomenon - a network of milk white lines on the surface of merging papules
  • Koebner phenomenon - isomorphic irritation effect
  • mucosa (more common), nail or scalp
  • super itchy
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11
Q

Lichen planus

  • diagnosis
  • treatment
A

-clinical features, histology, punch biopsy, dermoscopy –> Wickham’s sign

  • local: corticosteroids, anesthetic liquid for moth, immunomodulators
  • phototherapy
  • systemic: corticosteroids, anti-histamines, antibiotics
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12
Q

Contact dermatitis

  • definition
  • classification
A

-skin inflammatory reaction to substances that come in contact with the skin

Irritant contact dermatitis - most common - caused by direct contact with irritant substance. No sensitization is required.
-acute, subacute, chronic

Allergic contact dermatitis - caused by antigens that elicit hypersensitivity reaction in area of contact = requires previous exposure and sensitization
-acute, chronic

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13
Q

Contact dermatitis

-etiology

A

Irritant contact dermatitis - physical and chemical irritants, direct tissue damage
-acids, alkalis, organic solvents, detergents

Allergic contact dermatitis - immunologic mechanism, T cell mediated
-cosmetics, metals, fragrant substances, preservatives

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14
Q

Contact dermatitis

-Clinical features

A

Acute - erythema, edema, vesiculations, papules, erosion, crusting, scaling
Chronic - erythema, less vesicles, papules, scaling, fissures, lichenification

  • sharp margination, stickly confined to exposure site –> mostly hand and forearms
    stages: edema –> bullae –> erosions –> crusts –> scales
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15
Q

Contact dermatitis

  • diagnosis
  • treatment
A
  • anamnesis, inspection, lab tests - patch test
  • elimination of the allergen, restore skin barrier with emollients, reduction of inflammation, reduction of itching - anti-histamines, prophylaxis
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16
Q

Atopic dermatitis

  • definition
  • etiopathogenesis
A

-chronic, inflammatory skin disease

  • allergic: IgE and non- IgE associated
  • non allergic: genetic predisposition, filaggrin deficiency (less binding of water –> skin barrier dysfunction –> immune dysregulation)
17
Q

Atopic dermatitis

-clinical features

A
  • infantile type - wet forms - vesicle, erosions. Location: face, trunk, extensor surface of arms/legs
  • childhood type - dry forms - papules, lichenifaction, excoriations. Location: face, lateral aspects of neck, nuchal region, flexor surfaces of arms/legs
  • atopic diathesis = atopic triad –> atopic dermatitis, allergic conjunctivitis/rhinitis, allergic asthma
18
Q

Atopic dermatitis

  • diagnosis
  • treatment
A

-anamnesis, inspection, path test, prick test, blood test, skin biopsy

  • elimination of the allergen, restore skin barrier with emollients, reduction of inflammation, reduction of itching - anti-histamines, prophylaxis
  • phototherapy
19
Q

Seborrheic Dermatitis

  • definition
  • etiopathogenesis
A

-chronic inflammatory skin disease affecting seborrheic body sites (head, face, upper trunk)

I. Malassezia infection
II. Immunologic mechanisms
III. Hyperproliferative changes

20
Q

Seborrheic Dermatitis

-clinical features

A

in infants - pink squamous patches and/or plaques, scales are yellow/greasy, oily looking thick fissured crust on scalp
-diaper region, face, neck, chest, retroauricular folds

in adults - pink squamous patches and/or plaques. Scales are yellow and greasy

21
Q

Seborrheic Dermatitis

  • diagnosis
  • treatment
A

-anamnesis, presentation, culture

I. loosening of scales - keratolytic, emollients
II. inhibition of yeast colonization - anti-mycotics
III. prophylaxis
IV. reduction of inflammation
V. phototherapy

22
Q

Diaper dermatitis

  • definition
  • etiopathogenesis
A

-inflammatory skin disease affecting regions covered by diaper

  • mechanical impact of diaper, wet environment
  • feces contain urease –> break down urea into ammonia –> increase pH of skin –> pH activates fecal enzymes –> breakdown of proteins and lipids in the skin –> keratinocytes release cytokines –> inflammation
23
Q

Diaper dermatitis

-clinical features

A
  • erythematous squamous patches and/or plaques in the diaper area
  • vesicles, oozing, crusts
24
Q

Diaper dermatitis

  • diagnosis
  • treatment
A

-anamnesis, clinical presentation, culture

  • frequent diaper change, local anti-mycotics, emollients, weak potency corticosteroids
  • prophylaxis: zinc cream
25
Q

Dyshidrotic dermatitis

  • definition
  • etiopathogenesis
A
  • acute or chronic, relapsing dermatitis of the hands and feet characterized by small to large blister formation
  • hyperhidrosis, atopy, secondary infection common
26
Q

Dyshidrotic dermatitis

-clinical features

A
  • hands, palms, feet, soles and lateral surface of fingers
  • severe itching
  • acute - multiple small clear fluid filled vesicles, erosion, crusting, scaling
  • chronic - without inflammation signs, recurrent episodes of vesicle formation, vesicles dry up and become round cavities of keratinic layer, scaling
27
Q

Dyshidrotic dermatitis

  • diagnosis
  • treatment
A

-anamnesis, clinical presentation, culture

restore skin barrier function - emollients 
drying agents - zinc preparation
reduce inflammation - corticosteroids 
reduction of itching - anti-histamines 
prophylaxis and treatment 
phototherapy
28
Q

Nummular dermatitis

  • definition
  • etiopathogenesis
A
  • chronic form of dermatitis characterized by coin-shaped lesion
  • local sensibilization to Ag of local infection
29
Q

Nummular dermatitis

-clinical features

A
  • extension surfaces of lower limbs
  • well defined, coin shaped erythosquamous plaques and papulovesicles
  • severe itching
30
Q

Nummular dermatitis

  • diagnosis
  • treatment
A

-anamnesis, clinical presentation, culture

eliminate the infection 
restore skin barrier function - emollients 
reduce inflammation - corticosteroids 
reduction of itching - anti-histamines 
prophylaxis and treatment 
phototherapy

Dermatology (10 decks)

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