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Eczematous & Papulosquamous Disorders Flashcards

1
Q

Types of Eczematous Disorders

A 
Atopic
Nummular eczema
Lichen simplex chronica
Dyshydrotic eczema
Contact
Diaper
Candidiasis
Perioral
Seborrheic
Stasis
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2
Q

Types of Papulosquamous Disorders

A

Lichen planus

Pityriasis rosea

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3
Q

Characteristics of Eczematous Lesions

A

Scaling
Crusting
Serous oozing

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4
Q

Define Dermatitis

A

Describes multiple types of skin disorders

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5
Q

Common Name for Atopic Dermatitis

A

Eczema

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6
Q

2 Theories of Atopic Dermatitis Pathogenesis

A

Impaired epidermal barrier function due to intrinsic structural & functional abnormalities in the skin
Immune function disorder in which Langerhans cells, T-cells, & immune effector cells modulate an inflammatory response to environmental factors

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7
Q

Clinical Manifestations of Atopic Dermatitis

A

Pruritus
Eczematous change & lichenification
Lesions ooze, crust & become purulent

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8
Q

Location of Atopic Dermatitis in Adults

A

Neck
Wrists
Behind ears
Antecubital & popliteal flexure areas

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9
Q

Location of Atopic Dermatitis in Children

A 
Neck
Wrists
Behind ears
Antecubital & popliteal flexure areas
Cheeks/face
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10
Q

Treatment of Atopic Dermatitis Treatment

A 
Eliminate exacerbating factors
Antihistamines used to treat pruritus
Hydration!!
Topical steroids
Burrow's solution for oozing lesions
Treat skin infections
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11
Q

Eliminating Exacerbating Factors for Atopic Dermatitis Treatment

A

Avoid triggers: heat, low humidity, perspiration

Treat stress & anxiety

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12
Q

Antihistamines Used in Atopic Dermatitis

A

Doxepin

Vistaril

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13
Q

Mild to Moderate Cases of Atopic Dermatitis

A

Topical steroids & emollients
Mild: low potency steroid cream or ointment
Moderate: medium to high potency steroids

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14
Q

Topical Steroids SE

A 
Atrophy
Telangiectasia
Purpura
Striae
Acneform eruption
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15
Q

> 3 weeks of therapy for the face or skin folds should use what class of medications

A

Topical calcineurin inhibitors

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16
Q

Black Box Warning for Topical Calcineurin Inhibitors

A

Increase the incidence of skin cancer & lymphoma with long term use

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17
Q

1st Line Treatment for Atopic Dermatitis

A

Hydration

Antidepressants

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18
Q

2nd Line Treatment for Atopic Dermatitis

A

Steroids

Topical calcineurin inhibitors

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19
Q

Define Nummular Eczema

A

Eczema that is described as coin shaped lesions

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20
Q

Where does nummular eczema usually occur?

A

Trunk

Lower extremities

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21
Q

What may be an alternative treatment for atopic dermatitis?

A

Phototherapy

Immunosuppressants: methotrexate, azithiorpine, cyclosporine, systemic steroids, IVIG

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22
Q

Describe Lichen Simplex Chronicus

A

What occurs as a result of chronic eczematous changes & scratching

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23
Q

Define Lichen Simplex Chronicus

A

Circumscribed plaque of thickened skin with increased markings with some scaling

24
Q

Describe Dyshydrotic Eczema

A

Vesicular eruption on the skin of the hand & feet marked by intense itching
Scaling, fissures, & lichenification may follow

25
Treatment of Dyshydrotic Eczema
High potency topical steroids May need to be given with occlusion Hydration of the skin
26
Define Contact Dermatitis
Dermatitis due to a direct exposure to a substance | From allergy or irritation
27
Common Offenders of Contact Dermatitis in the U.S.
``` Poison ivy Poison oak Poison sumac Skin of mangoes Gingko fruit Nickel Formaldehyde Perfumes/cosmetics Preservatives Rubber & chemicals in shoes Topical hydrocortison Topical antibiotics Topical benzecaine, thimersol Laundry detergents ```
28
Presentation of Contact Dermatitis
``` Intense pruritus Rash Papular, erythematous lesions Papule from fluid in epidermis Vesicles & serous oozing ```
29
Treatment of Plant Based Contact Dermatitis
Topical symptomatic therapy Antihistamines High potency topical corticosteroids Systemic corticosteroids
30
Topical Symptomatic Therapy for Contact Dermatitis
``` Oatmeal baths Cool, wet compresses Calamine lotion Burrow's or Domeboro solution for weeping lesions Zanfel soap ```
31
Treatment of Contact Dermatitis
``` Remove offending agent Topical symptomatic therapy Medium to high potency topical steroids Systemic steroids in severe cases Burrow's solution for weeping blisters Antihistamines for pruritis Treat secondary bacterial infections ```
32
What causes diaper dermatitis?
Combination of wetness, pH elevation, & friction
33
Clinical Presentation of Diaper Dermatitis
Erythema in the diaper area | Determine if it's from wetness, irritation from diaper, or a yeast infection
34
Treatment for Diaper Dermatitis Without Yeast Infection
Frequent diaper changes | Barrier treatment with Vaseline or Desitin
35
Treatment for Diaper Dermatitis with Yeast Infection
Topical antifungal: nystatin, miconazole, clotrimazole | Barrier lubricants such as Vaseline
36
Treatment of Thrush
Nystatin | Clotrimazole
37
Treatment of Cutaneous Candidiasis Infection
Nystatin powder Clotrimazole (Lotrimin) Ketoconazole Oral fluconazole (Diflucan)
38
Clinical Manifestations of Perioral Dermatitis
1-2 mm clustered erythematous papules, papulovesicles, or papulopustules Most often around mouth Spares vermillion border Asymptomatic OR associated with burning or stinging
39
Treatment of Perioral Dermatitis
May resolve on own 1st: Topical calcineurin inhibitor, topical erythromycin, topical metronidazole Moderate to severe: systemic tetracyclines (adults), Erythromycin (kids)
40
Describe Seborrheic Dermatitis
Erythematous scaling patches develop in areas of sebaceous glands (scalp, face, trunk)
41
Clinical Manifestations of Seborrheic Dermatitis
``` Erythema (reddish or pink color) Swollen/greasy appearance White/yellow scales Pruritis Distribution ```
42
Distribution of Seborrheic Dermatitis
``` Lateral sides of the nose Eyebrows Glabella Scalp Chest Upper back Axillae ```
43
Diagnosis of Seborrheic Dermatitis
Usually PE | Biopsy
44
Treatment of Seborrheic Dermatitis on the Scalp
Antiproliferative shampoo | Antifungal shampoo
45
Examples of Antiproliferative Shampoo
``` T-Gel extra Selenium sulfide (Selsun, Exelderm) Zinc pyrithione (Head & Shoulders, Zincon, DHS zinc) ```
46
Examples of Antifungal Shampoo
Ketoconazole 2% | Ciclopirox shampoo 1%
47
Treatment of Non-Scalp Seborrheic Dermatitis
``` Ketoconzole 2% cream or gel Ciclopirox 1% cream Tacrolimus 0.03% & 0.1% Pimecromlimus 1% cream Severe: low potency topical corticosteroid ```
48
Define Stasis Dermatitis
Occurs from blood pooling due to chronic venous insufficiency Increased pressure in capillaries Extravasation
49
Treatment of Stasis Dermatitis
``` Prevent edema Compression stockings Elevation of legs Skin cleansing Emollients Topical steroids for pruritis Wet dressing for crusts or open lesions ```
50
What areas can lichen planus effect?
``` Skin Oral cavity Genitalia Scalp (penile or vulvar) Nails Esophagus ```
51
Clinical Manifestations of Lichen Planus
Shiny, flat, polygonal, violaceous papule or plaques with white lacy pattern Intensely pruritic
52
Diagnosis of Lichen Planus
Biopsy
53
Treatment of Lichen Planus
Localized: High potency or super high potency topical corticosteroid Hypertrophic: Intralesional corticosteroids Widespread severe: phototherapy, systemic steroids acitretin
54
Describe Pityriasis Rosea
"Herald patch" Multiple new lesions appear centrally on trunk Pruritic Not contagious
55
Treatment for Pityriasis Rosea
Self limiting Pruritis: medium potency topical steroid Severe: acyclovir or phototherapy
56
Tinea Versicolor vs. Vitiligo
Both: hypopigmentation TV: scaling Vitiligo: no scaling

Dermatology (13 decks)

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