Facial Rashes Flashcards
What is chloasma?
What areas are more commonly affected?
Symmetrical pigmentary disorder affecting facial skin of women associated with hormone changes (pregnancy/birth control)
Forehead > cheeks and chin
What are some common complications of rosacea?
- Keratitis (inflammation of the cornea)
- Rhinophyma (hyperplasia of nasal sebaceous glands and connective tissue)
- Conjunctivitis (inflammation of the conjuctiva)
How is chloasma managed?
Management with sunscreens and camouflage cosmetics
(Improves spontaneously following birth/stopping birth control)
Define Nodule
Solid elevation of skin larger than 5 mm in diameter
Similar to papule but larger than 5 mm
Define Papule
Small solid elevation of skin < 5 mm in diameter
What age and demographic is Rosacea common in?
Mostly Middle aged (but can affect anyone)
Mainly affects caucasian origin (uncommon in people of colour)
Describe the clinical appearance of Kaposi sarcoma
What are common sites for these lesions?
Red/purplish macules, papules and nodules anywhere on skin or mucous membranes
Mouth, nose, and throat; lymph nodes; or other organs
Initially small/painless, but can grow to ulcerate and become painful
How does eczema herpeticum arise?
Involves dissemination of herpes simplex virus on a background of preexisting eczema
What is photodamage and how is it exacerbated?
Extrinsic ageing caused by chronic ultraviolet (UV) radiation exposure
This is exacerabated by smoking and pollutants
What are commonly affected nerves in a patient with shingles?
Cranial Nerve V
Cranial Nerve VII
Thoracic spinal nerves
What is the most common type of skin cancer in the UK?
Basal cell carcinoma
>75,000 new cases a year
What cells are involved in a basal cell carcinoma?
Locally invasive cancer of epidermal basaloid cells
What symptoms may you see in a patient preceding (before) eczema herpeticum?
Malaise
Fever
Lymphadenopathy
What is Rosacea?
Chronic inflammatory facial dermatosis characterised by erythema and pustules
(almost exclusively confined to face)
Define Macule
Localized area of colour or textural change
in skin
What are some risk factors of severe eczema herpeticum?
Pregnancy
Immunosuppression
What is the presentation of Basal cell carcinoma?
What are the two types?
Spontaneous ulcer that fails to heal
May bleed with crust formation which may separate during sleep to leave blood on pillow
Can be
Nodular BCC - pearly papule with a rolled edge, telangectasia and central depression
Superficial BCC - Slowly growing scaly pink patch or plaque
What is Kaposi sarcoma?
(what type of disease?)
A disease of endothelial cells of blood vessels and lymphatic system
What are some predisposing factors of SCC/BCC?
- Arsenic ingestion in tonics
- Burn / vaccination scars
- Skin type I or II (freckles)
- UV radiation (sun exposure in childhood)
- Ionizing radiation
- Immunosuppression
What is the prognosis of a basal cell carcinoma?
Most BCCs grow slowly and are nonaggressive
If long standing can destroy skin and deep tissues (rodent ulcers)
Only rarely metastasise
What is Seborrhoeic dermatitis?
What causes this?
Chronic scaly inflmmatory eruption of face, scalp and eyebrows
Overgrowth of commensal yeast P. ovale implicated
What is the clinincal presentation of rosacea?
Facial flushing
Eryhthema and telangectasia with recurrent pustules over areas exposed to light
dilated/broken blood vessels near surface of skin or mucous membranes.
How do you manage Seborrhoeic dermatitis?
Scalp - medicated shampoo
Facial lesions - Antimicrobial often combined with 1% hydrocortisone cream
Recurrence is common so treatment may require to be repeated
What are the clinical features of Perioral dermatitis?
Small reddish papules with tiny pustules
Spreads around mouth
Clear zone immediately adjacent to vermillion border
Females aged between 15-25 years typically affected
What is a severe side effect that could arise from a patient having eczema herpeticum?
Keratoconjunctivitis leading to sight loss
inflammation of the cornea and conjunctiva
What gender and age are Basal cell carcinomas more common in?
Male > Female
40+ age
What is Eczematous cheilitis?
Inflammation of lips with redness, dryness and scaling
2 major groups:
(i) Endogenous: eg atopic eczema (allergy related)
(ii) Exogenous : eg Lip licking dermatitis or Allergic contact cheilitis
What is the link between immunosuppression and Kaposi Sarcoma?
The greater the immunosuppression the more extensive and aggressive Kaposi Sarcoma
What is actinic keratosis?
How do you manage this?
Discrete scaly hyperkerartotic lesions found on sun exposed areas of hands face and neck
Treatment: curettage, excision or application of 5-fluorouracil
Can progress to SCC
How do you manage a patient with Rosacea? (2)
Topical metronidazole gel twice daily
Oral tetracycline for 2-3 months
Why is the role of a GDP important when dealing with the skins?
GDPs likely to see patients more regularly than medical GPs and so have a great opportunity to make an early diagnosis of skin disease involving head and neck
What is a risk of patients with opthalmic shingles (opthalmic herpes zoster) and what should you do if a patient presents with that?
Risk - Corneal scarring with result lost of vision
Action - Urgent referral to Ophthalmology
