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Dermatology > Inflammatory skin condition > Flashcards

Inflammatory skin condition Flashcards

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Dermatology Board Prep flashcards
1
Q

Alopecia : Causes

A
  1. Male pattern baldness
  2. Drugs;
    * Carbimazole
    * Heparin
    * Oral contraceptive pill,
    * Colchicine
  3. Nutritional: iron and zinc deficiency
  4. Autoimmune: alopecia areata
  5. Telogen effluvium : hair loss following stressful period
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2
Q

Alopecia areata : Definition

A
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3
Q

Alopecia areata : Definition

A

Alopecia areata is a presumed autoimmune condition causing localised hair loss

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4
Q

Alopecia areata : Clinical features

A
  1. Well demarcated patches of hair loss.
  2. Edge of hair loss - small, broken ‘exclamation mark’ hairs
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5
Q

Alopecia areata : Management

A
  1. Potent topical corticosteroid
  2. Topical minoxidil
  3. Refer to dermatology;
    * Intralesional corticosteroid

Prognosis
Hair will regrow in 50% of patients by 1 year, and in 80-90% eventually.

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6
Q

Acne vulgaris : classification

A
  1. Mild : comedomes with sparse inflammatory lesions
  2. Moderate : Wide spread non inflammatory lesions - papule and pustules
  3. Severe acne : Extensive inflammatory lesions, pitting and scarring of skin
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7
Q

Mild Acne vulgaris : Mx

A

12 week course of topical combination therapy

  • Topical Benzoyl peroxide + one of
    2. Topical Clindamycin (not to coprescribed with PO Abx)
    3. Topical Adapalene
    4. Topical Tretinoin (coprescibe with PO Abx)
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8
Q

Moderate Acne vulgaris : Mx

A

Topical combination therapy +

1 . Orał Lymecycline/Doxycycline (< 6 months)

2 . COCP in women
* 2nd line : Dianette

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9
Q

Severe Acne Vulgaris : Mx

A
  1. Oral isotretinoin } only under specialist supervision
  2. Refer to dermatology if;
    * Nodular-Cystic Acne
    * No response after 2x courses
    * Acne with scarring or pigment change
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10
Q

Acne vulgaris : Complications of management therapy

A
  1. Tetracycline : Avoid in pregnancy except for
  2. Erythromycin : SAFE IN PREGNANCY
  3. Topical/Oral retinoids avoided in pregnancy
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11
Q

Acne vulgaris : SE of Retinoid use

A
  1. Teratogenicity : 2 x forms of COCP
  2. Dry skin/eyes/lips
  3. Low mood
  4. Raised Triglycerides
  5. Hair thinning
  6. Intracranial hypertension } should not be combined with Tetracyclines
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12
Q

Rosacea : Definition

A

Chronic skin disease that primarily affects the face, causing redness, visible blood vessels and small bumps pretending acne.

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13
Q

Rosacea : Clinical features

A

1 . Erythema (Redness):
* Persistent redness : Nose, cheeks fore head } central face

2 . Telangiectasia:
* Small, visible blood vessels (telangiectasia or spider veins)

3 . Papules and Pustules:
* Red bumps resembling acne lesions

4 . Thickening of the Skin:
* rhinophyma : skin on the nose may become thickened and bulbous

5 . Eye Symptoms:
* redness, dryness, and irritation. This is known as ocular rosacea.

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14
Q

Rosacea : Triggers

A

Sunlight can exacerbate symptoms

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15
Q

Rosacea : Management

A

1 . Sunscreen
2 . Erythema
* Topical Brimonide gel } Temporary reduction of redness

3 . Papules
* Topical invermectin +/- PO Doxycycline

4 . Telangiectasia
* Laser therapy

  1. Topical methotrexate therapy may be used
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16
Q

Dermatitis Herpetiformis : Definition

A

Autoimmune blistering skin disorder associated with coeliac disease.
It is caused by deposition of IgA in the dermis.

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17
Q

Dermatitis Herpetiformis : Trigger

A

Gluten intolerance - Coeliac’s disease

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18
Q

Dermatitis Herpetiformis : Clinical features

A

Itchy, vesicular skin lesion on extensor surfaces - elbows, knees, buttocks

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19
Q

Dermatitis Herpetiformis : Diagnosis

A

Skin biopsy : Granular pattern of IgA deposit

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20
Q

Dermatitis Herpetiformis : Management

A
  1. Gluten free diet
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21
Q

Eryhthema multiform : Definition

A

Hypersensitivity reaction that is most commonly triggered by infections

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22
Q

Eryhthema multiform : Clinical features

A
  1. Rash : Target lesions
  2. Spread : Back of hand + UL > LL - spread to torso
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23
Q

Eryhthema multiform : Trigger

A

1 . Virus : Herpes Simplex virus (most common cause)

2 . Bacteria : Streptoccus

3 . Connective tissue disease;
* SLE (Lupus)
* Sarcoidosis

4 . Drug allergy : Penicillin, COCP, Allopurinol, NSAID

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24
Q

Eryhthema multiform : Drug causes

A
  1. penicillin
  2. sulphonamides
  3. carbamazepine
  4. allopurinol,
  5. NSAIDs
  6. oral contraceptive pill,
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25
Q

Erythema nodosum : Definition

A
  • Hypersensitivity reaction that leads to the inflammation of the subcutaneous fat tissue
  • Immune mediated - secondary to deposition of immune complexes
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26
Q

Erythema nodosum : Clinical features

A
  1. Rash : Red nodules develop on shins
    * Tender to touch
  2. Distribution : Shins (most common)
  3. Symptoms : May have mild fever, malaise and joint pain

Prognosis : Self resolves

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27
Q

Erythema nodosum : Trigger

A

1 . Infection :
* Streptoccus
* Tuberculosis

2 . Systemic disease
* Sarcoidosis
* Inflammatory bowel disease

3 . Drugs } Same as for erythema multiform
* Penicillin
* Suphonomides e.g. Sulfasalazine
* COCP

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28
Q

Shingles : Definition

A
  • Shingles (herpes zoster infection) is an acute, unilateral, painful blistering rash caused by reactivation of the varicella-zoster virus (VZV).
  • Following primary infection with VZV (chickenpox), the virus lies dormant in the dorsal root or cranial nerve ganglia.
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29
Q

Shingles : Pathophysiology

A
  1. VZV reactivates from sensory nerve ganglia
    * Triggered by : Immunosupression e.g. HIV

2 . Virus replication : travels down the nerve fibres to the skin
* Inflammation of the nerve causes pain and irritation

3 . Nerve involvement
* Commonly affects T1-L2 dermatome skin

4 . Skin eruption
* Blistering, painful rash appears along distribution of affected nerve

30
Q

Shingles : Clinical features

A

1 . Appearance :
* Erythematous, macular rash over affected dermatome } well demarcated
* Becomes vesicular and blisters form

2 . Severe burning pain over sit of skin

31
Q

Shingles : Management

A

Acyclovir

  • Indication : < 72 hours unless patient <50 and has mild truncal rash and no over risk factors

1 . Infectious until lesions crusted over
2 . Analgesia : NSAID or neuropathic agents
3 . Oral corticosteroid : Immunocompromised

32
Q

Shingles : Complication

A

1 . Post-herpetic neuralgia } most common
* On going neurological pain

2 . Ramsay Hunt syndrome

3 . Herpes zoster opthalmicus
* virus affects ocular division of trigeminal nerve

33
Q

Molluscum contagiosom : Definition

A

Viral skin infection molluscum contagiosum virus (MCV), a poxvirus

34
Q

Molluscum contagiosom : Clinical features

A
  1. small, dome-shaped, 2. flesh-colored papules
  2. Central indentation/dimple
35
Q

Molluscum contagiosom : Mx

A
  1. Highly contagious - avoid sharing towels/contact etc
  2. Self resolves
36
Q

Tinea capitis : Definition

A

Fungal infection of the scalp
Cause : Fungus Trichophyton tonsurans

37
Q

Tinea capitis : Clinical features

A
  1. Scaling, flaking of skin
  2. Red, inflamed patches
  3. Itching
  4. Scarring alopecia - hairloss ‘black dot’ appearance
38
Q

Tinea Capitis : Management

A

Terbinafine

39
Q

Tinea corporis : Definition

A

Fungal infection of body’s skin

40
Q

Tinea corporis : Clinical features

A
  • Well-defined circular erythematous lesion - centre may clear
  • Scaling and redness
  • Itching
  • Pustules and papules
41
Q

Tinea corporis : Mx

A

Oral Fluconozole

42
Q

Tinea Pedis : Definition

A
  • Atheletes foot
  • Fungal infection, affects skin between toes
43
Q

Tinea Pedis : Clinical features

A
  1. Itching between toes
  2. Redness, inflammation
  3. Scaling, Peeling
44
Q

Tinea Pedis : Mx

A
  1. Avoid environments of tramission : Communal showers, swimming pools } moist environments
45
Q

Tinea corporis : Definition

A

‘Ring worm’ - superficial fungal infection of the skin
Refers to : infection of the body only

46
Q

Tinea corporis : Clinical features

A
  1. Well demarcated - circular, red, and scaly rash with raised edges
  2. Central hypopigmentation
47
Q

Tinea corporis : Mx

A

Oral fluconazole

48
Q

Scabies : Definition

A

Scabies is caused by the** mite /Sarcoptes scabiei/ **

spread by prolonged skin contact.

  • typically affects children and young adults.
49
Q

Scabies : Clinical features

A
  1. Wide spread pruritus : scratching and excoriation present
  2. Linear burrows : side of fingers, between fingers and flexor aspect of wrist
50
Q

Scabies : Management

A
  1. All house hold and contacts treated + bedding washed
  2. First line : Permethrin 5%
51
Q

Pyoderma gangrenosum : Definition

A

rare, non-infectious, inflammatory disorder.
* Caused by dense infiltration of neutrophils
* It is an uncommon cause of very painful skin ulceration.

52
Q

Pyoderma gangrenosum : Causes

A
  1. Idiopathic 50%
  2. inflammatory bowel disease in
    • ulcerative colitis
    • Crohn’s
  3. Rheumatological
    • rheumatoid arthritis
    • SLE
53
Q

Pyoderma gangrenosum : Cancer risk

A

Haemotological cancer
* Myeloproliferative, Lymphoma, Myeloid leukaemia
(excess neurtrophisl)

54
Q

Pyoderma gangrenosum :Clinical features

A
  1. Lower limbs } most common
  2. Start : small red pustule
  3. Progress : Painful purple ulcer
  • Systemic sx : Fever, Myalggia
55
Q

Pyoderma gangrenosum : Management

A
  1. PO Steroids
  2. Immunosupression : Ciclosporin
56
Q

Pityriasis versicolor - Definition

A

Common yeast infection of the skin, caused by the fungus /Malassezia/

57
Q

Pityriasis versicolor - Clinical features

A
  1. Hypopigemented patches (also be hyperpigmented)
  2. On the trunk
  3. Mild pruritus and scaling
58
Q

Pityriasis versicolor - Mx

A
  1. Ketoconozole Shampoo - large areas
  2. Skin scraping and oral itraconzole
59
Q

Lichen planus : Definition

A

Immune mediated chronic inflammatory condition affecting skin and body

60
Q

Lichen planus : Clinical features

A
  1. Polyglonal papular rash - white line pattern
  2. Itchy
  3. Soles, palms, and flexor surface of arms
  4. Oral involvement common : white laced pattern on buccal mucosa
  5. Nail thinning
61
Q

Lichen planus : Management

A
  1. Potent topical steroid
  2. Benzydamine mouth wash for oral mucosa
62
Q

Bullous pemphigoid : Definition

A
  • autoimmune condition causing sub-epidermal blistering of the skin.
  • This is secondary to the development of antibodies agaisnt trigger.
63
Q

Bullous pemphigoid : Clinical presentation

A

More common in elderly patients
* itchy, tense blisters typically around flexures
* No mucusoa ingolvement - seem in pemphigus

64
Q

Bullous pemphigoid : Management

A
  1. Referral to Dermatology for Skin biopsy - shows IgG and C4
  2. Oral corticosterpods
65
Q

Pityriasis Rosea : Definition

A

Acute rash caused by herpes hominis virus 7

Affects young adults

66
Q

Pityriasis Rosea : Clinical features

A
  1. Hx of revent iral infection
  2. Herald patch - on trunk
  3. Erythemaous oval scaly patches running parallael
67
Q

Pityriasis Rosea : Mx

A

Self limiting

68
Q

Contact dermatitis : Types

A
  • irritant contact dermatitis: common - non-allergic reaction
  • allergic contact dermatitis: type IV hypersensitivity reaction.
69
Q

irritant contact dermatitis: Clinical features

A

Erythema is typical, crusting

vesicles are rare

70
Q

allergic contact dermatitis: Clinical features

A

often seen on the head following hair dyes. Presents as an acute weeping eczema

Mx : Potent steroid

71
Q

Contact dermatitis : Ix

A

Skin patch test

Dermatology (4 decks)

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