Inflammatory skin conditions Flashcards
First line management for polymorphic light eruption
Oral antihistamines
- Loratidine
Hydrocortisone
Eczema rash is characterised by…
Vesicles/ papules on a erythematous base
Complications of eczema
Eczema herpeticum
Molluscum contagiosum
Secondary bacterial infections
What % of children are affected with eczema?
20%
Eczema is associated with…
Positive family history
Atopic history: asthma, allergic rhinitis
General advise for atopic dermatitis
Avoid fragranced creams/ soaps
Avoid foaming agents (SLS)/ soaps
Good hydration
First line management for atopic dermatitis
Emollient + mild topical steroid (hydrocortisone)
What treatment is indicated for severe atopic dermatitis/ high risk sites
Calcineurin inhibitors
- Tacrolimus, pimecrolimus
Calcineurin inhibitors is not licensed in …
Age <2
Pompholyx dermatitis typically affects what region?
Hands, fingers, soles of feet
Asteatosis is also known as…
Eczema craquele
Contact dermatitis involves what hypersensitivity reaction?
Type 4
Atopic dermatitis typically affects what regions?
Flexors
- inner elbow, back of knees
Extensors in infants
Face
Acute atopic dermatitis can present as…
Exudative, vesicular rash
Exacerbating features of atopic dermatitis [4]
Allergen exposure
Sweating/ Heat
Severe stress
Hormonal changes in women
Discoid dermatitis presents as…
Discoid shaped plaques
- Afffects the limbs
Varicose dermatitis can present as….
Erythematous, dry itchy skin
Haemosiderin deposits
Lipodermatosclerosis
Atophie blanche
Corona phlebactatica
Eczema craquele presents as…
Dry, cracked skin
Diamond shaped plates in skin
- Separated by red bands
Lichenification describes…
Skin thickening as a result of chronic scratching
First line investigation for contact dermatitis
Patch test
What scoring system is used for eczema in children?
Children’s dermatology life quality index (CDQLI)
What scoring system is used for eczema in adults
What scoring system is used for eczema in Adults
General advise for contact dermatitis
Avoid the precipitating cause
Avoid soap
Dry skin carefully
Use gloves in hand dermatitis
First line management of contact dermatitis
Avoiding/ removing the cause
Potent corticosteroids
- Betnovate/ Dermovate
Emollient
First line management of seborrhoeic dermatitis
Non soap cleanser
Topical antifungal (OD 2-4 weeka) - Ketoconazole/ clotimazole
Mild topical corticosteroid (BD, 1-2 weeks and wean)
- Hydrocortisone
Triggers of psoriasis [5]
Streptococcal infections (and other infections)
Stress
Medications
Smoking/ alcohol
Skin injury
Types of psoriasis
Plaque
Pustular
Guttate
Flexural
Erythrodermic (medical emergency)
Pustural psoriasis mainly affects what regions?
Hands and feet (if localised)
Primary care management of psoriasis
Emollient
Medium-high potent topical steroids
Salicylic acid
Vitamin D cream (Calcipotriol)
______ is a vitamin D cream that can be used to treat psoriasis
Calcipotriol
Biologics is indicated in psoriasis when…
Systemic DMARDs fail/
Body surface areas >10 is affected
Lichen planus affecting the mouth carries a risk of…
Squamous cell carcinoma
Lichen planus is associated with which GI conditions
Primary biliary cirrhosis
Hepatitis B/C
Wilkham straie describes ________ and is a feature of _______
Describes white streaks seen in lichen planus
Lichen planus typically affects
Flexor surfaces:
Wrist
Forearms
Legs
First investigation for lichen planus is ______ which shows ______
Skin biopsy and histology
Saw-tooth epidermal hyperplasia
Lichen planus typically …
Resolves within a year
Lichen planus presents as…
Skin
- Pruritic, pupuric/ hyperpigmented patch
- Polygonal shape
- Wilkham straie
Nails
- Thin plate, longitudinal ridging
Oral
- White-lacy pattern in buccal mucosa
Pharmacological treatment of lichen planus
Moderate/ potent steroid
- Betnovate/ Eumovate
Antihistamines for pruritis
Pharmacological treatment of lichen planus
Moderate/ potent steroid
- Betnovate/ Eumovate
Antihistamines for pruritis
What drugs can trigger lichen planus?
Gold
Quinine
Thiazide
Examples of medications that exacerbate psoriasis
Cardiac drugs
- Beta blockers
- ACEi
Antimalarials
Lithium
NSAIDs
First line management for mild acne
Topical benzoyl peroxide / topical retinoids
First line management for moderate acne
Topical macrolide (clindamycin) + topical benzoyl peroxide/ retinoid - Antibiotics used up to 6 weeks
Second line management for moderate acne
Oral antibiotic (lymecycline) + topical retinoids/ benzoyl peroxide/ COCP
Management of severe, cystic acne
Oral isotretinoin
Side effects of retinoids
Dry skin
Low mood
Hypersensitivity to the sun
What COCP is prescribed for acne?
Co-cyprindiol (Ethinylestradiol/cyproterone acetate)
First line management of urticaria
Non-sedating antihistamine
- i.e. cetirizine
Examples of drugs that cause urticaria
Aspirin/ NSAIDs
Penicillins
Opioids
Management of recurrent/ severe urticaria
Oral prednisolone
Types of urticaria
Acute
- IgE, allergy mediated
Chronic
- Chronic idiopathic
- Chronic inducible
- Autoimmune
Triggers for chronic, inducible urticaria
Exercise
Temperature changes
Pressure
Sunlight
Strong emotions
Anti-leukotrienes such as ______ may be used by specialist to manage chronic urticaria
Montelukast
Erythema nodosum is associated with which chronic diseases?
Sarcoidosis
Inflammatory bowel disease
Lymphoma, leukaemia
What medications can trigger erythema nodosum
COCP
NSAIDs
Erythema nodosum describes…
Inflammation of subcutaneous fat (panniculitis) on the shin
What triggers are associated with erythema nodosum?
Infections
- Strep throat
- Mycoplasma pnuemoniae
- TB
- gastroenteritis
Pregnancy
Features of eyrthema multiforme
Erythematous, pruritis rash
- Targe lesion
Sides on arm/ legs- spreads to trunk
Most common cause of erythema multiforme is…
HSV infection
