Inflammatory Skin conditions Flashcards
how might atopic eczema present?
- itchy erythmatous dry scaly patches
- on face and extensor regions in infants
- flexor aspect child / adult
- chronic scratching leads to excoriations and lichenification
What do acute lesions of eczema look like?
erythematous, vesicular and weepy (exudative)
what are the exacerbating factors of eczema
- infection
- allergens e.g. chmicals, food, dust, pet fur
- sweating
- heat
- severe stress
What are the nail signs of eczema
nail pitting and ridgin
How is eczema managed?
1) emollients / bandages / bath oil / soap subsitute
2) topical steroids for flare ups OR topical immunomodulators e.g (tracrolimus , pimecrolimus)
3) Oral therapy (antihistamins for symptom relief)
4) oral antibiotics e.g fluclox for secondary bact inf
5) antivirals e.g. aciclovir for secondary herpes inf
6) Phototherapy / immuosuppressants e.g. oral prednisolone, azothioprine, ciclosporin
What are the complications of atopic eczema?
1) bacterial inf
3) viral infection e.g, molluscum contagiosum, viral warts, eczema herpeticum
who is affected by acne vulgaris?
80% of teenagers
what causes acne vulgaris?
hormones (androgens)
What factors contribute to acne vulgaris?
1) increased sebum production
2) abnormal follicular keratinization
3) bacterial colonisation
4) inflammation
How does acne vulgaris present?
1) non inflammatory = open (blackheads) and closed (whiteheads) comodomes
2) inflammatory = papules, pustules, nodules and cysts
what areas are usually affected by acne vulgaris?
face, chest, upper back
How long does treatment need to be continued to have an effect on acne vulgaris?
6 weeks
What are the treatments for acne vulgaris?
- Topical (for mild acne) = benzoyl peroxide and topical antibiotics and topical retinoids
- Oral ( moderate) = oral abx e.g. tetracycline and anti-androgens
- severe - oral retinoids e.g. roacutane
what is psoriasis?
A chronic inflammatory skin disease due to hyperproliferation of kertinocytes and inflammatory cell infiltrate.
What are the types of psoriasis?
- chronic plaque psoriasis (most common)
- guttate (raindrop lesions)
- seborrhoeic (naso -labial and retro-auricular)
- flexural (body folds)
- pustular ( palmar / plantar)
- erythrodermic (total body redness)
What is the Koebner phenomenon?
lesions occur in scars
- psoriasis
- lichen planus
How does psoriasis present?
- well demarcated erythematous sclay plaques
- itchy, burning or painful
- extensor surfaces or scalp
- pitting, onycholysis of nails
- psoriatic arthritis
What is the treatment for psoriasis?
- emollients
- topical (vitamin D anologues, corticosteroids, coal-tar , dithranol, retinoids, keratolytics and scalp preparations.)
- Phototherapy (for extensive psoriasis) - UVB
- Oral therapies ( methotrexate, retinoids, ciclosporin, mycophenolate, mofetil, fumaric acid esters)
- biological agents e.g. infliximab
What are the complications of psoriasis/
erythroderma
What are the 6 Ps of Lichen Planus?
- Pruritic
- Planar
- Purple
- Polygonal
- Papules
- plaques
How does lichen planus present?
- flat topped, smooth, shiny polygonal purplish red itchy papules
- symmetrical distribution
- flexural aspect of wrist
- wickham’s striae (lacy white streaks) overly papules. if on tongue cannot be scraped off.
- koebner phenomenon
- nail dystrophy
- effects skin and mucosal surfaces
What are the differentials for lichen planus?
- drug reaction
- eczema
- psoriasis
- candidiasis
What inv are done for lichen planus?
skin biopsy
How is lichen planus treated?
- topical corticosteroids e.g. elocon to reduce inflammation
