Inflammatory Skin Disease Flashcards
What causes stasis dermatitis?
Chronic venous insufficiency of the lower extremities associated with lower extremity edema.
What do patients with stasis dermatitis usually complain of?
- Dryness
- Itching
- Allergic contaact dermatitis due to use of topical preparations
- Anemia of Chronic Disease in majority of patients
- Irritant Dermatitis due to wound exudates
How would you treat contact dermatitis?
- Compression
- Elevation
- Exercise calf muscles
- Vascular surger
- Topical steroids
- Avoid allergens
How does the morphology of dermatitis differ from the morphology of cellulitis?
Dermatitis- Erythematous papules and thin plaques with scales
Cellulitis- Warm, tender, erythematous patches or plaques
How does the location of inflammation differ in dermatitis from that of cellulitis?
Dermatitis- Epidermis and dermis
Cellulitis- Dermis and subcutaneous tissue
When do the majority of atopic dermatitis occur?
Majority begin before age 5
Xerosis (dry skin) and a history of atopy (asthma, allergic rhinitis) are associated with what skin condition?
Atopic dermatitis
What are the three stages of atopic dermatitis?
Infantile
Childhood
Adult
Itchy skin + Plus is the diagnostic criteria of what skin condition?
Atopic dermatitis
Itchy skin + Plus. What can the plus be?
- History of involvement of skin creases or face
- Personal history of asthma or hay fever
- History of dry skin within the last year
- Visible flexural eczema
- Onset under 2 years of age
What causes atopic dermatitis?
- Barrier disrupted skin
- Filaggrin mutation
- Staphlyococcus aureus
- Elevated IgE
- Eosinophilia
- Th2 type cytokines
What is irritant contact dermatitis?
non-immunologically mediated reaction resulting from a direct cytotoxic effect
What is the most common types of contact dermatitis?
Irritant contact dermatitis
Name some strong irritants.
Strong acids or strong bases
Name a weak irritant.
Soap and water
Perfumes
What type of dermatitis requires contact exposure of an allergen, immune response and development of “memory” T cells?
Allergic Contact Dermatitis
What type of immunopathology describes allergic contact dermatitis?
Type IV, delayed-type hypersensitivity reaction.
24-48 hours after exposure
What is the most common allergen?
Nickel sulfate
Is fragrance a contact allergen?
Yes over 100 are known to be
What is the most commonly used topical antibiotic that is also a contact allergen?
neomycin sulfate
Bacitracin is a topical antibiotic, but is it also a contact allergen?
Yes
What most commonly causes exanthematous eruptions?
They are usually drug induced in adults
What enhances the risk of drug eruptions?
Viral infections like... EBV Enterovirus Adenovirus HIV
What is the treatment for drug induced exanthematous eruptions
- Remove offending drug
- They will resolve in 1-2 weeks - Topical steroids for pruritus
What is the super smart word for hives?
Urticaria
How long does each individual hive last?
> 24 hours
What would the histology reveal with someone with urticaria?
dermal edema with eosinophils +/- neutrophils
What is the treatment for urticaria?
Antihistamines
What distinguishes acute urticaria from chronic urticaria?
6 weeks
Acute urticaria represents what type of hypersensitivity reaction?
Immediate type I hypersensitivity
Are physical urticarias a thing?
Apparently
What is the clinical presentation of seborrheic dermatitis?
Appearance: Sharply demarcated patches with pink or slightly orange-yellow erythema
Timeline: Infancy and post-puberty
Location: Sebaceous glands
Where does seborrheic dermatitis usually occur in adults?
Commonly in scalph
Facial involvement
Chronic relapse
Seborrheic dermatitis is usually associated with what disease?
Parkinson’s Disease
But, if a patient with HIV gets soborrheic dermatitis it will be worse because they are immunodeficient
What does seborrheic dermatitis usually occur in infants?
“Cradle cap”, inguinal folds or axillae, face, posterior ears, neck
1 week after birth
What causes seborrheic dermatitis?
Malassezia furfur- a yeast considered normal flora.
May be linked to imbalance of normal flora
What is the treatment for seborrheic dermatitis?
Ketochonazole cream
Hydrocortisone Cream
Ketoconazole Shapmoo (adults)
Name the clinical subtypes of psoriasis
- Chronic plaque disease
- Guttate
- Erythroderma
- Pustular Psoriatic Arthritis
What diseases are associated with psoriasis?
Arthritis Crohn's disease Persistent low grade inflammation Metabolic syndromes Cardiovascular disease
How do you treat localized psoriasis?
Phototherapy
Calcipotriol
Corticosteroids
Topical retinoids
How do you treat widespread disease +/- Psoriatic arthritis
Methotrexate
Cyclosporin
Systemic retinoids
Biologics
