Inflammatory Skin Disease

Question 1

What causes stasis dermatitis?

Answer 1

Chronic venous insufficiency of the lower extremities associated with lower extremity edema.

Question 2

What do patients with stasis dermatitis usually complain of?

Answer 2

• 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

Question 3

How would you treat contact dermatitis?

Answer 3

• Compression
• Elevation
• Exercise calf muscles
• Vascular surger
• Topical steroids
• Avoid allergens

Question 4

How does the morphology of dermatitis differ from the morphology of cellulitis?

Answer 4

Dermatitis- Erythematous papules and thin plaques with scales

Cellulitis- Warm, tender, erythematous patches or plaques

Question 5

How does the location of inflammation differ in dermatitis from that of cellulitis?

Answer 5

Dermatitis- Epidermis and dermis

Cellulitis- Dermis and subcutaneous tissue

Question 6

When do the majority of atopic dermatitis occur?

Answer 6

Majority begin before age 5

Question 7

Xerosis (dry skin) and a history of atopy (asthma, allergic rhinitis) are associated with what skin condition?

Answer 7

Atopic dermatitis

Question 8

What are the three stages of atopic dermatitis?

Answer 8

Infantile
Childhood
Adult

Question 9

Itchy skin + Plus is the diagnostic criteria of what skin condition?

Answer 9

Atopic dermatitis

Question 10

Itchy skin + Plus. What can the plus be?

Answer 10

• 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

Question 11

What causes atopic dermatitis?

Answer 11

• Barrier disrupted skin
• Filaggrin mutation
• Staphlyococcus aureus
• Elevated IgE
• Eosinophilia
• Th2 type cytokines

Question 12

What is irritant contact dermatitis?

Answer 12

non-immunologically mediated reaction resulting from a direct cytotoxic effect

Question 13

What is the most common types of contact dermatitis?

Answer 13

Irritant contact dermatitis

Question 14

Name some strong irritants.

Answer 14

Strong acids or strong bases

Question 15

Name a weak irritant.

Answer 15

Soap and water

Perfumes

Question 16

What type of dermatitis requires contact exposure of an allergen, immune response and development of “memory” T cells?

Answer 16

Allergic Contact Dermatitis

Question 17

What type of immunopathology describes allergic contact dermatitis?

Answer 17

Type IV, delayed-type hypersensitivity reaction.

24-48 hours after exposure

Question 18

What is the most common allergen?

Answer 18

Nickel sulfate

Question 19

Is fragrance a contact allergen?

Answer 19

Yes over 100 are known to be

Question 20

What is the most commonly used topical antibiotic that is also a contact allergen?

Answer 20

neomycin sulfate

Question 21

Bacitracin is a topical antibiotic, but is it also a contact allergen?

Answer 21

Yes

Question 22

What most commonly causes exanthematous eruptions?

Answer 22

They are usually drug induced in adults

Question 23

What enhances the risk of drug eruptions?

Answer 23

Viral infections like...
EBV
Enterovirus
Adenovirus
HIV

Question 24

What is the treatment for drug induced exanthematous eruptions

Answer 24

1. Remove offending drug
   - They will resolve in 1-2 weeks
2. Topical steroids for pruritus

Question 25

What is the super smart word for hives?

Answer 25

Urticaria

Question 26

How long does each individual hive last?

Answer 26

> 24 hours

Question 27

What would the histology reveal with someone with urticaria?

Answer 27

dermal edema with eosinophils +/- neutrophils

Question 28

What is the treatment for urticaria?

Answer 28

Antihistamines

Question 29

What distinguishes acute urticaria from chronic urticaria?

Answer 29

6 weeks

Question 30

Acute urticaria represents what type of hypersensitivity reaction?

Answer 30

Immediate type I hypersensitivity

Question 31

Are physical urticarias a thing?

Answer 31

Apparently

Question 32

What is the clinical presentation of seborrheic dermatitis?

Answer 32

Appearance: Sharply demarcated patches with pink or slightly orange-yellow erythema

Timeline: Infancy and post-puberty

Location: Sebaceous glands

Question 33

Where does seborrheic dermatitis usually occur in adults?

Answer 33

Commonly in scalph
Facial involvement
Chronic relapse

Question 34

Seborrheic dermatitis is usually associated with what disease?

Answer 34

Parkinson’s Disease

But, if a patient with HIV gets soborrheic dermatitis it will be worse because they are immunodeficient

Question 35

What does seborrheic dermatitis usually occur in infants?

Answer 35

“Cradle cap”, inguinal folds or axillae, face, posterior ears, neck
1 week after birth

Question 36

What causes seborrheic dermatitis?

Answer 36

Malassezia furfur- a yeast considered normal flora.

May be linked to imbalance of normal flora

Question 37

What is the treatment for seborrheic dermatitis?

Answer 37

Ketochonazole cream
Hydrocortisone Cream
Ketoconazole Shapmoo (adults)

Question 38

Name the clinical subtypes of psoriasis

Answer 38

1. Chronic plaque disease
2. Guttate
3. Erythroderma
4. Pustular Psoriatic Arthritis

Question 39

What diseases are associated with psoriasis?

Answer 39

Arthritis 
Crohn's disease 
Persistent low grade inflammation
Metabolic syndromes
Cardiovascular disease

Question 40

How do you treat localized psoriasis?

Answer 40

Phototherapy
Calcipotriol
Corticosteroids
Topical retinoids

Question 41

How do you treat widespread disease +/- Psoriatic arthritis

Answer 41

Methotrexate
Cyclosporin
Systemic retinoids
Biologics