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Dermatology > Inflammatory Skin Disease > Flashcards

Inflammatory Skin Disease Flashcards

1
Q

Describe the pathogenesis of eczema, with reference to the barrier effect?

A

Inflammatory condition of the skin caused by a combination of genetic, immune and reactions to stimuli
The barrier effects leads to increased permeability and reduced antimicrobial activity

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2
Q

An inherited abnormality in Filaggrin expression is a primary cause of disordered barrier function in eczema. What is filaggrin?

A

A group of proteins which bind to keratin fibres in epidermal cells

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3
Q

What are the subtypes of endogenous eczema?

A 
Atopic
Seborrhoeic
Discoid
Varicose
Pompholyx
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4
Q

What are the subtypes of exogenous eczema?

A

Contact (allergic)

Photoreaction

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5
Q

What other conditions is atopic eczema associated with?

A

Allergic rhinitis
Conjunctivitis
Hayfever

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6
Q

There are high levels of which antibody in atopic eczema?

A

IgE

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7
Q

Atopic eczema is common in infants and usually regresses by adolescence. T/F?

A

True

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8
Q

Most patients with atopic eczema have a family history of atopic illness. T/F?

A

True

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9
Q

What is the main symptom of atopic eczema?

A

Itchy rash

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10
Q

Atopic eczema often causes secondary infection. T/F?

A

True

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11
Q

Which sites are commonly affected by atopic eczema?

A 
Face
Flexor surfaces (elbows, backs of knees)
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12
Q

What foodstuffs can aggravate atopic eczema in infants?

A

Milk

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13
Q

Food can aggravate atopic eczema in adults. T/F?

A

False - this is important in infants but far less significant in adults

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14
Q

What are the potential complications of atopic eczema?

A 
Bacterial infection with s.aureus
Viral infection with molluscus, viral warts of eczema herpeticum
Tiredness
Growth reduction
Psychological impact
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15
Q

How is atopic eczema treated?

A 
Emollients
Topical steroids
Bandages
Antihistamine
Antibiotics/antivirals
Education for parents and child
Avoidance of exacerbating factors
Systemic immunosupressants e.g. cyclosporin, methotrexate
New biologic agents
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16
Q

Give examples of common allergens (and objects in which they are found) which can cause contact dermatitis

A

Nickel - jewellery, zips, scissors, coins
Chromate - cement, tanned leather
Cobalt - pigment, dyes
Colophony - glue, adhesive tape, plasters
Fragrance - cosmetics, creams, soaps

17
Q

Describe the appearance of seborrhoeic dermatitis?

A

Chronic, scaly inflammatory condition

18
Q

What type of eczema may occur in severe HIV?

A

Seborrhoeic dermatitis

19
Q

What sites are commonly affected by seborrhoeic dermatitis?

A

Face
Scalp
Eyebrows
Occasionally the upper chest

20
Q

What is the cause of seborrhoeic dermatitis?

A

Overgrowth of pittosporum ovale yeast

21
Q

How is seborrhoeic dermatitis on the scalp treated?

A

Medicated anti-yeast shampoo containing ketoconazole

22
Q

How is seborrhoeic dermatitis on the face treated?

A

Anti-microbial e.g. daktacort cream
Mild steroid
Simple moisturisers

23
Q

What type of eczema is caused by underlying venous disease?

A

Venous dermatitis

24
Q

What is the cause of venous dermatitis?

A

Underlying venous disease which results in incompetence of the deep perforating veins and increase hydrostatic pressure

25
Q

How is venous dermatitis managed?

A

Emollients
Mild/moderate topic steroid
Compression bandaging
Consideration of early venous surgical intervention

26
Q

What is psoriasis?

A

A chronic relapsing and reciting scaling skin disease

27
Q

What are the two peaks of age at which psoriasis presentation is most prevalent?

A

20-30 years

50-60 years

28
Q

Describe the pathogenesis of psoriasis?

A

T cell mediated autoimmune disease
Abnormal infiltration of T cells. results in release of inflammatory cytokines including interferon, interleukins and TNF and increased keratinocyte proliferation

29
Q

What conditions are associated with psoriasis?

A

Psoriatic arthritis
Metabolic syndrome
Liver disease/alcohol misuse
Depression

30
Q

There is a strong family history in psoriasis. T/F?

A

True

31
Q

Which genes are associated with psoriasis?

A

PSORS genes

HLA-Cw0602

32
Q

What are the treatment options for psoriasis?

A

Topical creams and ointments
Phototherapy light treatment
Systemic drugs / immunosuppressants
Biologic therapies

33
Q

What topical therapies can be sued in the treatment of psoriasis?

A

Moisturisers to help reduce dryness and flaking
Steroids to reduce the autoimmune response, redness, itching and inflammation
Salicylic acid to dissolve thick dead skin
Vitamine D analogues/coal tar/dithranol to slow. down keratinocyte proliferation

34
Q

What are the risks fo UV phototherapy in the treatment of psoriasis?

A

Burning

Risk of skin cancer

35
Q

Describe the use of UV phototherapy in the treatment of psoriasis?

A

Reduces T cell proliferations, encourages vitamin D production and reduces skin turover
UVB light is commonly used

36
Q

What systemic therapies can be used in the treatment of psoriasis?

A 
Immunosuppressants - methotrexate, ciclosporin
Acitretin
Dimethyl fumarate
Apremilast
Adalimumab
Ustekinumab
37
Q

What are the potential side effects of systemic therapies used in the treatment of psoriasis?

A

Liver dysfunction
Hypertension
Increased risk of infection

38
Q

What are the symptoms of psoriasis?

A

Itch

Occasional pain if thick plaques on hands and feet with fissuring

39
Q

What pattern of join pains might be seen in a patient with psoriasis?

A

Small joint, digit arthritis with swelling, redness, arthralgia
Acial sacroiliac

Dermatology (8 decks)

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