Inflammatory Skin Diseases Flashcards by Imogen Smedley

what are the 4 types of inflammatory skin diseases

Spongiotic intra-epidermal oedema
Psoriasiform-elongation of rete ridges
Lichenoid basal layer damage
Vesiculobullous blistering

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example of spongiotic intra-epidermal oedema inflammatory skin diseases

eczemas, contact dermatitis, drug eruptions

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example of lichenoid basal layer damage inflammatory skin diseases

lichen planus, lupus, drug eruption, TEN, erythema multiforme

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protein mutated in eczema

fillagrin

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what is the koebner phenomenum

outbreak at sight of trauma

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what is lichenification

increased skin markings

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describe the rash in atopic dermatitis

flexural erthymatous dry scaly + lichenifications + excoriations

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what is required for a diagnosis of atopic dermatitis

itch + 3 of

flexural rash
PMH flexural rash
atopy
FH if <4y.o.
onset <2y.o.

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general management of atopic dermatitis

emollients and topical steroids

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last last management of atopic dermatits

UVB phototherapy and oral immunosuppressants

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what can cause ‘monomorphic punched out lesions’

eczema herpeticum

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what pathogen can infect atopic dermatits

herpes simplex

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how to diagnose contact allergic eczema

patch test

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what type of eczema is nappy rash

contact irritant

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what APC is involved in contact allergic eczema

Langerhans cell

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what is the management of severe contact irritant eczema

TOP steroid

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what clue on examination can help diagnose phosensitive dermatits

stops at collar

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what causes photosensitive dermatitis

secondary to photosensitizing drug or atopy

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what type hypersensitivity is a drug eruption

i or iv

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what type of eczema can occur on the back of the neck / side of the leg due to scratching

lichen simplex eczema

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what type of eczema causes defined oval discs of eczema

discoid eczema

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what is seborrhoeic dermatitis

cradle cap eczema

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what conditions does having psoriasis increase the risk of

CVD, psoriatic arthritis

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what layer of skin undergoes hyperplasia in psoriasis vulgaris

epidermis, particularly keratin layer

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which parts of the body are commonly affected by psoriasis vulgaris

hairline, extensor surfaces, nails

what conditions are affected by the koebner phenomenum

atopic dermatitis, psoriasis vulgaris, lichen planus

describe the rash in psoriasis

sharply demarcated scaly erythematous plaques

are psoriasis plaques reversible

yes

what changes can be seen in the nails in psoriasis

pitting, oncholysis, dystrophy, subungal hyperkeratosis

what is auspitz sign

removal of surface scale reveals tiny bleeding dilated capillary

what is a risk factor for guttate psoriasis

recent antibiotic treatment

what is the presentation of guttate psorasis

acute widespread itchy psoriasis

what is the management of guttate proasis

short course UVB therapy

what is the presentation of erythroderma

acute widespread red pustules

what conditions are linked to erythroderma

eczema, drugs, malignancy

what type of psoriasis affects the soles of the feet

palmoplantar pustular

what is the 1st line management of psoriasis

TOP vit D analogue calcipotriol

what is the 1st line management of severe psoriasis

TOP steroid

what is available 2nd line for psoriasis

emollient, coal tar, dithranol, TOP steroid, keratolytic

what is available last line for psoriasis

UVB phototherapy or methotrexate

what is the management of scalp psorasis

greasy ointment, tar/steroid shampoo, vit D analogue

which layer of skin is affected by lichen planus

basal layer and between epidermis and dermis

what term describes the white lacey pattern on buccal mucosa in lichen planus

wickham's striae

what is the pathology of lichen planus

orthrokeratosis, hypergranulosis, irregular sawtooth acanthosis

what areas are affected by lichen planus

wrists, shins, ankles, nails, buccal mucosa

how does lichen planus affect the nails

nail ridging

describe the rash in lichen planus

itchy shiny flat violet/pink pustules/plaques/papules

what is the management of lichen planus

TOP steroid

what is the management of severe lichen planus

PO steroid

what skin layer is affected by bullus pemphigoid

DEJ

is bullus pemphigoid autoimmune

yes

is acantholysis present is pemphigus vulgaris

yes

is acantholysis present is bullus pemphigoid

what skin layer is affected by pemphigus vulgaris

prickle cell layer

what is IgG reacting with in bullus pemphigoid

hemidesmosome antigen

what is the function of the hemidesmosome antigen

anchors basal cells to basement membrane

is pemphigus vulgaris autoimmune

yes

what is IgG reacting with in pemphigus vulgaris

desmoglein 3

what is the function of desmoglein 3

maintains desmosomal attachments

what is acantholysis

intracellular adhesion cite lysis

what ages are affected by bullus pemphigoid

elderly

what ages are affected by pemphigus vulgaris

middle age

what is nikolsky's sign

top skin layers fall away when rubbed

which condition is nikolsky's sign postivite in

pemphigus vulgaris

does bullus pemphigoid scar

what is the initial presentation of bullus pemphigoid

itchy plaque/pustule

what is the presentation of bullus pemphigoid

widespread or localised large erythematous bullae

what test diagnoses bullus pemphigoid

biopsy for immunofluorescence

what is seen on immunofluorescence in bullus pemphigoid

IgG and complement at basement membrane, straight line

what antibiotic is given for bullus pemphigoid

tetracycline

what is the management of bullus pemphigoid

antibiotic, TOP + PO steroid, emollient, antiseptic

what topical steroid is given for bullus pemphigoid

dermovate

what areas of the body are affected by pemphigus vulgaris

scalp, face, axilla, groin, trunk, mucosa

what test is required for a diagnosis of pemphigus vulgaris

biopsy for immunofluorescence

what is seen on immunofluorescence in pemphigus vulgaris

mesh/chicken wire appearance

what is the management of pemphigus vulgaris

PO steroid, antiseptic, emollient +- immunosuppressive

is dermatitis herpetiformis autoimmune

yes

what HLA type is affected from dermatitis herpetiformis

HLA-DQ2

what condition is linked to dermatitis herpetiformis

coeliac disease

can you have dermatitis herpetiformis and not have coeliac disease

yes

what areas of the body are affected by dermatitis herpetiformis

symmetrical on extensor surfaces/buttocks

describe the rash in dermatitis herpetiformis

itchy erythematous papules

what layer of the skin is affected by dermatitis herpetiformis

dermis

what test is diagnostic of dermatitis herpetiformis

immunofluorescence

what is seen on immunofluorescence in dermatitis herpetiformis

IgG in dermal papilla targeting gliadin

what is the management of dermatitis herpetiformis

dapsone cream and investigate for coeliac if not diagnosed

what test is diagnostic of coeliac disease

IgG ATTG test