Inflammatory Skin Diseases Flashcards

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1
Q

what are the 4 types of inflammatory skin diseases

A

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

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2
Q

example of spongiotic intra-epidermal oedema inflammatory skin diseases

A

eczemas, contact dermatitis, drug eruptions

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3
Q

example of lichenoid basal layer damage inflammatory skin diseases

A

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

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4
Q

protein mutated in eczema

A

fillagrin

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5
Q

what is the koebner phenomenum

A

outbreak at sight of trauma

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6
Q

what is lichenification

A

increased skin markings

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7
Q

describe the rash in atopic dermatitis

A

flexural erthymatous dry scaly + lichenifications + excoriations

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8
Q

what is required for a diagnosis of atopic dermatitis

A

itch + 3 of

  • flexural rash
  • PMH flexural rash
  • atopy
  • FH if <4y.o.
  • onset <2y.o.
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9
Q

general management of atopic dermatitis

A

emollients and topical steroids

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10
Q

last last management of atopic dermatits

A

UVB phototherapy and oral immunosuppressants

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11
Q

what can cause ‘monomorphic punched out lesions’

A

eczema herpeticum

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12
Q

what pathogen can infect atopic dermatits

A

herpes simplex

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13
Q

how to diagnose contact allergic eczema

A

patch test

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14
Q

what type of eczema is nappy rash

A

contact irritant

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15
Q

what APC is involved in contact allergic eczema

A

Langerhans cell

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16
Q

what is the management of severe contact irritant eczema

A

TOP steroid

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17
Q

what clue on examination can help diagnose phosensitive dermatits

A

stops at collar

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18
Q

what causes photosensitive dermatitis

A

secondary to photosensitizing drug or atopy

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19
Q

what type hypersensitivity is a drug eruption

A

i or iv

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20
Q

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

A

lichen simplex eczema

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21
Q

what type of eczema causes defined oval discs of eczema

A

discoid eczema

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22
Q

what is seborrhoeic dermatitis

A

cradle cap eczema

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23
Q

what conditions does having psoriasis increase the risk of

A

CVD, psoriatic arthritis

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24
Q

what layer of skin undergoes hyperplasia in psoriasis vulgaris

A

epidermis, particularly keratin layer

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25
Q

which parts of the body are commonly affected by psoriasis vulgaris

A

hairline, extensor surfaces, nails

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26
Q

what conditions are affected by the koebner phenomenum

A

atopic dermatitis, psoriasis vulgaris, lichen planus

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27
Q

describe the rash in psoriasis

A

sharply demarcated scaly erythematous plaques

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28
Q

are psoriasis plaques reversible

A

yes

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29
Q

what changes can be seen in the nails in psoriasis

A

pitting, oncholysis, dystrophy, subungal hyperkeratosis

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30
Q

what is auspitz sign

A

removal of surface scale reveals tiny bleeding dilated capillary

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31
Q

what is a risk factor for guttate psoriasis

A

recent antibiotic treatment

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32
Q

what is the presentation of guttate psorasis

A

acute widespread itchy psoriasis

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33
Q

what is the management of guttate proasis

A

short course UVB therapy

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34
Q

what is the presentation of erythroderma

A

acute widespread red pustules

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35
Q

what conditions are linked to erythroderma

A

eczema, drugs, malignancy

36
Q

what type of psoriasis affects the soles of the feet

A

palmoplantar pustular

37
Q

what is the 1st line management of psoriasis

A

TOP vit D analogue calcipotriol

38
Q

what is the 1st line management of severe psoriasis

A

TOP steroid

39
Q

what is available 2nd line for psoriasis

A

emollient, coal tar, dithranol, TOP steroid, keratolytic

40
Q

what is available last line for psoriasis

A

UVB phototherapy or methotrexate

41
Q

what is the management of scalp psorasis

A

greasy ointment, tar/steroid shampoo, vit D analogue

42
Q

which layer of skin is affected by lichen planus

A

basal layer and between epidermis and dermis

43
Q

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

A

wickham’s striae

44
Q

what is the pathology of lichen planus

A

orthrokeratosis, hypergranulosis, irregular sawtooth acanthosis

45
Q

what areas are affected by lichen planus

A

wrists, shins, ankles, nails, buccal mucosa

46
Q

how does lichen planus affect the nails

A

nail ridging

47
Q

describe the rash in lichen planus

A

itchy shiny flat violet/pink pustules/plaques/papules

48
Q

what is the management of lichen planus

A

TOP steroid

49
Q

what is the management of severe lichen planus

A

PO steroid

50
Q

what skin layer is affected by bullus pemphigoid

A

DEJ

51
Q

is bullus pemphigoid autoimmune

A

yes

52
Q

is acantholysis present is pemphigus vulgaris

A

yes

53
Q

is acantholysis present is bullus pemphigoid

A

no

54
Q

what skin layer is affected by pemphigus vulgaris

A

prickle cell layer

55
Q

what is IgG reacting with in bullus pemphigoid

A

hemidesmosome antigen

56
Q

what is the function of the hemidesmosome antigen

A

anchors basal cells to basement membrane

57
Q

is pemphigus vulgaris autoimmune

A

yes

58
Q

what is IgG reacting with in pemphigus vulgaris

A

desmoglein 3

59
Q

what is the function of desmoglein 3

A

maintains desmosomal attachments

60
Q

what is acantholysis

A

intracellular adhesion cite lysis

61
Q

what ages are affected by bullus pemphigoid

A

elderly

62
Q

what ages are affected by pemphigus vulgaris

A

middle age

63
Q

what is nikolsky’s sign

A

top skin layers fall away when rubbed

64
Q

which condition is nikolsky’s sign postivite in

A

pemphigus vulgaris

65
Q

does bullus pemphigoid scar

A

no

66
Q

what is the initial presentation of bullus pemphigoid

A

itchy plaque/pustule

67
Q

what is the presentation of bullus pemphigoid

A

widespread or localised large erythematous bullae

68
Q

what test diagnoses bullus pemphigoid

A

biopsy for immunofluorescence

69
Q

what is seen on immunofluorescence in bullus pemphigoid

A

IgG and complement at basement membrane, straight line

70
Q

what antibiotic is given for bullus pemphigoid

A

tetracycline

71
Q

what is the management of bullus pemphigoid

A

antibiotic, TOP + PO steroid, emollient, antiseptic

72
Q

what topical steroid is given for bullus pemphigoid

A

dermovate

73
Q

what areas of the body are affected by pemphigus vulgaris

A

scalp, face, axilla, groin, trunk, mucosa

74
Q

what test is required for a diagnosis of pemphigus vulgaris

A

biopsy for immunofluorescence

75
Q

what is seen on immunofluorescence in pemphigus vulgaris

A

mesh/chicken wire appearance

76
Q

what is the management of pemphigus vulgaris

A

PO steroid, antiseptic, emollient +- immunosuppressive

77
Q

is dermatitis herpetiformis autoimmune

A

yes

78
Q

what HLA type is affected from dermatitis herpetiformis

A

HLA-DQ2

79
Q

what condition is linked to dermatitis herpetiformis

A

coeliac disease

80
Q

can you have dermatitis herpetiformis and not have coeliac disease

A

yes

81
Q

what areas of the body are affected by dermatitis herpetiformis

A

symmetrical on extensor surfaces/buttocks

82
Q

describe the rash in dermatitis herpetiformis

A

itchy erythematous papules

83
Q

what layer of the skin is affected by dermatitis herpetiformis

A

dermis

84
Q

what test is diagnostic of dermatitis herpetiformis

A

immunofluorescence

85
Q

what is seen on immunofluorescence in dermatitis herpetiformis

A

IgG in dermal papilla targeting gliadin

86
Q

what is the management of dermatitis herpetiformis

A

dapsone cream and investigate for coeliac if not diagnosed

87
Q

what test is diagnostic of coeliac disease

A

IgG ATTG test