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MSS > Inflammatory Skin Dz > Flashcards

Inflammatory Skin Dz Flashcards

1
Q

Primary lesion: flat, <1cm

A

macule

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2
Q

Primary lesion: flat, >1cm

A

patch

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3
Q

Primary lesion: violaceous patch, > 1cm

A

purpura

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4
Q

Primary lesion: violaceous patch, <1cm

A

petechiae

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5
Q

Primary lesion: raised, <1cm

A

papule

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6
Q

Primary lesion: raised, >1cm

A

plaque

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7
Q

Primary lesion: raised, <1cm, filled with fluid

A

vesicle

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8
Q

Primary lesion: raised, >1cm, filled with fluid

A

bulla

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9
Q

Which class of corticosteroids has the highest potency?

A

Class I

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10
Q

List the SE of topical corticosteroids on the skin, eyes, and face

A

skin: hypopigmentation, hypertrichosis, skin atrophy, telangiectasia, striae
face: acne, perioral dermatitis/rosacea
Eyes: glaucoma, cataracts

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11
Q

What is hypertrichosis

A

abnormal amount of hair growth on body

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12
Q

a fingertip unit of topical medicine will cover how much area?

A

two palms (or one palm, two applications)

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13
Q

Name the idiopathic inflammatory disease of skin and mucous membranes that is associated with HepC (and HBV vaccine) exposure

A

Lichen planus

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14
Q

In what age-range is lichen planus most commonly seen?

A

middle-aged adults

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15
Q

which disease presents with polygonal, purple, pruritic, planar papules and plaques with wickham’s striae?

A

lichen planus

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16
Q

Where on the body is lichen planus seen?

A

flexures, tops of hands, shins, orogenital mucosa (reticular white patches or erosions)

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17
Q

How do should you treat lichens planus?

A

spontaneous remission may occur, so eliminate any suspect medications
mild - topical corticosteroids and anti-His
severe - phototherapy and immunosuppression

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18
Q

Name the AI polygenic skin condition that is triggered by trauma, infections, meds, etc. in predisposed people

A

Psoriasis

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19
Q

what other comorbidities are associated with psoriasis?

A

psoriatic arthritis (20-30%) and increased risk of metabolic disease and atherosclerotic CV disease

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20
Q

what is the most common clinical variant of psoriasis and how does it present?

A

plaque psoriasis

  • symmetric (elbows and knees)
  • nail changes - yellow and pitting
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21
Q

Which clinical variant of psoriasis is often triggered by Strep infection? how does it present?

A

Guttate psoriasis - numerous small erythematous lesions with overlying silvery scale, well demarcated

22
Q

a pt with psoriasis has generalized erythema. which clinical variant does she have?

A

erythrodermic psoriasis

23
Q

Pt with psoriasis presents with broad patches of erythema an overlying pustules. which clinical variant does she have?

A

pustular psoriasis

24
Q

How do you treat mild and severe psoriasis?

A

Mild - topical corticosteroids (also, retinoids, coal tar derivatives, calcineurin inhibitors)
severe - systemic meds, phototherapy and topical (immune suppressors - oral corticosteroids should be avoided)

25
Q

vitD derivatives and retinoids work by…

A

inhibiting keratinocyte proliferation

26
Q

salicylic and lactic acids work by….

A

keratolysis

27
Q

coal tar works by…

A

anti-inflammatory, inhibits keratinocyte proliferation

28
Q

calcineurin inhibitors work by…

A

anti-inflammatory (prevents T-cell activation)

29
Q

what light waves are used in phototherapy

A

narrowband UVB

30
Q

What is the name of the phenomenon in which psoriatic skin lesions develop at sights of injury (scratching, sunburn)

A

Koebner

31
Q

Pinpoint bleeding points seen when psoriatic scale is removed

A

Auspitz sign, d/t capillaries at papillary dermis

32
Q

Name the mild, self-limited inflammatory condition often d/t Malessezia furfur and high sebum production…

A

Seborrheic Dermatitis

33
Q

How does Seborrheic dermatitis USUALLY present in infants?

A

cradle cap: yellow, greasy adherent scale on the scalp

34
Q

In infants, describe the 3 extensions of seborrheic dermatitis

A

Face - small pink papules
intertriginous areas - moist pink patches; secondary infxn with candida and strep
trunk/extermities - thin oval pink scaly patches (may be difficult to distinguish from atopic dermatitis)

35
Q

How can you distinguish between psoriasis and seborrheic dermatitis in adolescents/adults

A

SD is more diffuse and ill-defined (SD presents at areas of high sebum production: face, ears, eyebrows, upper chest, intertriginous area)

36
Q

how do you typically treat seborrheic dermatitis in infants?

A

gentle cleansers with use of emollients (moisturizers)

37
Q

how do you typically treat seborrheic dermatitis in adults (relapse is common)

A

topical anti-fungals for chronic therapy

low potency topical steroid for acute therapy

38
Q

Name a derm condition that is associated with other allergic conditions and is the most common chronic inflammatory skin disease

A

Atopic dermatitis/eczema

39
Q

Explain the pathogenesis of atopic dermatitis

A

multifactorial:

  • impaired barrier d/t mut of profilaggrin gene
  • immune dysregulation - acute (Th2), chronic (Th1)
  • allergens/infections: S. aureus 2/2 AD is common and can aggravate AD by stimulating inflammatory cascade
40
Q

rapid dissemination of HSV with areas of eczema, a complication of atopic dermatitis, is called

A

eczema herpeticum

41
Q

what is xerosis?

A

dry skin

42
Q

describe the appearance of acute atopic dermatitis

A

dedematous, erythematous papules/plaques, may ooze

43
Q

describe the appearance of sub-acute atopic dermatitis

A

erythematous, scaly, may be crusted, LESS WELL DEFINED THAN PSORIASIS

44
Q

describe the appearance of chronic atopic dermatitis

A

thickened, with lichenification

45
Q

what is lichenification

A

exaggerated skin lines

46
Q

In infants, how does atopic dermatitis present?

A

cheeks, primarily, lesions are often exudative with oozing and crusting
- associated with Staph, poor sleep (pruritis), and FTT

47
Q

In the childhood phase of atopic dermatitis, what is the typical presentation?

A

flexural involvement, lesions are less exudative, lichenification may be seen

48
Q

what are the different outcomes/presentations of atopic dermatitis in adult hood?

A

75% outgrow

  • or, more chronic and severe, with evidence of scratching/rubbing leading to chronic papules
  • may be more resistant to treatment
  • limited to hands or more generalized
49
Q

how do you treat actively inflamed atopic dermatitis

A

education to minimize further skin disruption

  • gentle skin care (daily baths, gentle cleansers, thick emollients 2x/day, avoid irritants)
  • topical corticosteroids or calcineurin inhibitors
50
Q

how do you treat severe/recalcitrant atopic dermatitis?

A

phototherapy and immunosuppressants

  • anti-His to releive pruritis (H1-blockers are sedative)
  • bleach baths to tx secondary infections

MSS (7 decks)

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