Lichenifcation & Acantholysis Flashcards
What is tiny perifollicular papules around hair follicles?
keratosis pilaris
What causes keratosis pilaris?
keratization causing plugging hair follicular
Where do you get keratosis pilaris?
upper thighs, lateral upper arms and cheeks
What is the treatment of keratosis pilaris?
moisturizers with ingredients like lactic acid, urea, salicyclic acid (Cerave SA, amlactin)
What type of condiation is ichthyosis vulgaris?
Autosomal dominant
Fine, adherent scale on extremities and trunk with sparing of flexures, larger scale on lower legs, hyperlinear palms and soles
Ichthyosis Vulgaris
What is the pathology of ichthyosis vulgaris?
absent stratum granulosum in some people, decreased or absent profilaggrin, also possible increased adherence of stratum corneum
What do pt have ichthyosis vulgaris with (secondary)?
malnutrition, infectious disease, sarcoidosis and other paraneoplastic disorders
How do you treat ichthyosis vulgaris?
reduction of scales as in KP
the patient has an itch in a particular location and begins to itch – the itching causes a cascade of itching/ scratching in a cycle which leads to thickening of the skin
Lichen Simplex Chronicus
When do lichen simplex chronicus pts complain of symptoms?
at rest, not when busy
What are the histologic findings for LSC?
epidermal thickening, hyperkeratosis, acanthosis, spongiosis. Papillary dermal fibrosis with vertical streaking of collagen bundles
What is the treatment for LSC?
topical steroid, itch prevention, oral snti-puritics including doxepin, phototherapy, psych referral
Darkening and thickening of the skin – marker of underlying disease
ACANTHOSIS NIGRICANS
Where does acanthosis nigricans present?
skin folds - axillae, groin, back of neck
What are the 7 types of acanthosis nigricans?
obesity related, syndromic (Cushings, PCOS), benign(over dorsal hands and feet in AA), drug induced (nicotinic acid, insulin, systemic steroids, hormonal tx), hereditary (autosomal dominant), malignant (stomach CA in 90%), mixed
When is acanthosis nigricans itchy?
malignancy
What is threatment for acanthosis nigricans?
topical retinoids for cosmetic apperance, creams with exfoliating properties
Chronic inflammatory skin condition that is a T cell mediated auto immune disease
lichen planus/ lichen planopilaris
Where does lichen planus occur?
nails, hair follicles, skin, oral mucosa, vaginal mucosa, penis
What can cause lichen planus/lichen planopilaris?
stress, genetic predisposition, skin trauma (koebnerization), herpes zoster, hepatitis (self antigen modification on surface of basal keratinocytes), meds such as quinidine, hydrxychloroquine, captopril
What is the skin findings for lichen planus?
usually symmetrical, scaly papules and plaques, purplish to pink, flat topped, mildly pruritic , may be linea
What do you see orally in lichen planus?
Wickham Striae
What do you see on the scalp with lichen planus?
telangectasia, erythemia, scarring
