Misc. Flashcards
What is lichen sclerosis? Management?
Autoimmune disorder Elastic tissue turns to collagen Bruised red, purpuric signs may appear Vulva gradually becomes white, flat and shiny Intensely itchy May be pre-malignany
Mx:
Clobetasol propionate cream (topical steroid)daily for 28 days
then alternate days for 4 weeks, then twice weekly for 8 weeks then as needed
Steroid unresponsive may respond to topical tacrolimus
What is lichen planus? Features? Where do they occur? Management?
Lesions on flexor aspects of wrists/forearms/ankles/legs Purple Pruritix Poly-angular Planar (flat topped Papiles Seen at any age + white lacy markings
Lesions elsewhere: Scalp (Scarring alopecia) Nails (longitudinal ridges) Tongue Mouth Genitals
Often arise at site of trauma (Koebner phenomenon)
Mx: Topical steroids ± topical antifungals
What is koebners phenomenon? What conditions is it seen in?
Skin lesion which appear at the site of injury Psoriasis Warts Vitiligo Lichen planus Lichen sclerosus Molluscum contagiosum
What is seborrhoeic keratoses? Features? Mx?
Benign epidermal skin lesions seen in older people
Large variation in skin colour from flesh to light brown to black
Stuck on appearance
Keratotic plugs may be seen on surface
Reassure
Curretage, cryosurgery, shave biopsy
What is pityriasis rosea? Mx?
Acute, self-limiting rash which tends to affect young adults. The aetiology is not fully understood but is thought that herpes hominis virus 7 (HHV-7) may play a role.
Rash is preceded by a herald patch (oval red scaly patch)
It affects the neck, trunk and proximal limbs
Self-limiting 4-12 weeks
How can you differentiate guttate psoriasis from pityriasis rosea?
GP - preceded by strep throat infection
PR - recent RTI
GP - tear drop scaly applies on trunk and limbs
PR - herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with fine scale confined to the outer aspect of lesions
GP - resolve spontaneously 2-3 m
PR - resolve 6wks
What is port wine stain?
Vascular birthmarks that tend to be unilateral
Deep rend or purple
Do not resolve spontaneously
Darken and become raised over time
Treat with cosmetic camouflage or laser therapy
What are strawberry naeevi?
Infantile haemanglioma
Rapidly enlarging bright red spot
Most go by 5-7 years
No treatment unless a vital function is impaired.
What are salmon patches?
Flat dull red areas found on face or neck
Asymptomatic and removed for cosmetic purposes
What is polymorphic eruption of pregnancy>
Pruritic condition associated with last trimester
Lesions often first appear in abdominal striae
Management depends on severity:
Emollients
Mild topical steorids
Oral steroids
What is phemphigoid gestations?
Pruritic blistering lesions
Often peri-umbilical later trunk, back, buttocks and arms
Usually 2nd/3rd trimester
Oral corticosteroids
What is a pyogenic granuloma?
Vascular lesion thought to arise as a result of minor trauma, typically occurring on fingers
It appears as a fleshy moist red lesion which grows and often bleeds easily
(not granulomas or pyogenic)
Eruptive haemangioma
Caused by trauma, pregnancy
Most common sites are head/neck upper trunk and hands.
Oral mucosa lesions in pregnancy
Initially small brown spot - progresses to red/brown lesions spherical in shape.
Lesions bleed profusely/ulcerate
Curettage, cauterisation, cryotherapy, excision
What are skin causes of pruririts?
Eczema Scabies Phemigoid eruptions Asteatotic eczema Pityriasis rosea Psoriasis Urticaria
What is asteatotic eczema?
Affects lower legs with dry eczema that polygonally fissures into a paving pattern
Emollients and soap substitutes help + moderately potent steroid (eumovate) for affected itchy inflamed areas
What are medical causes of pruritus?
Liver disease Iron deficiency anaemia Lymphoma Polycythaemia CKD Hypo/hyperthyroidism Diabetes Pregnancy
